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How do you heal diastasis recti?

In this blog post I’m going to go through all the things you need to do to address your DR.

We are going to talk about exercises that focus on the abdominal muscles as they are absolutely an important part of rehabilitation.

HOWEVER, they are not the ONLY part of rehab.

So we’re going to start with a couple of things that you might not have thought of and THEN we will talk about ab exercises - (part 3, if you want to skip to it).

THE BREATH

The first thing you should address is your breathing mechanics - I know, I know, you think it’s mega boring and CBA* - just get to the core exercises! But breathing is the first function of the core (think, your baby can do this, but can’t yet hold itself up). I have met a lot of women with a stubborn DR, and when we improve their breathing mechanics, it suddenly gets a lot better.

* CBA = British slang for can’t be arsed

I won’t bore you with a full spiel on breathing, but here are a few things you should be looking for.

  • Chest breathing - lots of women breath up into their chests, and not down into their belly and pelvic floor. This means those muscles aren’t going through a gentle stretch-contract cycle, which is important for their proper function

  • Holding your tummy in all the time - if you are trying to suck your tummy in ALL the time, you can’t breath into it.

  • Overactive diaphragm - some women bear down unnecessarily with their diaphragm in order to exhale or create stability - this creates a lot of pressure down on the lower belly (and pelvic floor) which can cause these muscles to bulge. These women need to learn to relax their diaphragms.

If you would like to know more about breathing, you can watch this video.

If you are a total geek (like me) and would STILL like to know MORE - please let me know and I will create more content on breathing (it just doesn’t seem to interest most people)

ALIGNMENT

You just need to stand up straight right?

Well, yeah, but most women, when they try to do this just thrust their chest up into the air, like this:

This is called a “military stance” and isn’t really ideal either. Sucking your tummy in hard and thrusting your rib cage up isn’t an ideal strategy.

The posture habit that I most see with mums is a tucked bum, and the rib cage translated backwards, like this:

Notice how the upper back lines up with the bum. This tends to jutt the hips forward - the bum goes flat and the belly sticks out.

I drew a picture of it, to help you visualize it better. Notice how in the drawing on the right, the plumb line from the upper back is behind the bum. On the left drawing, head, rib cage, pelvis and feet all line up.

There also tends to be a lot of internal rotation of the shoulders and the chest muscles get really tight, and the upper back muscles get weak (which we can stretch with mobility work and strengthen with strength training respectively).

And it’s not a surprise that women get stuck like this, because it’s really common in pregnancy to stand like this:

And then when you’ve got a newborn to stand like this:

While it's ok to hold your baby like this (it's very hard not to!) it is important that we get into better alignment when we can, which means that the diaphragm (bottom of the rib cage) lines up with the pelvic floor. It doesn’t have to be perfect all the time, but recognizing and getting into better alignment is the first step. Then we need to use strength training to strengthen the bits that are going to help you get and stay there.

CORE EXERCISES

Ok, so now we’re on to the bit that you really want to know… “what core exercises should I do?”

So I often get asked “can you give me a few exercises to get rid of my pouch”, and there are plenty of videos and articles on the internet that proclaim “3 exercises to get rid of your mummy tummy NOW!”.

It’s not quite as simple as this, if it were, no-one would be asking this question. There simply are not 3 exercises that help EVERYONE. A diastasis looks and functions differently from person to person. It might be higher up or lower down. The severity might be different - it might be deeper or wider. One woman may be able to engage her core better than another. One might bulge when she does a crunch, but not when she does a plank; another bulges when she leans back but can perform a crunch no problem - so we need to see how each woman performs in different exercises and movements.

Then we need to figure out how we can CHALLENGE those muscles (and connective tissue) in various movements, but not OVERWHELM them. If the movement or exercise is too difficult, the muscles will bulge.