Pregnancy is a wonderful moment in any woman's life, but it comes with its drawbacks. Carrying a baby for nine months can take a toll on your body and leave permanent marks, but in the end, it's all worth it. A common problem is diastasis recti abdominis, or abdominal separation, which affects most pregnant women. Certain exercises, especially those targeting the core muscles, can help correct this issue.
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What Is Abdominal Separation?
When you're pregnant, the uterus enlarges to accommodate your baby. This causes the abdominal muscles to stretch and separate, causing a bulge or "pooch" in the middle of the abdominal region. The bulge tends to be more visible when your abs are tense, such as when you're working out.
As the Mayo Clinic notes, abdominal separation is more likely to occur in women over the age of 30 as well as in those who are carrying a large baby, twins or triplets. Pregnancy isn't the only cause of diastasis recti, though. Newborns and men can experience this problem too. A poor lifting technique, obesity and multiple pregnancies are all common causes.
Diastasis recti isn't a medical emergency and doesn't pose major health risks. However, it may contribute to back pain, poor trunk stability, bladder and bowel incontinence, pelvic organ prolapse, umbilical hernia and other complications. According to a 2015 research paper published in Current Women's Health Reviews, this condition affects all women during pregnancy and may persist in up to 60 percent of cases after childbirth.
Is Diastasis Recti Painful?
Ab separation in pregnancy contributes to the dreaded "mummy tummy." That's why your pooch doesn't go away for weeks or months after giving birth. In fact, one in three women is still struggling with it 12 months after delivery. Constipation, heavy lifting and excessive core training only make things worse.
Diastasis recti may cause pain during intercourse, as well as hip, back and pelvic pain, according to the American Physical Therapy Association. A 2015 study published in Manual Therapy, on the other hand, indicates no association between this condition and lumbopelvic pain. Its symptoms vary from one woman to another, so it's hard to tell what to expect.
In general, abdominal separation causes weaknesses in the core region and bulging of the abdominal wall, which can affect your day-to-day activities. The good news is that you can fix diastasis recti through regular exercise. According to a 2016 review featured in Fisioterapia em Movimento, it takes about six months for the abdominal muscles to return to full strength. A qualified physiotherapist can assess your condition and develop an exercise plan that suits your needs.
How to Identify Diastasis Recti
First of all, make sure you actually have diastasis recti. This condition is fairly easy to identify.
Lie on your back with your knees bent and your feet flat on the floor. Lift your head and neck into a "crunch" and gently press your fingertips above the belly button. If you feel a gap or small separation in the middle of the abdominal area, that's diastasis recti.
This condition can also be diagnosed with a CT scan, ultrasound investigation or calipers. The last two measurement methods appear to be the most effective.
Diastasis Recti Exercises
Abdominal separation can be treated surgically; this option, though, is recommended only in severe cases. Most times, diastasis recti can be reduced through exercise. Just make sure you resume your workouts slowly after giving birth; listen to your body and don't push yourself too hard. Your body is still recovering from the changes it went through during pregnancy.
As the American Physical Therapy Association points out, because it's a natural part of pregnancy, this condition can't be prevented. Core and pelvic exercises, postural training, stretching and bracing can help reduce abdominal separation and improve core function. Some workouts are more effective than others.
The MUTU System, for example, is a complete diastasis recti workout program for moms of all ages and fitness levels. It's one of the few exercise plans backed up by the medical community. It encompasses movements that help improve your posture, strengthen the abdominal and pelvic floor muscles, increase core strength and speed up the recovery process. Your diastasis recti workout may include the following exercises:
Try Abdominal Crunches
Until recently, crunches were not recommended after childbirth. According to a 2015 study published in the journal Physiotherapy, this exercise is actually safe and beneficial for moms with diastasis recti.
After comparing drawing-in ("vacuum") exercises and crunches, researchers concluded that the latter was the most effective. Women who included crunches in their routine experienced major improvements in abdominal separation; this was the only exercise to reduce diastasis recti above the umbilicus.
The downside is that crunches, situps and other core movements put stress on the pelvic floor and cause your belly to bulge. For this reason, they're not recommended in the first few months after giving birth. Before doing these exercises, it's important to work the deeper abdominal muscle and build core strength. You may perform crunches when your abdominal muscles are fully restored.
Do Squats Against the Wall
Certified strength and conditioning specialist Ivana Chapman recommends that moms include wall squats in their routine. This exercise targets the quad muscles and helps build core strength. It also improves your balance and range of motion, preparing your body for more challenging workouts.
To get started, stand against a wall with your feet shoulder-width apart. Keep your arms by your sides or extend them in front of you. Lean slowly against the wall while taking deep breaths; squeeze your abs and glutes. Lower your body until your thighs are at or below parallel to the floor.
Hold the contraction for a second or two and return slowly to the starting position by pushing through your heels. Complete three or four of 12 to 15 reps each.
Perform Glute Bridges
Nicole Crawford, a certified personal trainer and women's fitness specialist, suggests that new moms with diastasis recti should add glute bridges, bodyweight squats and side planks to their workouts. Exercises that engage the shoulder and gluteal muscles appear to be the most effective at activating the core and lower back muscles.
The glute bridge, for example, builds lower body strength, with an emphasis on the glutes. When done right, it lifts and shapes your buttocks, strengthens the core muscles and improves your stability.
Lie on your back with your knees bent and your arms by your sides. Keep your feet shoulder-width apart. Squeeze your core and gluteal muscles while lifting your hips off the floor with a slow, controlled motion. Maintain this position for a few seconds, lower your hips back down and repeat.
Try the Superman
Musculoskeletal physical therapist Marika Hart recommends the superman exercise for abdominal separation. This movement forces your core muscles to work against gravity, leading to stronger abs. It also targets your glutes and lower back muscles, increases your endurance and may relieve back pain.
To perform this exercise, lie face down on a mat. Keep your arms fully extended in front of you. Raise your arms and legs simultaneously as if you were flying. Squeeze your lower back and glutes.
Remain in this position for about two seconds and repeat. Use a slow, controlled motion in order to fully activate your muscles.
Other diastasis recti exercises include squats with light weights, heel slides, pelvic tilts and standing rotational exercises. Certain yoga poses, such as the bird dog and the bridge pose, can help too. Planks are an excellent choice once your abdominal muscles are fully recovered.
- Mayo Clinic: Why Do Abdominal Muscles Sometimes Separate During Pregnancy?
- NHS Barts Health: Diastasis Rectus Abdominis
- Core Concepts: Diastasis Recti Abdominis
- Current Women's Health Reviews: Diastasis Recti Abdominis in Pregnancy and Postpartum Period
- Move Forward PT: Physical Therapist's Guide to Diastasis Rectus Abdominis
- Manual Therapy: Prevalence and Risk Factors of Diastasis Recti Abdominis From Late Pregnancy to 6 Months Postpartum, and Relationship With Lumbo-Pelvic Pain
- Fisioterapia em Movimento: Diastasis of the Rectus Abdominis Muscle Prevalence in Postpartum
- MUTU System: How Do I Know If I Have a Diastasis?
- Musculoskeletal Science & Practice: Measurement Methods to Assess Diastasis of the Rectus Abdominis Muscle (DRAM)
- MUTU System: Medical Testimonials
- Physiotherapy Journal: Abdominal Exercises Affect Inter-Rectus Distance in Postpartum Women
- Physiopedia: Diastasis Recti Abdominis
- MUTU System: Why Crunches Could Be Making Your Symptoms Worse... and Other Things Your Doctor Didn’t Tell You About Your Post Baby Body!
- Ivana Chapman: Get Stronger, Flatter Abs by Healing Your Diastasis Recti
- Breaking Muscle: 12 Weeks of Workouts to Rebuild After Diastasis Recti
- Lilynicholsrdn: Can Pilates During Pregnancy Prevent Diastasis Recti?
- Cleveland Clinic: Got Back Pain? Try Doing ‘Superman’ and 3 More Exercises
- Yoga International: Yoga and Diastasis Recti