What is diastasis recti?

Diastasis Recti, also known as Rectus Diastasis, is a separation of the rectus abdominis (otherwise known as the six-pack muscle). Diastasis means separation. Recti refers to your ab muscles called the rectus abdominis. This separation can happen during pregnancy and postpartum. Diastasis recti can occur in anybody.  But since you happen to be on a website made for moms, we will be focusing on diastasis recti during pregnancy and after pregnancy.

Research has shown that at least 45% of moms have an abdominal separation (or diastasis recti) six months postpartum. Most don’t even know that it’s there until they experience a weak core, a belly they don’t like (i.e. the mommy tummy, muffin top or any other ugly name we call it!) and low back pain.

Meet Jenn, a mom who didn’t discover her own mild diastasis until she was over 5 years postpartum! In this video, Megan, a Physical Therapist, shows how and where to find an abdominal separation:

What can happen as a result of an expanding belly during pregnancy is the distancing of the two sides of the rectus abdominis muscles. It creates a distance between your rectus abdonimis muscles into a left and right side and the muscles can no longer contract effectively.Diastasis Recti occurs in 33-60% of pregnant women.[2][3]

You are more prone to this abdominal gap if you have a weaker abdominal wall, if you are carrying a large baby, if you are carrying more than one baby, if you have a narrow pelvis, if you have more than one child, if had them close together, or if you’re over 35 when you get pregnant.

After this long list of predisposing factors, you can see why this condition is prevalent.

That said our bodies are made to bear children and are also resilient in getting back to their prior self.  There is less intra-abdominal pressure – as regain your former self, body fat decreases, baby is out and pressure is reduced.

If you recently had a baby you will want to also read about postpartum recovery, the first 8 weeks.

Diastasis Recti After Pregnancy

We all have connective tissue between the recti belly muscles. We all have a gap or distance between our two recti muscles. A normal gap is 1-2 finger widths. I say gap or distance because I don’t want you to think these muscles are separated and will never get back together!  If this gap is over 2.7 cm or two fingerwidths, it’s considered diastasis recti.

If you have this separation (or gap), do not worry it does not always mean you need surgery! But know that doing traditional ab exercises that load your abdominal wall (i.e. plank) can make it worse and not help it heal.

Important note: it cannot be assumed you have diastasis recti if your belly isn’t flattening after birth or a c-section…most of the time a distended belly is due to an under cued transverse abdominis or deep core musculature. After having a baby it is essential you know how the transverse abdominis and pelvic floor can be recruited during exercise. It’s not your fault – it might have never been cued and our bodies always take the easy route. But it is essential for a healthy core!

 

What should I do if I think I have diastasis recti

It is always best to get a diagnosis with your doctor and let he/she guide you in healing this condition. It if is a mild case you can follow the 4 pointers we have listed below. Otherwise 1-1 attention with a physiotherapist or physical therapist will be the best route! He/she can correct your alignment, muscles imbalances and posture, as well as give you additional exercises and cues for a healthy core.

How can I test for diastasis recti?

This video is a general self test for diastasis recti. Diastasis Recti is a medical condition and should be diagnosed by a doctor.  This condition can be grouped into 3 types, and depending on the severity, some cases can be healed with exercises modified for diastasis recti.

Mild Case – 2-3 fingerwidths

Moderate -3-4 fingerwidths

Severe – 4+ fingerwidths

 

 

4 Pointers to improve Diastasis Recti

#1 Your posture minimizes pressure on the diastasis

Stand with your feet parallel. Then stack your pelvis over your feet (not your toes!) Stack your rib cage over your pelvis.  Or as I like to call it “close your ribs”. Don’t stand with a swayback and open rib cage. This exacerbates the pressure on the tissue where the distance occurs. The smallest of changes – closing the ribs and stacking the pelvis over the feet – takes pressure off that tissue (linea alba). *note: as you “close” your rib cage be careful that you do not tuck your pelvis.

You will want to correct your posture in everyday activity – sitting, standing, walking, exercising, etc. Watch this quick 15 second video on correcting your posture!

#2 Perform Specific Exercises for Diastasis Recti

You should start with training the pelvic floor and transverse abdominis –this will create a healthy core without adding pressure to the belly tissues.

Of course you want your core to be healthy. But I am willing to bet you are also after the cosmetic reason – the flattening of your stomach. Your body (specifically your abdominal wall) was made to carry a baby. But diastasis recti doesn’t always resolve itself on its own after the baby is born. As you regain your former self, body fat decreases and so does the pressure on the abdominal wall.

You will find exercises like these, plus many more in our 30 Day Restore and Postnatal SlimDown 360 programs – you can try them free here.

Pelvic Floor Activation – This is important for every mom! Act as though you are stopping the flow of urine or contracting your anus, hold for 10 seconds and release. Repeat 10-20x. The pelvic floor is not meant to be “turned on” all day.

Transverse Abdominis (TA) Breath – Start by taking a deep breath. No, seriously, I mean it. Take a deep breath. What happened to your upper body when you did that?  If your chest expanded and your shoulders rose, then you aren’t breathing properly. Don’t be ashamed: most of us don’t breathe correctly all the time. What we fail to do is to use our diaphragms to take advantage of more of our lung’s capacity.

Try it this way to make sure you are using your core breath at it’s full capacity.

  • Lie on your back on a flat surface or in bed, with your knees bent. Place one hand on your belly. This will allow you to feel your diaphragm move as you breathe.
  • Breathe in slowly through your nose so that your stomach moves out against your hand.
  • As you exhale through pursed lips tighten your stomach muscles, letting them fall inward. Try to keep your chest still, this move comes from the belly and lower rib cage.

Pregnant? Check out the Pregnancy transverse abdominis breath.

When you first learn the TA breath, it’ll be easier for you to follow the instructions lying down. When you get better at it, you can try while sitting in a chair. Repeat the same steps as above. You can also do this while standing and while exercising.

We have an entire page dedicated to the transverse abdominis if you want to more info;)

Bridge – as you perform a bridge keep your core neutral, TA is engaged.  It’s important your hips stay level so you do not add any strain on the abdominal wall.  Be careful as not to arch your back … go into a bridge with a flat back.  Repeat slowly 15-20x.

bridge

You can do these exercises daily. The most convenient time is bedtime!

These are some general guidelines. If you want a comprehensive routine and program, click here for 30 Day Restore.

#3 Add Daily Strength Training

Overall what we see is non-exercising women don’t usually see improvement in the recti distance, while exercising women better theirs. As you incorporate strength training and cardiovascular exercise it is important you don’t load the abs. For example, if you are in a hinged position performing rows, your abdominal wall is loaded. You can see a list of the dos’ and don’t of diastasis recti below. Overall you will want to use a comprehensive workout that does not load the abs. If you are not working with a physiotherapist or physical therapist I recommend using our Postnatal SlimDown 360 program or 30 Day Restore program – all workouts in these programs are modified for diastasis recti.

dvd-modified-for-diastasis-recti

 

#4 The Don’ts of Diastasis Recti

There is no universal list of don’ts in the diastasis recti world. But because it is usually the intra-abdominal pressure that causes the recti muscles to have a bigger gap between them, we usually stay away from applying extra intra-abdominal pressure.

You should refrain from twisting. We also recommend you don’t do planks, push ups, quadruped positions, crunches and most traditional abdominal exercises that can create extra pressure on the condition.

Note there was a study done in 2015 found that a crunch reduced the distance of the rectus, but the research noted it requires more study on exercises to explore effect of ab training. Planks can be a great exercise, but only recommended when working closely with a physical therapist or physiotherapist or when the condition has improved.

ab-loading-exercise

Exercises that load the abdominal wall, such as a hinged reverse row, place added pressure on the tissues.

 

Moms Into Fitness is not a medical facility. All exercises should be discussed with your doctor prior to exercise.

[1] http://bjsm.bmj.com/content/early/2016/06/20/bjsports-2016-096065.full, accessed August 1, 2016.
[2] Ibid.
[3] Boissonnault JS. Incidence of diastasis recti abdominis during the childbearing year. Phys Ther (1988)
[4] http://journals.lww.com/greenjournal/Abstract/2014/05001/Postnatal_Exercise_Can_Reverse_Diastasis_Recti_.352.aspx, accessed December 1, 2015.

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