Managing Diastasis Recti postpartum

Diastasis Recti (DR) is the separation of the rectus abdominus muscles down the midline during pregnancy. This is partly due to the increased pressure on the muscles in the 2nd and the 3rd trimesters, and partly due to the hormonal changes that take place during pregnancy. DR often becomes apparent and is diagnosed postpartum by feeling a palpable ‘gap’ between the abdominal muscles, down the midline of the abdominal muscles and/or visibly, by the appearance of ‘coning’ or ‘bulging’ down the midline when the abdominal muscles are activated. It is important to remember that DR is a normal response to pregnancy, and it can be expected to be experienced in most pregnancies. There is no definitive scientific answer and whether or not it can be avoided (Benjamin, van de Water and Peiris, 2014), however there are certain steps that can be taken to reduce the severity of DR.

One of the best ways to reduce the likelihood of experiencing a severe DR is to remain active and participate in regular physical activity before and during your pregnancy. Exercises that cause ‘coning’ or ‘bulging’ down the midline of the abdomen should be avoided such as sit-ups, planking and leg raises to name a few. Exercises that encourage activation of the pelvic floor and transverse abdominus should be implemented. These exercises in particular help to support the belly and reduce tension on the rectus abdominus. The postpartum management of DR is dependant on the severity. A small DR of between 1.5-2cm (extremely common) can be managed quite simply by completing a few easy exercises at home on a daily basis. Exercises to assist with DR postpartum should begin with re-learning correct core activation and breathing patterns with low load and small controlled movements such as pelvic tilting, glute bridges and cat-cow. These can then be progressed gradually to more upright positions, challenging the body to maintain tension and support in the abdominals while moving through a range of postures. Body weight exercises and eventually resistance-based strengthening exercises can then be implemented in a progressive fashion, as the client reaches their functional goals and targets.

As always, before commencing any form of new exercises we recommend you seek medical clearance from your treating doctor. Before commencing any specific exercises to treat DR, you should be properly assessed and diagnosed by a qualified and accredited allied health professional with experience in managing pre and post-natal clients, this could be either a Physiotherapist or an Accredited Exercise Physiologist. They will then be able to guide you through the correct exercises and progress your programme as appropriate. Each case of DR will behave differently and need an individualised approach to ensure a full and happy recovery.

For more information, visit www.absolutebalance.com.au or send us an email to info@absolutebalance.com.au.

Alixe Marion (B.Sc. – Exercise Physiology)
Clinic Manager – Senior Accredited Exercise Physiologist (AEP) (ESSAM)

 

Benjamin, D., van de Water, A. and Peiris, C. (2014). Effects of exercise on diastasis of the rectus abdominis muscle in the antenatal and postnatal periods: a systematic review. Physiotherapy, [online] 100(1), pp.1-8. Available at: https://www.physiotherapyjournal.com/article/S0031-9406(13)00083-7/fulltext [Accessed 8 Jul. 2019].