Pilates instructor Kristin McGee shares the moves she's using to heal from diastasis recti after the birth of her twins.
Diastasis Recti happens when the abdomen stretches during pregnancy and separates at the center, leaving a gap. "Diastasis" means separation. "Recti" refers to the rectus abdominis, aka the six-pack muscle group. When those muscles come apart, the belly may bulge out, causing a "pooch" that can make a woman look pregnant long after she has given birth. Now that I am dealing with diastasis recti personally, I know firsthand how frustrating it can be.
Diastasis is common in moms who have repeated pregnancies, are older than 35, or deliver twins, multiples, or a baby with a high birth weight. With my first son, Timothy, I only gained about 28 pounds and was three years younger than I am now. With my twins, Robert and William—who just turned seven months—it’s been a whole different story. I carried them nearly to full-term; and they weighed 6.8 and 7.1 pounds at birth.
I have a separation right above my belly button that's about two fingers' wide. Even though I am back down to my pre-pregnancy weight, I still have a pregnant-looking belly by the end of the day.
I didn't realize that I was dealing with diastasis recti when I first started exercising again; I was eager to get back into my routine, and probably doing too many things, too quickly—without a proper focus on healing and strengthening my core. That's why I want to warn all postpartum moms to check if they have diastasis recti, since so many things (including crunches) can make it much worse. Aside from the pooch, the condition can cause constipation, low back pain, and urinary incontinence as well.
To do a self-test for diastasis recti, lie on your back with your knees bent and feet flat on the floor. Place your fingertips across your midline and parallel to your waist at you navel. Place your other hand behind your head and lift your head up while gently pressing your fingertips down.
If you don’t feel the space between your muscles narrowing, or your fingers sink into the gap, you may have a diastasis. Move your fingers down your abdomen and keep testing along the way. (Some moms can have a separation as wide as four fingers or more.) You may also want to get a professional to check for you.
If you are dealing with diastasis recti, you should avoid doing exercises that can make the separation worse, such as crunches, planks, and twists. Jumping out of bed is also a no-no (always roll to the side first), as is any movement that causes a visible coning, or doming, in your ab muscles. Learning to use your deep core to lift your legs is important. And strengthening the transverse abdominals, the deepest layer of abs, is essential.
The key to healing (and I know this is probably not what you want to hear) is working mindfully and slowly—and taking deep diaphragmatic breaths into the back of the ribs. As you work your core, think about knitting the muscles together, and drawing in and up. Some people recommend a splint, but I personally think it’s better to work the core internally.
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Diastasis recti exercises
In the video below, I demonstrate a few moves you can practice at home on a daily basis. Of course, if you feel any pain or see coning in your abs, you should stop.
Start by lying on your back. I like to do these exercises on a prop called the Parasetter, because it helps me direct my breath to the right place as I work. If you don't have a Parasetter, try placing a rolled up yoga blanket or towel between your shoulder blades. And if you don't have either of those, just lie on the floor.
Remember to contract your pelvic floor as you exhale, and keep your core engaged throughout the exercises.
1. Hold a magic circle, yoga block, or squishy ball above your chest, arms straight. Squeeze in as you imagine wrapping your front ribs together, and engaging your oblique muscles and pelvic floor muscles.
2. Extend your arms overhead without letting your ribs open. Use the abs to draw everything in. Then return to the start position.
3. Lift your legs to table top, mindfully keeping everything drawn in. Slowly lower one leg at a time to tap your toes on the floor. If you see coning in your abs, don't drop your toes all the way to the floor. Alternatively, you can place your feet flat on the floor and use your core muscles to lift each foot a few inches at a time.
4. With the circle, block, or ball between your legs, and your feet flat on the floor, raise your butt until your back forms a straight line from knees to shoulders. Really concentrate on engaging your pelvic floor and inner thigh muscles as you exhale and lift up into the hip bridge. Then inhale as your lower back down. And repeat.
Kristin McGee is a leading yoga and Pilates instructor, and a contributing fitness editor at Health.