Diastasis Recti also known as abdominal separation is when intra-abdominal pressure splits the rectus abdominis or “six pack” in the middle. This commonly happens to women during pregnancy, newborn babies, and from yo-yo dieting and doing abdominal exercises such as crunches incorrectly. Most often in newborns the condition will heal over time. For postpartum moms who have this condition it will return to normal over several months however sometimes it won’t. With this in mind this will be geared towards helping postpartum moms however all this information is applicable to anyone that has diastasis recti. I will go over all the beneficial exercises, no-nos and equipment to help with your condition.
First you need to identify if you have abdominal separation and that is the case if you have roughly a 3 cm gap between the two sides. That is equivalent to approximately two or three fingers being able to fit in that gap. It is important to note that if this condition does not heal normally and is not attended to it can cause lower back pain, constipation, urine leaking, difficulty breathing, and in rare cases tissue could tear causing a hernia.
Equipment that you may want to invest in is a stomach splint. It is a strap that you wrap around the abdominal region and its function is similar to a corset. It helps pull together the two sides of the abdominal muscles to reconnect and let them to heal. I recommend you wear this at all times except when you work out. When you work out you don’t want any extra support but rather focus on strengthening your muscles on your own. Similar to a weight lifting belt you don’t wear it the whole time because then your deep core muscles such as the transverse abdominis aren’t required to work as hard because of the pressure produced from the belt. You only use it when you are going for very high weight to increase that intra-abdominal pressure has high as possible to protect the spine. However you do not want to get high abdominal pressure with abdominal separation because that is how you will develop a hernia.
Just wearing the stomach splint throughout the day is not enough so you actively need to contract those muscles. You do this by doing the drawing in maneuver when ever you are getting up or down, lifting up stuff or carrying around your baby. To do the draw in maneuver you want to pull in the stomach and you should be able to hold this contract for around 10 seconds and breathe normally. Do note that you do not want to hold your breath while lifting because that will increase intra-abdominal pressure which we want to avoid.
You also want to practice breathing and I know that sounds silly but your core is more engaged in your breathing then you think and can be strengthened by doing so. You want to start by laying on your back and taking a deep inhale through your belly and chest. Then slowly but forcefully blowing out while drawing the abdominal wall in similarly to the drawing in maneuver we just talked about. Repeat this as many times as you want and do as often as you can throughout the day. This will really condition the core and help the recovery process a lot.
Now we will go over the things you absolutely shouldn’t do that are almost as important as the things you should do. Any kind of spine flexion such as crunches, sit-ups or v-sits as well as leg lifts while laying on back should be avoided. Exercises that should be restricted till the core is feeling stronger include planks, push-ups, downwards dog and cat and cow stretch.
Resistance training for the rest of the body to keep it strong is recommended however there are general guidelines to do doing so. You want to keep weight low so not exceeding 40 lbs for lower body movements and 12 lbs/side for upper body. For unilateral exercises weight should be held at the chest to change the center of gravity away from placing to much strain on the pelvis and abdominal area. Weight can be held at sides during bilateral movements because less pelvic and abdominal stability is required.
Now for core specific exercises to help muscle reconnection as well as tension. For all of these it's important to keep a neutral spine and if you feel any kind of pain to stop immediately. First exercise is a dead bug variation with your feet flat on the ground and then if that’s to easy you can move on to regular deadbug. Other beneficial exercises would be swiss ball supergirls, side plank, hip bridging and standing knee raises. As you can see all these exercises not only strengthen the abdominal muscles but also the spinal erectors and lumbo-pelvic hip complex.