What is Diastasis Recti?

Today, my youngest turned 11 months, and I am 11 months postpartum. I lost over 40 pounds after giving birth but still have the "Mommy Bulge." Many women suffer from diastasis recti or abdominal separation. Yet, they are unaware that they have it or heal correctly after their little one's birth.

Diastasis Recti is a condition in which the large abdominal muscles separates. It is common in women with high numbers of pregnancy or delivered a high birth weight baby. Many women can see the separation in their midsection; however, seeking a proper diagnosis from your primary care provider is the best way to start treatment.

The treatment to correct diastasic recti focuses on rehab exercises to repair the separation. Before doing these exercises, please advise your primary care physician.

1. Supine Dead Bug

This exercise requires no equipment and for beginners.

Step 1

Starting Position: Lie supine (on your back) on an exercise mat or firm surface, bending your knees until your feet are positioned flat on the floor 12 - 18" from your buttocks. Allow your arms to lie along your side and bend the elbows so your hands are pointing towards the ceiling. Breathe deeply for a 30 seconds relaxing your body and allowing gravity to gently pull your lower back and shoulders towards the floor.  Depress and retract your scapulae (pull your shoulders down and back) without increasing the arch in your low back or lifting your hips off the mat / floot.  Hold this position throughout the exercise. 

Step 2

To start the exercise, initiate a Hollowing Movement: Breathe normally and at the end of your breaths (end-tidal volume), perform the following actions individually at first, then combine them together:

1. Perform a gentle "kegel" contraction without moving your hips or ribcage (the kegel contraction of the pelvic floor is the same contraction your would perform when resisting the urge to urinate).

2. Draw your belly button towards your spine without moving your hips or rib cage (visualize narrowing your waist circumference without taking a deep breath). Any movement of the hips or rib cage indicates activation of your larger abdominal muscles (e.g. rectus abdominis).

3. Combining both 1 and 2 above.

4. Combining 1 and 2, but counting out loud while breathing normally (i.e. holding the contractions through normal breathing)

Once you have used a hollowing movement to stabilize your spine and pelvis, lift both legs and arms off of the floor; the knees should be directly over the hip joints and bent ninety degrees (pictured) and the elbows should be directly over the shoulder joints so your hands are pointed over your head (pictured). 

Step 3

Inhale and maintain the abdominal hollowing while slowly lowering the right heel and left hand towards the floor.  The hand and heel should lightly touch the floor (but not rest), exhale continue the abdominal hollowing and slowly bring the leg and arm back to the initial starting position.  Alternate to use the right arm and left leg; continue to complete a specific number of repetitions or a certain period of time. 

Step 4 

Exercise Variation: To have more control (making it easier) when learning this exercise, start with the hands resting on the floor above the head and the feet resting gently on the floor in front of the buttocks; slowly lift the right arm and left leg off of the floor together while maintaining the abdominal hollowing, lower and alternate sides.  

Continue to breathe while holding the abdominal hollowing and bracing.

2. Glute Bridge Exercise

This exercise requires no equipment and for beginners.

Step 1

Starting Position: Lie supine (on your back) on an exercise mat or the floor in a bent-knee position with your feet flat on the floor. Place your feet hip-width apart with the toes facing away from you. Gently contract your abdominal muscles to flatten your low back into the floor. Attempt to maintain this gentle muscle contraction throughout the exercise

Step 2

Upward Phase: Gently exhale while holding your abdominal contraction and press your hips upwards off the floor into extension by contracting your glutes (butt muscles). At the same time press your heels into the floor for more stability. Avoid pushing your hips too high as this generally increases the amount of hyperextension (arching) in your low back. Maintaining your abdominal contraction helps avoid excessive arching in your low back.

Step 3

Lowering Phase: Inhale and slowly lower yourself back towards your starting position.

Step 4

Progression: Gradually progress this exercise by starting with both feet together and extending one leg while in the raised position.

Avoid arching your lower back as your press your hips upward which normally occurs if your attempt to push your hips as high as possible. This can be achieved by contracting your abdominal muscles prior to lifting, and keeping them engaged throughout the lift

Sources:

Diastasis Recti: What Is It and How It's Treated. Verywell Family. (2020). Retrieved 5 October 2020, from https://www.verywellfamily.com/diastasis-recti-symptoms-risk-factors-diagnosis-treatment-and-coping-4774439.

Exercise Library:Supine Dead Bug. Acefitness.org. (2020). Retrieved 5 October 2020, from https://www.acefitness.org/education-and-resources/lifestyle/exercise-library/147/supine-dead-bug/.

Therapy, B. (2020).Diastasis Recti (Part 1) - Body Harmony Physical Therapy. Body Harmony Physical Therapy. Retrieved 5 October 2020, from https://bodyharmonypt.com/diastasis-recti-part-1/.