It’s estimated that two out of three of women experience separated abdominals during pregnancy or postpartum due to diastasis recti. 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. Healing diastasis recti and integrating with functional fitness is what we seek to do.
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 on how to heal with 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.
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.
First, you will need to determine the severity of the separation:
After assessing the separation, the next step is to provide manual support in the form of an abdominal binder, a scarf or Moby Wrap. 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.
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:
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 yourself or your clients in recovering from diastasis recti, please check out or videos on diastasis recti recovery.