Being pregnant for 10 months takes a serious toll on one’s body. Unlike running a marathon or training for a one-time athletic competition, the effects of pregnancy can last long after delivery, especially if the abdominal muscles have separated in a condition called diastasis recti (DR). DR occurs when the central, vertical strips of rectus abdominus muscle separate more than 2.7cm, resulting in a visible “pooch” or distended belly area where the separation occurs.
Worse even than the visible effects of DR are the physiological ones. Mothers with the condition report greater incidences of lower back pain, constipation, urinary incontinence, and even hernia. The discomfort of DR can be both physical and mental – many women report feelings of despair about DR even though nearly 98% of women experience it to some degree.
There are a few ways to prevent DR from happening while you’re still pregnant, although the mere pressure of the pregnancy itself may make it impossible to prevent for some mothers. One way to prevent damage is to avoid lifting very heavy objects while pregnant (this is not the time to start your career as a competition CrossFitter!). A second strategy is to practice engaging the lower abdomen when getting out of bed (rolling on your side before getting up) instead of “pulling” yourself upright.
When it comes to exercise after birth, there are a few necessary proscriptions one must consider when returning to a regular workout programme after having been diagnosed with DR. Abdominal movements such as planks, crunches, and twists should be avoided at first, as should repetitive rotational exercises like swimming or any movements starting from hands and knees (such as downward facing dog).
One strategy to consider is wearing a Tupler splint, which binds the abdominal muscles together, while performing approved exercises. Another method that is gentle enough for most mothers is targeted diaphragmatic breathing (also known as TvA breathing). A third option for women who want to begin strengthening the abdominal muscles without worsening the DR separation is heel slides, in which you lie on your back with your knees bent and slide one leg straight, then activate your abdominal muscles deeply as you slide the leg back in with the heel on the floor.
The good news about DR is that it is usually not a permanent status: most women recover from diastasis recti about six to nine months post-partum. There are several companies dedicated to helping certify fitness professionals to work with post-partum women (FitForBirth and BeFit-Mom are some examples), so make sure that if you are working with a trainer or coach to help repair your DR (they should carry a relevant certification to keep you safe and strong throughout your recovery).
Finally, make sure to listen to your body – and your physician and midwife/doula – throughout your post-partum recovery. If an exercise feels like it’s too much, too early, or too unsafe, don’t push through it. The healthiest post-partum exercise you can do is taking care of yourself and your baby so that you both can thrive through baby’s first few months of life!