Can you fix Diastasis Recti?
Yes, there is hope for those diagnosed. But the fix happens over time.
Instead of ‘fix’, let’s focus on restoring. Fix implies quick; restore implies over time. And it takes time to restore and correct a Diastasis Recti.
If you haven’t read part 1 and part 2 of this 3 part series on Diastasis Recti (DR) I encourage you to do so.
In Part 1-Diastasis Recti -Should Pregnant Women Do Sit-Ups? I go over the anatomy of the abs, give a detailed explanation as to what DR actually is, how to check for it, and whether or not pregnant women should be doing sit-ups. (The answer is-it depends)
In Part 2 of 3 of this series on Diastasis Recti (DR,) I went over common assumptions and half-truths about DR, answer the question Does Exercise Prevent DR (the answer is yes!), and share resources with you so that you can make your own educated assumption.
Now in part 3 I will go over
- When is the best time to correct DR?
- How to restore abs with 2 Pilates-based concepts
- Exercises to avoid, and Exercises that are safe with DR
In part one I share Katy Bowman’s (biomechanist and author of the book Diastasis Recti) explanation of DR:
- Diastasis Recti is a symptom of a whole body problem, which is why isolated ab exercises and abdominal wraps won’t correct Diastasis Recti.
- Also that you must recognize the visible (anatomy) and invisible (movements throughout our everyday life, and internal forces like pregnancy) forces that have contributed to DR to properly restore the core (including diaphragm and pelvic floor) and correct the DR.
When is the Best time to correct Diastasis Recti?
The best time to correct a Diastasis Recti is when there is something stressing the linea alba, like pregnancy, according to Bowman.
How do pregnant women begin this process?
We have to start by understanding the state our client’s body is in. For a tutorial on the basic anatomy of pregnancy, please see the following posts:
First we want to make sure that mom-to-be has her ribs lined up properly with the pelvis-that she is not thrusting, or pushing the bottom ribs out, which is more common during pregnancy.
To fix thrusting ribs,
- close the ribs down, as we cue in Pilates
- make sure the ribs are in line with the pelvis – on the same plane as the pelvis
- you may think this lessens the amount of room for the expanding uterus, but it actually creates more efficient room because we are opening up the back of the ribs.
How to Restore the Abs to Correct DR in Pregnant Women with Pilates-Based Concepts
To correct Diastasis Recti, we have to correct daily movement deficiencies. The following exercises are basic concepts that will give you the foundation you need when working with women diagnosed with DR.
1. Hug the Baby – The pregnant woman’s version of belly to spine.
What it does:
- Corrects faulty postural alignment to optimal postural alignment.
- Teaches how to optimally activate core muscles and use them efficiently.
- Teaches how to relax core muscles efficiently.
- All of the above keep the linea alba from over-stretching, keeping DR in check from getting worse, and on the road to correction.
How to Hug the Baby (pic below steps)
1. Stand up tall, lengthening the spine to the ceiling, like you have a string on the top of your head.
2. Line up the bottom of the ribs with the pelvis (no rib thrusting)
3. Inhale deeply, allowing the air to fill down the sides and back of the ribs, (Lateral Thoracic Breathing).
4. Exhale, hugging the baby (pulling baby or belly to the spine), while lifting the pelvic floor. Keep the pelvis neutral (don’t tuck). This action contracts the transverse abdominals and pelvic floor creating a total support system for the fetus.
5. Feel equal weight on your feet, pressing down into the floor. You should feel a vertical, oppositional pull through the spine, up through the top of the head, and down through your feet. Don’t let the ribs collapse.
6. Continue with lateral thoracic breathing feeling the spine lengthen every time you exhale, for about 4 breaths.
7. Then reverse the process, relaxing the abs with every exhale. Don’t force the belly out, just let it release. This may take some practice for women who are use to holding their belly in.
Knowing how to relax the abdominals is just as important as learning how to contract the abdominals.
Poor posture is simply an invitation for life-stopping back pain. No matter where you are, think about lifting your head up and back, as if a string were pulling the top of your head toward the ceiling. As you lift up, you relieve some of the tension in your spine. (YOU Having a Baby, pg. 216)
If pregnant women know how to Hug the Baby – use those transverse abdominals, pelvic floor, and proper diaphragmatic breathing to support their growing uterus, it helps correct several pregnancy related issues such as diastasis recti.
2. Spinal Dance
What it does:
- Teaches how to properly move the pelvis rocking and tilting, without compromising posture or core, putting less strain on the linea alba (the tissue that connects the rectus abdominus, and that stretches to cause a DR)
How to do the Spinal Dance:
Follow the steps in the pics. Remember to keep Hugging the Baby.
Movements to be cautious of when correcting a Diastasis Recti
Remember that the linea alba connects from the sternum to the pubic bone (see pic.) Now, think about all of the movements that tug on the linea alba.
- In a car, reaching from the drivers seat to the back seat,
- twisting the torso during exercise, dancing, or while hoola hooping ,
- kicking the legs,
- doing back-bends
- doing front bends-abdominal exercises-crunches,
- pushing with heavy force, pulling with heavy force
- sitting too long or standing too long in one place
Think about movements that disrupt the alignment from the sternum (chest) to the pelvis.
Twisting is a big one.
Avoid twisting exercises and focus on exercises that keep the sternum and the pelvis in the same plane of motion.
For Postpartum Women
The postpartum body is in recovery. You want to condition the pelvic floor and transverse abdominals back to ‘normal’, or without carrying a child.
Always make sure your client has been cleared by her doctor to exercise again.
Hand to Knee-Postpartum
This exercise engages the pelvic floor, transverse abdominals and the obliques. You are going for 2 finger widths or less, but in the end, the most important factor is how optimal the trunk is moving
- Inhale in a neutral pelvis
- Exhale pulling the belly to the spine and engaging the pelvic floor, lifting the head and shoulders, staying in neutral.
- Press the hand to the inside of the opposite knee
- Apply equal resistance to both
- Release and repeat 4-5 times *The release is just as important as the resistance
The exercise above is not the exclusive DR fix. It is one exercise that helps in the rehabilitation process.
This ends Part 3 in this series of 3 posts on Diastasis Recti.
Thank you for hanging out with me! Give yourself a high 5 for taking the time to educate your mind! If you are currently working with pregnant women, I encourage you to share this information with them.
If you have questions or comments, please fill in the contact form below, or e-mail me directly at firstname.lastname@example.org
If you haven’t done so yet, please pick up my complimentary PDF Pre & Postnatal Pilates Instructor Crash Course
Be sure to pick up Katy Bowman’s book “Diastasis Recti”
And check out the resources below for further study!
Alison B. Marsh
Resources for learning more about DR
Katie Bowman, a movement expert and biomechanist, who writes in-depth about Diastasis Recti, has the most relevant information on DR, including a brand new book titled Diastasis Recti (a must have for your continuing education library).
Katie Bowman Blog Posts:
Mutu System: An in-depth description of diastasis recti. I encourage you to brows this site under the resources tab. It is full of information on pre and postnatal health
Nutritious Movement: Katy Bowman of Nutritious Movement and the author of the new book Diastasis Recti