Healing diastasis recti: tips for birth and fitness professionals February 18 2015, 0 Comments
It’s estimated that two out of three of women experience separated abdominals during pregnancy or postpartum. So when women come to me complaining of back pain or pelvic floor dysfunction, five days or even 15 years postpartum, the first thing I do is assess their abdominals. Separated abdominals affect the entire core and how it is (or isn’t!) supporting, performing, stabilizing, and loading the pelvis and back.
Although many people experience diastasis recti, new moms are at higher risk due to the constant lifting, twisting, carrying, and wearing of babies and toddlers. So what causes separated abdominals and what are the most effective steps to encourage healing? Here we diagnose diastasis, as well as provide tips and modifications for recovery.
What is diastasis recti?
The linea alba is a band of connective tissue that binds the right and left side of the rectus abdominals (six–pack) muscles together. This band of connective tissue is designed to stretch during pregnancy to make space for the growing baby and uterus. If the abdominals are too weak (or too tight!) and alignment is poor, this band will separate. This gap exposes the internal organs and compromises the “inner corset.”
Separation can be shallow or deep and can occur from the zyphoid process down to the pubic bone, but is most commonly found at the belly button. A small separation can become larger if not treated.
What causes diastasis recti?
Diastasis recti comes in all shapes and sizes. It's determined that poor alignment, weak or tight abdominals, too much rectus ab work during pregnancy, and a short torso all contribute to abdominal separation.
How to promote healing
First, you will need to determine the severity of the separation:
- Where is the separation located?
- How long and how deep is the separation?
- Can the abs be drawn in to promote safe healing?
- This video reviews how to diagnose diastasis.
After assessing the separation, the next step is to provide manual support in the form of an abdominal binder. A scarf or Moby Wrap can be used, however therapeutic binders are also readily available and may be covered by insurance. When not wearing an abdominal binder, instruction should be provided on using the hands to support the core when leaning forward.
The next step is to provide instruction on restorative exercise and how to adjust movement patterns to incorporate proper biomechanics. This video demonstrates how to promote healing. Restorative exercises are also taught in our mamalates workshops and trainings.
Modifications during exercise
There are many modifications to keep in mind when exercising with separated abdominals, however simple strengthening exercises and focus on alignment will be the most helpful. Tips include:
- Any exercises where the ribs flare and shoulder girdle stabilization is lost are contraindicated.
- Abdominals MUST be supported manually or with a binder during forward folds.
- Rotations should be limited to 60%- ribs should rotate together, not away from each other.
For severe separation, physical therapy may be recommended. Remember to check with insurance companies regarding reimbursement for birth recovery sessions, classes, and products.
For more information and exercises to support your clients in recovering from diastasis recti, please join us at one of our upcoming trainings.
Wendy Foster is the creator of mamalates and the master trainer for all mamalates licensing programs. An internationally certified Pilates instructor, pre/post fitness specialist, and birth recovery expert, Wendy has been teaching Pilates since 1999 and practicing yoga for nearly two decades. She owns a studio in Southeast Portland, OR. Contact her at firstname.lastname@example.org or visit mamalates.com.