Your body does so many amazing things during pregnancy to accommodate your growing baby, and the expansion of the muscles in your abdomen is no exception.
The right and left sides of the abdominis rectus muscle separate as your linea alba (the tissue between your muscles) stretches to make room for your baby.
After pregnancy, many new moms notice an indentation in the middle of their bellies, in the center of where a ‘six-pack’ would be. While this gap normally heals 8 weeks after giving birth, some women have a wider gap that needs some help being repaired.
This wider separation is called Diastasis Recti, and it’s not just a visual condition. Symptoms include back pain and abdominal weakness.
If you experience Diastasis Recti, don’t be alarmed! You’re not alone.
One in two women experience it, and it is often referred to by a less alarming term - ab separation. While it is very common, certain factors make it even more likely for women to experience Diastasis Recti.
Women who are expecting multiple babies are at more risk since their belly has to stretch wider to accommodate more babies.
Ab separation is also common in women who have been pregnant more than once because their muscles have stretched multiple times.
Women who are obese are also more likely to develop Diastasis Recti, and there is also a genetic component too. If your mom had Diastasis Recti, this makes you slightly more likely to develop it too.
How do I know if I have Diastasis Recti?
While you should always consult a doctor or physical therapist about Diastasis Recti, there is a way to detect it for yourself.
First, lay on your back with your feet flat on the floor and your knees bent. Curl your head up off the floor so your six-pack muscles are engaged, and feel along the indent down the center of your stomach. This is the linea alba.
Focus on your belly button and feel just above and below in a straight line. If you can press your fingers down, you may have separation.
But how can you tell normal ab separation from Diastasis Recti? The width and depth of the separation are key.
To determine the depth, push down gently and feel for any pushback or tension, or if your fingers just sink. You can measure the width with your fingers.
A width of one to two fingers is normal, while three or more could be a sign of Diastasis Recti.
How do I fix Diastasis Recti?
With all the changes that happen to your body, it’s natural that your core becomes affected during pregnancy.
Rebuilding your core from the inside out is the key to healing Diastasis Recti. Specifically, the Transverse Abdominis (TVA) muscle needs to be strengthened. This is the deepest abdominal muscle and supports those muscles that have been stretched.
The more you strengthen your TVA, the more tension you will feel. Make sure to track your progress, and when you can feel some more resistance in your gap you should be ready to expand your ab workouts.
You should avoid any crunches and planking until your gap is starting to close and you have regained some strength in your abs. You may be tempted to push yourself, but you must refrain from doing this as it can actually worsen your Diastasis Recti.
The exercises below are simple and easy to do at home, rebuilding your TVA muscle and therefore healing your Diastasis Recti.
But while strengthening your TVA is key, you should also work to regain strength in your diaphragm and pelvic floor which work alongside your ab muscles. Remember to focus on your breathing and engage your pelvic floor while doing these exercises.
Below, you will find some exercises that will strengthen your TVA and help heal your Diastasis Recti.
Umbrella Breathing with Kegel
This exercise is so named because you need to imagine your ribcage is like an umbrella opening 360 degrees as you inhale.
Start in a standing position with your knees slightly bent, or you can start sitting on a chair or yoga ball.
Initiate your exhale with a kegel. Empty your low belly, then middle, and finally your chest, engaging your abdominal muscles up and in as you go.
While standing up you can do 10 concentrated breaths standing, and then continue with this breathing pattern for the rest of the exercises.
Pelvic Tilts on Hands and Knees
Start on your hands and knees with your spine in a neutral position.
Take a big breath into the sides of your ribcage, then exhale with a kegel, drawing your tailbone down and under so your spine is curled.
Inhale as your spine returns to neutral. Make sure you relax your glutes and move from your lower abs. Arching upwards (or Cow position) is not advised if you have severe Diastasis Recti.
Perform 10 tilts while moving slowly and consciously.
Kneeling Arm and Leg Extension with Kneecap
Start on your hands and knees, and then exhale and draw your core up towards your spine.
Maintain your core contraction as you inhale. Reach your right arm ahead and left leg straight behind you.
Exhale and tap your right elbow towards your left knee. Inhale with both limbs long and return to neutral.
Perform 10 reps on each side, alternating sides as you go.
Toe Taps Lying on Back
While lying flat on your back, bring your legs to a tabletop position with your knees directly over your hips. Make sure you aren’t arching your back or tucking your pelvis.
Inhale into your ribcage and exhale as you tap your right foot down to the floor, all the while drawing in your core and maintaining pelvic alignment.
Inhale as you return to neutral and do 10 reps on each side.
Single-Leg Reach Lying on Back
Start in a tabletop position and keep your pelvis still. Then, reach your right leg long on a high diagonal when you exhale.
Inhale as you return to neutral and perform 10 reps on each side.
Leg Extension with Weights
You can try this exercise without weights until you feel stable, then add one to two-pound weights.
Start flat on your back with your feet planted hip-width apart. Then, inhale and draw your right knee to a tabletop position with your arms framing your knee.
Reach your leg on a high diagonal with arms just overhead when you exhale. Don’t let your back arch.
Inhale and return to tabletop position, before performing 10 reps on each side.
Double Leg Extension
After practicing the above exercise, you can try this one. As before, do not use any weights at first and then add some if you feel ready.
Start with both legs in a tabletop position, then inhale as your arms frame your knees.
Exhale as your legs reach a high diagonal with arms slightly overhead, keeping your back and pelvis still.
When you inhale, return to neutral and perform 10 reps.
Start with sitting high on your sit bones with your feet wide and your hands behind your knees.
Gently rock back, being careful not to let your chest sink in.
Staying reclined, exhale as you pulse backward so your low belly hollows out. Try to go for 20-30 pulses.
This exercise is a good alternative for a high plank if you’re in a workout class and you’re asked to plank.
Side planks can be done at any time during your postpartum period, but high plank and elbow planks should not be attempted until your TVA is strengthened and your Diastasis Recti has almost healed.
Place your elbow directly underneath your shoulder and stack your top leg in front of your back leg so both feet are touching the floor. Make sure your shoulders and hips are stacked so they are in line with your head and feet.
Also, make sure to keep breathing and drawing in your core as you hold this pose. Starting off, don’t hold for longer than 15-20 seconds.
Can you prevent Diastasis Recti?
Unfortunately, the biggest factors of Diastasis Recti are out of your control. But stronger abs are more likely to resist dramatic separation.
If you’re trying to get pregnant, including exercises that strengthen the abdominal muscles into your regular exercise routine is a good somewhat preventive measure, but if you’re already expecting you can try some pregnancy-safe ab exercises - as long as your doctor says it’s okay, of course!
Try exercises such as pelvic tilts that engage the deeper TVA muscles. These are the muscles under your rectus abdominis that run perpendicular and crossewide from hip to hip.
Unless your doctor has recommended you limit exercise during pregnancy, most abdominal exercises are safe in early pregnancy.
Of course, these may require some modifications and there are a few exercises you should absolutely avoid while pregnant.
Research has found there is no link between moderate or even vigorous exercise and early pregnancy loss.
But exercising during early pregnancy is key here, as your baby bump that usually appears in your second trimester will make some abdominal exercises more difficult if not impossible.
However, as long as your doctor says it's okay, then you can exercise your abs throughout your entire pregnancy if they are modified accordingly.
Strengthening your abs when you’re expecting even supports your pelvic organs as your baby bump grows.
Having strong abs can also take the pressure off your back and help with proper posture. Having proper posture reduces lower back pain that so many moms experience during pregnancy.
What’s more, a strong core may also increase your sense of control during labor as well as aid quick recovery after birth.
What Ab Exercises Should I Avoid During Pregnancy?
It’s not a good idea to do full sit-ups and double leg lifts any time during pregnancy as these exercises put more pressure and pull on the abdomen.
You should also avoid any moves that involve bending over backwards or contorting your body. Always make sure to breathe steadily as you exercise, so you and your baby are getting a steady flow of oxygen.
You should also avoid any exercises that involve lying face-up on your back (like crunches) after the end of your first trimester.
This is because your enlarged uterus could potentially compress the vena cava (the vein that carries blood to your heart), and this could be dangerous for you and your baby.
However, you can relieve some pressure without narrowing down your options for ab exercise by propping yourself up on your forearms instead of lying on your back.
When propping yourself up on your forearms, make sure your heart is above your navel.
You can also use a wedge, a Swiss ball, or even a couple of pillows. Or, you can practice exercises performed in alternative positions, like standing upright, lying on your side, or on all fours.
If you develop a Diastasis Recti with a gap of more than three fingers-width, you should avoid crunches, sit-ups or other exercises where your abs bulge, as this adds extra strain to your abdominus rectus.
However, the most important advice we can give is to always listen to your body. If an exercise doesn’t feel right, stop immediately, especially if it becomes painful.
If you are concerned and unsure then consult your doctor or a personal trainer and explore the many alternatives out there.