Diastasis Recti is an often poorly diagnosed and mismanaged condition that affects over 50% of women post-natally. This condition is accompanied by a number of related pelvic complications, including pelvic pain and urinary incontinence that further prevents these women from being able to move and exercise safely and effectively. A misunderstanding of how the body’s anatomy and biomechanics operate with this condition prevents many fitness and medical professionals from providing effective modifications to promote safe movement. In this informative two-part series, you will learn valuable information and strategies to remedy the Diastasis safely and effectively, and finally regain an active lifestyle.
In Part 1, we will explore the anatomy and biomechanics associated with a Diastasis, and the movements that should be avoided to promote healing. To follow, Part 2 will delve deeper into strategies and modifications for safe exercise that will get you back in shape while correcting the Diastasis once and for all.
The Corset vs The 6-Pack
The roles of the Transverse Abdominis and Rectus Abdominis in Post-Natal Diastasis Recti:
A Diastasis Recti is a separation along the linea alba between the two halves of the Rectus Abdominis (RA) that occurs during the pre-natal phase of pregnancy, and remains after the baby is born. The RA flexes the body forward bringing the front ribs towards the pelvis. When the Rectus contracts/shortens, when rounding the spine forward (flexion) in bending, or doing abdominal crunches, the Diastasis opens and reinforces the separation.
The Obliques, which are the twisting and side bending muscles, also attach at the linea alba in the center of the abdomen. Any movement that side bends and twists the torso also reinforces the separation.
A Diastasis Recti sounds impossible to repair, but great news, it’s not! When treated properly through effective movements, and strengthening of the deep stabilizing muscles of the Core, a Diastasis can effectively be corrected, and normal movement patterns restored.
Enter the Transverse Abdominis!
This is the largest and deepest core muscle that wraps like a corset from the spine to the center of the abdomen, and from the ribs to the pelvis. Strengthening this muscle happens automatically when moving the arms and legs while intentionally keeping the torso stable (ie walking, balancing, sitting on a stability ball while moving arms and legs). This is not a mover muscle, it’s a stabilizer, and therefore involuntarily contracts when called upon to keep the torso still. When the Diastasis is not aggravated by counter-productive movements, the Transverse Abdomins gains strength, and will draw and hold the separation together so that it can heal along the linea alba.
Know Your Limit, Move Within It!
In addition to rounding the spine forward, extending it backward, side bending and twisting, there are other movements to be aware of and modify to prevent reinforcing the Diastasis. These include:
- Heavy lifting avoid any weight that is challenging to lift, and increases the appearance of the “belly bulge” during the lift. When lifting your baby (with or without carrier) or other items, try your best to bend your knees to lower down to your baby or item that you are preparing to lift. While keeping a straight spine, draw your baby or item as close to your body as possible before you lift.
- All-fours positions (including plank, push-ups, mountain climbers, cat/cow, child’s pose, etc) – this position puts undue pressure on the Diastasis as the weight of your organs fall downward against the Diastasis. Contrary to popular belief, Plank position will not effectively build your Transverse Abdominis strength if you have a Diastasis because the separation is being pulled apart in this position.
- Lying on your Tummy Exercises like the Cobra pose, Pilates Swan, and lifting both legs off the floor at the same time are to be avoided to limit stretching the abdominal connective structures. Positions that involve lying flat on your tummy with head down, and moving your legs and arms individually are okay if comfortable. These types of movements will help build Transverse Abdominis strength while in this neutral spine and pelvis position, and your body will assist in holding the Diastasis together as you move your limbs.
- Prolonged side-lying – this will separate the Diastasis on one side as the Rectus Abdominis falls towards the floor under the weight of the organs. If you would like to do side-lying work in an exercise class, place a towel or prop under your side between your lower ribs and pelvis, and use your opposite hand to hold the two halves of the Rectus Abdominis together in the center of your belly. This is called Manual Splinting.
- Jumping/Running/High-Impact Movements – these activities place excessive pressure on the Diastasis as the weight of the organs rise and fall as you bounce, causing the Diastasis to separate with the impact of each landing.
While your baby is a cute little bundle of joy, they grow quickly and come with a never-ending list of accessories that add to the load you have to carry every day. You can’t worry too much about this aspect of your life, you have enough on your plate. Whenever possible, just be aware of keeping a straight spine, lifting from bent knees, and drawing the baby or items close to your body to lift. Simply avoid aggravating movements in other activities that you can control, like exercise.
Join me for Part 2, where we will further address safe modifications for popular exercise choices. Explore how to make small changes for great success in any exercise class.
Move Smart, Move Safe, Feel Great!
A highly-trained movement practitioner specializing in pre- and post-natal care can provide valuable tips and tricks to help you move safely, correct the Diastasis, and get back in shape.
Holly Wallis, Certified Movement & Rehabilitation Specialist, PMA®-CPT
Director of US Operations, Body Harmonics Pilates & Movement Institute
Studio Director, ReActive Movement, 6200 LaSalle Ave, Oakland, CA 94611
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