By Prodyut Das

Exercises for diastasis recti

Exercises for diastasis recti

Exercises for diastasis recti improves pelvic alignment, tones the abs, flattens the abdominal wall, shortens muscle fibres, develops dynamic stability, and trains synergistic functioning between the external and internal layers of the abdominal wall.

Diastasis recti or mummy tummy, is the separation of normally joined abdominal muscles- frequently as a result of pregnancy. Diastasis occurs with approximately 1/3 of women who have had a baby. This is frequently what technically leads to lower back pain during pregnancy. Before you launch into doing abdominal crunches or sit ups, have you had your abdominal muscles checked by a physio for any abdominal separation? If you detect a separation in the muscles about one to two fingers wide, you may be experiencing diastasis recti. Performing exercises for diastasis recti to strengthen the muscles can help to correct the condition.

Our abdominal muscles provide an internal corset protecting our vital organs and providing support to our spine and pelvis. The abdominal muscles are made up of different layers of muscle. These are the rectus abdominis, internal and external obliques and transversus abdominis.

If you think you have a rectus diastasis see your physiotherapist for corrective exercises for diastasis recti. Your physiotherapist will also ensure you are bracing and using your deep abdominal muscles (transversus abdominis) correctly and avoiding movements that are likely to increase the diastasis. Remember, a poorly managed rectus diastasis can lead to an abdominal hernia.

Impacts of pregnancy on Spinal Alignment and Postnatal Posture

As you now know, reliance on supine (on the back) abdominal exercises that flex the upper spine, including most traditional abdominal exercises, many Pilates mat exercises, and some yoga poses, should be avoided immediately after pregnancy. In postpartum women, the curve of the upper back has increased significantly; a kyphotic posture. This is why so many new moms feel "hunched over" after childbirth. Habitually performing exercises that flex the upper spine aggravates the problem. It is far better for new moms to focus on lower spine flexion, which improves pelvic alignment, and to perform abdominal exercises where the upper spine is stabilized in the neutral position. 

Muscular Imbalances in the Torso 

Pregnancy creates system wide changes in your body. As a result of the postural changes of pregnancy, (increased curves in both the lower back and upper back) specific muscle groups have become too tight, while other muscle groups have weakened. To fully rebound from pregnancy, and develop a body that not only looks good, but feel great and functions well, you need to address all of these changes.

Muscle groups that become too tight as a result of pregnancy:

  • Hip flexors
  • Lower back
  • Thighs
  • Chest
  • Shoulders, (particularly muscles that elevate the shoulder blades)
  • Back of the Neck

Muscle groups that weaken as a result of pregnancy:

  • Pelvic floor
  • Upper Back Muscles
  • External rotators of the shoulder
  • Buttocks
  • Front of the neck
  • Abdominal Wall- The abdominal wall is not just weak after pregnancy, it's also too long, a condition called laxity. This is why the abdomen feels mushy and droops directly after childbirth. This extreme lack of tone (remember it is temporary) often shocks many first time moms.

Corrective exercises for diastasis recti

1. Start your abdominal muscle training by learning how to brace your transverses abdominis.

Start on your hands and knees. Your hands should be directly under your shoulders, and your knees should be under your hips. Keep your back straight. Relax your abdominal muscles forward. Slowly and gently draw your abdominal muscles inwards towards your spine. Continue to breathe normally. Practice holding for 5 seconds and repeat 5 times.

2.To correct diastasis recti, begin by lying on your back with your knees bent. Cross your hands at your waist, or use a towel to wrap around your midsection, and begin to guide your stomach muscles together. Take a deep breath in, and as you exhale, contract your pelvic floor while you raise only your head off of the ground. While you lift, continue to pull your muscles together to start lessening the gap. Perform 10 repetitions of these exercises for diastasis recti three times per day.

3.Once you have stabilized your midsection and closed the gap, it should then be safe to try exercises for diastasis recti, to further strengthen your abdominal muscles. On your own, you should begin to strengthen your transverse abdominis, or TVA, and pelvic floor. An example exercise that can help strengthen both is called a heel slide with belly scoop. Begin by lying on your back with your knees bent. Squeeze your belly toward your spine to activate your TVA. Tilt your pelvis up away from the floor as you slide the heel of one foot forward until your leg is almost straight. Slide the heel back in and repeat on the other side. Continue drawing your belly in and tilting your pelvis up as you perform 10 repetitions on each side. Only once your TVA and pelvic floor have strengthened should you begin to strengthen your outer abdominal wall, including the obliques and rectus abdominis.

4.Weight Loss It is important to commence some form of aerobic exercise after pregnancy to regain general fitness and lose any excess body fat gained from pregnancy. You can commence a gentle aerobic exercise program from 6 weeks after delivery of your baby. If you are breast feeding it is important to choose a form of exercise that is low impact and of moderate intensity. Research has concluded that exercise of low to moderate intensity will not affect production of breast milk or lactic acid build up. Ensure you are wearing a good fitting supportive bra. Aim for 45-60 minutes of aerobic exercise 3-5 days per week. Try walking, swimming, low impact aerobics, cycling etc. Remember the following simple formula: Energy Input (from food) must be less that Energy Output (from exercise) for weight loss. Don’t forget to stay hydrated by drinking an extra litre of water during your exercise session. Speak to a dietitian if you are concerned about your diet whilst breastfeeding.

5.Weight training will also assist with weight loss by increasing your metabolism. A simple weights training program can be performed at home such as wall squats, lunges and push ups. Try the following after baby workout at home.

Wall Squats Lean back into a wall (or place your fit ball against the wall and lean back into the ball so your lower back is supported by the ball). Lower into a squat by bending your knees, keep your knees in line with your toes, push through your heels and return to the starting position.

6.Exercises to Avoid
Crunches, sit-ups, oblique (twists) combined with crunches; anything that ‘jack-knifes’ the body, by pivoting at the hip & placing strain on the abdominals such as straight leg lifts or holds from lying on your back & some Pliates moves. In terms of every day movements, avoid lifting straight up from a horizontal lying position – always roll to your side & push up from there; be careful when twisting & turning from the waist, keep thinking ‘core’ & pull belly button through to spine whenever you lift, twist or get up from lying, bending or crouching.

Further Reading

  • Sharma G, Lobo T, Keller L. Postnatal exercise can reverse diastasis recti. Obstet Gynecol. 2014 May;123 Suppl 1:171S. 
  • Benjamin DR, van de Water AT, Peiris CL. Effects of exercise on diastasis of the rectus abdominis muscle in the antenatal and postnatal periods: a systematic review. Physiotherapy. 2014 Mar;100(1):1-8.
  • Diastasis Recti.
  • The 3 Best exercises for getting rid of diastasis recti.
  • Exercises to Heal Your ‘Mummy Tummy’.
  • What is the Tupler Technique?

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