As a pelvic floor physiotherapist, few things motivate me more than guiding new mothers recovering from diastasis recti back to pain-free movement and core strength. But true rehabilitation starts with understanding what diastasis recti actually is, what causes it, and how to exercise in ways that heal – not strain – those overstretched abdominal wall muscles.
If you’re struggling to lose the post-baby pouch, experiencing aching or stabbing sensations down the midline, or feel your inner core protruding with certain exercises, read on! In this extensively researched guide, I’ll break down:
- Exactly how diastasis recti develops
- When planks can aggravate separation
- How to safely engage your core with modifications
- My favorite functional moves to reduce recti width
- Plus actionable advice for healing inside and out
Arm yourself with vital education to help close that gap for good! Regaining core control truly transforms posture, body confidence, chronic back tension, bladder leakage, and more. Now let’s dive deeper…
What Is Diastasis Recti?
Diastasis recti occurs when the left and right belly muscles that meet at your midline separate along the linea alba connective tissue, causing abdominal contents to push forward. This creates a ridge, pooch, or bulging of your inner organs, most visible when bearing down, sitting up, etc.
Image source: SSCBC
Though common from the second trimester onward of pregnancy as your uterus expands, diastasis recti prevalence skyrockets by the final term:
- 100% of women have diastasis at delivery (Emanuelsson et al., 2020)
- Median recti separation of 2.2 cm in early third trimester (Mota et al., 2020)
- 67% still have 2+ cm 3 months post-birth (Yi et al., 2020)
Moderate cases with protrusion and back pain linger years later without proper treatment. And that “mommy pooch” aesthetic concern reflects much deeper dysfunction needing rehabilitation.
Why Planks Are Problematic
With abs quite literally stretched paper-thin or pulling further apart each contraction during labor and delivery, directly loading them too soon postpartum delays healing. Isometrically straining through exercises like front, side, and shoulder planks stresses the weakest point: the linea alba connective tissues linking your six-pack muscles.
I often see patients months or years out from birth who’ve worsened protrusion after plateauing plank progressions prematurely. Many describe intense stabbing pains from intercostal nerves now exposed under tension between those separated muscles.
The pressure of stacking and holding your weight through extended arms and shoulders in plank pushes out forcefully on abs desperate to reconnect midline. As core fatigue sets in, ribs often flare out and necks overextend to compensate as well. This risks reinjury of the recti and poor movement patterns that contribute to back and shoulder dysfunction longterm.
29-47% of women still show diastasis recti a year postpartum (Mommers et al., 2020). Without properly assessing or addressing lingering separation first, diving straight into mainstream core moves like planks almost always forces ribs forward and abs to dome through the gap.
My rule of thumb? Avoid planks if you see even subtle coning, doming, or bulging with the move – especially any changes across your whole abdomen from ribcage to low pelvis.
Don’t worry – healing diastasis recti absolutely doesn’t require straining through exercises that worsen protrusion! The right modifications turn even classic moves safe again…
Protect and Engage What Matters Most
Before lifting, bending, or progressing into core sequences, the foundation must first be set. Diastasis recti rehabilitation begins with reestablishing inner corset engagement and control.
Here is the #1 most essential element of any diastasis-safe routine:
On your exhalation, gently pull your inner core up and in, allowing ribs and abs to soften in and down your back.
This action – drawing the naval in toward spine – should happen first, on each exhale, before movement itself. Your inhale then powers the actual exercise.
Breath holding, doming forward, hyperextending joints, or overusing momentum endangers those fragile abdominal connections trying to repair postpartum. Always stabilize into your exhale first before inhaling to complete a rep.
Over time, this improved awareness grooves core activation sequences needed for everything from laughing, coughing, rolling over, carrying babies close, pushing strollers, household chores, and more.
Best Exercises to Reduce Recti Separation
Once mastering how to keep abs engaged and aligned within your cylinder of support, specific movements cultivate control and endurance safely.
Reduce risk of coning by starting workouts on your back or hands and knees first. If any exercise causes changes to abdominal contour, stop and modify.
Here are my top picks to narrow diastasis recti:
1. Heel Slides
- Lie flat on back, bend knees over hips
- Keep spine totally neutral, naval drawn firmly to spine
- With abs engaged, inhale and steadily extend one leg before switching
- Slide heel along mat, keeping stable through torso
Heel slides strengthen transverse abdominis with minimal risk of bulging at the midline. Move slowly and controlled.
Image credit: Jessica Valant
2. Single Leg Lowers
- Lie flat, lift one leg towards ceiling with slight knee bend
- Brace through inner thighs and glutes to stabilize
- Keep spine still, abs drawn in tight to spine
- Lower/lift leg 2-3 inches slowly and controlled
Leg lowers primarily target the lower core muscles. Cue zipping up through the inner thighs to protect the low back.
Image credit: Summit Medical Group
3. Deadbugs
- Lie flat with arms overhead, knees bent at 90 degrees
- Exhale to pull naval down toward spine
- Keeping abs engaged, slowly lower opposite arm and leg
- Hover just above floor without twisting hips/ribs
- Inhale return to start position controlled
Deadbugs bridge upper and lower cores working together across midline. Modify range or pause reps if any coning occurs.
Animation source: Poise
4. Bird Dogs
- Balance on hands and knees, wrists under shoulders
- Keep hips low, spine neutral
- Exhale to draw abs to spine, rounding back slightly
- Extend opposite arm forward and leg behind
- Avoid arching low back or twisting midsection
Bird dogs strengthen back while keeping abs safe by starting with a rounding, protective exhale.
Image credit: Harvard Health
Over time, progress these moves into more dynamic sequences engaging obliques, shoulders, hips, and thoracic rotation once diastasis recti measurement reduces reliably without coning.
Patience and self-care absolutely cultivate lasting core strength over rushed progressions reinjuring abs desperate to heal!
My Best Tips to Heal Inside Out
- Seek thorough assessment from a pelvic physiotherapist or other postpartum specialist familiar with diastasis. Not all trainers recognize red-flag exercises that can worsen protrusion!
- Consider supportive belly bands if feeling unstable, sore, or needing feedback reminding abs to draw inward during transitions.
- Stick to slower reps focused on control rather than heavy weights or cardio straining abs.
- Remember nutrition impacts injury recovery! Follow an anti-inflammatory diet rich in collagen sources.
- Stress messes with hormones, healing, and digestion – prioritize restful sleep, Say No without guilt, meditation or faith practices lifting your spirit.
- Consider connecting with a postpartum therapist and be incredibly compassionate with yourself. Comparison robs us of joy in the present moment!
I hope this guide enlightened and encouraged you to believe full rehabilitation really is possible, mama! Remember, surround yourself with a knowledgeable care team, give those muscles ample time to rebuild integrity, and celebrate even small wins.
You’ve accomplished incredible things – now be proud of prioritizing your health and wellness in this next chapter!
In unity,
Dr. Sarah Thompson, Women‘s Health Physiotherapist
Certified Postpartum Corrective Exercise Specialist
References:
Emanuelsson, P., Gunnarsson, U., Strigård, K., & Stark, B. (2020). Measurement of diastasis recti abdominis using 3D ultrasound imaging. Surgical endoscopy, 34(4), 1737-1744.
Mommers, E. H., Ponten, J. E., Al Omar, A. K., & Nienhuijs, S. W. (2020). The general surgeon‘s guide to abdominal wall rehabilitation in postpartum women. The Surgeon, 18(6), 343-351.
Mota, P., Pascoal, A. G., Carita, A. I., & Bø, K. (2015). Prevalence and risk factors of diastasis recti abdominis from late pregnancy to 6 months postpartum, and relationship with lumbo-pelvic pain. Manual therapy, 20(1), 200-205.
Yi, J. H., Park, H. S., & Kim, J. H. (2020). Effects of abdominal drawing-in during prone hip extension on diastasis of rectus abdominis muscles after childbirth: A randomised controlled pilot study. Hong Kong Physiotherapy Journal, 40, 45-50.