4 Exercises to Strengthen Your Core After Diastasis Recti

Pilates instructor Kristin McGee shares the moves she's using to treat her diastasis recti after the birth of her twins.

Diastasis recti abdominis (DRA), sometimes called just diastasis recti, is when the abdomen stretches and partially or fully separates at the center, leaving a ga, according to a review published in August 2021 in Hernia. "Diastasis" means separation. "Recti" refers to the rectus abdominis, sometimes called the "six-pack" muscle group. When those muscles come apart, the belly may bulge, causing a "pooch."

DRA is not a hernia, as noted in a 2014 review in the Journal of Plastic Surgery and Hand Surgery, and has few major complications. A study published in March 2018 in Physical Therapy found that the width of a person's diastasis recti (known as the interrectus distance, or IRD) could affect their body image. Aside from its visible symptoms, DRA can cause constipation, low back pain, and urinary incontinence, according to a 2019 study published in the Journal of Musculoskeletal and Neuronal Interactions (JMNI).

Now that I am dealing with diastasis recti personally, I know firsthand how frustrating it can be.

No study has been able to give an exact prevalence for DRA, according the August 2021 review in Hernia. However, a study published in 2016 in the British Journal of Sports Medicine (BMJ), found diastasis recti occurred most commonly during pregnancy and after childbirth.

Diastasis recti is also more common in people who have repeated pregnancies, according to the August 2021 review in Hernia.

I had my first child, Timothy, about three years before getting pregnant with my twins, Robert and William. My second pregnancy was a whole new experience. I carried my twins 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 to my pre-pregnancy weight, I still have a pregnant-looking belly by the end of the day.

I didn't realize 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 people to check if they have diastasis recti.

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 your 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 people have a separation as wide as four fingers or more.) You may also want to have a healthcare provider examine 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. When getting out of bed, roll to the side first. Avoid 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. That 2019 JMNI study found that deep core stability exercise programs could effectively treat diastasis recti.

The American College of Obstetricians and Gynecologists (ACOG) says if you've had an uncomplicated pregnancy and vaginal delivery, you can start exercising even a few days after the baby is born. If you had a cesarean birth or complications, you should ask your healthcare provider when you can safely begin exercising again. You should begin moderately (even 10 minutes a day will do) and with low-impact exercises.

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.

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. You can do these exercises on a rolled-up yoga blanket or towel between your shoulder blades to help direct your breath to the right place as you work. And if you don't have either of those, just lie on the floor.

Remember to contract your pelvic floor muscles 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 engage 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 a tabletop position, 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.

Diastasis recti abdominis can be an unexpected and frustrating experience. Safely improving your core stability and strength after pregnancy may be able to help. Talk to a healthcare provider about how to safely exercise during and after pregnancy.

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