During my pregnancy I went into mega research mode. Two of the main areas I studied were Diastasis Recti and Pelvic Floor Health. As it turns out, both are very inter-related. If you have a problem with one, you most likely have a problem with the other.
You might already be familiar with Diastasis Recti, or those words might be brand new to you. Basically, it means abdominal separation. It commonly occurs after pregnancy. For some women the gap in their abdominal muscles closes on it’s own. For other women that gap remains and requires a lot of work to heal. Pregnancy isn’t the only cause of abdominal separation. It also occurs in body builders!
The cause of Diastasis Recti is increased intra-abdominal pressure (this is why it’s so important not to hold your breath during core exercises!) The midline of your abs is called the Linea Alba.
The Linea Alba is connective tissue, and when it is under a lot of pressure it can separate.This leads to a bulge around the belly button and in the lower abs. If you have Diastasis Recti no amount of crunches is going to give you a smaller belly—In Fact, crunches will make it worse! Not only that, but you are more prone to back pain, overall core weakness, decreased posture, and increased risk of developing a hernia.
Now that you know what Diastasis Recti is, this is how you can test for it: (Demonstrated in the video below).
Lie supine (face up) on the floor. Bend both knees, with your feet flat on the floor. Place one hand gently behind your head (for support, no pulling!) and with the other hand place your fingertips over your belly button. Contract your abdominals, lifting your head slightly off the floor, and moving your rib cage toward your abdomen (imagine hooking your lower ribs over the top of your abs). If you feel a gap in between both sides of the rectus abdominus (the six pack abs on either side of the belly button) that is larger than 2.5 finger widths apart, you most likely have Diastasis Recti. You can also have a doctor check you for this if you aren’t sure.
Other signs: The gap doesn’t close when you contract your abdominal muscles, and you may have a ridge or “shark fin” like line up the center of your abs when you do this test.
Exercises to Avoid with Diastasis Recti:
The Rectus Abdominus muscles are responsible for trunk flexion. Any traditional core exercise, like crunches, will increase the pressure to this area, and can make your abdominal separation worse. Avoid spinal rotation, as this can cause further separation of the abdominal muscles. You should also avoid deep backbends, and exercises that stretch the abdominal muscles (like leaning back over an exercise ball).
If you have a large Diastasis (greater than 4-5 finger widths apart) it is best to see an Occupational or Physical Therapist for a personalized strengthening program. While it is never to late to start a program (even if you have had Diastasis for years!) starting your program as soon as possible can help prevent additional problems or development of compensatory movement patterns.
If you have urinary incontinence or leaking, I highly encourage you to see an Occupational or Physical therapist who is certified in Pelvic Floor health. Even after a baby, leakage is never normal, and indicates a problem. Plus, with help and the correct exercises it’s fixable!
The exercises below are appropriate for helping to close an abdominal separation (and for strengthening even if you don’t have a separation!)
Exercises to Strengthening Your Core & Help Close Diastasis Recti:
*Do not start these exercises until you are at least 6-weeks postpartum, and have been cleared by your doctor. Listen to your body. If you are postpartum and experience increased, red bleeding it’s a sign that you are doing too much and are not yet ready for exercise. It is always best to consult a physician before starting a new exercise program.
Important things to know before getting started:
Avoid crunches and trunk flexion exercises, or exercises that require deep back bending/abdominal stretching.
Avoid front planks until you are able to maintain a strong core/transverse ab hold, and demonstrate improved density of the connective tissue.
****Glute & Back Exercises support core strength and closure of the Diastasis. Perform all exercises with transverse ab engagement. This workout is core specific, but a well rounded exercise program will speed up your results****
You Are Not Ready to Progress to “Regular” Core Exercises until:
- Core remains engaged during all exercises-no bulging belly.
- The exercises don’t make you feel like peeing or cause urinary incontience
- You have no back pain/pressure during the exercises
- No Excessive trembling/shaking occurs during the exercises
- Connective tissue should feel firmer
*Exercises 1-4 are progressive. You will add exercises 2,3, and 4 progressively. Exercises 5-8 can be completed immediately with no progression required.
Checking for Diastasis: 2:55
The Exercises: 7:13
Exercise #1: 7:46
Exercise #2: 11:05
Exercise #3: 15:18
Exercise #4: 17:46
Exercise #5: 19:42
Exercise #6: 22:52
Exercise #7: 25:16
Exercise #8: 27:24
- Heel Slides: Bend your knees and keep your arms at your sides. Slide leg out while inhaling, until your leg is parallel with the floor. Exhale to return to starting position. Alternate legs. Listen to your body and over time increase to 20 reps per leg before progressing to exercise #2.
- Table Top Heel Slide: Exhale one leg to table top position, knee directly over your hip and shin parallel to the ground. Inhale and extend leg close to the floor-as close as possible without arching your back. Start with one leg at a time. Alternate and build to 20 reps. When you can do 20 Reps you can advance to using both legs. Once you can complete 20 reps per son of exercise #1 and #2 you can progress to including exercise #3 in your program.
- Toe Taps: Lift both legs to Table Top position. Maintain a 90 degree bend of the knees and tap your toes, alternating legs. Make sure you have no back arch/lift. Once you can complete 20 reps with good form, progress to including exercise #4 in your program.
- Double Leg Lower: Start with both legs extended toward the ceiling, directly over your hips. Gently lower legs toward the floor, and return to starting position. Only go as far as you are able to without belly bulging or back arching. Build to 20 reps.
- Transverse Ab Squeeze: Pull the core in tight, from the bottom to the top. Ensure that you can breath, and build up to a 20-breath hold.
- Pelvic Tilt: Start in supine with knees bent close to your backside. Keep your glutes relaxed, and use the lower abs to tilt your hip bones toward your rib cage.
- Pelvic Bridge: Start in supine with knees bent close to your backside. Keeping the core engaged, lift your hips and squeeze your glutes toward the ceiling.
- Reverse Plank: Place hands below your shoulders. Lift your body until you form a straight line from head to hips to heels. Progress to 60-second hold.