The "D" Word

OK, so you just had a baby. Congratulations!! You go to your doctor or midwife and they tell you that you have a condition called "Diastasis Recti". Now what? Maybe you've heard this word and thought, "Oh great, I have a DISEASE and now I have to take care of my baby." Well, you're not alone. In fact, you may have been postpartum for years and have just found out that you have Diastasis. 

Oh and by the way- Diastasis is NOT a disease. It's simply just a separation of the fascia (or connective tissue) between the rectus abdominus muscle- your 6 pack muscle. Guess what...you are going to be OK. This separation sometimes goes back on its own, but if your separation is two or more fingers separated, you need to do some work to help it come back together. 

So many women come to me asking how they can heal their DR. I feel so passionate about helping women heal and bring their separation back together, because there is such little information from our health care professionals. They tell us we have this and then send us on our way. I know women that have had Diastasis for 20 or more years! No one ever diagnosed them and now they are in their 40's or 50's with back pain, and pelvic floor disfunction. Now we have so much information about Diastasis that every woman should know what it is and what to do about it! 

The goal in healing DR is to help bring the deep abdominal muscles back to the center by strengthening them. Here are the muscles we will focus on: Deepest abdominal muscle- the Transverse Abdominis, and the Obliques.

What not to do

There are a few NO NO's when it comes to healing DR. 

1.No planks- The intra abdominal pressure could push out against the connective tissue between the rectus, causing further separation. Half planks on the knees and side planks are great.

2. No extreme extension of the spine. For example, up dog in Yoga or swan in Pilates. Again, this could cause further separation of the Rectus Abdominis. 

3. No forward flexion. This is a biggie! For example: Getting out of bed (Roll over to get up). No crunches or roll ups. This could also further separate the Rectus Abdominis. 

What to do

Here are a few exercises that you can do at home- right on the floor with your littles. These exercises are gentle and should be done after approval from your OB or Midwife. If anything doesn't feel comfortable, don't do it- listen to your body!

Keep in mind that I am second trimester pregnant in these photos and you can definitely check for DR throughout your pregnancy. 

 

Diastasis Check 

How to check for Diastasis Recti  1. Lay on back, support head with one hand. Inhale and lift head off the floor. Curl forward just enough to engage abdominals.  2. Check at belly button, below the belly button, and above the belly button. Take two fingers and move back and forth between the rectus abdominis. There will be a space there and you measure the distance between the muscle based on how many fingers you can fit.  3. One finger distance is in the "normal range" and two or more is considered Diastasis Recti

How to check for Diastasis Recti

1. Lay on back, support head with one hand. Inhale and lift head off the floor. Curl forward just enough to engage abdominals.

2. Check at belly button, below the belly button, and above the belly button. Take two fingers and move back and forth between the rectus abdominis. There will be a space there and you measure the distance between the muscle based on how many fingers you can fit.

3. One finger distance is in the "normal range" and two or more is considered Diastasis Recti

Breathing

This is one of my favorites! It is a 3 step breathing exercise to help you gently connect to your deepest abdominal muscle (Transverse Abdominis) and to the pelvic floor.  1. Sit up tall directly over sitting bones, feeling belly button draw back towards the spine (You can also do this lying down). Place hands around rib cage and breathe into hands. Inhale widen ribcage and exhale narrow the ribs, feeling them pull together.  2. Place hands on hip bones. Again, breathe into hands and imagine hip bones widening like the rib cage (the hip bones will not really move. We are using imagery to help us find lower abdominals). Exhale and imagine the hip bones are narrowing towards each other. This will help activate the lower abdominal muscles and bring awareness to this area.  3. Picture your sitting bones. Inhale, breathe into the space between them and picture the sitting bones widening (pelvic floor releasing). Exhale imagine hip bones narrowing together (pelvic floor engaging gently). Be careful not to squeeze your glutes, instead really try to engage the pelvic floor. This may take some practice!

This is one of my favorites! It is a 3 step breathing exercise to help you gently connect to your deepest abdominal muscle (Transverse Abdominis) and to the pelvic floor.

1. Sit up tall directly over sitting bones, feeling belly button draw back towards the spine (You can also do this lying down). Place hands around rib cage and breathe into hands. Inhale widen ribcage and exhale narrow the ribs, feeling them pull together.

2. Place hands on hip bones. Again, breathe into hands and imagine hip bones widening like the rib cage (the hip bones will not really move. We are using imagery to help us find lower abdominals). Exhale and imagine the hip bones are narrowing towards each other. This will help activate the lower abdominal muscles and bring awareness to this area.

3. Picture your sitting bones. Inhale, breathe into the space between them and picture the sitting bones widening (pelvic floor releasing). Exhale imagine hip bones narrowing together (pelvic floor engaging gently). Be careful not to squeeze your glutes, instead really try to engage the pelvic floor. This may take some practice!

Pelvic Tilts

1. Begin on your back. Place hands on the hip bones.  2. Gently flatten the low back into the mat, tilting the pubic bone slightly up towards the ceiling.  3. Gently arch the low back, tilting the pubic bone slightly towards your heels.  Keep in mind these are small movements and you only want your pelvis to move. Try not to engage your glutes or thighs to move the pelvis, but allow the low abdominals to do the work.

1. Begin on your back. Place hands on the hip bones.

2. Gently flatten the low back into the mat, tilting the pubic bone slightly up towards the ceiling.

3. Gently arch the low back, tilting the pubic bone slightly towards your heels.

Keep in mind these are small movements and you only want your pelvis to move. Try not to engage your glutes or thighs to move the pelvis, but allow the low abdominals to do the work.

Shoulder Bridge 

Begin laying on your back.  Inhale, slowly roll the spine up off of the mat, one vertebrae at a time. Once up, make sure the hips are higher than the ribs.  Press into feet to feel the back of the hamstrings and glutes engage.  Exhale, roll back down one vertebrae at a time (from top to bottom).  5-8 times

Begin laying on your back.

Inhale, slowly roll the spine up off of the mat, one vertebrae at a time. Once up, make sure the hips are higher than the ribs.

Press into feet to feel the back of the hamstrings and glutes engage.

Exhale, roll back down one vertebrae at a time (from top to bottom).

5-8 times

Stability Marching

Begin laying on your back. Inhale, then exhale to feel the abdominal muscles gently connect together (belly button to spine).  1. Spine is in neutral pelvis (resting naturally- not tucked or arched).  2. Keep the weight of your body right in the center of your pelvis. Inhale, pick up one leg to "table top" position. Exhale, lower the leg down. Switch legs. 5-8 times each leg  3. As you march in place, feel the abdominals staying engaged, without tilting to one side to life the leg. Keep the weight in the center of the pelvis.  This exercise will help to strengthen the Transverse Abdominis, help to create stability in the torso and pelvis, and establish deep abdominal connections.

Begin laying on your back. Inhale, then exhale to feel the abdominal muscles gently connect together (belly button to spine).

1. Spine is in neutral pelvis (resting naturally- not tucked or arched).

2. Keep the weight of your body right in the center of your pelvis. Inhale, pick up one leg to "table top" position. Exhale, lower the leg down. Switch legs. 5-8 times each leg

3. As you march in place, feel the abdominals staying engaged, without tilting to one side to life the leg. Keep the weight in the center of the pelvis.

This exercise will help to strengthen the Transverse Abdominis, help to create stability in the torso and pelvis, and establish deep abdominal connections.

Toe Taps-Single Leg

Begin laying on your back. Inhale, then exhale to feel the abdominal muscles gently connect together (belly button to spine).  1. Bring both legs up to "table top" position.  2. Keep the weight of your body right in the center of your pelvis. Inhale, lower one leg to the mat (or half way down, depending on where you're at), tap the mat. Exhale, bring the leg back. Switch legs.  3. As you lower each leg, make sure that you keep the low back against the mat, abs engaged. Do not allow the low back to arch- then you've lost your abdominal connection.

Begin laying on your back. Inhale, then exhale to feel the abdominal muscles gently connect together (belly button to spine).

1. Bring both legs up to "table top" position.

2. Keep the weight of your body right in the center of your pelvis. Inhale, lower one leg to the mat (or half way down, depending on where you're at), tap the mat. Exhale, bring the leg back. Switch legs.

3. As you lower each leg, make sure that you keep the low back against the mat, abs engaged. Do not allow the low back to arch- then you've lost your abdominal connection.

Toe Taps-Double Leg

Begin laying on your back. Inhale, then exhale to feel the abdominal muscles gently connect together (belly button to spine).  1. Bring both legs up to "table top" position.  2. Keep the weight of your body right in the center of your pelvis. Inhale, lower both legs to the mat (only half way down). Exhale, bring both legs back to "table top".  3. As you lower each leg, make sure that you keep the low back against the mat, abs engaged. Do not allow the low back to arch- then you've lost your abdominal connection.

Begin laying on your back. Inhale, then exhale to feel the abdominal muscles gently connect together (belly button to spine).

1. Bring both legs up to "table top" position.

2. Keep the weight of your body right in the center of your pelvis. Inhale, lower both legs to the mat (only half way down). Exhale, bring both legs back to "table top".

3. As you lower each leg, make sure that you keep the low back against the mat, abs engaged. Do not allow the low back to arch- then you've lost your abdominal connection.