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.

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/.

The One Thing You Can Do For Your Core RIGHT NOW!

Did you know that diaphragmatic breathing can be one of the most powerful exercises to improve your core?

This type of breath work is a fundamental exercise in almost all the programs that I give to my clients . Before diving in to the actual exercise, let’s begin with talking about what the “core” is.

What actually is your “core?”

Although many people use the term “core” synonymously with “abs,” your “core” is actually the entire trunk of your body. Specifically, the muscles that we are talking about are the:

Transverse Abdominals

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Diaphragm

Pelvic Floor Muscles

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• Multifidus: These are the muscles on your back, superficial to your spine. (Not pictured above)

• Transverse abdominals: These are your deep ab muscles that act as a corset around your torso. (Pictured on the left)

• Diaphragm: This is your breathing muscle, below your lungs. (Pictured in the middle)

• Pelvic Floor: This is the hammock of muscles supporting your pelvic organs. (Pictured on the right)

So… why is breathing important to their function?

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. That rubber is going to become much thinner, weaker, and likely unable to handle the same amount of air.

Now, apply this to your body!

Think of your core like a canister (although it’s not as stretchy as a balloon!) If you have rigid walls to your canister, the internal pressure is going to build up and have adverse effects on the supporting structure. The inability to manage internal pressure can contribute to pelvic floor dysfunction, diastasis recti, back pain, and other repercussions down the kinetic chain.

Because of the physical changes your body goes through during pregnancy, it can initially be difficult to coordinate the expansion and recoil of your core with your breath. The overall goal is for this expansion and recoil to eventually happen naturally, without much thought.

To help re-train a proper deep breathing pattern, let’s try the 360 connection breath.

1. Start by sitting or lying down on the floor.

2. Slowly inhale through your nose. As you do this, imagine your pelvic floor relaxing and lengthening down.

3. Focus on allowing your ribcage to expand during the inhale. You’ll want to feel this expansion travel around your sides and into your back, and slightly in your belly.

4. Now exhale slowly through your mouth. Notice a natural recoil as the pelvic floor gently lifts and returns to its starting position. You’ll feel your abdominals gently come back in, as well as your ribs.

5. Repeat 5-8 breaths slowly. You can try this daily during pregnancy and your postpartum recovery to help reconnect to your core and breath

A couple of tips:

• Try not to breathe with a lot of upper body movement. If you notice your shoulders rising and falling with your breath, reset yourself and try to relax your upper back and neck. This would indicate a shallow breathing pattern rather than a deep breathing pattern.

• If you are having a hard time breathing into your back, try laying on your side with your knees bent. Put a pillow under your head and under your side ribs. Bring your knees up slightly higher than 90 degrees so your back is in a soft curve. Now try breathing into your back. Do you feel more movement?

• Picture your pelvic floor like an elevator. As you inhale, your pelvic floor travels down from the first floor to the basement ( lengthening and relaxing). As you exhale, your pelvic floor gently lifts back to the first floor. Avoid bearing down.
  

Interested in learning more about building core strength? Schedule a free 20-minute consultation so we can chat!

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So, You’re One Year Postpartum… Now What? 5 Steps to Getting Back to Exercise

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!