Diastasis Recti - Do's and Don'ts
Diastasis recti occurs when the connective tissue in the abdominal wall thins and contributes to your rectus muscles (think 6-pack) moving away from the midline
Ask The Expert
Kim Vopni, The Vagina Coach, and owner of Bellies Inc., provides proactive and restorative products and programs to women in pregnancy and beyond.
While diastasis recti is defined by the gap between the rectus muscles, it is actually more accurately reflected as the inability to create tension in the linea alba - the connective tissue that holds the 2 straps of the rectus abdominis in place at the midline.
The distance between the 2 rectus muscles is called the inter-recti distance and is what is most commonly measured in a diastasis recti assessment. There has never been a consensus on what is considered a normal inter-recti distance but it is perhaps commonly agreed that somewhere around a 1-2 finger gap would be 'normal'.
After pregnancy and birth it is very common to have a gap that is 3 or 5 or even 7 fingers wide but more and more research is pointing to the fact that the inter-recti distance is not the biggest determinant of function but rather the ability of the connective tissue to generate and maintain tension needed for control and support.
One piece of research shows that almost 100% of women will have some degree of diastasis recti in pregnancy, with 60% still left with some degree of separation of the rectus muscles at six months postpartum. This research only looked at inter-recti distance and not at the tension in the connective tissue.
Diastasis recti is considered a normal response to pregnancy and it is important to be aware of it so you can take a proactive approach to managing the development of the condition while pregnant and then know how to optimize recovery so you can return to full form and function.
Deadlift with Bolster Over Chair
To determine if you have diastasis recti, you can perform a self test - see what these steps look like in practice in this video from Bellies Inc.’s Kim Vopni (this is a postpartum assessment)
Kim Vopni - YouTube
Here is a photo of what diastasis looks like in pregnancy. To test you simply sit on the floor and start to lean back. Do you see a dome along the midline like the one in the photo?
Diastasis Recti in Pregnancy
Here is a general list of do’s and don’ts.
- Pay attention to how you hold your body in pregnancy- your posture. Here is a great video explaining it.
- See a pelvic floor physiotherapist to have your abdominal wall assessed as well as your pelvic floor. The key to healing the abdominal wall is a pelvic floor that is working synergistically as part of the inner core unit.
- Move in varied ways. Restricting movement for fear of making it worse is not ideal. Move with awareness and find ways to move that does not contribute to doming or an inability to manage the pressure.
- Wrap the pelvis/belly postpartum. By providing temporary external support to the pelvis and abdomen in the early weeks postpartum it helps support the muscles that are hindered in their ability to contribute to control. Internal support is re-trained with the use of restorative exercises.
- Re-train the core. Healing the abdominal wall requires core synergy between the diaphragm, the pelvic floor, the transversus abdominis and the multifidus - the core 4. Re-training the synergy with posture and restorative exercise is key. The Core Confidence Program is an 8 week core retraining protocol that is very effective.
- Don't Stop Exercising. Many women with diastasis often stop doing core work or stop exercising for fear of making it worse. Doing nothing does not support healing. Movement does. It is about finding what movements you can do that do not contribute to doming in the abdomen. It is not about the exercise but about the execution of the exercise.
- Don't Panic. The internet has done great things for increasing awareness about diastasis recti but it has also contributed to a lot of fear. Many people (myself included) have gaps that are larger than 1-2 fingers and are completely functional and not limited in movement.
- Don't Practice Static Front Loaded Positions in Pregnancy. When the abdominal wall is under stretch and strain as the pregnancy progresses, I advise women to avoid static front loaded positions like plank and bird dog. They place further load on the connective tissue and are not functional - meaning, you don't need to be able to plank and do bird dog in labour so why train in that position in pregnancy? Dynamically loading the abdominal wall such as doing a deadlift is much more effective and trains you for putting your baby into a crib and picking up a car set.
The founders of Bellies Inc recognized a void in information, exercise and postpartum support for new moms. They also recognized that a proactive approach to core function and postpartum recovery was essential so they developed a product that helps women prepare for birth, recover with support and restore their core function after pregnancy.
The Ab System provides you with the core confidence exercises to be done while pregnant as a safe and effective core exercise routine. You then have the Ab Tank and Wrap to wear in the early weeks postpartum to help support the core while it heals. Core restoration is facilitated by re-starting the core confidence exercise program to retrain the core and rebuild the internal support.
You deserve to be supported through your pregnancy, birth and postpartum recovery.