Erica Friedman Wellness

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4 Tips to Improving Diastasis Recti

At almost 11 weeks postpartum my body is still healing. Two pregnancies in two years has taken my body through a lot of change.

At this stage in my postpartum recovery, I do have a Diastasis Recti (DRA). I did after my first pregnancy too. For some women, the healing process is quick. The first 6-8 weeks postpartum is generally when the spontaneous healing tends to occur. But for others, like me, it can take a bit more time. If DRA is still persistent after 8 weeks postpartum, the chance of it spontaneously healing without intentional rehab is much lower. There are many factors contributing to the healing timeline, such as genetics, baby’s size, labor, nutrition, support system, sleep, etc. Some of these we have control over and several, we do not.

First up, what is Diastasis Recti?

Diastasis Recti (DRA) is the stretching of the linea alba, the connective tissue that holds the right and left sides of our abdominal (six-pack abs) wall together. It’s naturally occuring and not something to fear. During pregnancy each half of our rectus abdominis (six-pack abs) separate in order to allow you baby to grow. Almost 100% of pregnant mamas will have DRA by the time they give birth.

Diastasis healing takes a whole body approach, and is often a symptom of a bigger problem or pressure “leak” in the system, not necessarily the problem itself. By tapping into the entire body and looking beyond “the gap,” we can get better results and function long term.

There are a lot of things to consider with diastasis healing, but I wanted to touch on three areas we have a bit more control and awareness over in pregnancy and beyond.

4 Tips for Healing Diastasis Recti 

1. Focus on breathing: seems simple, right? As pregnancy continues, the diaphragm's movement becomes more restricted, often leading to altered breathing patterns. These often stick around postpartum too.

Breathing is a huge piece toward stabilization through the core and pressure management in the system postpartum, so these altered breathing patterns can contribute towards a lingering diastasis.

We often hear of belly breathing or chest breathing.

  • Chest Breathing (lifting the chest and shoulders, inhaling upwards as opposed to downwards)

  • Belly Breathing (emphasis on belly movement when inhaling)

Early postpartum we start with the breath to kickoff the healing process. During an inhale, the pressure in the abdominal cavity increases. If the abdominal wall and pelvic floor cannot manage the pressure, there will often be a “leak” somewhere in the body: diastasis, hernia, prolapse, leaking, etc.

How should we breathe instead?

When we breathe, we want to focus on a 360 expansion of the abdomen as we inhale - movement in the front, sides, back, and bottom expanding. When we exhale everything returns back to it’s initial position.

2. Release your back/back body expansion:  Does your back feel super tight? I often feel like I could lay on a foam roller all day! In pregnancy as the belly grows our center of mass shifts forward, creating postural shifts. These often result in limited thoracic movement and a tight low back.

Thinking about the muscles - All tissues function most optimally when they can BOTH shorten and lengthen. If the abdominal wall is overly lengthened in the front, it can be hard to compress. If the tissues are shortened (tight back!), it can be hard to let the tissues and muscle go. TLDR: If the back is super tight and can’t lengthen, it will be harder to shorten the opposing side (abdominals). If your rib cage cannot expand 360 degrees (including the back), you’ll find length through the path of least resistance, the belly. This constant pressure out on the belly and a lingering diastasis limits tissue healing.
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We can do all the heel slides, dead bugs, etc., but if we can’t expand into those tight areas in the back, it’s going to be really hard to effectively breathe under a brace and heal.

This is where breathwork comes in to help! We can lengthen the tissue on the back side that’s super tight, and compress the tissue on the front side.

Check out this post for more!

Some of my favorite exercises for thoracic rotation and back body breathing include:

In addition to releasing your back, add some rotation and movement through the midline. Back tightness may be a sign you’re not utilizing your abdominals. Your QL muscle may tighten due to lack of lateral abdominal use (I strained my QL while pregnant). Consider adding rotation exercises like side plank, lunges, or pallof press variations.

Here are some my favorite QL stretches. 

3. Postural Awareness: As the belly grows during pregnancy there is an increase in weight out on the front. As our center of mass shifts forward our body takes on new positions to stay “upright.” These new positions can make it more difficult to manage pressure through the system and stabilize the spine. There is no perfect posture, but being aware of our tendencies and where our body likes to live is great feedback. The problem becomes when we get stuck in one position all the time. Postpartum, moving away from our body’s new "go to" position takes time!

I took a photo of myself pregnant and postpartum just so I could see where I like to hang out. This photo gives me clues on what muscles may need some release, what areas may be a bit “grippy,” and what muscles may use some strength work.

Generally speaking, the mid/low traps, abdominals, and glutes are great areas to focus on. We bend over to pick up things all the time. We need mid-back strength. Otherwise other muscles jump in, like the QL muscle.The body is all connected. Honestly, I think it’s SO cool.

4. Exercise Selection

There isn't a list of "YES" and "NO" exercises when it comes to diastasis per se, but rather a focus on HOW you perform the movement. Movements that you can perform in a good position with great breathing and pressure management are great movements to try! But, if you cannot, that's when we may want to switch it up.

Typically activities such as pull-ups, sit-ups, isolated core movements, or movements that involve excessive flexion or extension of the spine may contribute towards issues with diastasis, especially if you are not able to maintain a good breathing and pressure management strategy.

Checklist for exercise selection:

  • Can perform movement in an optimal position

  • Good breathing and pressure management

  • Feel good before and after

Check out this post for more.

Final thoughts

There are so many things to consider when it comes to Diastasis Recti, even digestion and gut health (MamasteFit had a post on this). But, becoming more aware of of how our body moves through space, how we breathe, and adding some movement and rotation are a few things to consider.

Questions about Diastasis Recti healing? I’d love to support you through 1:1 coaching or my 8-Week Postpartum Fitness Program, or refer you to a professional who can too (like a Pelvic Floor PT!)

Feel good mama.

Xoxo,