Core Focus - Diastasis Recti: What It Is and What You Can Do About It
Today on the blog, we’re joined by a guest contributor, Annie Lane. Annie is a pre and post-natal corrective exercise specialist and the owner of Vibrant Mamai, a health and wellness studio located in Raleigh. Annie is passionate about prenatal and postnatal physical health, with a focus on functional training and core health. She is writing for us today about the importance of assessing, diagnosing, and rehabiliting Diastasis Recti.
Did you know that 1 in 2 people will experience Diastasis Recti (DR) by 6 months postpartum? In other words, half of all people who give birth will experience Diastasis Recti within the first 6 months after having their baby. Depending on the severity, the injuries caused by DR can greatly affect one’s quality of life. The good news is that most cases can be prevented and/or rehabilitated. So let’s talk about it!
“Diasta...Whaa??”
First things first - let’s discuss what exactly Diastasis Recti is. Diastasis Recti as a term itself just means the separation of the rectus abdominis muscles. In fact, it is estimated that every person will experience a natural separation of their abdominal muscles at some point during their pregnancy (typically towards the end). Which makes sense, right? The bigger baby gets, the less room they have and they will eventually push up against different abdominal structures. This is totally normal and our bodies are prepared to make space.
Back to Diastasis Recti. When dysfunctions and/or injuries arise, it typically is a result of issues within the linea alba. The linea alba is the connective tissue that holds the abdominal muscles in their correct place. This tissue runs vertically down the midline of your abdomen. Over time, increased intra-abdominal pressure (unregulated pressure within your abdomen) can compromise the integrity of the linea alba. When the integrity of this connective tissue is compromised, it becomes “weaker” and loses its ability to hold the abdominal muscles together, which is why DR often appears visually as a separation of the two rectus abdominis muscles. To clarify, the injury of Diastasis Recti is not solely the separation of the rectus abdominis muscles, but the separation coupled with the weakened linea alba connective tissue.
“OK, great! But...how do I know if I have it?”
Now that you have a better understanding of what Diastasis Recti is and what causes the associated injuries, let’s talk about how to know if you have it. Of course, getting evaluated by a professional (corrective exercise specialist, physical therapist, etc.) would be ideal. But there is also a super simple way that you can check yourself right now!
HOW TO CHECK YOURSELF FOR DIASTASIS RECTI IN 4 STEPS:
To see this assessment in action, check out this Instagram reel.
Step #1: Lie on your back. This assessment works best when you are touching your skin directly, rather than feeling through your clothes.
Step #2: Place your index finger and middle finger below your breast bone (sternum). Walk your fingers along the midline of your abdomen. Is there a separation between your rectus abdominis muscles? (This can be present down your entire abdomen or only in certain areas).
Step #3: Gently press your fingers inward toward your spine. Do this down the entire midline of your belly. Do your fingers sink inwards? Is there a depression when you press in? This checks the integrity of your linea alba connective tissue. (It is normal to have more sinking near your belly button.)
Step #4: Crunch your head up slightly and observe your midsection. Is there a coning or ridging along the midline of your abdomen?
Quick Tips to Keep in Mind:
Remember there is a very small natural separation of the rectus abdominis muscles, but generally we are looking to feel if there is a significant separation that is about ½ index finger width or greater. If this is present, it is usually a good indication that some level of DR exists.
For Step #3, you should be able to feel that you are met with some resistance when you press inward. If you feel as though your fingers are going significantly deep, almost like you’re about to start feeling some organs, this is also an indication that the linea alba is lacking integrity and DR may be present.
Diastasis Recti can be present during pregnancy, after pregnancy, and even if you have never been pregnant or given birth! Ideally, training your deep core before DR develops is the most efficient way to prevent it. However if you do already have DR, it can likely still be rehabilitated with exercise. The sooner it’s caught, the better!
If you have any of these symptoms, it is likely time for a further professional evaluation so you can begin rehabilitating that core!
“Check myself for Diastasis Recti - CHECK! Now what?”
Regardless of your results from your self-assessment, and regardless of where you are (or are not) in your childbearing journey, you should begin training your deep core ASAP. I am a nerd about core health, so to avoid rambling on too much, I’ll say this - EVERY ONE has a deep core, and its functionality is directly related to so many factors that contribute to one’s quality of life. So, let’s take care of it, yes?
Finally, we’re at the point of this blog that you’ve probably been waiting for - what exercises are best for DR prevention and/or rehabilitation?
Drumroll please…the answer is...BREATHWORK! That’s right, breathing exercises are the ONLY way to train your deep core muscles. And we need strong, functioning, balanced deep core muscles in order to prevent and rehabilitate Diastasis Recti. I’m going to leave you with 3 exercises that you can begin doing right now.
*DISCLAIMER: Be sure to obtain medical clearance prior to starting any exercise. Again, if you are able to, I would recommend working with a professional such as a physical therapist or a corrective exercise specialist to further assess and guide you through this process, especially if you are showing signs of a core dysfunction.*
Foundational Exercises for Preventing and Rehabilitating Diastasis Recti:
Diaphragmatic Breathing - Take an inhale and think of breathing into your belly, first by filling your belly with air and then allowing the lower ribcage to expand at the very end. Placing your hands on your mid-abdomen and trying to breathe into your hands may be a helpful cue.
Pelvic Floor Contractions - AKA the infamous kegels! Once you’ve got your inhale portion down, let’s move onto the exhale. For the exhale, we’ll first be working with the Pelvic Floor, the muscle group that sits at the base of your deep core. After a belly breath inhale, initiate your exhale by drawing your pelvic floor muscles up and in. This is the same sensation as if you were to stop your urine mid-stream. You may feel this as tightening from the base of your pelvis into your low abdomen.
Transverse Abdominis Wrapping - We’ll “wrap” (pun intended) the exhale portion of our breathwork up with the Transverse Abdominis (TVA) muscle. I like to refer to this muscle as your “corset” muscle, because it is arranged in your abdomen like a corset with the fibers running perpendicular to your linea alba (below your rectus abdominis and obliques). To finish your exhale, allow the pelvic floor contraction to continue traveling up your abdomen as you wrap your TVA muscle inwards. Imagining bringing your lower ribs in towards each other might be a helpful cue. Ensure that you are not “sucking in” as this is a much different motion and sensation.
And that’s it! While these may seem like simple breathing exercises, they are the foundation for creating a functional and strong core and body in general. To learn more about these deep core foundations, or to see these exercises visually, you can head to my virtual studio, where I walk you through these steps and show you exactly how to do them. In this studio, I also teach you how to progress into higher intensity exercises while maintaining these same foundations and preventing injury.
I hope this was helpful and that you have a better understanding of Diastasis Recti and your deep core health in general. If you have more questions or concerns, you can head to my instagram where I discuss all of these topics and more.
Wishing you all a healthy and vibrant journey,
Annie