Diastasis Recti: what is it and how can I prevent it during Pregnancy?

Verena Wiechers 28.03.18
rectus diastase, vorbeugen

Pregnancy tends to throw your midsection a bit off balance: shape and statics change dramatically, all structures (including muscles, fascia and joints) are now softer and strained by the growing baby bump. Your abdominal wall is particularly strained: the transverse (deep) abdominal muscles, the obliques and the straight abdominal muscles must become soft and stretch significantly. All abdominal muscles lose some strength and basic tension. From the 20th week of pregnancy, the two muscle strands of the straight abdominal muscles drift apart to make more room for the baby. The result is the so-called diastasis recti (abdominal separation). As a result, the straight abdominal muscles can only perform their normal functions increasingly poorly; the lower part of the abdomen has less stability, straight posture is more difficult to maintain, and some trunk movements are more difficult to perform.

How can you protect your abdominal muscles from diastasis recti?

Diastasis recti is a normal occurrence during pregnancy. When you lift yourself up from the supine position, you can feel or even see the cleft, because your abdominal interior bulges outward between the straight abdominal muscles on the left and right; creating a sort of ‘pooch’. After birth, the body has to “contract” these abdominal muscles back into their original position. This rewind to the previous state is not always completely successful.

Rectal diastasic in the postnatal phase 

Unfortunately, some women have rectal diastasis in the postnatal phase; this condition manifests itself through an obviously bulging stomach and various physical complaints.

How wide your abdominal muscle-gap is and whether it returns completely back to its original state after the birth depends on two things. Firstly, it depends on one’s personal predisposition and the pregnancy or birth course. Secondly, it can be affected by pre- and postnatal everyday behavior and sports. There are measures one can take to prevent the midsection from being overwhelmed, and your abdominal muscles from being unnecessarily strained. While it is important to protect the middle of the body and to protect it against strains, these muscles must also be strengthened and stabilized by gentle exercises.

8 tips to prevent increased diastasis recti

  1. Physical strain drives the abdominal muscles apart. Protect the middle of your body in sports and everyday life. Avoid intense pulling, pushing, heavy lifting and carrying. Ask for help with activities that require effort for your midsection.
  2. If you already have small children, take them on your lap while sitting down and carry them as little as possible.
  3. Cavity pressure should be avoided: no intensive strength training or comparable efforts! Pay attention to a good and smooth digestion, otherwise you have to press while in the restroom, which strains your muscles. For colds, a laterally supported, half-lying position when coughing or sneezing is recommended.
  4. All movements that roll up the body from the supine position push the abdominal muscle strands apart even more. You should therefore ALWAYS lie down or rise from your side rather than flat on your back, both in sports and in everyday life.
  5. From the second half of pregnancy, you should definitely avoid exercises that require intensive holding power of the abdominal muscles. These include all support exercises with long levers, see example.
  6. A good posture adapted to pregnancy, see example.
  7. If you cannot avoid physical exertion, activate your pelvic floor and transverse abdominal muscles (also known as the corset muscles) to stabilize the body’s core beforehand.
  8. Integrate gentle strengthening of the pelvic floor and abdominal muscles by adding prenatal exercises into your workout routine!

 

Support positions with long levers (= legs long, knees in the air):

At least from the 6th week of pregnancy you should avoid long levers, as they burden the body‘s core too much!

Bitte diese Stellung ab dem 6. Schwangerschaftsmonat nicht üben! Foto: MamaWorkout
Don’t try this position when you are already in the sixth month of pregnancy! Photo: MamaWorkout

Static core strengthening exercises in support positions

Support positions are generally well-suited to strengthen the abdominal muscles statically.

Always gently activate your pelvic floor and transverse abdominal muscles (corset muscles) in the starting position! Your core must always remain stable during the exercise. Avoid a strong hollow back, a “sagging belly” or a gaping diastasis recti! The abdominal muscles must not work hard to hold the support. As soon as the abdominal muscles tremble, burn or as soon as the core can no longer be stabilized, you should stop the exercise!

All static exercises work similarly:

  • Set up:
    Get into a support position, activate the pelvic floor and, bring the baby to you with gentle tension. The abdominal muscles hold the baby.
  • Technique:
    The legs and/or arms can perform movements, but the core must remain calm and stable. Strengthening of the muscles results from their stabilization.
  • Alternatives:
    The more movement in the extremities, the more intense the abdominal training. You can intensify the leg movements, but only to a point where you can still keep your trunk and pelvis absolutely still.
  • Static abdominal strengthening while lying down: You can strengthen the abdominal muscles while lying down up to the third trimester with static trunk exercises. If the supine position is uncomfortable, you feel nauseous, dizzy, etc., then the baby is pushing on a vessel or organ of yours.

 

Immediate action: Lie down on your left side!

Long-term action: Leave out the exercises in supine position!

 

Foto: MamaWORKOUT
Photo: MamaWORKOUT

For static abdominal strengthening in the supine position please note:

Tighten the abdominal muscles gently (do not press!). It should be a “pleasantly strenuous” sensation, the abdominal muscles must not burn or tremble. The diastasis recti must not open. The lumbar spine stays on the ground at all times. It is helpful to put both hands under your tailbone.

All static supine exercises are similar:

– Supine position, hip joints at 90°, knee joints at 90°

– Gently activate pelvic floor and the corset muscles, flatten your lumbar spine against the ground with the help of your abdominal muscles

– Legs are moving (e.g., aerial biking), focusing on stabilizing the trunk

In the lateral position, the oblique abdominal muscles can be strengthened dynamically:

Foto: MamaWORKOUT
Photo: MamaWORKOUT

Setup: 

Stable side position, the soles of your feet on top of each other, palms pressed in front of the chest into the ground, possibly a small pillow under the baby bump, pelvic floor and corset muscle are activated.

Technique: 

Raise and lower the legs from the waist, 15 repetitions.

 

About the Author:

Verena Wiechers, head of the ACADEMY OF PRE- & POSTNATAL TRAINING, has developed the MamaWORKOUT concept for pregnant women and mothers. At www.mamaworkout.de you can find videos, a book, and courses by qualified pre- and postnatal trainers throughout Germany.



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