Exercises for Diastasis Recti

Diastasis recti, a condition that causes your abdominal muscles to separate, commonly occurs after pregnancy. This can be uncomfortable, but doing some daily exercises can help you heal.

pregnant woman doing yoga
Artem Varnitsin / Getty Images

Your body undergoes several changes during pregnancy and postpartum. You may notice your hips widening, skin stretching, and changes to your abdominal muscles, such as a splitting between the muscles, what's known as diastasis recti. Diastasis recti causes your rectus abdominis (or, your "abs") to separate and your linea alba—a band of fibers and tissue that runs through your abs—to thin and widen.1

A physical therapist can identify diastasis recti by using their fingers to measure the gap between your muscles. Typically, a gap wider than two fingers indicates diastasis recti. The condition can also be diagnosed and confirmed via ultrasound.2

Diastasis recti can make daily activities difficult. You may experience stomach discomfort, lower back pain, and pelvic floor dysfunction, which can affect bowel movements and bladder control.3

Doing core exercises can reduce symptoms and will often re-establish the connection between your abs and supporting muscles. This means many cases of diastasis recti will resolve with minor intervention. However, around 40% of people with diastasis recti may still feel a muscle gap six months postpartum, while 33% have a widened muscle gap at the one-year mark.2,4 Understanding the basics of diastasis recti and which exercises to practice can help you alleviate symptoms.

Healing Diastasis Recti with Exercise

Core exercises can help strengthen your abdominal muscles. A study involving 43 postpartum women with diastasis recti found that participants were able to improve their symptoms and reduce the width of their stomach muscle gap within 12 weeks of starting an online core strengthening program. The online program used low-impact exercises such as wall-sits and planks that were suitable for postpartum mothers. A total of 19 postpartum women from the original group went on to complete an additional 12 weeks of the program which further decreased the width of their muscle gaps, leading researchers to believe that continued exercise after pregnancy can significantly reduce symptoms.5

Similarly, a 2019 study monitoring the effects of deep core stability exercises among 40 women with diastasis recti found that an eight-week program reduced their muscle gap.1. The exercises in this program included pelvic tilts and low squats. This workout program helped re-establish the connection between the deepest layer of abs (the transverse abdominis), pelvic floor, diaphragm, and other connective abdominal tissue.1

Although these studies looked at specific workout programs, you do not need to participate in a specific long-term workout program to improve your condition. Research suggests that simple daily core exercises may best reduce diastasis recti.

Good Exercises for Diastasis Recti

Just as you would allow your body the time to heal after an injury, the same goes for childbirth. Before you start using your workout materials, make sure to get the all-clear from your OB/GYN to start exercising, especially before you experiment with ab-centric movements. Depending on your experience, exercise might be off-limits for weeks to months following childbirth.

When you're ready to start working out, remember to keep your stomach tight in order to engage your deep core muscles and protect your lower back. Emptying your bladder before exercising is also a good idea. You may also want to have a small pillow for your head and a soft mat to lie on during your workout.

You may consider giving these six exercises for diastasis recti a try.7,8

Diaphragmatic Breathing

Also known as abdominal breathing, this exercise serves as a reminder to breathe using your diaphragm and can help activate your deep abdominal muscles.

How to do it: Lie on your back with your knees bent. You can place a pillow under your head for comfort. Rest your right palm flat on your chest and your left palm on your stomach just below your rib cage. Take a slow, deep breath in through the nose. You should feel your stomach rise while your chest remains in place. When you are ready to exhale, count to three and allow your stomach to drop back down with control. This completes one full breath. For best results, you may consider doing three rounds of breath exercises with 10 sets each or adjust the number of breaths depending on what is most comfortable for you.

Pelvic Floor Contraction

Diastasis recti can weaken your pelvic floor. When your pelvic muscles are weak, abdominal pressure like sneezing or laughing can cause a leaky bladder. Pelvic floor exercises (also known as kegels), not only promote bladder and bowel control, but can also reduce pain during sex.8

How to do it: Lie on your back with your knees bent and feet flat on the floor. Squeeze your pelvic floor muscles, as if you are trying to stop urination mid-flow. Hold the tension for 5 seconds. Slowly relax the muscles and rest for five seconds before repeating. You may try doing 10 contractions over three sets, or altering the number to what is most comfortable for you. Try to be mindful of your breathing and not hold your breath during the exercise.

Posterior Pelvic Tilts

Posterior pelvic tilts shift your pelvis backward to bring your lower back in contact with the floor. They can help strengthen your abdominal muscles and improve posture.

How to do it: Lie on your back with your knees bent and feet flat on the floor, hip-width apart. Squeeze in your stomach to engage your abs. Tilt your pelvis back until you feel the length of your spine pressed flat against the mat. Hold for five seconds and then slowly release. Rest for a few seconds before repeating. Try these for one minute at a time.

Heel Slides

Heel slides combine the benefits of abdominal and pelvic exercises to build up control and strength of your deep core muscles.

How to do it: Lie flat on your back with your knees bent and feet planted on the ground. Perform a posterior pelvic tilt (as above), making sure your lower back is in contact with the mat. Squeeze your stomach muscles pulling your belly button toward your spine. Maintain this pelvic position for the duration of the exercise. With pointed toes, slide your right heel along the floor until the leg is fully straightened. Use your core to slide the leg back to its bent position, and alternate sides. It may be helpful to aim for 10 slides on each leg for three rounds. You can adjust the frequency based on your comfort level.

Single-Leg Heel Taps

Single-leg heel taps strengthen your core by working the muscles in your lower back and abs. As a bonus, they also work your glutes and thighs.

How to do it: Start with your knees bent and legs suspended off the floor. Your knees should be aligned with your hips and your feet should be in the air. With your arms resting by your side, squeeze in your pelvic muscles while inhaling. When you are ready to exhale, slowly lower your right leg down until your heel touches the mat. Your left leg should still be suspended off the floor. Bring your right leg back to the original position and then switch sides. You may try alternating the heel taps for a total of 20 repetitions or adjusting the number to what is most comfortable for you.

If you need to rest in between alternating legs, you can do so in a neutral spine, meaning your pelvis is not tilted back or forward.

Glute Bridge

The glute bridge is a good way to strengthen butt muscles and hamstrings, while also building up your core through hip exercises.

How to do it: Lie flat on your back with your knees bent and your feet on the mat. Tilt your pelvis upward and plant both heels firmly onto the ground. Slowly lift yourself up until your hips float above your ribs. Keep your shoulders resting on the mat. Squeeze your glutes for three to five seconds before slowly lowering yourself back down. You may want to do this exercise for 30 seconds when you start and slowly build up to two minutes as you get stronger.

Exercises to Avoid If You Have Diastasis Recti

While core exercises can help reduce diastasis recti symptoms, some workouts may be harmful. Avoid any exercises that will place direct pressure on your stomach, which can cause your midsection to bulge or worsen muscle separation. That means you can cross forward-flexion exercises such as sit-ups, twists, and crunches off the list. These exercises may cause abdominal pain and potentially worsen your muscle separation.5 Swap these exercises out for safe diastasis recti exercises such as single-leg raises, wall-sits or planks until your condition improves.

Summary

Diastasis recti is a condition many pregnant and postpartum people experience. Core-focused exercises and physical therapy can help improve your symptoms and reduce the width of your muscle gap.

If your muscle gap has not improved within 12 months of giving birth, don't fret. Around 33% of postpartum women studied still had a separation greater than two finger widths at the one-year mark. Additional treatment with a physical therapist might speed up your recovery. Surgery may also be an option to close the muscle gap.

Sources

  1. Thabet AA, Alshehri MA. Efficacy of deep core stability exercise program in postpartum women with diastasis recti abdominis: a randomised controlled trial. J Musculoskelet Neuronal Interact. 2019;19(1):62-68.PMID:30839304
  2. Vesting S, Olsen MF, Gutke A, Rembeck G, Larsson MEH. Clinical assessment of pelvic floor and abdominal muscles 3 months post partum: an inter-rater reliability study. BMJ Open. 2021;11(9):e049082. doi: 10.1136/bmjopen-2021-049082
  3. Gluppe S, Engh ME, Bø K. What is the evidence for abdominal and pelvic floor muscle training to treat diastasis recti abdominis postpartum? A systematic review with meta-analysis. Braz J Phys Ther. 2021;25(6):664-675. doi:10.1016/j.bjpt.2021.06.006
  4. Eriksson Crommert M, Petrov Fieril K, Gustavsson C. Women's experiences of living with increased inter-recti distance after childbirth: an interview study. BMC Women's Health. 2020;20(1):260. doi:10.1186/s12905-020-01123-1
  5. Leopold M, Santiago K, Cheng J, et al. Efficacy of a core strengthening program for diastasis rectus abdominis in postpartum women: a prospective observational study. Journal of Women's Health Physical Therapy. 2021;45(4):147-163. doi:10.1097/JWH.0000000000000214
  6. Jessen ML, Öberg S, Rosenberg J. Treatment options for abdominal rectus diastasis. Front Surg. 2019;0. doi:10.3389/fsurg.2019.00065
  7. Learning diaphragmatic breathing. Harvard Health. Published March 10, 2016.
  8. Fitz FF, Gimenez MM, de Azevedo Ferreira L, Matias MMP, Bortolini MAT, Castro RA. Effects of voluntary pre-contraction of the pelvic floor muscles (The knack) on female stress urinary incontinence—a study protocol for a RCT. Trials. 2021;22(1):484. doi:10.1186/s13063-021-05440-0
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