Working out with Diastasis Recti
Hi friends! Happy Thursday! What are you up to this morning?? I’m getting in a strength workout and am excited to start packing up for a little Sedona getaway.
For this morning’s post, debated about whether I should put it on the family page. Then, I thought about the fact that I wish I would have known more about diastasis recti before I got pregnant. Also, abnormal ab separation doesn’t just affect postpartum mamas; women who have never been pregnant, men, and babies/kids can all experience a diastasis recti in their lifestyle. It’s extremely common, and I thought I’d share some of the things I’ve learned in my postpartum experience, as well as awesome resources if you have DR.
What the heck is diastasis recti?
DR is defined by abnormal separation of the rectus abdominis (the outer layer of our abdomen, aka our six-pack muscles). There is a connective tissue that runs down the middle of your core, called the linea alba, which can become weak and/or stretched out from a variety of factors, like pregnancy, poor posture/alignment, weak core, etc. Looking back on it, I can exactly pinpoint the things that potentially made my DR worse: standing with my giant pregnant belly while holding Liv and pushing my hips to one side, bad posture, + sneezing with so much force and gusto at least 50x a day (my allergies were SO bad in SD) without supporting my belly or contracting any muscles. I seriously let everything forcefully push out which made my linea alba crooked (!) and stretched out beyond its poor means.
DR is often referred to as a “mummy tummy” because it can cause protrusion from the abs. It can make you look pregnant when you’re not, and because the core muscles are weak, it can throw a lot of other things out of whack. Other symptoms of DR include back pain and pelvic floor-related issues, like incontinence. (Peeing when you sneeze is not normal and can absolutely be fixed. With treatment, you can fix it and it doesn’t have to be your new normal after you have a baby.) Also, it’s worth noting that people with large bellies don’t necessarily have DR, and people with washboard abs could absolutely have ab separation. It’s all about function, not appearance.
If you think you may have DR, ask your doctor or a physical therapist to check you. There are also YouTube tutorials online, and Jess describes how to check for diastasis recti here. If you check yourself, be sure to be SUPER careful. If you have ab separation, if you push down on the center, you’re pressing on your organs. Not to freak you out of anything, but be super super gentle. Diastasis recti is usually rated on the degree of finger separation (usually a 2-finger gap or less is considered “normal”) but the degree of separation doesn’t indicate the depth of the gap (which makes a difference) and the strength of the supporting structures (makes a huge difference). So if you have it, take your degree of ab separation with a grain of salt, and focus on total body alignment and rehabilitating your core.
I had a 3-4 finger gap closer to P’s birth -I didn’t have it formally checked until after my surgery debacles- and it’s down to 2 fingers and close to 3 at my belly button. The depth has also reduced. I’m still working on healing my core -birthing an almost 11-lb baby has given me a lot of new things to learn about my body haha- and if I do too much, I can definitely feel it and see it the next day. After filming the HIIT workouts for Winter Shape Up, I looked super bloated for an entire week.
Here are some of the things that have helped me:
-Seeing a pelvic floor physical therapist.
I had to see her to help me with other issues after P’s birth (which thankfully have all been resolved), and she ended up helping me with EVERYTHING. Pelvic floor PT should absolutely be offered and included in postpartum care in the US. (If you are having a baby, request a referral! Even if it’s just for a check-up and to make sure everything is good, chances are that you won’t regret it.) She gave me so many corrective exercises, modifications for my routine, and taught me how to get my body in proper alignment.
-Reading Diastasis Recti by Katy Bowman (as well as Alignment Matters), and reading as much as possible from her blog.
All hail, Katy Bowman, the one who saves core muscles, poor posture, and pelvic floors everywhere. She’s sharing her knowledge so generously, and it’s up to me to soak.it.up.
-Modifying the heck out of my exercises. I can do pretty much everything now, but I watch the oblique work (if they’re too tight/strong they can pull the abs apart even more) and modify core series.
Here is a video with my usual modifications:
(Notice how I roll to the side instead of sitting straight up to transition. If you have DR, avoid all sit-up and crunching type motions.)
*Note: many of the programs I’ve seen online are a combo of the above exercises. I would see a PT to make sure you’re doing the exercises and engaging your core properly, and read Diastasis Recti. It’s all worth it. I am also a fan of the Tupler Technique (we used many of these strategies in my PT sessions) and have heard great things about MuTu.
Exercises and tips:
-Diaphragmatic breathing. Fill your belly completely, but avoid letting your ribs move up as you inhale. Instead, think of your belly and ribcage as an umbrella: open it completely. As you exhale, close the *umbrella* and draw the belly towards the spine. You can also add a pelvic floor contraction + lift, but it’s important to make sure you’re doing these correctly. (<— reason 297338 why a pelvic floor PT will help you)
-Marches and toe drops. Keep everything else stable, your abs pulled in -if you feel anything pushing out, take it back and maybe just hold a tabletop position- as you lift each leg one at a time. Once this feels good and you maintain core stabilization, try toe drops. Start in table top and gently lower one toe towards the floor at a time. Make sure to breathe!
-Hip raises. Ground your shoulders into the floor and press your weight into your heels. Exhale and squeeze your glutes as you press up, and slowly lower down.
-Spinal balance. Make sure to keep your transverse abdominis engaged (really think about keeping the lower part of the abs pulled in, and breathe). To start, do one leg at a time, then one arm at a time. Once this feels good and you have the stability, try opposite hand and legs. Finally, add tiny pulses at the top.
(Photo: Scott Hubbard)
-Cat cow. This is a great one for pregnancy, too! Start with your hands under your shoulders and knees under your hips. As you inhale, fill your belly and drop it towards the floor, exhale to press out the air, drawing your belly up and in. While you do this move, make sure that your obliques are relaxed.
-Giving myself time and patience. I know that going through all of these unique experiences of the past year have made me a better instructor and trainer. I feel confident providing modifications for women in various stages of life, which feels pretty awesome. Of course, I’m going to continue to read and learn as much as possible, but am thankful for all of the new knowledge this required me to learn.
If you’re a postpartum or expecting mama and you’re looking for a safe and effective postpartum fitness plan, PBB is here! I also have an advanced plan for mamas whose babies are over 1 year old and you’re comfortably back in the fitness game.
What’s your all-time favorite core exercise? Any of my fellow mama friends working on healing their ab separation?
xoxo
Gina
Tips for core training during pregnancy
Video: Grant Hunker
Location: BreakOut Studios
Wearing: Fabletics + Nike shoes (<— on sale)
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Thank you for posting this! Priceless information!!! ?
<3 <3 thank you for reading!!
Thank you for posting this! I don’t think I have this issue but I do have a horrible what I call “tummy shed” now. After the swelling from the baby went down, it’s like the skin and muscles literally hang now. Any exercises you would recommend?
time is really going to help the most. with the loose skin, unfortunately there isn’t a lot you can do except moisturize, eat well (collagen is a huge help!!), and give it time. i thought my stomach was going to look like a sad old man face forever, and while it definitely isn’t a 100%, it’s really improved
“Sad old man face”– PERFECT description!! Lol!!! Any suggestions on collagen? Brand, amount, how to incorporate? I know nothing but am intrigued!
This is so helpful! I also experienced a bit of this after having an abdominal myomectomy (they cut through the ab wall for the surgery). No fun! But I found that the faster you get back to moving & strength training, the better (as soon as it’s safe, of course!)
So glad you wrote about this. A friend of mine had DR after her second pregnancy, and everyone kept telling her everything was fine and normal and would eventually go back in place. Nope. She needed physical therapy, which she finally got after six months of nonsense.
that’s such a bummer. i experienced that with my postpartum issues (the midwives just brushed it off) and also with my thumb. it’s frustrating but worth it when you have to fight a little for the care you know you need
Yes! I definitely struggled with this after I had twins. It was horrible and I didn’t know that I had DR until I saw a pelvic floor specialist for pain I was having. She checked me out (I had 3 fingers of separation) and gave me many of the exercises you shared above. It was incredibly helpful! I wish more people knew about this issue. Thank you for posting!
so happy to hear you got the help you needed! PT makes such a huge difference
Awesome tips, Gina! This really should be an issue talked about more, because so many women go through it!
thank you, friend! yes, it’s so common
hope you’re having a great week
These look like good exercise even for those who don’t have postpartum issues just to help with posture!
yes! they’re great core exercises no matter what
This is such a helpful post! Having given birth and then gone through prenatal yoga teacher training, this was talked about a lot but I still have so much to learn. DR and pelvic floor issues were not mentioned once by any of my healthcare professionals while being pregnant, giving birth or after but its SO common and serious which is scary. Thank you for all this helpful info and resources!
i feel like with all of my trainings, it was discussed, but kind of skimmed over? so happy that women are starting to become more familiar with it, and also know that it’s super common so they don’t feel alone <3
I appreciate people like you; who put this type of information out. I have this issue and did not know until my cousin mentioned it. I have been trying to work out my core and i hope i have not made it worst because I have been doing squats and sit-ups. I will begin these workouts this week; just wished I had it last year to began. My son is now 11 months hopefully I am not to late.
Would these be considered safe for a csection mom? I had a csection about 3 weeks ago and have been trying to figure out what to do once I am cleared for working out. I want to take me time with getting back into shape…I was on modified bed rest for the last 16 weeks so I feel like I am starting from square one!
they should be safe depending on how you’re healing and how you feel. i’d talk to your doc just to make sure!!
also even if you’re cleared at 6 weeks, i’d wait to do official workouts (anything that isn’t walking) until at least 8 weeks pp. it’s hard to wait, but it’s worth it to let your body heal <3
I just met with my PT today about my DR, actually. I had a 4 finger separation and am just at 3 right at my belly button. It is hard to not be discouraged because it makes my belly pooch out so much. Especially being back at prepregnancy weight. But the hubby tells me I’m beautiful no matter what and I know I’m doing all the right things. It’ll just take time. Something I didn’t know that my PT told me was that while you’re still breastfeeding your body still produces the hormone relaxin. So, it is a lot harder to bring the muscles back together until you wean. The hormone is also still present for up to 3 months after weaning, too. So, just food for thought for any mommas out there trying to heal and still bf’ing. I really appreciate this post Gina and all the time you take to educate women on these issues!
Thanks for sharing this Gina. For those of us who haven’t had babies yet, is it possible to prevent DR? Or can you point to any resources in how to prepare your core for pregnancy?
i have a core training guide on the PBB site – it’s free, you just have to sign up for my newsletter
i would just make sure to avoid overtraining the obliques during pregnancy (if they’re too strong they can work to pull the abs apart), watch out for any exercises that make a cone shape with the belly (a sign it’s too much pressure on the linea alba) and be smart about postpartum training.
xoxo
I thankfully avoided diastasis recti through 2 pregnancies, but recently learned I have a labral tear (cartilage) in my hip… which I first started feeling discomfort from when pregnant with my daughter who’s now two! Just wanted to say after hearing you rave about Alignment Matters, I just ordered it to learn as much as I can moving forward after surgery and rehabilitatio.
Oh DR ughhhh!! My twin pregnancy certainly messed me up. Gave me a 4.5 finger gap, two hernias and gallstones. I was having frequent attacks after birth and had a giant surgery to fix all of it. Worst pain of my life and pumping while in a hospital for a week was like death. The babies were just three months then. I guess I took the easy road because I needed the surgery but before the gallbladder attacks I was 100% going to try PT. I’m a total believer in it and I’m so glad it helped you! Also I didn’t get any plastic surgery so I still have tons of flabby mom skin and some weird hanging of fat leftover from pregnancy. Womp haha. GL ladies!!
Thank you for this post! I have a nearly 19 month old and a 3.5 year old and my DR is pretty significant after my second child. I had two home births and my midwife did tell me to do wall planks for 30-60 seconds a few times a day after I gave birth but besides that, I’ve had no access to any PP pelvic floor help. When I ask at the gym, I get blank stares even from the most experienced seeming trainers and instructors. I fear that I made it worse with some of the exercises I’ve tried in the past so I tend to completely avoid working my core which leaves it weak and I do look pregnant. I’ve even been asked if I’m pregnant at least twice in the past year and a half, at 118 lbs or so. Super frustrating and I feel defeated. I’m determined to resolve this! Any advice on how to find a pelvic floor specialist in my area?
where do you live?? i’ll do some googling for ya 😉
Love these tips! My LO is 11 months. I have pretty much healer my DR but my pelvic floor is still very weak. I think it is worth noting that the two do not always go together. You can have DR and a strong pelvic floor or you can have a weak pelvic floor and no DR. My doctor told me I need to go see a PT but due to our location we do not have any trained providers I available. I hate that so many women think that these problems are normal so they just feel they have to life with them! Thank you for sharing all you knowledge with us!
that is such a great point. it’s the imbalances that can throw things off; too weak or too strong.
This is so helpful! I don’t think I have DR (my doctor didn’t check), but am definitely working on getting core strength back after my baby and love seeing a collection of safe ab exercises. Thank you!!
usually doctors don’t check! i wouldn’t worry about it unless you start to have symptoms, and just focus on safe postpartum exercises
This is really great!! I didn’t realize this was a big issue, but Im sure in the future, I will experience it!
having the tools in place to help can make such a huge difference <3
Hi Gina- would the same apply for a umbilical hernia? I was also told to avoid situps of any kind but at a loss as to how to get strength back in my abs.
these should be safe, but i’d talk to your doc just to be sure
while i have no aspirations or plans to have kids (and TBH, still single 😉 ) i found this post incredibly informative and interesting! thanks for always posting such quality!
Hi Gina! Random question, why did you feel so bloated a week after filming the videos? Is it something related to dr? Thanks!
Why do you think the HIIT left you bloated? I am 7 months pp with my second and I don’t think I have DR but I do struggle with bloating. I didn’t work out for two weeks due to a foot injury and I didn’t have as much bloating and I weighed a few pounds less. Now that’s I’m back to working out again for a few weeks the bloat and extra couple pounds have returned.
it was too much impact for me with the ab separation. i can do a workout here and there, but filming all of the workouts in two days left my core confused and super bloated
Hi!
I love this post! I definitely want to address my DR so that I can progress with more advanced exercise. I was just wondering if you can suggest how many reps of each to do for, let’s say a 20-30 minute workout to ensure the workout is effective, etc.
I was wondering how many reps also?
Engaging your core all the time should help? I’ve been having excruciating attacattacks from this after carrying my son the wrong way or bending wrong.
Thanks so much.
i would definitely seek out a pelvic floor physical therapist. they can help!!
How many reps and sets for each exercise?
How long does it take to begin seeing results? How many reps of each exercise should I do as I include these in my workouts 4 times a week – should I increase as I get stronger ?
I had extensive abdominal surgery, now DR I have been doing Pilates since August and the exercises I use are strictly supervised, and the know what’s up. THANKS for the additional info.
How many time a week would you suggest doing these exercises? I was pretty active before my little guy (now 7 months) was born but have really let that slip.I’m fairly certain i have some significant DR (which also caused a umbilical hernia) though my OB brushed it off. Definitely looking into seeing a PT as I feel like i want to work out again but don’t know where to start.
you can do these exercises every day if you want to! (just check with your doc first and i highly recommend seeking out a PT)
xo
Is it also ok to do all of these exercises while pregnant? Trying to do some preventative work 🙂
how many weeks are you? i’d skip the exercises on your back after the first trimester
How many reps for each workout?
i’d do 15-20