Diastasis Recti Exercises to Avoid
What is diastasis recti?
Diastasis recti (DRA), also known as abdominal separation, occurs when the two halves of the rectus abdominis (the "six-pack" muscles) separate along the linea alba (midline) of the abdomen.
Pregnancy is the leading cause of diastasis recti, but anyone can get it from core-straining exercises or movements that put excessive pressure on the abdominals.
If you have diastasis recti, it's important to be mindful of exercises that may worsen the separation or place excessive strain on the core as this could lead to further complications and dysfunctions.
This blog post will go over diastasis recti exercises to avoid.
Should I be aware of every movement and avoid exercising with diastasis recti?
Short answer, no.
With any diagnosis, there are recommendations as well as contraindications to guide people and healthcare providers on certain tasks to avoid, or watch out for, in order to reduce side effects or worsen the condition.
The good news is that a targeted therapeutic exercise routine can help alleviate or even completely heal diastasis recti symptoms! However, before sticking to the usual routine, it's important to understand which diastasis recti exercises are safe and effective, and which diastasis recti exercises to avoid.
What do we need to consider when exercising with diastasis recti?
When exercising with diastasis recti, the core muscles lack integrity and optimal strength. This increases the risk of injury, particularly to the back, core, and pelvic floor musculature.
Additionally, many common exercises people use to strengthen their core can actually worsen or aggravate diastasis recti.
When intra-abdominal pressure increases to unsafe levels, it puts additional strain on the overstretched tissue at the front and center of the abdomen, worsening the separation of the rectus abdominis muscles.
This pressure may also apply downward forces on the pelvic floor, potentially leading to pelvic prolapse and incontinence if not corrected over time. In more severe cases, improper loading and overloading of the abdominal musculature could lead to abdominal or inguinal hernias.
What are some diastasis recti exercises to avoid? Tips:
Avoid exercises or body positions that push the abdominal muscles forward forcefully, cause coning or doming along the midline excessively, or create pain or downward pressure on the pelvic floor.
To safely control intra-abdominal pressure, it’s crucial to consciously exhale and draw the belly-button toward the spine with each exertion. This involves exhaling during the effort phase of an exercise, such as when lifting or pushing.
In the beginning phases of rehabilitation and healing, avoid lifting both shoulders off the floor while lying on your back. This includes refraining from crunches, sit-ups, or even getting out of bed sitting up straight from the back. Once both shoulders are lifted, it becomes biomechanically impossible to prevent the abdominal muscles from bulging forward when the deep core and trunk stability mechanism is not working properly.
It is possible to train the core while laying on the back with modifications, ex. lift one leg at a time while exhaling and pressing your abdominal muscles toward the floor instead of lifting both legs from the ground.
If you notice excessive coning or doming on all fours (ex. a plank position), avoid doing this repeatedly as well. Rather than doing full backbends, upward-facing dog, or full cobra, choose poses with smaller ranges of motion that help keep your ribs anchored in a neutral position.
Especially in early postpartum and early rehabilitation stages, opt for low-impact cardio, like brisk walking, cycling, or swimming, instead of running or jumping.
If doing high-impact activities, use proper breathing and core engagement to manage pressure.
For example, exhale and engage your pelvic floor and core each time you land from a jump.
If you experience pelvic pressure, vaginal heaviness, or urine leakage, stop and focus on diastasis recti exercises until your core and pelvic floor are strong enough for high-impact exercise
See a pelvic floor physical therapist to help guide your rehabilitation
How can pelvic floor physical therapy help in providing appropriate abdominal support and eliminating diastasis recti symptoms?
The earlier pelvic floor physical therapy is started, the faster the road to improved function will occur.
Pelvic floor physical therapy will cover which ab exercises to avoid with your specific symptoms, then offer modifications and movements that are safe for exercising with diastasis recti. Your provider will give you detailed education on why certain exercises should be avoided, as well as step-by-step guides for the modifications and recommended exercises.
It’s important to address the entire body, as some muscles may become overactive and tight during pregnancy. Therefore, improving postural control is crucial for treating diastasis recti as well as focusing on activating the transverse abdominis and pelvic floor.
Pelvic floor physical therapy also helps apply progress to daily activities and ensures proper form for tasks like lifting and carrying a baby.
Working with a qualified pelvic floor physical therapist can help create a personalized plan to improve abdominal and pelvic health, no matter how long the condition has been present.
Even with breastfeeding, it's important to note that hormonal changes can affect muscles and fascia, and full recovery may not be evident until 3-6 months after breastfeeding has stopped.
Research shows it can take 2-3 years for tissue to regain its original strength, so it's essential to challenge the tissue with advanced abdominal exercises and proper form to rebuild resilience.
Where to get help if you have diastasis recti
If you are local to the Jacksonville area and are experiencing pelvic discomfort, frequent urination, leaking with exercise/exertion, or are looking for pelvic floor support during your menopausal years, we’d love to help you here at Samson Strength and Performance Physical Therapy. We offer pelvic health physical therapy services inside our Jacksonville Beach clinic and you can request a call to get started. We’d love to help you.