What is Diastasis Recti?
Diastasis Recti is the thinning of the linea alba, which is the connective tissue that runs down the middle of your rectus abdominis muscle (more commonly known as the “6-pack abs.”) This often occurs as a result of pregnancy, but can also occur in women and men due to inefficient breathing, posture, and muscle firing.
Diastasis Recti is the thinning of the linea alba, which is the connective tissue that runs down the middle of your rectus abdominis muscle (more commonly known as the “6-pack abs.”) This often occurs as a result of pregnancy, but can also occur in women and men due to inefficient breathing, posture, and muscle firing.
This tissue is similar to plastic food wrap. Thinning of the linea alba can occur above the belly button, below the belly, button, around the belly button, or along the entire length from the ribs to the pubic bone.
Diastasis recti is a normal result of pregnancy. A 2015 study showed that 100% of women have a diastasis at their due date, and 39% of them still have one 6 months postpartum. Many women continue to have a diastasis several years later because they were never taught the proper strategies to help heal it!
Before we dive any further, let's perform a screening to see if you have a diastasis. Check out this video by one of my mentors, Dr. Sarah Duvall, on how to check on your own abdomen. If you think you have a diastasis, don't worry! This is something that can be greatly improved by working on posture, breathing, and core strength.
A diastasis often causes what we call "doming" or "coning" in your abs. The right side of this image is an example of what that looks like.
The bulging appearance is a result of pressure in your system coming from the inside out. Picture a balloon. As air fills the balloon, the rubber expands 360 degrees to allow even pressure in all directions. As the balloon deflates, there is a natural recoil inward. Because of this even distribution of internal pressure, the balloon can inflate and deflate without issue
Alternatively, if we were to take the balloon and restrict the back half from expanding, all the pressure will go into the front. The pressure will always travel to the path of least resistance. Over time, that rubber in the front is going to become much thinner, weaker, and likely unable to handle the same amount of air.
In this situation, the pressure would be going into the thinned out tissue of the linea alba. If we are constantly allowing that pressure to travel into the front and cause doming, the diastasis will have a very difficult time healing.
This can often become more pronounced with exercises that cause increased pressure in your system, such as crunches or front planks.
So, what can we do? First, I recommend seeking out a local pelvic health physical therapist to get an official assessment. Pelvic PT can help SO much!
Next, we are going to focus on managing pressure in your abs. If we continue to have too much pressure on the linea alba, symptoms will likely continue and prevent the tissue from healing. We will focus on breathing, deep core exercises, posture, and mid-back mobility. Here is one of my favorite breathing exercises you can try!
Additionally, I recommend avoiding exercises that cause doming or coning. Common exercises that cause doming with diastasis recti are crunches, sit-ups, front planks, and push-ups. If these exercises do not cause you to have doming, great! If they do cause doming, you will want to hold off on them until you can better manage your pressure.
If you are ready to get started on the journey to a stronger core, check out my online 4-week program Core Essentials. In just 15 minutes x 3 days a week you will see improvements! Email me at rachel@mamabefit.com if you have any questions.
For further information on diastasis recti, please check out this awesome article by Dr. Anna Hammond, DPT, OCS, CSCS.
Sources:
Fernandes da Mota, Patrícia Gonçalves et al. “Prevalence and risk factors of diastasis recti abdominis from late pregnancy to 6 months postpartum, and relationship with lumbo-pelvic pain.” Manual therapy vol. 20,1 (2015): 200-5. doi:10.1016/j.math.2014.09.002
Hammond, Dr. Anna. “How to Check for Diastasis Recti.” Core Exercise Solutions, 22 Aug. 2022, https://www.coreexercisesolutions.com/how-to-check-for-diastasis-recti/.
So, You’re One Year Postpartum… Now What? 5 Steps to Getting Back to Exercise
I am speaking directly to all those moms who are frustrated with having a year or more pass by without “feeling back to normal” yet. You nourished, grew, and carried a baby for approximately 9 months. Then, you gave birth, which is an extremely physical feat for your body to accomplish. After that, your body needed time to recover both physically and emotionally, which takes several months. This is close to a one-year journey.
The expectation placed on yourself to “bounce back” in a much shorter timeframe is unfair and unrealistic. So, if you find yourself one (or more) years postpartum and just starting to feel ready to get back into a more serious exercise routine, then you are right on track. So, what action steps can you take today to get started?
Returning to regular exercise after having a baby is not easy. In addition to your body recovering from pregnancy and childbirth, you are simultaneously adjusting to motherhood and a new “routine of not having a routine.”
Now, I am speaking directly to all those moms who are frustrated with having a year or more pass by without “feeling back to normal” yet. You nourished, grew, and carried a baby for approximately 9 months. Then, you gave birth, which is an extremely physical feat for your body to accomplish. After that, your body needed time to recover both physically and emotionally, which takes several months. This is close to a one-year journey.
The expectation placed on yourself to “bounce back” in a much shorter timeframe is unfair and unrealistic. So, if you find yourself one (or more) years postpartum and just starting to feel ready to get back into a more serious exercise routine, then you are right on track. So, what action steps can you take today to get started?
1. Assess yourself for symptoms of pelvic health dysfunction. Two common areas where women find more difficulty recovering are the pelvic floor and the abdominal muscles. If not addressed, you are likely to have symptoms that persist even years after childbirth. Here are some indicators that you might need pelvic health physical therapy prior to starting your exercise program:
Heaviness or pain in the vaginal area
Pain during intercourse
Constipation
Leaking of urine or stool
Constant urge to urinate
Unexplained low back pain
Dome, bulge, or “pooch” in the abdomen above or below the belly button
The feeling of extreme weakness in the core
Difficulty lifting objects without strain
2. Make sure you have exercise clothes that fit and you feel confident in. If you find yourself avoiding purchasing clothes that fit properly because you don’t want to go up in size compared to pre-pregnancy, I urge you to shift your mindset. Wearing clothes that you feel good in will likely improve your self-confidence and encourage you to follow through with your exercise. So please… treat yourself to some comfortable workout gear; it doesn’t have to be fancy or expensive!
3. Sit down and make a list of the types of exercise that you think you would enjoy doing during this stage of your life. The key to this step is focusing on what appeals to you right now, not what you used to do for exercise pre-pregnancy. Be honest and don’t put down what you think you should be doing for exercise, but what you want to be doing. For example, if you force yourself to return to an old routine that you actually hate, there is a high likelihood that you will not be consistent. Alternatively, if you find yourself getting excited about regular stroller walks and at-home strength training… then that’s the way to go!
4. Start small. Choose three days each week to get some movement in. Even if you want to eventually exercise 5+ days weekly for 60 minutes, that is not the place to begin. Once you can regularly accomplish three days weekly for two months, try adding to a day. Be open to flexing your exercise routine with your busy work and home schedules.
5. Seek out guidance and instruction if you do not know where to begin. This is extremely important to not only help prevent injury but additionally save you time and help expedite progress. Instruction should come from someone knowledgeable about postpartum exercise and have adequate education. There are a variety of ways to seek this out, such as online exercise programs, group classes, or personal training. If you are looking into working with a fitness professional, be sure to research their background and see if they have a degree in exercise science, kinesiology, or a related field. Please note that just because someone has had personal success with their own exercise regimen does not qualify them to coach others!
There is no “right time” to start focusing on your health. So why wait? Check out my free beginner strength program here! Also, if you are more recently postpartum and have received clearance from your medical providers, try out my free Postpartum Back to Exercise 5-Day Challenge!
5 Tips for Starting a Postpartum Exercise Routine
Starting a postpartum exercise routine can often feel confusing, overwhelming, and at times near impossible. My question to you is: why does beginning a postpartum fitness journey have to feel this way? Let’s talk about five ways you can make your experience more enjoyable, sustainable, and successful.
Starting a postpartum exercise routine can often feel confusing, overwhelming, and at times near impossible.
My question to you is: why does beginning a postpartum fitness journey have to feel this way? Let’s talk about five ways you can make your experience more enjoyable, sustainable, and successful.
1. Stop consuming social media content that promotes “getting your body back.” Did you know it takes most women over a year to get close to what they weighed before pregnancy? And in some cases, it takes much longer. Too often do I see social media accounts where new moms are posting before and after photos of themselves. While the transformation can sometimes be inspiring, it is more often a catalyst for setting unrealistic expectations for others.
If weight loss is a goal during your postpartum journey, I highly recommend linking that goal with something else that is of value to you. For example, you can pursue weight loss in addition to gaining strength or improving your stamina. While your body may be different than it was pre-pregnancy, it is by no means worse. Try shifting your mindset to focus on exercise as a means of making yourself stronger instead of making yourself smaller.
2. Don’t over-commit. The postpartum period is one of the busiest seasons that you might encounter in your life. In addition to caring for a newborn, you’ll likely find yourself trying to recover while simultaneously returning to all the tasks you were doing before you gave birth. It is easy for a fitness professional to give you an exercise program that will consume 30-60 minutes of your day 4-5 times weekly. But my question to you is… does that sound like something you can achieve right now? Does the thought of scheduling that into your life seem realistic, or overwhelming?
I often encourage new moms to start off by performing 1-2 days weekly of twenty-minute strength workouts, with frequent walking (as their schedule allows). Commit to what you know you can confidently achieve. This will set you up for success. Once you’ve established a schedule you can regularly stick to, then it’s time to build. Overcommitting to a rigorous exercise regimen often causes feelings of overwhelm, stress, and disappointment. Start slow and allow yourself to grow.
3. Do your research. What exactly should you be doing for exercise during the postpartum period? Most likely, you should NOT jump right back into what you were doing before pregnancy. And just because you might have considered yourself “fit” before, doesn’t mean you are an exception. You might, however, be able to progress quicker. Postpartum fitness should be focused on allowing your body to heal while also performing movements to strengthen it. Once cleared by your provider to return to exercise, your routine should focus on:
Breathing exercises
Walking or other low-impact aerobic exercise
Low-impact strength training
Restorative stretching
Guidance for postpartum exercise should be coming from a medical provider (such as a pelvic floor physical therapist) or a qualified perinatal fitness professional…. NOT your favorite Instagram fitness account.
4. Pick exercises you enjoy. Back when I was in high school, I did a video workout program with my friend that consisted of intense bodyweight exercises. The program was EXTREMELY difficult. I hated every minute of it, but I felt “soooo good” when it was done. Right? WRONG! I felt “so good” because I was totally exhausted and simply happy it was over! I look back on all the fitness classes or workouts I’ve tried over the years and there are many that I did not enjoy doing. So, why did I suffer through them? There was no need!
Exercise is exercise, so pick something you like. If you hate walking, try riding a bike…. or swimming… or dancing…. Keep trying things out until you find something that you get excited to do! A fitness routine is not a one size fits all approach. Your journey needs to be just that, your journey.
5. Don’t give up. Release yourself from the stress of being perfect. Allow yourself to be present and resist the urge to compare the current you to past or future versions of yourself. Did you have a busy week and miss your exercise sessions? Oh well! Move forward and continue on doing the things that will push you closer to your goals. It is not an “all or nothing approach.” Give yourself grace and focus on why exercise is beneficial to you. C’mon sister, you just grew and gave birth to a baby… you can do anything! So don’t let one day, one week, or one month throw you “off track.” Take things one step at a time and remember… don’t give up.