If you’ve found me via google search or similar, you’re probably experiencing diastasis recti, have been told by a doctor that you may have it, or have heard the term at some point throughout a pregnancy.
You’re in luck:
My goal with this post is to explain what it is, how it occurs, and how to best PREVENT and TREAT diastasis recti.
Diastasis Recti Definition
Diastasis recti is a separation of the abdominal muscles. “Diastasis” means separation and “recti” means abs. It sounds so scary, right? Have no fear, it’s a very common issue and it’s treatable.
Diastasis recti is common among pregnant women because the uterus expands, causing abdominal pressure. What happens is the left and right abdominal muscles stretch apart and separate. After giving birth they come back together, usually. But how long that takes varies. Therefore you may look like you have a belly pooch for a while (no fun).
You’re more likely to get diastasis recti if you’ve had multiple pregnancies, if you are over 35 years old, or you’re having twins, triplets, etc. Diastasis recti can occur in men, newborns, and children too from injury or surgery, however it is most common with pregnant women.
Diastasis Recti Signs and Symptoms
Signs of diastasis recti are a pooch or protruding belly, or visible separation of the abs. Symptoms are urine leaking, constipation, lower back pain, and abdominal weakness. You can also measure a gap between your left and right abs that is larger than 2.7cm (or about 2 finger widths). This gap can occur along the entire span of the abs or just above or below the navel. It is most common right near the navel (belly button).
To test if you have a diastasis recti, lie on your back, place your fingers at the belly button, and feel that area while you do a crunch. Feel at the belly button, below it, and above it. If the gap is more than two finger widths, you may have diastasis recti. You can see a medical professional to confirm, however only serious cases typically require medical or surgical intervention. See your doctor to confirm.
Diastasis Recti Prevention
If you already have diastasis recti, you want to avoid straining because that can make it worse. For example, lifting your kids, lifting heavy objects, and straining to go to the bathroom. Also, be very careful with exercising. Common exercises that can strain the connective tissue are sit-ups crunches, planks, pushups.
If you are a mommy-to-be, know that it may not be possible to 100% prevent a diastasis recti, but you can definitely prevent how severe it may get and how quickly you heal from it by addressing it early with abdominal exercises. These exercises should include abdominal strengthening and stretching. The strengthening exercises are shown below. In order to stretch the abdominals, my favorite stretch is to hold an Upward Dog and take deep breaths. This stretch will allow the muscles to elongate and be more flexible and prepared for the future baby that will be kicking away in there.
Diastasis Recti Treatment
In order to treat diastasis recti, there are a few options:
The first treatment to try is conservative: exercise. You want to choose exercises that will improve your abdominal strength but not cause too much pressure and straining in your abs. I’m not talking about doing a hundred crunches a day. I actually don’t promote doing crunches to my patients because they put pressure on the linea alba which connects the left and right abs and can bulge it. Instead, pilates exercises can be very beneficial for the treatment of diastasis recti because most pilates exercises target your pelvic floor and core muscles in a safe way. Pilates is safe because it focuses on core and spine stability while watching your posture. Whereas other forms of exercise like yoga focus a lot on spine extension and prolonged stretching.
Should you expect to be cured within one week? No. Be patient because the diastasis recti won’t go away overnight. It could take months and even a year for it to improve if you work at it consistently.
Always consult your Physician before beginning new exercises. If you need assistance, request some physical therapy to help you treat this.
If you have more than a mild case of diastasis recti, your doctor may recommend a splint or brace. In my opinion, splinting turns off the stabilizing function of your core muscles and may delay your recovery process. I prefer patients maintain good core awareness throughout the entire day instead of wearing a splint or brace. However, consult your doctor.
Lastly, for more severe cases, surgery may be needed for diastasis recti treatment.
If you want to read more about diastasic recti, check this book out:
Activating your Core
Before beginning exercises for diastasis recti, we must first make sure you understand how to activate your pelvic floor muscles. This can be difficult to understand and feel. So I am going to use a couple different examples and hopefully at least one of these connects with you.
First let’s understand the muscles you are firing. Your transverse abdominis muscle wraps around your abs in horizontal fashion and almost acts like a natural back brace, corset, or weight belt for you. It provides stability for your lumbar spine and supports your organs. If you strength this, it will shrink your waistline, flatten your belly, and close the gap or separation between left and right abs.
Example 1: Pretend you are sitting on the toilet peeing and you hear your child scream, so you stop peeing so you can hear what’s going on. That sensation you performed to stop the pee from streaming was activation of your pelvic floor. There is zero movement involved. It is internal activation of those muscles.
Example 2: Sit with some sort of bottoms on (pants, shorts, jeans). Pretend like you are trying to shrink your waist inward so the pants aren’t as tight around your waist.
Example 3: You are standing facing me and you see me draw my fist back and go in to punch you in the stomach. What do you do? You brace your stomach muscles to guard against my punch. (you don’t punch me back because you’re too nice to do that)
Those 3 examples helped you engage your pelvic floor and transverse abdominis muscles. Later in the workout shared below, you will engage your other abdominal muscles (rectus abdominis and obliques) with more flexion and rotation movements.
Diastasis Recti Exercises
Now that you know what it feels like to brace your abs and pelvic floor, let’s move on to the real diastasis recti exercises. I will start with the beginner exercises. Spend about 3-4 weeks perfecting these before you move on to the intermediate and advanced levels. Perform these exercises on a daily basis for better success. There are 23 exercises total. Watch them in this video and read more detailed descriptions below. Grab a mat and let's get started! Descriptions are below the video.
*Perform each exercise for 3 sets of 10
-Sidelying abdominal bracing: Lie on your side, place your hands on your lower abdomen, draw your belly button to your spine, hold for ten seconds maintaining normal breathing, then relax.
-Supine abdominal bracing: Lie on your back, legs bent, place your hands on your lower abdomen, draw your abdominals inward and tighten your abs, hold for ten seconds maintaining normal breathing, then relax.
-Supine pelvic tilt: Lie on your back, legs bent, place your hands at your lower back, draw your belly button to your spine, tilt your pelvic bones to your lower ribs as your lower back flattens onto the ground, hold for ten seconds, then relax.
-Supine heel slides: Lie on your back, legs bent, activate your lower abs with pelvic tilt, then slowly straighten one leg away from you and then back up while keeping the abs engaged. Repeat on the other leg.
-Supine knee fall outs: Lie on your back, legs bent, activate your lower abs with pelvic tilt, then slowly lower one knee down straight, drop that knee out to the side, and then slide it back up to where it started. Do this while maintaining abdominal activation and keep your pelvic bones level. Repeat on the other leg.
-Supine pelvic tilt with march: Perform the supine pelvic tilt we did above, but during the ten second hold, march your legs in the air one at a time while maintaining the tilt.
-Lower trunk rotations: Lie on your back, arms out in a “t”, legs bent, toes pointed, slowly lower both knees to the left, then back to the center, repeat to the right.
-Standing pelvic tilt: Standing against a wall, legs slightly bent, hands behind your lower back, pelvic tilt and flatten your back into the wall, hold ten seconds maintaining normal breathing, then relax.
*Perform each exercise for 3 sets of 10
-Bridge: Lie on your back, arms at your side, keeping your spine neutral, raise your hips straight up toward the ceiling, hold one second, then lower down.
-Hip Roll: Same as the bridge above, however as you raise your hips up toward the ceiling do so one vertebrae at a time. To do this, pelvic tilt, lift your lower lumbar spine up, then your mid thoracic spine up. Hold one second. Then lower back down slowly, one vertebrae at a time.
-Supine arm/leg extension: Lie on your back, arms at your side, legs bent, reach your left leg out straight and your right arm straight overhead while maintaining abdominal activation, hold one second, then return the arm and leg to where you started. Repeat on the other side.
-Supine leg circle: Lie on your back, arms at your side, one leg bent, one leg straight up in the air. With the leg in the air, perform circles the size of a basketball 10x each direction while maintaining abdominal activation. Then repeat on the other leg.
-Single leg stretch: Lie on your back, legs bent at 90/90 in the air, hands at the outsides of your knees, head stays down, pelvic tilt. Kick one leg out straight while maintaining your pelvic tilt, hold for one second, then bend it back in. Repeat on the other leg.
-Double leg stretch: Lie on your back, legs bent at 90/90 in the air, arms at your side, head stays down, pelvic tilt. Kick both legs out straight while maintaining your pelvic tilt, hold for one second, then bend them both back in. Only have your legs as low to the ground as you maintain the tilt.
-Half roll back: Sit with your legs bent and arms reaching forward. Lower your torso down to the ground and open your right arm out to the side as you turn to the right. Hold one second and then return to the start position. Repeat to the left side.
-Sidelying leg arcs: Lie on your side with legs straight and top hand can be on the ground. Raise the top leg up a few inches. Make an arch or a rainbow with that top leg by bringing it forward in front, up to the ceiling, then backward behind you. Perform all the reps. Then repeat on the other leg.
*Perform each exercise for 3 sets of 10
-Supine leg scissors: Lie on your back, arms at your side, head down, legs straight up to the ceiling. Slowly lower one leg down to the ground, hold one second, then switch legs by bringing that leg up and dropping the other leg down.
-Supine dead bugs: Lie on your backs, arms straight up to the ceiling, head down, legs bent at 90/90 in the air, perform a pelvic tilt, hold that tilt while you reach the opposite arm and opposite leg out, then switch sides.
-Leg lift and lowers: Lie on your back, arms at your side, head down, legs straight up to the ceiling, perform a pelvic tilt, slowly lower both legs down to the ground while maintaining that pelvic tilt and then bring them back up. Only go as far down as you can maintain the pelvic tilt with lower back flat on the ground.
-Single leg bridge: Lie on your back, arms at your side, feet hip distance apart, one leg bent, the other leg straight out. Then bridge your hips up to the ceiling, keeping your hips/pelvis level. Hold one second and then lower down. Repeat on the other leg.
-Single leg deadlift: In standing, arms at hips, stand on one leg, bring the other leg straight back behind you as you hinge forward at your hips. Keep the hips levels. Hold one second and then return to the start position. Repeat on the other leg.
-Wall squat: Stand with your back against a wall, squat down to 90 degrees, keep your abdominals engaged the whole time, and hold this isometric squat for 30 seconds before standing back up.
-Reverse plank: On your feet and hands, hold a reverse plank for 30 seconds while keeping your core activated and body in a straight line.
At this point you should have a much better understanding of diastasis recti, what it is, how it occurs, and how to treat or prevent it. I hope this article was helpful and educational. I encourage you to be diligent and consistent with the exercises to have a better chance of a full recovery. You may even build up some beautiful abs over time. Once these diastasis recti exercises becomes easy, consider progressing to a Pilates class for a more challenging workout! I absolutely love pilates reformer classes and find them great for posture, core strength, and flexibility. Pilates is wonderful for everyone: men, women, children, elderly, and even the injured population.
If you desire more guidance with a diastasis recti exercise program or want to advance your workouts even more, I am happy to provide you with 1-on-1 coaching so you can see even better results.
Before I go, shout out to the new mommy and my sister-in-law Ashley for just having her first son! She inspired me to write this post. So I wish all you new mommies out there the best of luck with your recovery and raising your new beautiful babies.