Diastasis Recti:  Abdominal Separation and Exercise Precautions

What is it?

Diastasis recti is a common condition in pregnant and postpartum people. It occurs when the rectus abdominis muscles (six-pack ab muscles) separate during pregnancy from being stretched. It can be repaired or improved with certain deep core exercises but there should also be precautions taken until you have healed those muscles.

How common is it?

Diastasis recti is common in women who are over 35, deliver a high birth weight baby, or have a multiple pregnancy. It’s usually most noticeable right after delivery. It also occurs in middle aged and older men with abdominal obesity.

How do I know if I have diastasis?

Common signs of diastasis recti are:

• A visible bulge or “pooch” that protrudes just above or below the belly button.
• Softness or jelly-like feeling around your belly button.
• Coning or doming when you contract your ab muscles.
• Pelvic or hip pain.
• Low back pain
• Poor posture.
• Urine leaking when you sneeze or cough.
• Feeling weak in your abdominals.

What exercises can help heal a diastasis or improve it?

The best exercises for diastasis recti are those that engage the deep abdominals. Most diastasis recti exercises involve deep breathing and slow, controlled movements. Unfortunately, many of the most common ab exercises (like crunches) can worsen your diastasis.

What exercises should I avoid?

In some cases, it is best to avoid the following categories of exercise in early postpartum (when you are least likely to be able to control intra-abdominal pressure effectively):

• Advanced abdominal exercises that put a lot of stress on the abdominal wall
• Plyometric exercises
• Intense exercises or exercise classes

• Exercises in which the belly/lower pelvic region is bulging up or out (e.g., crunches and sit-ups, leg raises, bicycles, knee tucks, jackknives).
• Exercises in which the belly is hanging down toward the floor and the hands are a farther distance from the feet or knees (e.g., front planks and variations, pushups, renegade rows).

*This is not to say that these exercises are “bad” and must always be avoided, postnatal women should gradually progress toward these exercises, rather than start with them.

Meeting with a physical therapist who specializes in pelvic health and choosing a fitness professional who is aware of diastasis recti are the best tools you have in regaining strength and functionality of these muscles.