The physical changes to your body during pregnancy don't immediately disappear postpartum. One common change is diastasis recti abdominis (DRA), also known as abdominal separation. While this might sound intimidating, it's essential to recognize that DRA is a natural part of pregnancy in order to make room for your growing baby. It's also important to note that if you have abdominal separation, with the right guidance, you can regain core strength and confidence, and return to physical activity and exercise.
Understanding Diastasis Recti:
Diastasis recti, or abdominal separation, occurs as the linea alba (the connective tissue that runs vertically in the middle of your abs) widens and weakens to accommodate your growing baby. This caused your rectus abdominis (six-pack abs) to separate from each other. For some moms, the linea alba naturally tightens post-birth, bringing your rectus abdominis muscles closer together again. For others, the separation can persist, leaving a gap. The opinion about diastasis recti has shifted to such that rehabilitation is less about closing the gap, and more about being able to create tension so that your core can act as the stabilizer that it is designed to be.
Pelvic Floor Physical Therapy/Women’s Health PT
Many moms will look toward physical therapists for support. During your treatment, you'll focus on core muscle activation and breathing. This may result in your gap closing, but even if it doesn't you'll learn to have a strong and functional core so that your DRA doesn't impact your quality of life. It’s important to trust the process even if the exercises feel too basic. The basics are what create a strong fitness foundation so that you can progress and reach your postpartum fitness goals.
Exercise After Physical Therapy
After you've focused on core muscle coordination and have regained some strength, you'll be discharged from PT. You may then wonder what's next and still have questions about what exercises are safe. The key here is to realize that there is no one-size-fits-all approach. It's about personalizing your fitness program and performing exercises that allow you to have core strength and control. I've worked with many postpartum moms returning to exercise while managing abdominal separation, or after pelvic floor physical therapy and I’m happy to share my insight with you.
Tips & Strategies for Exercising with Diastasis Recti
Note, that it is recommended you work with a qualified postnatal fitness professional or see a pelvic floor physical therapist if you're looking for diagnosis or treatment.
Gradual Progression: Start with exercises that focus on activating your deepest core muscle the transverse abdominis. Move to coordinate that muscle activation with breath and pelvic floor. Progress to more complex movements gradually, incorporating resistance, repetitions, and different positions.
Manage the pressure you create within your abdominal cavity: Be mindful of everyday activities that increase your intra-abdominal pressure, such as sneezing, coughing, or lifting. Use your transverse abdominis activation strategies and breath to help manage the pressure and force on your healing abdominal wall.
Exercise Selection: Choose exercises that align with your core strength and function. There isn’t a definitive list of “bad exercises” or “exercises to avoid if you have diastasis recti”. Rather it should be based on your personal ability. If you can lift 20 pounds fairly easily without having to bear down or hold your breath, then that exercise may be appropriate. However if someone else goes to bench press 20 pounds and struggles and grunts and has to create a lot of pressure in the abdomen to perform the movement, then that exercise should be avoided until the core is stronger and the tissue is more healed. Most people will void high-impact or heavy-lifting activities initially.
Muscle Recruitment: Pay attention to recruiting the right muscles at the right time. For example, many people think of the chest, shoulders and arms for a push-up and don’t realize that it is very much a core exercise. To stabilize the spine during a push-up your core muscles should engage. Ensure your deep abs activate for stability before movement.
Avoid back pain and incontinence
Although more research needs to be done when it comes to diastasis recti impacting pain and incontinence, many moms that I work with who are concerned about abdominal separation are also concerned about incontinence and back pain. Both of those conditions are common during and after pregnancy so their concerns are valid. Rather than fearing these conditions, I created a free 5-day program to empower you and educate you on how to have a strong and functional core in order to reduce your risk of pain and leaking when you sneeze or cough. By understanding your body and following a tailored fitness approach, you can confidently navigate your fitness journey with diastasis recti or any other condition resulting from pregnancy.
Ready for more tips? Download 5 Tips for a Stronger Core After Pregnancy.