Why the Best Exercises for Diastasis Recti are Different for Everyone

When it comes to healing diastasis recti abdominis (DRA), exercise is one of your best tools. Moving your body with intention will help you regain some of the strength and energy you may have lost in those early weeks after having your baby. Exercise can also help you restore confidence and feel good in your skin. But if you have diastasis recti, exercising in certain ways can also make your condition worse.

That doesn't mean you should be scared to move your body or assume you can't do the activities you love. The key is listening to your body and understanding the difference between what's safe when exercising with diastasis recti — and what isn't.

Understanding Diastasis Recti Abdominis

A diastasis recti abdominis or DRA is a widening of the space between the two sides of your “six-pack muscle” (aka your rectus abdominis muscle) that measures more than 2 cm. This widening happens to all pregnant people in their last trimester to make room for a baby. For the majority of people, it resolves on its own. Unfortunately, about 39% of postpartum individuals still have DRA 6 months after childbirth.

It's the linea alba that stretches and thins, causing the abdominal muscles to move further apart

Diastsis recti abdominis is sometimes referred to as "ab separation," but it isn't actually your abdominal muscles that are stretching apart. Your right and left rectus abdominis muscles are separated by a thick connective tissue known as the linea alba which helps to create strength and structure in your abdominal wall. When placed under chronic strain (as in pregnancy), it's the linea alba that stretches and thins, causing the abdominal muscles to move further apart — and for your abdomen to bulge forward.

Chronic stretching can occur as your belly grows during pregnancy, but other habits like excessively straining during daily bowel movements, or poor pressure management strategies while exercising may also leave you at risk for developing or worsening a diastasis recti, since these activities also place chronic strain on your abdominals.

Diastasis recti can appear as a gap, or doming of tissue along the midline of your abdomen, but it is not just the abdominals that are affected. The abdominal muscles work together with the pelvic floor muscles to support and protect abdominal organs, aide in breathing and coughing/vomiting, and stabilize the spine by maintaining intra-abdominal pressure.

With diastasis recti, you can experience abdominal muscle weakness, coordination dysfunction, poor posture, and studies have linked diastasis recti to pelvic floor dysfunction, low back pain, and pubic symphysis dysfunction.

All of these dysfunctions can not only make returning to exercise more difficult, but when not taking the proper precautions, exercise can increase the stress and strain on your abdominals and linea alba, making your symptoms, and diastasis recti worse.

The Importance of Safe Exercise for Diastasis Recti Abdominis

Focusing on healing your diastasis recti is critical, because without proper rehabilitation, DRA can persist and leave you at an increased risk for pain and dysfunction.

While there are many different exercises that can help you heal and recover in the postpartum period, it's important to choose exercises that focus on restoring the strength and coordination of your deep core, without exacerbating your symptoms or increasing intra-abdominal pressure.

The Best Exercises for Diastasis Recti Abdominis

Despite what the internet may tell you, there is no “one size fits all” exercise or exercise program that is best for healing diastasis recti. The exact exercises and how you should progress them should be unique and based on things like your level of fitness, how significantly your diastasis is impacting your function, how far along you are in your postpartum healing, and even details surrounding your medical history.

Despite what the internet may tell you, there is no “one size fits all” exercise or exercise program that is best for healing diastasis recti.

Research supports a comprehensive care program that addresses everything from intra-abdominal pressure management during exercise and daily activities, to improving body mechanics and posture, and a gentle and progressive exercise program that starts with a focus on your deep stabilizing muscles (transversus abdominis, multifidi, and pelvic floor muscles) to set a good foundation of stability and motor control before progressing to more challenging traditional core exercises.

During any exercise, it is important to pay attention to your symptoms. If you notice these signs or symptoms for the first time, or have an increase in any of the following signs or symptoms, your body is warning you that you are not quite ready for this exercise, and it may be unsafe for your diastasis recti:

• Pain in your low back, abdomen or pelvis
• A doming or bulging along the center of your abdomen during specific exercises or movement
• Breath holding as a strategy to accomplish the exercise
• Increased pelvic floor symptoms such as bowel or bladder leakage, or increased pelvic pressure

Avoid These Common DRA Mistakes:

While most exercises can be modified and scaled back to make them safe for diastasis recti healing, there are some common habits that can make any safe diastasis recti exercise, unsafe. It is best to avoid the following mistakes:

Overworking other muscles:

When muscles are weak or injured, it can be easy to recruit other muscles to help you out — or leave the weak or injured muscle out of the exercise entirely. This means you are not getting the right effect from the exercise, and may even risk straining your muscles and further injuring your diastasis.

Holding your breath:

To increase stability in our core, we must increase intra abdominal pressure. The best way to do this is to activate the muscles in our core, but when these muscles are weak it’s common to compensate by holding your breath and bearing down to complete the exercise. Unfortunately, these strategies can worsen your diastasis recti.

Poor form:

No matter which exercise you choose to help heal your diastasis, poor form can turn a typically safe exercise into an unsafe one. Make sure you are sticking with proper form, and enlist the help of a personal trainer, or physical therapist if you need assistance.

Ignoring symptoms and strain in your abdominals:

If you notice pelvic or low back pain, doming or bulging along the midline or your abdomen, or pelvic floor symptoms such as pelvic pressure, pain or bladder leakage either during, or after your exercise, these are signs that the diastasis recti exercise you are trying, is unsafe and should be modified.

Trying exercises that are too hard:

It’s natural to try and hop back into your old exercise routine when healing your diastasis recti, but with muscle strength impacted by pregnancy, recovery in the early postpartum, and diastasis recti, chances are your old ab routine is too difficult to hop back into. When exercises are hard we tend to compensate with all of the above mentioned poor habits: breath holding, muscle compensation, and poor form, which is a recipe for unsafe diastasis recti exercise.

Still Unsure? See a Pelvic Floor Physical Therapist

When done correctly, exercise has the potential to restore your strength, motor control, and function in the abdominal and pelvic areas, while improving pain in your low back and pelvis and reducing the gap between your abdominals. However, exercising with diastasis recti can also make symptoms worse, so it is crucial to understand the condition and the difference between safe and unsafe exercises.

To ensure that the diastasis recti exercises that you are doing are safe, one of the best things that you can do is see a pelvic health physical therapist. They will help you understand your diastasis, and figure out the exercises that are safe for you. They will also help to make sure you avoid the common mistakes that can make many exercises unsafe.