What is Diastasis Recti and How to Heal It

Diastasis Recti (ab separation) is a major struggle I've seen in many of my clients after having babies.  Today I've asked my friend and expert, Lynda Lippin, to share her best tips and practices for healing Diastasis.  I hope that this helps you in  your post pregnancy journey!  

Here's what Lynda had to share:  

Diastasis Recti can be either helped or worsened with Exercise.
Here's how you can help yourself.

I. What is Diastasis Recti?

Diastasis recti is a separation between the left and right side of the rectus abdominis muscle, which covers the front surface of the belly area.

Most diastasis is seen in pregnant women, where the muscle separates as the woman's belly expands. At the moment I am working with many women who worsened their diastasis through improper exercise techniques during and after pregnancy. 

Your torso is a big cylinder, with your diaphragm on top and your pelvic floor muscles at the bottom. The sides of the cylinder are made up of abdominal muscle. 

We have four layers of abdominal muscle - the transverse abdominus is the deepest, and runs horizontally around the entire torso, from lower back to front. Over that are the internal and external obliques, which wrap diagonally and connect ribs to pelvis for rotation and side bending. And then, on top of everything, running vertically, is the rectus abdominus (the six pack). 

Basically, it is crucial that the transverse abdominis and pelvic floor muscles be strengthened to help hold everything together. when this happens, the rectus will typically also start to pull back together. 

Diastasis is typically measured in "fingers" - literally how many fingers will fit in between the two muscle halves. I have personally worked with women who have had between two finger and six finger diastasis with great success.

II. Exercises to avoid with Diastasis

In terms of exercise, the approach to both diastasis prevention and diastasis repair are similar.

During and after pregnancy, until everything is working properly, avoid exercises that cause an increase in abdominal pressure that will push against the abdominal wall:

traditional crunches or head-up exercises
overhead presses
heavy weight lifting

If the muscle has already separated, it can be helpful to wear an elastic abdominal brace to physically hold the muscles together (which is what we visualize while doing exercises). But don't let the brace substitute for strength!

I encourage people who have a diastasis to try Pilates to strengthen your internal abdominal brace. Please make sure that your teachers are familiar with what diastasis recti is and how to properly manage it. If they ask you to do the hundred with your head up first thing, you are in the wrong place.
If you hear more about breathing, pulling "in and up", and not bulging at your abs, you are in the right place.

III. Exercises to embrace with Diastasis

Remember that even if you do require surgery to repair the separation, proper abdominal and strength training will help you maintain your abdominal corset of support before and after.

Breathing and Pelvic Stability

A stable pelvis is crucial, since so many women try to "tuck under" in order to hold their bellies in, leading to back pain and more abdominal pressure. 

1. Conscious Breathing

If your back, neck, and shoulders are tight there is a good chance that you are not breathing fully and deeply into your ribcage. Part of the pain response is that we tend to stop breathing, which when you have back pain makes everything much worse.  Your shoulder blades and collarbones are sitting on your ribs, so getting the ribcage moving more will help free up the entire area.  Here is a simple breathing exercise that will start the process of getting your ribcage to move more and feeling how you abdominal muscles assist in breathing.

Lie on your back with your knees bent, your feet hip bone width apart, and your arms by your sides.  Pay attention to your breathing and to the muscles in your torso.  The abdominal muscles are not just in front, they actually wrap around your torso from your spine to the front, around your ribs, waist, & pelvis, forming the round sides of a cylinder.

Feel your ribs move to the front, side, and back as you breathe--the abdominals are helping to move your ribs!  Now pay attention to your pelvis.  Make sure that you are not pushing your lower back into the floor; your pubic bones should be in the same horizontal line as your hip bones--you may have an arch in your lower back and that's OK, you are supposed to!

Now as you inhale let your ribcage, abs, and pelvis relax.  As you exhale contract your pelvic floor as though you had to stop peeing, feel your abs wrap tighter around your ribs and waist like a corset, and feel your diaphragm under your ribcage pull up and under the ribs. Make sure again that you are not flattening your lower back into the mat. Do this conscious breathing a few times.  

Put your hands on your belly and notice that now it pulls in (it may feel soft, but you are going for width and depth, not for tightness!).  Repeat 10-15 times.

Try breathing while sitting, standing, and on all fours.

2. Pelvic Rocking

Add a small rocking movement of your pelvis--tipping it back as you exhale (hipbones back and tailbone up) and forward on the inhale (arching the lower back).  Repeat the tilt/arch 10-15 times.

Then try to move side to side without moving your knees or ribcage.  Pretend that someone dropped a hot ash on your right hip bone so that it drops towards the mat a little, and then the left.  Breathe as you need to and go between the right and left hip 10-15 times.

Finally, combine these movements into a small circle.  Pretend that your belly is a big bowl of thick batter and you are trying slowly to move the batter all around the bowl without spilling any.  Begin by tilting your pelvis back and then go around to your right hip, your tailbone (arching the low back off), the left hip, and back to the beginning.  Repeat 3-6 times and then reverse the direction.  Breathe constantly and slowly.

3. Arm Circles

Still on your back with the pelvis neutral, bring your arms/hands back to your sides.  Slowly lift arms up to ceiling as you inhale.  When arms are at shoulder level exhale as you reach them towards the ceiling (keep head down) allowing your shoulder blades to lift and spread as wide as they can; then inhale as you drop the shoulder blades down and squeeze them together in your back while your arms stay in position towards the ceiling.  Repeat 5-10 times.

Keep your arms up but allow your shoulder blades to relax.   Keeping your ribcage down and plenty of space between your hands, exhale as you stretch your arms back overhead, and inhale as you circle them around to the sides and back to your hips.  It is important that your ribs stay down; it is not important that your hands touch the floor.  Do 4-6 in each direction.  This can also be done standing against a wall.

This should not hurt your shoulders.  Stay in a pain free range of motion.

You can check out the video below for Pelvic Stability Exercises.

I hope that this has been helpful and informational for you! If you are struggling with Diastasis after having your baby I encourage you to check out Lynda Lippin and her Core Restore 6 week program.  She has helped many women heal their Diastasis through this program.  You can receive a $40 discount by letting her know Jackie referred you!  Click HERE to learn more about the Core Restore program!

You can check out my live interview with Lynda below as well.

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