Regaining Core Strength After Pregnancy: A Guide to Diastasis Recti

Are you a new mom struggling to regain your core strength after pregnancy? Some of you who are nodding “yes” are 6 months postpartum…..and some of you are 6 years or more so please know you're not alone. Many women experience a common condition called diastasis rectus abdominus (DRA) which refers to the separation of the abdominal muscles, during pregnancy. While some will spontaneously heal in the postpartum period, many will not.  In an effort to “tone” their stretched-out bellies, women often punish themselves at the gym by doing traditional “ab” exercises which can heartbreakingly make the condition even worse.  In addition to causing the unsightly mom “pooch”, abdominal weakness can also cause lower back pain, poor posture, urinary leakage, and difficulty with everyday activities.

But don't worry, I’ve got you covered. In this comprehensive guide, I’ll do my best to provide you with expert tips and exercises to help you regain your core strength and help heal your diastasis recti while keeping in mind that everyone’s experience with DRA is individual and you need to take a total body approach to a midsection problem!

I understand the challenges new moms face when it comes to postpartum recovery. That's why I've compiled the latest research and insights from leading experts in the field. You can trust my content to be accurate, reliable, and tailored to your specific needs.

Whether you gave birth three months ago or three years ago, it's never too late to start strengthening your core. So let's get started on your journey to regaining core strength after pregnancy and coming home to your body.

What is Diastasis Rectus Abdominus?

DRA is a condition that occurs when the two “6 pack” muscles separate beyond a normal amount and stretch the connective tissue (linea alba) that lies between them.  So now you’re probably wondering “What’s a normal amount?”  Great question!  There is always a tiny space between these muscle bellies.  The normal space is about 0.5 cm or think about the distance between two of your knuckles.  Researchers debate the amount of space required to be considered DRA, but the general consensus is anything above 2 to 2.5 cm.  This separation is fairly common during and after pregnancy, as the growing uterus puts pressure on the connective tissue. Pregnant women are more vulnerable to experience this condition due to their hormonal environment which serves to soften the connective tissue all over the body and as a result of poor pressure management strategies combined with the extra weight and pressure of a pregnancy.

It's important to note that diastasis recti is not a medical emergency, but it can have a significant impact on your quality of life. Many women with diastasis recti experience lower back pain, poor posture, and a weakened core. If left untreated, it can also lead to a hernia or pelvic floor dysfunction.

Understanding the Causes and Symptoms of Diastasis Recti

Diastasis recti occurs when the connective tissue that holds the abdominal muscles together becomes thin and weak. This can happen due to a variety of factors, including:

1. Pregnancy: The growing uterus puts pressure on the connective tissue which causes the rectus abdominus muscles to separate.
2. Multiple pregnancies: Women who have had multiple pregnancies are more likely to develop diastasis recti, as the abdominal muscles have been stretched multiple times.
3. Age: As we age, our muscles naturally weaken and lose elasticity, making it easier for diastasis recti to occur.
4. Incorrect exercises: Certain exercises, such as traditional crunches or sit-ups, can put strain on the abdominal muscles and contribute to diastasis recti if intra-abdominal pressure is not managed.

The most common symptom of diastasis recti is a visible bulge or ridge in the middle of the abdomen. Many women report seeing a doming or tenting in this region especially when going from lying down to sitting up when engaging their abs with sit-ups or other exercises, and/or while standing and leaning backward.  Because this causes weakness of the core system, other symptoms may include lower back pain, poor posture, urinary leakage, and difficulty with everyday activities such as lifting heavy objects or getting up from a lying position.

The Importance of Regaining Core Strength After Pregnancy

Regaining core strength after pregnancy is crucial for several reasons. First and foremost, a strong core provides stability and support for the entire body. It helps maintain proper posture, prevents back pain, and improves overall strength and balance.

Additionally, a strong core is essential for functional movements and everyday activities. Whether you're carrying your baby, lifting groceries, or bending down to pick up toys, a strong core will make these tasks easier and safer.

Furthermore, regaining core strength can have a positive impact on your mental and emotional well-being. Pregnancy and childbirth can take a toll on your self-confidence and body image. By working on your core strength and seeing tangible improvements, you'll gain a sense of accomplishment and feel more confident in your postpartum body.

Diagnosing Diastasis Recti and Seeking Professional Help

If you suspect you have diastasis recti, it's important to get an accurate diagnosis from a healthcare professional. While self-diagnosis is possible, seeking professional help will ensure you receive the right treatment and guidance for your specific condition.

For step-by-step instructions on how to test yourself for this condition, watch this video: https://www.carriekoziol.com/testing-for-dra.

The benefits of being tested by a healthcare professional familiar with DRA, are that in addition to testing the depth and width of your separation at all three locations (just above the umbilicus, halfway between the umbilicus and sternum, and then halfway between the umbilicus and pubic bone), a DRA specialist can determine if you are generating tension in the connective tissue, assess your breathing pattern, analyze your posture, and evaluate core strength with special attention on the important pelvic floor muscles.

Based on the severity of your diastasis recti, your healthcare provider may recommend different treatment options. In some cases, physical therapy or specialized exercises may be sufficient to repair the separation. However, more severe cases may require surgical intervention.  Surgery is a last resort after more conservative options have been fully explored.  This surgery will repair the anatomical abnormality, but it will not address the biomechanical forces that created the separation and seeing a physical therapist or DRA specialist before and after the surgery is imperative to your full recovery.

Remember, every woman's body is unique, and what works for one person may not work for another. It's important to consult with a healthcare professional who can provide personalized guidance and support throughout your recovery journey.

Exercises and Techniques to Heal Diastasis Recti

There is not a “one size fits all” approach to healing DRA and it is necessary to take a whole-body approach when addressing a midsection problem. Fortunately, there are several exercises and techniques that can be helpful for almost everyone when it comes to healing diastasis recti and strengthening your core muscles. It's important to note that not all exercises are suitable for everyone, especially in the early stages of recovery. Always listen to your body and consult with a healthcare professional before starting any new exercise program.

1. Breathing exercises: Never before has it been more important to re-establish a 360 degree breath.  That means on the inhale your ribs are able to expand out to the sides, your sternum can move forward and you can breathe all the way in to your back.  This might require specific exercises to encourage rib mobility and stretch the intercostals (the tiny muscles within the rib cage).  Deep breathing like this not only sets up a coordinated “piston” system between your diaphragm and pelvic floor muscles but it also helps you tap into the parasympathetic nervous system, otherwise known as the rest and digest nervous system, where true healing can take place. 
2. Pelvic floor activation AND relaxation:  The pelvic floor is the bottom of your core and these muscles are best friends with your deep abdominals.  It’s virtually impossible to fully rehabilitate your abdominals without bringing these little gems along for the ride.  Most people can afford some strengthening in this area, especially after birth.  However, some people have hypertonic (or overactive pelvic floor muscles) and might need to work on lengthening and relaxing them before doing a lot of Kegels or pelvic floor contractions.  A healthcare professional like a pelvic floor specialist can help you determine what your body needs! 
3. Transversus abdominal exercises: The transversus abdominal muscles are the deepest layer of the core muscles and play a crucial role in stabilizing the spine. To engage these muscles, lie on your back with your knees bent and feet flat on the floor. Place your hands on your lower abdomen and imagine drawing your belly button halfway back towards your spine while trying to bring your front two pelvic bones towards the center of the body. Hold for a few seconds, then release. Repeat 10-15 times.

Remember to start slowly and gradually increase the intensity and duration of your exercises as your core strength improves. It's important to listen to your body and avoid any exercises that cause pain or discomfort. If you're unsure about proper form or technique, consider working with a qualified fitness professional or physical therapist.

Creating a Postpartum Fitness Routine to Regain Core Strength

In addition to specific exercises, incorporating a well-rounded postpartum fitness routine is key to regaining core strength and overall fitness. Here are some tips to help you create a routine that works for you:

1. Start with low-impact exercises: In the early stages of postpartum recovery, it's important to prioritize low-impact exercises that are gentle on your body. Your priority should be quality over quantity.
2. Gradually increase intensity: As your body begins to heal and your core strength improves, you can gradually incorporate higher-intensity exercises into your routine. Start with adding weights, resistance, or overpressure in anti-gravity positions.  Then progress to working in weight-bearing positions and in other planes of motion like the sagittal and transverse plane. 
3. Listen to your body: Pay attention to how your body feels during and after exercise. If you experience pain, dizziness, or any other discomfort, it's important to take a break and consult with a healthcare professional.
4. Stay consistent: Consistency is key when it comes to regaining core strength and overall fitness. Aim for at least 30 minutes of moderate-intensity exercise most days of the week. Find activities that you enjoy and make them a regular part of your routine.
5. Remember that your body responds to the forces you place on it all day long, not just during your exercise session.  Avoid getting stuck in one position for too long and instead strive to be dynamic in both your work and your play.  Be mindful of your posture and remember that you need a whole-body approach to a midsection issue.

Every woman's postpartum journey is unique, and it's important to honor your body's needs and limitations. Be patient with yourself and celebrate every small victory along the way.

Nutrition Tips for Healing Diastasis Recti

In addition to exercise, proper nutrition plays a crucial role in healing diastasis recti and supporting your overall postpartum recovery. As the saying goes: Abs are made in the kitchen and perfected with exercise.  Here are some nutrition tips to consider:

1. Stay hydrated: Drinking enough water is essential for overall health and recovery. Aim to drink at least 8-10 glasses of water per day, or more if you're breastfeeding.
2. Your goal is to avoid inflammatory foods and flock towards anti-inflammatory foods.  Everybody has a different tolerance to foods, but the biggest sources of inflammation for most people come from Omega 6 fatty acids (refined vegetable oils), sugar, dairy, red meat, gluten, alcohol, refined/processed grains and foods, wheat, high-carb/low protein diets, trans fats, caffeine, additives/colorings, and/or genetically modified organisms. Instead flock towards anti-inflammatory foods (if you tolerate them!) like bone broth, ginger, raw local honey, Vitamin A rich foods, coriander, onions, garlic, coconut/olive oil, foods high in Omega 3 fatty acids (fatty fish, chia seeds, grass-fed meats, and dairy), probiotics, foods rich in fiber, and fermented foods like sauerkraut, root kraut, Kimchi, and kefir.   
3. Support collagen production: Collagen is a protein that plays a key role in connective tissue health. Consuming foods rich in collagen, such as bone broth, fish, and poultry, can support the healing process.

Remember, nutrition is not about restriction or deprivation. It's about nourishing your body and providing it with the nutrients it needs to heal and thrive. Focus on making small, sustainable changes to your diet and listen to your body's hunger and fullness cues.

Postpartum Support Garments and Tools for Diastasis Recti

In addition to exercises and nutrition, there are various support garments and tools available that can aid in the healing process of diastasis recti. These include:

1. Abdominal binders: Abdominal binders provide support to the abdominal muscles and can help reduce the separation. They are typically worn around the waist and can be adjusted for a customized fit.  Using them temporarily to help engage the core muscles while providing a proprioceptive cue for better posture is imperative, as is ensuring there is not too much pressure being placed on the pelvic floor.  These are not long-term solutions. Taping techniques can also be used in place of binders.
2. Compression garments: Compression garments, such as postpartum belly wraps or leggings, provide gentle compression to the abdomen and can help support the healing process.
3. Core rehabilitation tools: There are various tools available that can assist with core rehabilitation, such as stability balls, resistance bands, and foam rollers. These tools can be used to target specific muscle groups and enhance the effectiveness of your exercises.

When using support garments or tools, it's important to follow the manufacturer's instructions and consult with a healthcare professional if you have any concerns or questions. These tools should be used as a complement to your exercise and nutrition routine, not as a substitute.

Conclusion: Embracing the Journey of Regaining Core Strength After Pregnancy

Regaining core strength after pregnancy and healing diastasis recti is a journey that requires time, patience, and dedication. It's important to approach it with a positive mindset and a commitment to self-care.

Remember, you are not alone in this journey. There are countless resources, healthcare professionals, and communities available to support you along the way. Embrace the process, celebrate your progress, and trust that with consistent effort, you will regain your core strength and live a healthier, more confident postpartum life.

So let's get started on your journey to regaining core strength after pregnancy and saying goodbye to feeling mushy in the middle.