What is diastasis recti?
Before we get to Diastasis Recti exercises, what is it? Diastasis recti, also referred to as ‘Divarication of the Recti’, DRA or ‘Rectus Divarification’, is the widening of the gap between the 2 sections of the Rectus Abdominis (or 6 pack) abdominal muscle. The split occurs at the Linea Alba, the mid-line collagen structures of connective tissue at the front of the abdomen. You can find out more about how to perform a diastasis recti test below.
100% of women have some level of diastasis of the rectus abdominis in the third trimester. (Gilliard and Brown 1996, Diane Lee 2013)
For many women the gap remains widened at 8 weeks, and may remain unchanged at 1 year postpartum. (Coldron et al 2008, Liaw et al 2011)
66% of women with diastasis recti have some level of pelvic floor dysfunction (Spitznagle et al 2007).
Diastasis recti and pelvic floor problems may present together. The Linea Alba (seam of tissue structures that form the meeting point of the 2 sides of all the core musculature) along with all the abdominal muscles, have stretched and thinned out.
ALL the muscles of the abdomen- Transversalis, internal and external obliques, as well as Rectus Abdominis – meet at this centre midline. This lack of stability can affect the whole body both aesthetically and functionally.
What does a diastasis look like?
You may see a ‘pooching’ or ‘doming’ of your stomach, especially when coming up from a lying position on your back. Sometimes you appear still a few months pregnant.
As well as the aesthetic concerns (not liking the way your tummy looks), diastasis recti may be associated with a weak core (and pelvic floor). This can lead to a lack of strength and stability in the entire pelvic region and midsection.
What causes diastasis recti?
Diastasis Recti is the result of excessive intra-abdominal pressure or loading. It is common (and normal!) in the later stages of pregnancy, particularly second or subsequent pregnancies. The increased oad and al the changes of pregnancy have stretched the entire abdominal structure.
The Rectus Abdominis is only 1 of 4 layers of abdominal muscles: the Transverse Abdominis (deepest muscle layer) the Interior and Exterior Obliques (next 2 layers) that form your waist, and then the Rectus Abdominis is on the outside.
When the 2 parts of the muscle separate or come apart, the connective mid-line is stretched and weakened as it takes all other muscular and fascial support structures along with it. This can mean the abdomen is unsupported or unstable. This seam of connective tissue is designed to be taut, at full length and aligned in a vertical (breastbone to pubic bone) plane. But it cannot perform or function optimally when alignment is ‘out’. So alignment is important when discussing diastasis.
Diastasis Recti is a symptom of excessive and unsupported intra abdominal pressure. This is the same issue that creates other pelvic and abdominal problems including hernia and prolapse. DR should therefore be treated as part of an integrated program designed to re-align, re-connect and then strengthen the entire core musculature, rather than be addressed in isolation.
The focus should not be only on ‘closing the gap’!
Diastasis recti test – how to do it?
Lie on your back with your knees bent and your feet flat on the floor. Relax your head and shoulders and place your fingers (palm facing you) just above your belly button.
Lift your head and neck very slightly off the floor and press down with your fingertips. If you feel a gap, that’s the diastasis. You will feel the muscles close in around your fingers as you lift your head and neck. Don’t lift your shoulders. Repeat the test in two other place: directly over the belly button, and a couple of inches below.
A diastasis recti gap is measured in finger width’s. You are aiming for a 1-2 finger gap or less, but don’t panic if it’s much bigger at first.
Even more important than the width of the gap though, is the tension (or lack of tension) in the midline – the linea alba. Contracting the muscles should create tension and resistance when you apply gentle pressure with your fingers to the midline. If it doesn’t – you have some re-connecting to do…
It’s important to understand too, that lying on your back is not the only position to assess a diastasis. A well informed specialist trainer or Physio may also have strategies to test your DR when standing, and even during functional movement.
Should you use a splint, belly binder, or abdominal wrap to bring a diastasis together?
Postpartum abdominal binding has been traditional practice in many parts of the world for generations. In my experience, supporting the abdomen during and immediately after pregnancy may be helpful in some cases with awareness of the abs and for lower back support. However, just wrapping it up tight, pulling the two sides together… won’t make them heal or stay there. Don’t use a wrap or splint as a substitute for actually engaging the right muscles… and remember that ‘narrowing the gap’ is really not the big goal! A DR gap is a symptom, a sign that directs us to adddress core engagement and strengthening. Just ‘closing it’ with a splint, binder or scarf is not the answser.
Remember the diastasis is caused by excess loading, stretching and pressure within the abdominal and pelvic cavity. A pressure that your body can’t withstand as it should. Wrapping it up in itself won’t fix it, it will just squidge your abdominal mass in a different direction (think of a tube of toothpaste squeezed in the middle…)
You need to correct alignment and re-engage an entire SYSTEM of muscles and fasica to put your tummy back where you want it for the long term.
MUTU System is for women who…
want their bodies to look, feel and function better after having a baby. Even if it’s a long time since having a baby. They want a core and a pelvic floor that work, that feel right and that do their job. It’s for women who want to lose weight after childbirth and keep it off. It’s the definitive, medically endorsed Mummy Tummy Workout System, created by postpartum fitness expert, Wendy Powell.
An international best-selling, industry acclaimed, award winning, holistic, realistic and supportive exercise and recovery program for Moms that truly works.
A proven, truly effective, tried and tested solution for ‘mummy tummy’, diastasis recti, pelvic floor weakness and core that isn’t as functional or strong as you’d like it to be.
Should I avoid crunches?
Crunches and sit-ups are often advised against if you have DR. However, crunches or sit-ups can be beneficial for loading the linea alba and strengthening the midline abdominal connective tissue and reducing a diastasis gap, dependent upon the deep core muscles recruiting and engaging correctly as you move. To determine whether this is happening may require some initial hands-on expert supervision from a pelvic health physiotherapist or specialist trainer.
If the deep core is not engaging optimally to bear the load of the exercise and strengthen the muscles and connective tissue, then a crunch or sit-up movement can have the opposite effect – increasing intra-abdominal pressure and not giving you the result you’re after.
It is for this reason that you will often see generic Diastasis Recti exercise advice recommending against sit-ups or crunches. Simply because if the move is not performed correctly, it may not be having the desired effect. We don’t include crunches in the online MUTU System program for this reason and teach you to understand core engagement and how it *feels* first.
The same advice applies to oblique (twists) combined with crunches; anything that ‘jack-knifes’ the body, by pivoting at the hip and placing strain on the abdominals – such as straight leg lifts or holds from lying on your back and similar Pilates moves. These moves can be great as you progress onto strengthening, provided you introduce them gradually with good core engagement.
My youngest is at school. Am I too late?
Activating and engaging your core transverse abdominis muscle and learning to re-align and strengthen your core and pelvis can be done at any stage postpartum! You can always make improvements to strength, stability AND the way your tummy looks!
What exercises will help with a diastasis?
MUTU System exercises will 🙂 In a 2018 survey of 906 MUTU customers, 94% of women reported an improvement in signs and symptoms of diastasis recti.
Start here – First, you want to FIND and connect with your deep core muscles. Here’s how: Without raising or tensing your chest or shoulders, GENTLY draw your belly button inwards as you slowly exhale. That’s the right muscle! You’re not ‘sucking in’ or making any forceful or exaggerated movement. Your pelvis shouldn’t tuck under as you do this – in fact nothing should be happening in your shoulders, chest or pelvis! It is just a subtle drawing in at the lower abs.
You are not… sucking in your stomach, holding your breath, moving your ribs or your shoulders. You’re not tucking your butt / tailbone under you or thrusting your hips. These movements indicate instead that the Transverse is not fully engaged. You need to find this this muscle first and re-connect with it, if it is going to play its vital role in your core and pelvic floor system.
We work on your ALIGNMENT – a factor in that excessive pressure and loading.
Then we learn to ENGAGE your transverse abdominis and pelvic floor muscles effectively and correctly, not only when you exercise, but also during every-day movements like lifting, sneezing or twisting. This is a natural, reactive movement which you won’t always have to do consciously! But to re-conenct, to realign and to restore, we isolate at first… and then progress quickly to functional movement.
Then we STRENGTHEN the deep core in a way that will draw your rectus abdominis muscle (the six pack, outermost one, the one that has separated) back in together, helping to pull your belly back in… flatter and stronger. These are not isolated ‘ab only’ exercises!
The most effective way to get your body to the aesthetic and functional place you want it… is with whole body movement, gradually adding load (weight / body weight) to challenge and strengthen, and listening to your body signals as you go, to back-up… or move on..