What’s the go with abdominal separation post birth?

 

Diastasis recti, or abdominal separation is very common to experience after birth. Your tummy muscles have literally been stretched to the max to carry and deliver this little miracle. 

 

What happens is the Linea Alba (connective tissue between the two rectus abdominal muscles ‘six pack muscles’) starts to stretch with the aid of the relaxin hormone, creating literally a gap or space between these muscles. The size of this gap can range from just a finger space or two, to severe separation of two hand spaces.

 

You need to always get the ok from your doctor prior to exercising again (this is normally around six weeks post birth) and ensure you do the appropriate abdominal exercises to help your body recover, not make it worse. We will go through some great exercises to help that separation heal, however you must also give it time depending on the severity of the separation.

 

Unfortunately, I have seen many women over the years who still have diastasis recti and are not even aware of it, thinking that it is just ‘loose skin,’ belly fat’ or ‘weak abdominals.’ Some of these women have given birth within the last three or six months, but some going on 10 years or greater that do not realise their tummy muscles are still separated and were not given adequate guidance at the start.

 

To be honest, had I not have known and studied anatomy, Pilates, fitness and postnatal exercises I don’t believe I would have recovered from my own ab separation, injured back and weakened pelvic floor with the sheet of paper they gave me at the hospital!! 

 

After I gave birth to Lincoln I had a seven finger abdominal space. It was a very weird sensation as I was used to being able to easily control and pull in my core after all these years of Pilates and exercise. 

 

*Side – note /funny story* one nurse at the hospital told me I was better off being unfit as the muscles would have stretched more easily (I wonder!?) however, in knowing what exercises to do and not to do I was able to rehab and full get my core back within about 12 months. 

 

It was a slow process and took 18 months for me to get the advanced ‘ab’ stuff I was doing prior, but I didn’t rush or push myself beyond what I was ready for and did not want to make the abdominal separation even worse, which is what many do unknowingly.

 

You may even be recommended to get a corset or abdominal support of sorts to help hug in the area, however do not rely on this as the solution as you are not really training and strengthening your muscles. It is simply to act as a support temporarily.

 

At the end of the day, you need to be doing the specific exercises listed below or whatever your physiotherapist has prescribed to help heal your diastasis recti. 

 

Here’s the low down to help understand ‘diastasis recti’ a little better:

 

How to test for ‘diastasis recti’

 

1. Lay on your back, knees bent
2. Place one hand behind your head, one hand with fingertips pointed downwards laying across midline, just under the belly button (you can also do this just above the belly aswell as this area may differ from the lower area.)
3. Lift your head and neck off the floor like you are about to do a ‘crunch’ type movement keeping hand on tummy, and hold yourself up till you feel how many fingers can fit between the two abdominal muscles just below your belly button. You will feel a ‘ditch’ or gap. This is the evidence that you have abdominal separation. 
4. If you do not feel that ‘gap’ when you are lifted (and remember it’s right below your belly button), then you do not have diastasis recti. 

 

**If you are still unsure however, do get your doctor to physically check you because the exercise path you choose from here can greatly help or hinder your ‘core’ and recovery of abdominals post birth.

 

Exercises to avoid during diastasis recti

 

In a nutshell avoid:

*crunches

*sit ups

*planks

*incline sit ups

*double leg lowers

*jack-knife type moves

*lifting the legs off the floor and rolling back and over 

*reverse crunches where knees come in

*back extensions (where you are laying on tummy and lifting your chest off the floor)

 

Pretty much any intensive loaded movement for the abs and core (including your back) which traditionally many fitness facilities and trainers would teach if they have not properly studied abdominal separation. I’ve seen it happen time and time again, women who are given exercises post birth wanting to get their body back but causing more damage. 

 

*Tip: ensure your trainer (if you are going to do face to face sessions with someone) has studied specific postnatal recovery in their fitness/ yoga/ pilates studies, whatever the case may be.

 

Why should I avoid those moves? 

 

Basically, if you think about two separated abdominals trying to mend back together, you would not do intense movements that create a tendency to ‘bulge’ out of that weakened area. If you ever do a crunch type movement it is likely that you would slightly pop out at the lower tummy area. 

 

If you are an expert at this and have the perfect deep core control where there is no bulge whatsoever when you lift your chest off the ground (and to be honest, I think I’ve met one or two people out of probably over 1000 I’ve taught over the years that can actually do this!!) then you are adding undue pressure on the abdominal cavity and damaging the wound, so to speak.

 

Think about it this way – if you cut your finger and put a bandaid over it, would you then go and squeeze your finger where the wound was pushing open? No way! You would keep it as straight as possible and allow it to rest and recover applying pressure the opposite way.

 

So in the case of your tummy – it is best to lay down on your back and train the muscles to draw in, lift up through your pelvic floor, and bring together those separated rectus abdominis. 

 

Exercises safe for diastasis recti

 

Tips:

*Focus on connecting to your deep abdominals

*Slow down your moves, it’s about deep internal muscles work different to regular ab exercises

*Be patient with these exercises as it takes time to firstly understand the technique, then feel the muscles, then correctly execute

 

The Exercises: I recommend doing these minimum three and up to six days per week. When you training deeper core muscles like this you are not really overdoing it,so the usual rest times for exercise do not apply. In fact, it will help your body greater if you can do them daily.

 

Note – each of these build on from each other, so do them in order for greater body awareness.

 

 

• Pelvic floor and TA activation: 

 

1. 1. 1. Lay on your back, shoulders relaxed
      2. Knees, bent, lower back in neutral (a small and natural gap between the floor and your lower back)
      3. Place two fingertips just inside both hip bones
      4. Take a deep breath in, and as you exhale gently lift your pelvic floor muscles upward, at the same time draw in your belly area toward your spine (without moving hips or pressing your lower back down)
      5. Hold the ab contraction for 5 to 10 seconds while breathing slowly
      6. Repeat 5 x times

 

• Knee Floats:

 

1. 1. 1. Lay on your back, shoulders relaxed
      2. Knees bent feet on floor, lower back in neutral, legs 90 degrees
      3. Bring hands resting on your belly area
      4. Inhale, and as your exhale pick up one leg to a 90 degree angle off floor, where your shin is parallel to the floor, knee above hip
      5. Inhale again, and float your other leg up to 90 degrees without popping your belly up at all – it is when that second leg lifts that you need to be drawing the lower core tightly in as best you can
      6. Hold for a breath, then inhale lower one leg, exhale lower the other keeping hip as stable as possible
      7. Repeat 10 x times

 

• Leg Extension

 

1. 1. 1. Lay on your back, shoulders relaxed
      2. Knees bent feet on floor, lower back in neutral, legs 90 degrees
      3. Bring hands resting on your belly area
      4. Inhale, and as your exhale pick up one leg to a 90 degree angle off floor, where your shin is parallel to the floor, knee above hip
      5. Inhale again, and float your other leg up to 90 degrees without popping your belly up at all – it is when that second leg lifts that you need to be drawing the lower core tightly in as best you can
      6. Inhale, stretch one leg out straightening your knee and squeezing your thigh (keeping foot in line with other knee, and other knee completely still)
      7. Exhale, bring the leg back in
      8. Repeat on other leg extending it out
      9. Repeat 10x each leg. If you feel you are starting to bulge out your lower abs, slowly bring your legs down and start again

 

 

• Knee Sides

 

1. 1. 1. Lay on your back, shoulders relaxed
      2. Knees bent feet on floor together (feet touching together), lower back in neutral, legs 90 degrees
      3. Rest hands on each hip bone to ensure they remain steady
      4. Inhale, then exhale drawing belly to spine without pressing back to the floor (just remain in neutral)
      5. Inhale, opening one knee towards the floor as if it is falling. Only open as far as you can without hips falling and maintaining that strong core
      6. Exhale, slowly bring the knee back up to start position
      7. Repeat 10 x each side

 

• Leg Circles

 

1. 1. Lay on your back, shoulders relaxed
   2. Knees bent feet on floor hip distance apart, spine in neutral
   3. Rest hands on each hip bone to ensure they remain steady
   4. Extend one leg straight up towards the ceiling, squeezing your thigh and gently pointing foot to engage leg muscles (imagine you are balancing a glass of water on your other knee which does not move at all)
   5. Start to draw a straight line down through that leg, slowly circling the leg around and back up to the start position
   6. Repeat 6-10 x each leg maintain hip stability and abs pulled in as best you can

 

Once you are getting the hang of these first 5, you can progress to :

 

Advanced: Double Leg lowers

1. Lay on your back, shoulders relaxed
2. Knees bent feet on floor, lower back in neutral, legs 90 degrees
3. Bring hands resting on your belly area
4. Inhale, and as your exhale pick up one leg to a 90 degree angle off floor, where your shin is parallel to the floor, knee above hip
5. Inhale again, and float your other leg up to 90 degrees without popping your belly up at all – it is when that second leg lifts that you need to be drawing the lower core tightly in as best you can
6. Bringing both knees and feet together, tap both feet to the floor maintain 90 degrees at the knees (not dropping your feet to your butt!)
7. ONLY do this if you can do a single version or the ‘leg extension’ exercise successfully without letting the tummy pop out at all

 

Allow your body at least 9 months to get back to how it was prebirth. But to be honest, longer is more realistic so do not get pressured by social media or ‘quick recoveries’ as we are all on a different journey.

 

Respect where you are at, build accordingly and be proud of yourself. After all, you had a baby! Totally amazing.

 

Once your diastasis recti is fully healed, then can you resume regular abdominal and other exercises however, you will always want to be doing precise and good technique with a focus on your deeper core forever, not just postpartum!

 

If you need help with this or have any questions at all about this, post below and I’ll get back to you. Xx

All the best! Chat soon,