Diastasis Recti (Part 2)

Last month, I shared with you guys Part 1 of the 2-part Diastasis Recti series, and the response was overwhelmingly positive!  I had more views on that blog post than nearly any other post on my entire site.  If you haven’t read Part 1 you can do so here. I got so many emails, message, and comments from you guys who had never heard of diastasis recti and were grateful to understand what was causing the muscle separation or ‘post baby tummy’.

In Part 2 of this diastasis recti series, we are going to review some of the reasons why diastasis recti happens after pregnancy, and in this part we are going to offer some suggestions on what you can do to help repair it.  I reached out to Fiona Trewhitt who is an Australian blogger who runs the blog Mumafit to see if she would help me write Part 2 of this series and she graciously agreed.  I started following Fiona a few years ago and I love the realistic and practical advice she offers. She is a mother of three young children (in four years!) and is passionate about inspiring women to live healthier, happier lives, particularly during and post pregnancy. Fiona is a degree qualified exercise professional and Life and Wellness Coach.

What is Diastasis Recti?

Diastasis recti is the separation of your rectus abdominus muscles, the outermost abdominal muscles. It can contribute to the ‘mummy tummy’ pouch and weaken your postural support, resulting in back pain. It makes sense that during pregnancy your muscles need to expand to accommodate the growing uterus. During this expansion, in some cases, the connective tissue holding the muscles together thins and weakens causing a ‘gap’ between the muscles.

Is there anything you can do to prevent diastasis recti from happening?

Yes, you can avoid anything that places too much pressure on your abdominals once your uterus has begun to expand. For example, if you were to do a frontal plank when heavily pregnant, and your abdominals are weakened to the point where they can’t sustain the contraction, then you can consider your abs like elevator doors – they start to slide open under the pressure. For this reason, you should avoid planks, crunches, sit ups, full push ups, and double leg lifts. Even sitting up straight in bed from a lying position should be avoided – roll to your side and use your arms to push yourself up instead.

Not everyone is affected by this condition (around 66% of post natal women) so this advice may be considered conservative by some, however pregnancy is a great time to exercise caution and moderation.

How can you tell if you have diastasis recti?

Once your baby is born, ask your doctor, midwife or a physiotherapist to assess you after having your baby. You can also self-assess by lying on your back with knees bent up, and placing your fingers in the midline of your belly and lifting your head slightly with abs relaxed. You are feeling for a gap between your left and right abdominal muscles. As you rise and lower slightly in this position, you may feel that your fingers sink in slightly and can feel the ridge of muscle on either side as you rise. If you rise in a sit up type movement, and see your tummy rise in a ridge or cone shape, this is also a sign that you have a diastasis.

How do I measure it?

If a gap is detected between your abdominals, you can measure its length, width and depth, and then monitor these measurements as you work to close it. Width is most commonly measured by ‘fingers’ and it can range from one finger width to a hand or more in severe cases.

What are exercises should you avoid doing if you do have diastasis recti?

You need to avoid the same exercises as listed above. Any frontal planks, crunches, sit ups and double leg lifts. There are several Pilates and yoga moves that are a ‘no no’ for this condition. To be your own judge of what you can and can’t do, pay close attention to how you are bracing or ‘holding’ your core abdominal muscles during absolutely any exercise that you do. If you notice that you can no longer hold your abdominals throughout an exercise, then stop and modify. Side Bridges and core stability exercises are ok.  If you want a complete program showing you exactly what exercises to do and NOT to do, click HERE.

If your baby is older, can you still heal your ab separation?

Yes, it’s usually never too late to heal your abdominals and it’s certainly never too late to start building a stronger core. In very extreme circumstances where there is no improvement with dedicated rehabilitation exercises, surgery may be required.

When is it safe to start doing crunches, planks, etc after I have had a baby?

For about 70% of women with a diastasis, it will heal itself during the first few post natal months. For others, it will only heal with dedicated rehabilitation exercises. You can safely resume these type of exercises once your gap is closed or less than 2.5cm and you have rebuilt your core abdominal strength so that you are strong enough to contract the muscles as you exert effort in any exercise.

What can I do to help heal it?

With dedication to abdominal rehabilitation exercises you can begin to reconnect the muscles. The correct rehab exercises teach you to isolate contraction of your transverse abdominal muscles (the deepest layer of muscle that runs horizontally). The connective tissue itself can remain weak for some time after birth due to the hormones in your body, so a little patience may be required. It’s a great idea to visit a specialist physiotherapist if you feel you need intensive help.

1. In a seated position, pull your belly (transverse) towards your spine and hold for 30 seconds, continuing to breathe whilst doing so.  Try and pull it even closer to the spine and then release.  Repeat 3 times.
2. In a seated position, pull your transverse towards your spine, then release, but not fully, immediately pull back towards your spine again and continue to repeat 50 times, slowly. Repeat 3 times.
3. Lying on your back, pull your transverse to your spine and hold, imagining a zipper like action as you contract your pelvic floor and abdominals at the same time – zipping everything up towards your rib cage. Tuck your chin to chest and lift your head slightly and repeat 10 times. Do 3 sets.

The above exercises need to be performed daily. You should start seeing a measurable improvement within a month. If you are not seeing improvement, you should consult a women’s physiotherapist in your area who specializes in this rehabilitation for further advice.

We have images and videos of the exact exercises you can do to improve your Diastasis Recti in our 30-Day “Abs, Core, and Pelvic Floor” program.  We wanted to offer a more comprehensive approach in our 30 day program.  You will learn about anatomy, pressure, posture, self affirmations, you’ll be able to watch videos, see pictures, and have written instructions. It’s lower cost ($37) and the information (almost 100 pages of content) will be an amazing resource to keep you on track!  You can find that HERE!
Bonus is, by healing your diastasis using these methods, you not only build improved core strength, you also reduce potential back pain, reduce waist size and gain a flatter tummy.

If you want to read more about Fiona (and I suggest you do!) you can follow her on Instagram @mumafit, Facebook, or her blog www.mumafit.com.au.

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