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Should I run with diastasis recti?

Megan Hoover, DPT, answered this question for us during the Moms Into Fitness Instructor Training.

This is a question I often get asked by ladies after having their babies. In my idealistic physical therapy world, the answer would be no. Now, before you completely write me off… please keep reading.

While my easy answer is no, I understand that runners are a unique and wonderful group and are very driven to return to their sport. I also know that most runners are going to return to running regardless. Trust me, I know… I am one of you. My hope is that we can help you run with less impact on your DR and help you understand why running may slow your progress of reducing your diastasis and can impact your pelvic floor. Regardless of if you had your baby/babies via vaginal delivery or C-section, your pelvic floor was impacted. For 10 months (seriously… whoever said pregnancy was 9 months obviously never was pregnant 😉), your pelvic floor kept that baby in and supported you both… That is a ton of work. Taking time to re-educated and strengthen your pelvic floor before you return to running and while you are running is so very important. It is not normal for you to pee every time you laugh, cough, sneeze, jump… Moms, you are incredibly selfless and put your kiddos’ needs before your own! Please do not put your pelvic floor and core in the back seat, mommas! You do not have to put up with pelvic pain and incontinence. If you read on you will find a list of exercises to help you activate your deeper core muscles to help combat your diastasis recti as well as strengthen your core and pelvic floor.

Diastasis recti abdominis (DR) is a condition in which the rectus abdominis muscle separates or thins along the middle of the muscle at the linea alba. It can be mild to severe. DR dramatically impacts the stability and integrity of your core muscles. The linea alba is made up of tissue known as fascia. Think of fascia as the saran wrap of the body. It covers our entire body, gives muscles their shape and is integral in any movement of the body. Now, think about your core as a bridge. The fascia, specifically the linea alba, is the rope along the sides of the bridge that you hold onto to cross and is what provides tension in the bridge. If you lose that tension, well, you’re probably not going to want to cross the Grand Canyon using a floppy bridge.

Let’s talk about the deeper abdominals or the Transverse Abdominis (TA). Pay attention my running mommas. This is where we talk about you successfully returning to running without making your DR worse. On either side of your floppy bridge are winches, otherwise known as your TA. Your TA fibers run horizontally and act as the corset of your core. As your TA gets stronger, those winches crank on your bridge and you get that tension back.

Next in…your pelvic floor. Your core/trunk is a transfer station for everything that goes on in the body. Running dramatically increases the amount of force through the core, pelvic floor and legs. If you have DR, your structural integrity is already compromised. When running with DR, you are likely compensating, which can lead to other structural issues including, knee pain, IT band pain, plantar fasciitis, low back pain and hip flexor issues, just to name a few. Not to mention increased strain through your pelvic floor. We need to address your compensations to insure you can run with proper alignment, so you can successfully return to one of your loves. It can be very difficult to know how you are compensating. Getting the help of a physical therapist or a personal trainer who is educated in working with post-partum mommas will be so helpful, if not essential to your success.

Give the exercises in the link above a shot to get those deeper core muscles activating accurately and safely! With that being said… core stability and strength take time and consistency. I find that it takes about 4-6 weeks of performing these exercises about 4-5 times/week to see a measurable change. Most of you will be running in conjunction with these exercises. If you are going to continue to run with a DR, please do these exercises! Please also avoid sprinting. When you sprint, you increase the force and rotation through your trunk muscles, which can really strain the linea alba and surrounding muscles and fascia. If you are not seeing a significant improvement in your DR after consistently doing the exercises, please get in touch with a Women’s Health physical therapist. Your core may not be firing correctly. A Women’s Health PT will be able to get your brain re-connected to the rest of you!

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