Diastasis recti abdominis or DRA is when the two rectus abdominis muscles become separated along the linea alba or the fibrous band of tissue that runs from the bottom of the sternum (xiphoid process) to the symphysis pubis.
- Lay down with knees bent and place two fingers horizontally directly above and below the umbilicus, palm facing you.
- Perform a sit up. Feel for space between the muscles, and how many finger widths can be fit into this space (the abdominal muscles will be felt to either side)
- The degree of separation is measured according to the number of finger widths that can be placed in the separation. A gap of 1 finger or less is considered normal.
- If separation is greater than 2 finger widths and you are still pregnant, do not directly train abdominals as you definitely have diastasis recti and can worsen it.
DRA occurs when there are changes in the elastic hormones in the connective tissue, increased stress put on the abdominal wall by the growing fetus, and the movement of abdominal organs. Other contributing factors include fetal size and number, number of previous pregnancies, placenta size, amount of amniotic fluid, amount of weight gain, length of torso and strength of abdominal muscles. Women with strong abs are likely more prepared to resist diastasis recti as ab exercise also increases strength and elasticity of linea alba. It is particularly important to train tranverse abs.
A bulge may appear in the abdomen where the separation occurs. This separation usually develops during the third trimester of pregnancy, however sometimes shows up in the second, or postpartum period.
DRA is fairly common and affects about 67% of pregnant women. 53% of women continue to see this separation in the immediate postpartum period.
Diastasis recti weakens the abdominal muscles and affects their function. The loss of trunk and pelvic stability, support in posture and abdominal viscera and compromise in respiration and trunk movement leaves to instability in the spine and pelvis. This leave the body more susceptible to injury.
It is not proven either way whether training core before pregnancy can reduce risk of developing DRA, however it is theoretically believed that women who exercise before and during pregnancy have stronger muscle activation and control, which reduces strain on the linea alba.
Are you free and clear to train core? You still have to adjust your core training during pregnancy, even if no diastasis recti has appeared yet. Here are some great, pregnancy safe core exercises if separation is less than 2 fingers and you do not experience any cramping or pain during these movements.
Best Core Exercises during Pregnancy:
Oblique Crunches with Towel
Crunches with Towel
Seated Position Abs
Side/Side Knee Twists
Plank Side Twists
Cat Cow Pose
What to avoid if you have DR:
– If you have DR, stop directly training core until postpartum (no sits up, planks, etc)
– Avoid upper or lower body exercises that involve spinal rotation because the internal and external obliques are indirectly attached to the rectus abdominis and exert a pull that may widen the gap as they contract and shorten.
– EXAMPLE OF EXERCISE TO AVOID: Side Lunge Twist to Overhead Press
What to do:
– Abdominal compression and pelvic tilt exercises train the deeper transverse abdominis and involve pulling the navel toward the spine while slowly and forcibly exhaling.
– Abdominal Compression
– Pelvic Tilt Against Wall
Pelvic tilt is another good option:
– Pelvic Tilt on Stability Ball
– Pelvic Tilt Against Wall
– Cat Cow Pose with Pelvic Rotation
- Both abdominal compression and pelvic tilts aid in postural alignment and pelvic stability
- Can be performed sitting, standing, side-lying, on hand-and-knees – just avoid supine after first trimester
- Try to maintain neutral pelvic and spinal alignment during all activities, not just when targeting core
Great news!!! It is never too late to correct this frustrating condition once your doctor gives you the approval to return to exercise post partum. Depending upon the severity of your separation, diastasis recti can be reversed in anywhere from 6 weeks to a year. It is important to gauge your progress by reevaluating your separation using the method explained earlier and not to push your body to heal too quickly. These things can take time, but your patience and attention to detail with form will pay off.
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