1. What is Diastasis Recti, and how do I know if I have it? Diastasis Recti is when the two halves of your Rectus Abdominis (6-pack muscle) separate beyond the natural amount. It is natural to have a small space between the two halves. (Most experts consider a gap of 1 finger width or less to be normal, and a gap of 2 fingers or more (about 25mm or 1in) to be Diastasis Recti.) It’s also natural for this space to become wider during pregnancy as the muscles and connective tissue stretch. It will be hard for you to tell if your muscles have spread a “natural pregnancy amount” or a “wider-than-natural pregnancy amount”. For this reason, I don’t recommend that you check yourself for DR when you are pregnant. There will be a gap, and it will freak you out unnecessarily.
DR is not a disease; it is a symptom of excessive intra-abdominal pressure, muscle tension and weakness, misalignment, and a core that is not functioning well. There are already so many good articles out there covering this question…why reinvent the wheel, right? For a full explanation of what it is and how to check for it, read this article from Mutu System’s Wendy Powell.
2. How do I heal it? Can I close the gap? Diastasis Recti is best healed by addressing your whole body alignment and changing the way you move in everyday life. I know that sounds like a HUGE undertaking (and it is), but there are some simple things you can do right now to bring profound changes. Start with these 5 Steps to a Stronger Core. It takes time to rehabilitate your core. Be very wary of people or programs that claim to have a “quick fix” or guarantee certain results….like this program that got a lot of press recently. You can read a GREAT response to this article here. (Seriously, it’s really good and it articulates my thoughts exactly.) It’s important to know that the gap might not necessarily close all the way, and that is ok. You can still have a strong and functional core with a small gap. In addition to changing the way you move and moving more, you can try exercises specifically designed to release tension in the trunk and help you reconnect with these muscles.
3. What core exercises are safe to do? I work with a lot of women who have DR and want to restore their core function, but they’re scared to do any type of core exercise because they’ve heard traditional core work, like crunches, can worsen their condition (and it can). Imagine squeezing a balloon. The displaced air has to go somewhere, and the increased pressure would cause the balloon to bulge. The same thing happens in your abdominal and pelvic cavities. Many abdominal exercises increase the intra-abdominal pressure, which pushes the contents of the belly forward and/or down. It’s pushing forward against the connective tissue that is already compromised or down on your pelvic floor, which is especially problematic if you are already experiencing incontinence or pelvic organ prolapse. There are a lot of core exercises that are safe, but they might not look like the core exercises you are used to. Here are a few you can try as a safe and gentle way to start reconnecting with your abdominal muscles. These can also be done during pregnancy!
4. What else can I do?
- Come to my Diastasis Recti Recovery workshop on October 22! Details and registration here.
- Do these alignment snacks: twisting the night away, let’s do the twist, and just a dab of abs.
- Check out the book Diastasis Recti: the whole body solution to abdominal weakness and separtaion, an excellent guide for anyone experiencing core and/or pelvic floor dysfunction (they often go together). It’s full of scientific explanations, practical tips and exercises.
- Read more about alignment and core function under my additional resources tab. (scroll to the bottom)
- Listen to these podcasts by Katy Bowman on the subject.
Everyone wants a strong core and knows that it’s important. What most people don’t realize is that having “6-pack” or a flat stomach, doesn’t necessarily equal strong. When I say “a strong core”, I’m talking about muscles that can do their job. The abdominal muscles are meant to decompress the spine, support the organs, provide movement, lower the pressure in the abdominal aorta, help you breathe/cough/vomit, and more. When you have muscles that function properly, you might also end up with a smaller waistline; however, a flat, fit, toned abdomen does not necessarily mean it’s strong and healthy. Plenty of very fit people have diastasis recti, hernias, digestive trouble, and pelvic floor issues. If you are after a strong and functional core, here are a few things you can do to start heading in the right direction. These things can help minimize back pain, decrease your chances of developing diastasis recti, and recover healthy core function, whether you are pregnant, postpartum, or neither.
1) Drop your ribs. The rib cage should be stacked right over the pelvis (see photo), not lifted or jutting forward. Read this post for a detailed description. This one small thing can have a huge impact on your core strength. The abdominal muscles attach on the rib cage. If you are constantly lifting them or jutting them forward, you are undermining their ability to function.
2) Release your belly. Constantly holding tension in your belly also undermines abdominal strength. This can come in the form of habitually sucking in your stomach or constantly bracing/tensing your abdominal muscles. For starters, just get on your hands and knees and try to let your belly relax towards the floor. Allow the tailbone to move up towards the ceiling. Notice any desire to pull your belly back up. Let it relax more. This article talks about why relaxing your belly is so hard. And this one gets into the difference between sucking in your stomach and activating your TVA.
3) Practice #1 & 2 in everyday life. Once you’ve learned how to drop your ribs and release the tension in your abdomen, start bringing these new habits into everyday life. Pay attention to them when you walk, stand, sit, drive your car, work on the computer, or hold your baby. This is a really great post on ways to move better in everyday life to heal diastasis recti. <— IF YOU HAVE DR, READ THIS POST!!
Dropping your ribs and releasing your belly is a great place to start. Doing those two things will relieve back pain, improve digestion, and increase the activity of your abdominal muscles. Your abdominal muscles can work reflexively (automatically) now that you’ve eliminated habits that were interfering with this process. They can now respond appropriately when you move and will become stronger.
4) Move more in everyday life. I’m going to repeat that: Your abdominal muscles can work reflexively (automatically) now that you’ve eliminated habits that were interfering with this process. They can now respond appropriately when you move and will become stronger. The real gains in strength come when you take your new found alignment and start moving more. Sitting with your ribs aligned and belly relaxed has its benefits, but your abdominals won’t be very active in this position because there is no need for it when you are sitting still. They are responding appropriately to your position. When you stand up, they should contract more. When you start walking, even more. If you walk carrying a baby or a grocery bag, even more.
After my daughter was born, I had a two finger gap both at my belly button and above it . In those first 3 month postpartum, I walked, stretched and paid attention to my alignment during everyday life; I didn’t do any “core exercises.” The gap above my belly button closed completely, and at my belly button it’s down to 1 finger. (Most experts consider a gap 1 finger width or less to be normal.) I did this intentionally, as a sort of experiment, to see what would happen. Going up and down stairs, getting up and down off the floor, and doing everyday life while holding a 10lb baby is a lot of work. I wasn’t “working out”, but my muscles did a lot of work because I was moving. Honestly, I did a lot of laying around and resting too, especially in the first 6 weeks. I don’t have a flat stomach, and I still look 3 months pregnant. My core definitely isn’t as strong as I’d like it to be, but moving well and moving more was enough to close the gap and restore function in a relatively short period of time.
5) Take a class. I know I just got done saying that you don’t need to exercise, but practicing exercises that encourage reflexive core activity are helpful for regaining healthy core function. If you’ve had years of rib thrusting and sucking in the stomach, chances are you have some tension in the trunk and some muscles that aren’t “online”. Specific exercises to release tension and reconnect with those muscles can be necessary. Here are two options starting May 16th (next week)!
I got my first postpartum “when is your baby due?” a couple weeks ago. My first knee jerk reaction was embarrassment, then the thoughts of “I’m so fat, she thinks I’m still pregnant”, then the indignant “Doesn’t she know you NEVER ask that?”. After a few seconds I just smiled and said, “She was born in December.” In her defense, I was sitting with my hand resting on my belly, which is the universal sign of “there’s a baby in here.” Apparently, this happens to Jennifer Garner a lot because she said this on the Ellen DeGeneres Show: “I am not pregnant, but I have had three kids and there is a bump … I get congratulated all the time by people I know … From now on, ladies, I will have a bump, and it will be my baby bump. It’s not going anywhere. Its name is Violet, Sam, and Sera.” I love that. My response wasn’t nearly as clever, but the experience got me thinking.
I’m going to get real here. One of these photos was taken when I was 3 months pregnant. The other was taken at 3 months postpartum. Can you tell which is which?
It’s ok, my husband couldn’t tell either. I can literally say, “I still look 3 months pregnant”, and it’s not an exaggeration. The reason I’m sharing this is to help normalize the postpartum experience and to say IT’S OK. It’s ok if you look 3 months pregnant. It’s ok if you look 6 months pregnant. It’s ok if you are bigger or smaller or a different shape than you used to be. It’s ok if you don’t look like you did before you were pregnant. And it’s ok that sometimes it doesn’t feel like it’s ok. I’ve heard people say, “It took your body almost a whole year to get where it is. You can’t expect it to bounce back right away.” I think there is some truth to this, but I also want to say that maybe our bodies aren’t meant to be the same.
This post isn’t about 3 steps to banish belly fat or how to fit into your pre-pregnancy jeans. This post is about the fact that when your body creates, grows, births and sustains a tiny human being, it’s a miracle. Natural, medicated, vaginal, cesarean, home, hospital….however you did it, when you bring a new life into this world, it’s a miracle. Your body will never be the same, and that isn’t a bad thing. We have this notion that we are supposed to go “back,” but maybe the truth is that when we become mothers, we go through a transformation. Every part of us is different, including our bodies, and that is something to be celebrated. On my best day, I’m totally on board with this statement. On my worst, I secretly want to look like my pre-pregnant self….or maybe even the super fit 20-year-old version of myself.
I’m about to do something you will never see me do again: reference celebrity advice in Cosmo Magazine. I can’t believe it, but this little gem is really worth reading. Read what these women have to say about the notion of getting your pre-baby body back. I couldn’t say it any better. As women, I think most of us struggle with body image to some extent. There have always been parts of my body that I didn’t like, but now that I’ve had my daughter, I have a whole new appreciation for my body. It’s incredible that you go from having an enormous belly one day to a tiny baby the next.
We are inundated with pictures of airbrushed models and the message that we should look like them. I encourage you to ignore those messages and replace it with this: Your body is amazing. Let’s focus on feeling good and being strong and healthy. Let’s value being able to run and jump and laugh without peeing our pants. Let’s aim to be strong enough to carry our babies without pain. Let’s be mobile enough to sit on the floor and play with our kids. Here are a few ways to get started:
- Take a daily walk. If you push your baby in a stroller, start carrying or wearing him/her for part of the way. Slowly increase the out of stroller time as you get stronger.
- Watch this video on alignment tips for pain free baby holding.
- Try sitting on the floor in different positions at least once a day.
- If you are experiencing incontinence, back/hip/pelvic pain, or pelvic organ prolapse, come to a pelvic floor workshop. Register here.
- Come to my series on Restorative Exercise for Diastasis Recti in May. Register here.
- Schedule a private session to set goals and work on your individual alignment needs.
My super fit 20-year-old self looked good, but she was also in chronic pain and not all that healthy. She wouldn’t have felt good carrying a baby for 41.5 weeks and certainly wasn’t mentally or physically prepared to birth that baby naturally. When I think about what my body has done, I don’t really want to go back.