Pilates and Diastasis Recti
After having a baby do you feel like there’s a pooch in your lower belly that just won’t go away?
Is it normal to look and feel 5 months pregnant after eating a big meal?
If so, you may want to do a quick check for Diastasi Recti.
Diastasis Recti occurs in the abdomen and relates to the abdominal muscles. During pregnancy, the rectus abdominis muscles can end up separating due to internal pressure and the growth of the fetus. The rectus abdominis muscles run parallel to each other and lengthwise along your abdomen. When affected by Diastasis recti, they are forced to separate away from the midline to allow space for the growing baby. The diagram below shows a normal Rectus Abdominis, compared to a separated Rectus Abdominis (Diastasis Recti):
The Linea Alba (connective tissue) also separates and thins which reduces the support of your organs and overall trunk stability.
(image courtesy of the Tupler Technique)
The majority of cases can be corrected or greatly improved through a specific and conscientious exercise routine. Pilates is an ideal program for women experiencing Diastasis Recti due to the precise training and focus on transverses abdominis strength.’
{quick cheat sheet}
Rectus Abdominis (RA): the “6 pack muscles” that run along the top of your belly.
Transverse Abdominus (TA): deep core stabilizing muscles that act as a corset around your waist and spine.
Diastasis Recti (DR): the vertical separation of the rectus abdominus/connective tissue.
“During the course of pregnancy, the abdominal muscles will stretch by over 50 percent of their original length” (pilates-pro.com)
Thanks to the extra hormones on our body during pregnancy our body is able to expand and stretch in an incredible way. But the issue arises when our muscles don’t return to their normal state.
Common exercises that work the rectus abdominis (aka: your “6 pack muscles”) such as crunches, actually hinder recovery and make the condition worse. So it’s very important to first, determine whether your not you have Diastasis Recti, and second, follow a safe, conscientious exercise plan as you attempt to correct the issue.
At-Home Test For Diastasis Recti:
1. Lie on your back with your knees bent.
2. Place two fingers just below your navel. Apply gentle pressure while slowly engaging your abdominals and raise the head, neck and shoulders to a chest lift position. Move your fingers to check at your belly button, and 3 inches above your belly button as well.
3. If you are able to feel a space that is MORE than two fingers’ width apart, you may have DR.
You’ll also want to notice the depth. You may be able to see a visible ridge running down the center of your abdomen, some ridges are deeper than others.
If you notice a gap wider than 2 fingers it would be a good idea to schedule an appointment with your doctor, a physical therapist and/or a trusted Pilates instructor to get a clear picture of how severe the separation is and what steps you can take to correct it.
Interesting facts About Diastasis Recti
It is very, very common and many women have it without realizing it.
It is possible to heal and recover but it may take time (1 year or more).
Healing DR is a matter of healing the connective tissue which will help to bring your abdominals back together again. It is not just about gaining more strength.
Surgery is an option but is generally recommended as a last resort for very severe cases.
Focusing on the transverse abdominis (as done in Pilates) is a major component of healing and re-gaining strength.
Even if you had a baby 8 years ago it is still possible to improve your condition.
Practicing smart, core-stabilizing exercises that engage the transverse abdominus and pelvic floor, along with strategic stretching can help prevent DR in future pregnancies.
Exercises To Heal Diastasis Recti:
Pilates and Diastasis Recti can go very well together. However, it is important to work with a qualified instructor and to gain a clear understanding of which exercises help and which exercises hinder the healing process.
The pelvic floor and TA should be a strong area of focus. Along with the upper back, gluteals, and surrounding muscles to restore postural balance.
One should return cautiously to exercise and work with a trained professional. I recommend a physical therapist/Pilates instructor with DR experience. I have also heard great things about the Mutu System.
Exercise Precautions For Diastasis Recti:
Due to the abdominal focus in Pilates, there are a few important concerns and precautions to consider.
Any action or exercise that causes the stomach to bulge or protrude forward should not be practiced. It does not help heal diastasis recti, in fact, it often makes it worse. This should be your number one consideration when re-training your abdominal region. You should never feel pain or or additional separation while performing exercises.
Movements to avoid:
forward flexion of the upper torso (i.e.: sit-ups/crunches)
upper body rotation with reaching
extreme back extension/arching
upper body flexion with rotation (i.e.: bicycle crunches)
sports with rigorous sudden rotation of the trunk such as tennis, baseball, lacrosse, etc.
While exercising, it can be helpful to place your hand over your abdominals to ensure that you are not bulging forward or putting excess pressure on the linea alba (middle line).
After pregnancy it can be challenging to FEEL the abdominals in the same way you did prior to pregnancy so it’s important to spend time on the basics as you re-gain the mind to muscle connection.
Movements should be focused on the proper engagement of the transverse abdominus (deep core muscle) and pelvic floor. Due to the hormone, relaxin, which is present in postpartum and breastfeeding women, it’s important to keep movements smaller than your maximum range of motion. (Relaxin increases flexibility and loosens joints.)
If something causes pain, discomfort, dizziness, nausea or breathlessness, it is imperative that you discontinue the exercise.
Women with DR are ideal candidates for a Pilates program, yet require a very focused conditioning program and very cautious progression. Pilates can be a great path to take because of the focus on the mind-body connection which is important in re-gaining strength, but also important to help women connect with their bodies again and in a whole new way.
The recipe for healing includes:
Deep, focused core work to with a trained professional to strengthen the transverse abdominus and pelvic floor.
Time (some women take 6 weeks, others take over a year to heal).
Splint/Belly Band. I have not used this myself but many people suggest that wearing a splint can help bring the connective tissue back together by increasing blood flow and restoring proper position. The Tupler Technique provides more information on this point.
I’ve filmed a short video with very basic exercises that are safe for Diastasis Recti, along with a tutorial on how to perform the self-test. Again, I would recommend that you consult with your doctor and meet with a trained professional in-person to find the best protocol for you and your individual needs.
How to prevent Diastasis Recti:
While it may not be possible to prevent DR 100%, it is possible to increase your odds of avoiding it or healing more quickly should it appear. Maintaining a safe, core-focused exercise routine during pregnancy can help to maintain healthy muscles and healthy connective tissue. I practiced Pilates throughout my entire pregnancy and after delivering I noticed a slight separation for the first few months. By slowly returning to my routine and practicing safe exercises, I was able to close the gap and continue on with my regular routine.
Of course, every body and every situation is unique, but ultimately, keeping yourself in good shape during pregnancy will put you in a better place to heal and recover postpartum.
You may benefit from my online prenatal Pilates program, Balanced Beginnings that is safe and effective for all 3 trimesters.
I hope this post is informative as you navigate the prenatal and postpartum world. If you found it helpful I’d love for you to share it with a friend in need or post it to Pinterest so that this information spreads. It’s important for women to know. 🙂
If you have any questions or have had success of your own in healing DR please feel free to post a comment!
xo,
Please keep in mind that I am not a doctor. This post is for informational purposes and I encourage you to do your own research and take your doctor’s advice before my own.
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