Diastasis recti (separation of the rectus abdominis) affects all expectant folks to some degree. However, some birthing parents will experience greater ab separation than others and as such, may want to take steps to heal it or know how to prevent it from becoming worse.
In this post we will discuss what yoga poses may help to heal diastasis recti and what yoga poses and movement patterns may inhibit healing. We will also examine what diastasis recti is and how we can measure it.
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What is diastasis recti and what causes it?
Firstly, let’s examine exactly what is diastasis recti. As mentioned before, diastasis recti is separation of the rectus abdominal muscles, also known as the “six-pack muscles” and a thinning of the linea alba, the connective tissue between the two sides of the rectus abdominals.
As your baby grows, pressure is asserted onto these muscles and as a result, the linea alba is being stretched and thinned. While some people may be able to retrain their muscles to approximate back together, if the linea alba is over stretched, in a relaxed state the rectus will separate again. This loss of core support can also be detrimental to maintaining healthy pelvic floor function.
Diastasis recti is not just about the width between the rectus abdominis but the integrity of the linea alba. It should have some resistance to it, feeling springy, not just smush when fingers press into it.
If you have diastasis recti, you may notice a slight bulge between your abs. I call it a “shark fin”, others refer to it as “doming” or “coning.” This is often noticeable when getting up from a reclining and lying down position or when you exert effort and the intra abdominal pressure pushes against the thinned out linea alba.
One study out of Norway sites that at 6 weeks postpartum 60% of participants still had diastasis recti, at 6 months the figure dropped to 45.4% and at 12 months it was 32.6%. So for many people the connective tissue regenerates and healed. But knowing what can help heal diastasis and what might inhibit it, is where education is essential!
How can you measure diastasis recti?
I always teach my postnatal yoga students how to measure their own diastasis recti so that they can see their own progress and not rely on someone else’s knowledge. Many of them find this very empowering!
Here’s how to measure diastasis recti:
- Palpate the midline from the sternum to the pubis to assess what you are feeling
- Measure at the navel, three fingers above, and below. What kind of tension are you feeling? Is it sinking in (I call this marshmallow)? Is there tension and springing back?
- Repeat the measurement you just did but this time and exhale, lift your head and shoulders slightly bringing your chin towards your chest.
We are looking to see how wide and firm the linea alba is. You do not want to feel the sharp inner edge of the rectus abdominis or see the muscles pull apart. Ideally, you should feel tension down the midline This gives an initial understanding to see how the rectus is reacting to engagement.
Next, exhale and focus on bringing ribs down and pelvic floor lifting. Reassess and see if there is now more tension created. For some, when they lift their head, the Transverse Abdominals (TA) do not activate and they get this doming or loafing which is just the rectus working and not the TA. This is a good indication we need to focus on TA activation. You can feel the TA engaged by finding the ASIS points and going in one inch and down one inch; you should feel the muscles engaging and tensing.
I had quite a diastasis after my first pregnancy. Fortunately, I worked with a PT and took a very mindful approach to my postnatal yoga practice!
Can postnatal yoga help to heal diastasis recti?
Postnatal yoga may help to heal diastasis recti in that we can help with correcting alignment, breathing patterns and posture that can inhibit healing. We also help you reconnect with your core and strengthen muscles that weaken and others that over stretched during pregnancy.
In order to heal ab separation caused by pregnancy, the focus should be on:
- Strengthening and training the core muscles: We need to focus on strengthening all of the core which includes the abdominals (rectus, obliques and transverse abdominals), the diaphragm, pelvic floor and multifidus muscles. In order for your core to stabilize well, all these muscles need to evenly show up. So if any part of the core is not functioning well, another part will overcompensate, usually the pelvic floor, which will become overly engaged.
- Addressing the pelvic floor muscles: Pelvic floor dysfunction can affect how diastasis recti will heal. If the pelvic floor is too tight and engaged, it will not stretch as easily on the inhale, which will increase intra abdominal pressure and push against the weakened midline, the linea alba.
- Open your back ribs! We need to open up the back ribs and the lateral abs! If they’re not mobile, the internal pressure and breath will look for the path of least resistance, which is the connective tissue between the rectus abdominals (the linea alba). This will worsen diastasis! Tight back ribs will also restrict the diaphragm’s movement. This can lead to tightness in the posterior pelvic floor. Also, the less the back and side ribs expand, the more the front ribs will flare which can prevent diastasis from healing.
- Correcting posture: As your pregnancy continued, you may have noticed your posture naturally adjusted to compensate for your growing belly. Your hips pressed forward, your ribs flared and your neck craned. All of this may have led to back, neck and pelvic pain as well putting pressure on your already stretched out abdominal muscles.
In postpartum we want to be mindful to “back it up and stack it up” to help realign your pelvis, ribcage and neck. Not only will this feel great on your back but help take the pressure off the abs and engage the abdominal muscles.
- You can do this by:
- Distributing your weight evenly on your feet.
- Drawing your thighs back
- Balancing your pelvis and stack your ribs on top of your pelvis
- Bring your chin slightly in.
Part of correcting postures is including yoga poses that support great alignment! This included poses that help strengthen the glutes and hamstrings and release tension in the pelvic floor, back and chest.
What yoga poses and movements to approach with caution for diastasis recti?
When deciding what yoga poses to introduce for someone with diastasis recti we have to examine whether the student is able to generate tension in the linea alba when engaging the abdominal muscles or if we are seeing “coning” or “doming”. If there’s “coning” or “doming”, it’s a sign to modify or omit the pose for now. We don’t want to continue to put too much pressure on the connective tissue creating more stretching and opening.
Here are some poses and breath exercises to approach with a watchful eye.
Belly Breathing
Belly breathing can put pressure on the abdominal muscles, making your diastasis recti worse. Instead, direct your breath to your side and back ribs. This is what we call 360-degree breathing. We want to eccentrically lengthen the abdominal muscles. When you focus on inhaling into your side and back ribs, you’re going to get eccentric lengthening of your transverse abdominals. With belly breathing, you do NOT get the eccentric lengthening of the transverse muscles.
Rib Flare
Diastasis is a pressure problem! Pressure is following the path of least resistance. So if the ribs are flared and we’re over-stretching the abdominal muscles, the pressure will continue to push forward into the connective tissue, not allowing it to heal.
So instead, focus on your posture and stack your rib cage over your pelvis.
Cow Pose
Dropping deep into the front body in cow pose can inhibit diastasis recti healing and put unnecessary pressure on the linea alba. We recommend avoiding inhaling in this deep backbend, as it can add more strain and stress to the already overstretched abdomen.
Instead, I invite you to think about creating some stability in the lower back and looking to find mobility in the upper thoracic spine (the upper back).
Backbends
Again, if someone has diastasis, we want to be mindful of how the ribs are expanding and the pressure into the front body. If the ribs are flared and we’re over-stretching the abdominal muscles, the pressure will continue to push forward into the connective tissue, therefore not allowing it to heal. On the other hand, for students without diastasis, backbends might be a welcome addition to class.
Deep twists
Twists create downward pressure (because those pelvic organs have to go somewhere)! If someone has a very weak pelvic floor, they may feel too much pressure in very deep twists. In this case, the focus of the twist should be on the upper body as opposed to deep in the abdominals.
Pranayama with breath retention
This can cause havoc for those with diastasis and pelvic floor weakness. Holding the breath creates intraabdominal pressure, and diastasis is a pressure problem! Air follows the path of least resistance and will therefore push against the weakened connective tissue and down into a weakened pelvic floor.
Yoga poses that help to heal postpartum diastasis
In order to heal diastasis recti, it is crucial to engage your core muscles correctly and adopt exercises and yoga poses that strengthen the transversus abdominis muscles, the obliques as well as the rectus abdominis, back and pelvic floor. Let’s discuss some yoga poses that can help to heal diastasis recti.
Transverse Abdominal (TA) Activation
One of the first exercises we introduce in postnatal yoga is learning to connect with the transverse abdominals, your deepest layer of anterior abs that wrap around like a corset. From there we need to make sure the pelvic floor and TAs are working well together.
Remember the transverse abdominal are the first muscles to show up for forced exhalation! Try a “HA” breathing pattern to see if that helps with abdominal engagement (or blowing up a balloon). More specifically, I cue students to lay on their back with a natural curve to their spine and take a breath down towards the pelvic floor, while bringing hands to the lower belly to feel the inhale expansion. As they exhale, lift the pelvic floor and think of drawing the hip points towards one another. Try this and see if you can feel your lower belly flatten out or at least draw in.
Once this foundation of connecting your breath and TA muscles is established, you can start to progress into other exercises like heel slides, dead bug and cross body activations.
Extended Bird Dog Pose
This is one of my favorite poses to work your core. While it may not look like much, it can create a lot of core stability. Your “core” is not just your abs, it’s also your back muscles, pelvic floor, and diaphragm. This pose very much engages your whole core.
Bird dog can help load the linea alba to help the connective tissue regenerate postpartum . But anyone who is seeing doming or coning in their abdomen should back off.
Plank Pose
Who ever said plank had to be done in one specific way? Variations allow us to practice and honor what our bodies need to be at that time.
Wall plank, is great for anyone dealing with severe doming and diastasis recti.
Half plank with your knees on the ground with a block between the thighs. I love adding the block since it can encourage the adductors to work and can give direction to the tailbone and help stabilize the pelvis and core.
Full plank can work for those with diastasis who have great recruitment of their abdominal muscles, while others have coning or doming. It all depends on how the muscles are firing.
Vasisthasana (Side Plank Pose)
Side planks are great for focusing on core stability. (Please remember to modify if wanted to needed with your knees down!) Try to keep the ribs and pelvis stacked and the spine from going all over the place! Please also notice if you are bulging at the linea alba or sinking which indicates this variation is not yet appropriate.
Watch the video below to discover a few postnatal yoga poses that can help repair diastasis recti and strengthen your pelvic floor.
Other remedies that may help
As well as being aware of our movements and modifying our yoga practice to help heal diastasis recti, did you know that diet can also play a role in repairing ab separation?
Alexandra Paetow, a guest on our Yoga|Birth|Babies Podcast, explains how food and nutrition can support the healing of weak connective tissue. She also provides specific foods that are high in collagen, a building block to help repair diastasis recti. Further to this, Paetow explains how a functioning digestive system can help to repair ab separation. For example, symptoms of a sluggish digestive system such as bloating and constipation can hinder recovery for diastasis recti so working to solve those issues can really speed up your recovery. If you would like to learn more about how nutrition can help repair diastasis recti then click below to listen to that podcast episode!
Have a listen to that podcast here.
Join our postnatal yoga classes
Join one of our online or in-person postnatal yoga classes for assistance in healing your diastasis recti. We understand the demands of pregnancy on the body and how to help strengthen and repair your body during the postpartum period. Click the button below to check out our class schedule!
For even more information about diastasis recti we recommend that you listen to the following podcast episodes below that we aired on Yoga|Birth|Babies. See episodes below!
Diastasis Recti and the Pelvic Floor with Dr. Sarah Duvall
Healing Diastasis Recti with Anna Hammond, PDT
FAQs
How many weeks postpartum can I do postnatal yoga?
The normal recommendation is 6 weeks after you have had your 6 week check-up with your healthcare provider and they have informed you that is safe to start physical exercise.
What other exercises can make diastasis recti worse?
Other exercises that can negatively impact diastasis recti are crunches and situps as they can create a bigger separation between your rectus abdominal muscles if you are seeing doming or coning.
