Diastasis Recti . . . mom pooch, mummy tummy. A buzzword you’ve probably seen scrolling through your newsfeed or heard a friend talking about. As a fitness professional who specializes in prenatal/postpartum women and pelvic floor dysfunction, this is a topic that every woman needs to know about – whether you are pregnant or your youngest is 50 years old.
So what exactly IS diastasis recti?
Let’s get technical for just a minute to explain diastasis recti. Diastasis recti is a separation of the “6 pack muscles” that occurs during pregnancy. As the uterus grows, the muscle separates to allow for the growth of the uterus. Although it may sound a little scary, this is a normal physiological change of pregnancy. Some studies say that up to 100% of women will experience a diastasis (separation) during pregnancy.
Why Does This Matter?
The short, simple answer is you don’t want to do activities that will open the gap wider. This is important because gaps will affect the ability of the core to prevent back injury and/or pelvic floor dysfunction such as incontinence or pain. Many don’t realize that pelvic floor dysfunction can present itself regardless of a vaginal or cesarean birth, and even in women who have never had a baby.
“You’re Cleared for All Activity”
You go to your six-week postpartum checkup and your doctor tells you “you are cleared for all activity.” What do the majority of women do when they leave that appointment excited to “get their body back?” Yep, they run home and start doing crunches. WAIT A MINUTE?!
You may have heard “do this, don’t do this” while pregnant. But, no one really talks about what to do and what not to do once you’re cleared for exercise! We are not taught how to check ourselves for an open diastasis. And, if we are “spritzing” a little bit when we cough, laugh, run or jump, we have been told by our mothers that is just our new norm since we have had a child. I am here to tell you that if any of the above is happening, it is common, but NOT normal!
What Exercises to Avoid
The answer of what to do and what not to do is not black and white – both during pregnancy and postpartum. What you should and shouldn’t do all truly depends. This is because what we are really paying attention to is the structural integrity of the diastasis and the core. It is a little bit counterintuitive because a lot of women think they need to do “core work” or crunches to flatten the stomach. If a mom has an open diastasis that is not supported and she is doing a lot of crunches to try to flatten the stomach, she may actually be doing more harm than good and opening the diastasis further.
But I thought crunches would give me a flat tummy?
A crunch or sit up mainly works the rectus muscles – the 6 pack muscles. The rectus doesn’t actually flatten the stomach. Its main responsibility is to shorten and bring the chest to the thighs.
The transverse muscles are the deepest core muscles. Think of them as a corset to help flatten the tummy and provide structural stability. Our focus should be on learning how to activate this muscle to support you when you are lifting – whether that is your children, strollers, car seats or weights in the gym. By activating the transverse abdominal muscles, we create tension in the connective tissue between the “6 pack muscles” and THAT improves the structural integrity of the core.
Real Life Example
This mom is 2.5 years postpartum with a 2.5 finger separation of the rectus muscles. Both pictures were taken within 1 hour of each other, so the gap did not miraculously come back together. On the left, you see coning which looks like a bump of the core. On the right, you see her supporting the connective tissue using her pelvic floor and transverse abdominal muscles together. The difference is amazing, isn’t it?
I see coning, what should I do?
If you experience this coning or doming during movements, stay away from push-ups, planks, pilates 100s, yoga boat posture and any crunching exercise that brings your chest toward your thighs – not forever, but until you are able to structurally support the diastasis. Also be sure to avoid any exercises that cause urine leakage. As I said above, a lot of women think that having a little bit of urine leakage is normal after childbirth, but although it is very common, it is not normal.
If you feel you may have an open diastasis or are having pelvic health issues, please reach out to a professional to help you get started toward healing. There is help and you don’t have to live worrying about if you’re going to cross your legs in time when you sneeze!