In Part 2 of our 3 part series on Diastasis Recti (Mommy Tummy) we are discussing the topic – How do I start to heal my Diastasis Recti Abdominis?
There are a number of things that need to be functioning properly to help heal diastasis recti (low back, pelvic floor, abdominals, and diaphragm), however there is not enough time in this article to go into all the details so I will touch on 2 big things and you are welcome to reach out for more info on the rest! See the video for an idea of what proper core activation should look like versus improper core activation.
- Proper Breathing Mechanics – This is one of the most important things to start the healing process of your DRA since increased intra-abdominal pressure (the pressure inside your abdomen) plays a large part in worsening your DRA. When we hold our breath and sit-up from bed or lift something heavy, the pressure inside our abdomen is pushing forcefully outward and will head in the direction of the weakest muscle, which is usually our abdomen or pelvic floor after pregnancy. The increased pressure pushes through the gap in the muscles (whether abdomen or pelvic floor) and can increase the width of the gap even more. Therefore, it is important to make sure that you do not hold your breath with exercise or lifting. Try to think about blowing out a birthday candle as you sit up from bed or pick up your child from the floor to help prevent your intra-abdominal pressure from increasing too much.
- Proper Core Activation – Your core is made up of several muscles, including the multifidi (low back), diaphragm (lungs), pelvic floor, and abdominals, all of which have an important role in making our core strong. We will focus on abdominals in this article, particularly the transverse abdominus, also known as your corset muscle. The transverse abdominus is the deepest layer of your core and wraps all the way from the front of the abdomen to the low back. Most people think of their “6-pack” or rectus abdominus as their core, however the core is made up of so much more and needs to be properly activated for optimal muscle performance. Think about gently drawing your hip bones up towards your belly button, your ribs together and down, your belly button to spine, and blow out an imaginary birthday candle (see video below) This can be hard to figure out initially and if you feel like you are having trouble you may need to reach out to a pelvic health physical therapist or other health care provider for guidance.
Several things I recommend avoiding (if possible) while you are healing from your diastasis recti are sit ups, push-ups, planks, and any other forward bending core exercises that may increase the intra-abdominal pressure and worsen your diastasis. Just remember, the goal is to be able to do those things again one day, but initially it is best to start slow and build up the strength in your core before attempting more vigorous exercises.
If you feel like these exercises were helpful, try incorporating them into your daily activities like getting out of bed, squatting to pick up your children, or while exercising at the gym and see if your symptoms start to improve. If you are having a hard time with breathing mechanics, activating your abdominal muscles, or don’t seem to be making any progress with the above tips then I recommend meeting with a pelvic health physical therapist or someone who specializes in diastasis recti to make sure you are performing the exercises properly and to see if anything else (low back, pelvic floor, etc.) may be contributing to your weakness or pain.
STAY TUNED for PART 3 to learn about how you can progress the above exercises and strengthen your core even more and READ PART 1 Now!
Mary Brian Yoffe, PT, DPT
Pelvic Health Specialist, Women’s Health Specialist