If a postpartum pooch is making you self-conscious, we know how you feel! Diastasis recti or the mommy tummy affects about 40 percent of unsuspecting new moms, causing them to look pregnant even 6 months after delivery.1 But this jutting out of the belly is not something that happens post delivery.
Our internal organs in the abdominal region are held together by the “six-pack” or rectus abdominis muscles. This set of two muscles stands guard, vertically, on each side of the abdomen. Through the course of your pregnancy, as the tummy grows, the linea alba, the tissue that connects this pair of muscles, stretches and becomes weak. The weakening is aggravated by the effect of pregnancy hormones such as relaxin, progesterone, and estrogen. This leads to diastasis recti or a separation of the rectus abdominis pair.
The abdominal separation occurs in all pregnant women and usually sorts itself out on its own after delivery. But in several cases, it continues to persist well past 4–8 weeks after delivery.2 When the separation between the abdominal muscles is over 2 finger spaces (about 25 mm), it causes the tummy to stick out, making you look pregnant (yes, we see the irony of it!). But physical appearance aside, because the muscles of the abdomen support trunk control, diastasis recti can adversely affect posture, core strength, trunk stability, and trunk rotation. It can also cause or aggravate lower back pain, urinary incontinence, umbilical hernia, and pain during sex.3 4
The exercises that follow for diastasis can be explored after your delivery and once you have your doctor’s go-ahead, especially if you’ve had a C-section. If you suspect diastasis during pregnancy and want to take remedial action, consult a physiotherapist who will check the integrity of the muscles and prescribe a safe prenatal regimen suited to you.
While severe cases of diastasis recti may need to be corrected surgically, exercise targeting the abs can make a great difference in most instances. The good news is that the right workout will help whether your separation is just three months old or you have a gorgeous teenager to show for it! Exercise programs such as the Tupler Technique and the Mutu systems that claim to specifically target diastasis recti have gained popularity in the last few years. These programs essentially focus on two aspects – strengthening the core and strengthening the transverse abdominal muscles. Strengthening these muscles ensures your abdominal organs are well-supported and there is less pressure on other connective tissue. These two aspects are considered more vital to overall strength and stability than closing the gap completely.
The exercises that follow can help you manage and heal diastasis recti. What makes these exercises ideal for busy new and not-so-new moms is that they do not need a separate regimen. Once you master exercises properly, you can do them even as you go about your daily routine.5
1. Tummy Tuck Exercise
Traditional abdominal exercises like crunches, bicycle crunches, or sit-ups may not work when it comes to diastasis recti. In fact, many experts suggest that some of these flexion moves, if done without appropriate modifications, may actually be counterproductive and stretch the linea alba further.6
This basic and deceptively simple move stabilizes your core and also strengthens and tones your transverse muscles. No wonder, then, that the tummy tuck exercise forms the foundation of exercises for diastasis recti.
- Lie on your back and keep your knees bent. Breathe normally.
- Pull in your tummy below the belly button, drawing in the abdomen all the way toward your spine.
- Do not suspend breathing or suck in the entire tummy as you would while posing for a photograph! The move should only involve the lower abdomen.
- Hold the move for 10–30 seconds.
- You can aim at 10 reps 3 times a day.
Once you master the exercise, you can do this contraction while sitting, standing, or even carrying your baby around.
2. Pelvic Squeeze
From sorting out urinary incontinence or even the inability to attain orgasm, there’s much that Kegels can do for you. This simple Kegels squeeze involves tightening your pelvic floor muscles and can help strengthen the core as well.
- Lie down in a comfortable position.
- While breathing normally, tighten the front and back pelvic floor muscles as if you were trying to stop yourself from urinating.
- Hold the contraction for 10 seconds.
- Do 20 reps three times a day.
Once you have perfected this, you can do faster rounds, squeezing for one second and then letting go. This move can be done anytime, in almost any position during the course of the day.
3. Pelvic Tilt
Be wary of exercise systems claiming to offer miracle cures for diastasis recti. For instance, a program that claimed to “close the gap” with a specific 10-min daily exercise raised hopes but also eyebrows – to the extent that the American Physical Therapy Association issued a statement pointing out the flaws in the assumptions.7
This fundamental move practiced in yoga and pilates works the transverse muscles and tightens them. The trick to perfecting this move is to keep the focus on the pelvic muscles without involving your glutes.
- Lie on your back with your knees bent.
- Place your hands, palms down, on your lower abdomen and contract your lower abdomen muscles.
- Breathe normally, while rolling the pelvis up till your lower back is flat against the floor. Keep the shoulders relaxed.
- Hold the position for 10 seconds and then relax the pelvis down. Do 5 reps of this move.
4. Upright Plank With Support
While the traditional plank pose is great for strengthening the core, it should be avoided if you have diastasis recti as it puts pressure on the abdominal separation.8 Instead, you can modify the plank pose and practice it in the standing position with a wall for support.
- Stand straight facing a wall and rest your palms flat on the wall, keeping your arms and shoulders straight.
- Draw your belly button close to your spine to engage your core, while breathing normally. Do ten reps.
- If you can hold this pose for 10 seconds and still feel strong in your core, you could give the move a boost by adding a few wall push-ups.
5. Upward Plank
Apart from these exercises, if you want to add another core strengthening exercise to your routine, the upward plank (purvottanasana in yoga) could be your best bet. This move has an additional perk – it also helps to strengthen your back.9
- Lie in the supine position. Keep your legs hip-width apart, with your feet flat on the ground, toes pointing straight forward.
- Support your shoulders by placing your hands beneath them. Slowly move your heels toward your buttocks so that your fingers can touch the heels.
- While breathing in, lift the hips up off the floor.
- While breathing out, press your hands into your shoulders and spread out your collarbones. Now breathe out slowly.
- Hold the pose for at least 5 breaths – you can gradually bring it up to 20 breaths.
6. Deep Belly Breathing
If you’ve had a history of diastasis and plan to get pregnant again soon, work on reducing the separation before your next pregnancy occurs. The diastasis weakens the body’s natural support system for the back and internal organs. When the uterus is not well supported, you may also have trouble pushing during labor.
The benefits of deep belly breathing are legendary. Practice it correctly and you can tone your abdominal muscles. The bonus? It stabilizes the heart rate, reduces blood pressure, and lowers stress levels.10
- Sit down cross-legged on the floor or lie on your back on a mat.
- Inhale deeply, till you can feel the fullness in your belly and chest.
- Then exhale gradually, tightening your abdominal wall.
- Do 10 reps, 3 times a day.
To splint or not to splint? Using a special diastasis recti splint to bind the belly, especially while exercising, is an integral part of some exercise systems. While there is little evidence to show that a splint can strengthen the core or close the gap, it can support your lower back and hold you in, making the pooch less obvious. If you choose to wear a splint, a physiotherapist can show you how to splint and help you find the best fit.
Strengthening and restoring the core after pregnancy is a holistic process that goes beyond healing the separation of muscles. Correct posture, getting enough rest, not engaging in heavy-duty work can all help. Once you have found the moves that work for your diastasis recti, make them a part of your daily routine and you will find several gaps closing on their own!
|↑1||Chiarello, Cynthia M., Laura A. Falzone, Kristin E. McCaslin, Mita N. Patel, and Kristen R. Ulery. “The effects of an exercise program on diastasis recti abdominis in pregnant women.” Journal of Women’s Health Physical Therapy 29, no. 1 (2005): 11-16.|
|↑2||Bursch, S. Gail. “Interrater reliability of diastasis recti abdominis measurement.” Physical therapy67, no. 7 (1987): 1077-1079.|
|↑3||Litos, Karen. “Progressive therapeutic exercise program for successful treatment of a postpartum woman with a severe diastasis recti abdominis.” Journal of Women’s Health Physical Therapy 38, no. 2 (2014): 58-73.|
|↑4||Kulhanek, J., and O. Mestak. “Treatment of umbilical hernia and recti muscles diastasis without a periumbilical incision.” Hernia 17, no. 4 (2013): 527-530.|
|↑5||Recti Divarication. Oxford University Hospitals.|
|↑6, ↑8||DiFiore, Judy. The complete guide to postnatal fitness. A&C Black, 2013.|
|↑7||APTA, Women’s Section Help Clear Up Misinformation in NPR ‘Mummy Tummy’ Report. American Physical Therapy Association.|
|↑9||Prenatal Yoga: 6 Feel Good Backbends Safe For Pregnancy. Yoga Journal|
|↑10||Relaxation Techniques: Breath Control Helps Quell Errant Stress Response. Harvard Medical School.|