Healing Diastasis Recti: What You Can Do
One of the most common body issues facing postpartum women is diastasis recti. This separation of abdominal muscles is common in pregnancy, and often made more severe during childbirth.
Unfortunately, while symptoms of diastasis recti are easy to spot, the condition often goes undiagnosed.
Because women don’t know they have this condition, they can live with weakened core muscles for years and even decades after childbirth!
Healing diastasis recti is one of the main concerns of women who inquire about my postpartum fitness coaching. Motivated by a desire to regain their pre-pregancy shape, women often overlook some of the important health reasons to focus on healing diastasis recti.
What Is Diastasis Recti?
Diastasis Recti is the separation of the rectus abdominus (six-pack) muscle along the midline of the body. Diastasis means separation and recti refers to the rectus abdominus.
It is extremely common in women who have been pregnant. The Mayo Clinic says about two-thirds of pregnant women develop a diastasis!
Pregnant women develop a diastasis simply due to the growing baby. As the baby grows within the uterus and other internal organs are pushed out of their usual place, the abdominal muscles stretch then move apart to make room.
Symptoms of Diastasis Recti
The good news is that diastasis recti symptoms are easy to identify, even for a regular tired-as-all-get-out new mom. There are three major symptoms of diastasis recti for you to identify:
- low back pain
- a pooch or doming of the abdominals, especially when the muscles are contracted
- bloating or constipation, unrelated to what you eat and drink
Are you suffering from low back pain, even though you haven’t done anything to cause it? Low back pain can result from diastasis recti because the abdominal muscles aren’t doing their job holding up your core. Your back is working too hard!
When you attempt a plank, does your stomach dome outward? The model below likely has diastasis recti– see how the middle of her abdomen hangs down lower than the sides? That’s one of the classic symptoms of diastasis recti.
The link between diastasis recti and constipation will be explored later in this post. For now, now that most people are chronically dehydrated, so trying to drink more water can help improve your bowel health and reduce episodes of constipation. Being well hydrated is a super easy way to improve your diastasis.
Do you have one or more of the symptoms of diastasis recti? Keep reading for how you can heal your diastasis.
How to Check for Diastasis Recti
Here’s what to do:
Lie down with your knees bent and feet flat on the floor. Put one hand behind your head and one hand on your abdomen. Inhale. As you exhale, raise your head and shoulder blades off the floor.
Use the hand on your abdomen to check both above and below your navel. Can you feel a valley? Can you fit more than two finger widths in the valley? If so, that’s a diastasis.
Alternatively, if you tense your abdominal muscles and see a dome-shape or protrusion, that is also the result of a diastasis.
The visual or tactile indication of an ab separation is confirmation of DR.
Is healing Diastasis Recti even possible?
If you have been diagnosed a diastasis, please know there wasn’t anything you did or didn’t do to cause it. Even women who have very strong abdominal muscles may still suffer from DR. It is simply the result of the contents of your insides being too big for the container of your abdomen.
Some women find wearing an abdominal splint in the early postpartum weeks helpful. The splint encourages your abdominal muscles to move back together toward the midline of the body.
While a splint offers support, the most important thing to encourage your body to knit the abdominal muscles back together is to avoid making the situation worse. That may sound obvious, but it means avoiding common exercises and activities.
Exercises to Avoid with Diastasis Recti
There are some common exercises to avoid with Diastasis Recti so that you don’t create extra pressure on your abdominal muscles. You also want to avoid any exercises that require intense rotation side-to-side until the DR has healed.
Exercises to avoid if you have DR include:
- sit ups
- push ups
- pull ups
- intense swimming (especially freestyle and butterfly)
And don’t think yoga, with it’s careful breath work, is all okay. Even something as seemingly harmless as downward dog builds internal pressure in your abdominal cavity so should be avoided.
Women who struggle with postpartum body image often want to return to exercise as quickly as possible. While that is understandable—for exercise has tremendous mental benefits as well as physical ones— there are certain exercises that will help (and not worsen) a diastasis.
Please confirm with your healthcare provider your readiness for exercise before attempting these—or any other—abdominal exercises.
Easy Diastasis Recti Exercises You Can Do At Home
Instead, focus on simple exercises that will support your body in healing diastasis recti. These at home exercises include:
Fog the Mirror- Pretend you are trying to fog a mirror by taking a deep inhale then exhaling forcefully with an open mouth. Feel the abdominal muscles just above the pubic bone contract. Those are your transverse abdominus (TVA) muscles. Healing diastasis recti starts with learning to engage the TVA.
Practice 8-10 fogging breaths, making sure to stop if you feel lightheaded.
Pelvic Tilts- Lie on your back on a yoga mat with your knees bent and your feet flat on the floor. Inhale to prepare, then on the exhale, use the TVA muscles to tilt the pelvis towards your head. Inhale and return to the start position.
Repeat for 8-10 breath cycles.
Bridging- Using the same start position as the pelvic tilts, on an exhale tilt the pelvis towards the head, then lift the hips off the mat. Inhale and slowly lower down to the mat.
Repeat for 8-10 breath cycles.
Heel Slides- Lay on your back with knees bent and feet flat on floor. Inhale and extend one leg by sliding the heel along the floor. When the leg is fully extended, exhale and use the low abdominal muscles (TVA) to draw it back to the start position. You may find it helpful to place your hand on your very low abdomen (TVA) on the side of the working leg right by the hip bones. This is a very subtle movement; try to use the abs and NOT the hip flexors or quadriceps.
Repeat for 6-8 breath cycles.
I think I need more help healing diastasis recti!
Working under the guidance of a knowledgeable, certified postnatal fitness specialist is a good investment. If there is not one in your area, I am available for virtual coaching. I love helping women heal their body to be happy, health, and strong again.
If your budget won’t allow one-on-one training, there are two home-based video programs I recommend.
First is the MUTU System, the worldwide leader in at home diastasis healing programs. You can try a FREE taster series of videos to see how quickly the MUTU System works.
Fit2B program is designed by Beth Learn who is an absolute expert in postnatal, tummy-safe fitness. The at-home, family friendly workouts are ideal for women working to heal their DR. With Fit2B, the exercises progress past DR healing in a logical, safe way.
You can also use this excellent book by Katy Bowman to guide your diastasis recti recovery.
If you find that your diastasis is more than four finger-widths, you are an excellent candidate for physical therapy. Find a women’s health physical therapy practice, and confirm they have experience healing Diastasis Recti. Don’t hesitate to reach out to me if you need help finding a qualified pelvic physical therapist in your area.
Can diastasis recti cause bowel problems?
In a word, YES!
Many women don’t realize that there is often a link between Diastasis Recti and bowel issues. Because the diastasis often affects gut motility (how fast your food moves through you), women with DR often suffer from constipation.
Consider also the fluctuating hormones of the postpartum months that further contribute to constipation. The high internal pressure in the bowel plus straining to have a bowel movement puts pressure on your abdominal muscles.
Imagine the outward pressure on the rectus abdominus muscle sustained when trying to pass hard stool. That same muscle you want to be knitted back together is being pushed apart by straining to pass a bowel movement.
So, you have a gut that is sluggish and doesn’t want to go, and you have abdominal muscles that strain apart– diastasis recti and bowel problems go hand in hand.
It’s a perfect storm of pooptastic proportions. (A shitstorm, so to speak.)
This sounds scary! What easy things can I do to improve my DR *and* make sure I protect my pelvic health?
A simple change in your toileting habits is a good place to start. Using a toilet stool like the Squatty Potty can help minimize the pressure pushing out on your healing abdominal muscles. The Squatty Potty puts your body in best alignment for eliminating with ease.
And for all those times you’re NOT on the toilet, there’s an even more simple habit that can positively affect your diastasis. If you can teach your body to “exhale on exertion”, you reduce the intra-abdominal pressure that is pushing your abs further apart and stressing your pelvic floor.
What does this mean? Every time you move against gravity, you exhale.
Example: As you roll to your side to sit up on your bed in the morning, exhale. As you stand up out of a chair, exhale. As you lift your baby, exhale. As you put a stack of dishes away in the cupboard, exhale. As you set the baby bucket into the car seat base, exhale.
While this breathing pattern won’t magically heal your diastasis recti overnight, it does promote the optimal conditions that allow your body to heal itself.
Don’t suffer in silence!
There are many talented professionals who devote their lives to healing diastasis recti. If you don’t know a reputable resource in your area, I am always happy to reach into my network of qualified women’s health physical therapists and physicians to find someone to help you.
There’s no reason to suffer in silence! Get the help you need so you can live the life you deserve.
Karen Shopoff Rooff is a certified health coach, personal trainer, and perinatal fitness specialist with more than a decade of experience. The Well Balanced Women blog is for educational purposes only and is not medical advice. Please discuss your health issues with a licensed medical practitioner.
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