One of the most important things we teach our clients about is DIASTASIS RECTI (abdominal separation) – a common pre/postnatal condition. It’s important to know what it is, as safe exercise can help control it but some types of exercise actually make it worse. Here’s what you need to know:
What is diastasis recti?
Diastasis Recti is a scary sounding phrase for a rather common pregnancy condition- the splitting of the rectus abdominals (the muscles that make up “six pack abs”). This happens as the baby grows and presses “out” against the mom’s abdominal muscles. Most moms don’t feel it happening- it’s not painful- but it can lead to back pain, pelvic pain and pelvic floor dysfunction if not addressed.
It happens in about 50% of pregnancies, usually in the third trimester. The good news is that abdominal separation can almost always be rehabbed after birth. Also, recent studies conducted by physical therapists have shown that exercise during pregnancy actually DECREASES the occurrence and width of diastasis recti .
Most moms don’t know abdominal separation can occur in pregnancy, so they don’t check for it or know how to fix it. It’s important to be educated- so you know what exercises can help manage Diastasis Recti during pregnancy and so you can correct it fully after your baby is born.
How do you check for it?
The first step in getting educated is checking to see if you are experiencing any separation. Most moms’ abs begin to “split” sometime in the third trimester. Taller women are less likely to show any separation because there’s more room for the baby to grow. Shorter women and moms having multiples will start to “split” sooner and are more likely to have some abdominal separation.
Watch this video on how to check yourself during pregnancy for diastasis recti.
(Note: – It can be hard to check yourself late in pregnancy as the pressure of the baby makes it difficult to feel what’s going on. If you think you have separation and can’t tell for sure, ask your doctor to check you.)
How to check yourself for Diastasis Recti:
Begin by lying on the floor in a traditional sit-up position, knees bent, with your feet flat on floor.
Perform a small crunch; this will engage the rectus abdominals.
Run your fingers laterally across your stomach, feeling for a ditch running vertically down the middle of their stomach. Check both above and below the belly button.
Feel for a ditch that will feel soft, with hard (engaged) abdominals on either side. You will want to see how many fingertips you can fit laterally into the ditch.
1-2 fingertips is considered normal, 3+ should be referred to a doctor or physical therapist postpartum.
What do you do when pregnant?
So now that you’ve checked yourself, what if you are pregnant and experiencing diastasis? Your body is likely going to “do what it’s going to do”—meaning it’ll split if it’s going to– but there are three big things you can do when pregnant to help:
1- Get educated on diastasis and how to check yourself.
Use the video above to check yourself for diastasis. Know that most women’s abs don’t split until sometime in the third trimester.
2- Work your transverse/inner abs
Whether or not you believe you have diastasis, transverse abdominal work is the most helpful exercise to do while pregnant. Gently hugging your baby with your ab muscles builds the inner layer of ab muscles while also putting less stress on the rectus abs, which can help lessen the split.
Watch this video to see how to on how to “hug” your baby with your abdominal muscles.
3- Avoid oblique work
Because oblique work puts more pull on the sides of the rectus abdominals at its weakened points, excessive, repetitive oblique exercises should be avoided. You will want to avoid exercises that repetitively twist, or shorten from hip to shoulder (like a traditional bicycle ab crunch). Instead abdominal stabilizing exercises, like those found in Pilates-based movements, should be used. Rolling like a ball and modified roll ups are great exercises to do instead of oblique work.
What do you do postpartum?
After birth, you’ll have a lot on your plate (that’s putting it mildly!) but many women who find out during pregnancy that they have diastasis recti are anxious to get it corrected postpartum. Here’s what you can do:
As soon as possible after birth, return to a regular practice of Kegels and transverse strengthening. Do these exercises early and often. It will go a long way to helping heal the diastasis. As we’ve shared before, the best three exercises to do after baby are
After a few weeks, check your diastasis using the guidelines above. We recommend doing this self-check before your 6 week postpartum ob visit so you can discuss your findings with your doctor. If you have a 3+ finger separation, mention it to your doctor and consider finding a physical therapist in your area.
If you have a less that 3 finger separation, begin to repair the interior abdominals through Kegels and add in transverse abdominal work. The Kegels help strengthen the pelvic floor and a technique called “hollowing” can strengthen the transverse abdominals.
Watch this video to see the “hollowing” technique:
If you’d like, you can also wear a postpartum belly wrap – many women find this helps pull their rectus abs back together (and is very similar to “splinting”, a technique many physical therapists use to repair diastais) especially when worn in combination with safe abdominal work. Watch this video to see how splinting works and use this technique as you return to abdominal work after baby.
Also, oblique work is generally to be avoided prior to six months postpartum as it can work against pulling the rectus abs back together. Focus first on the transverse abs, then the rectus and leave the twisting movements until after your baby is 6 months old.
The bottom line on Diastais Recti/Abdominal Separation:
The splitting of the rectus abdominals during pregnancy is normal, and exercise during and after pregnancy can help both manage and repair the condition.