Core strength and Diastasis Recti during Pregnancy

I have had women contact me who are pregnant and realize they have the abdominal separation that often happens in this season, Diastasis Recti. This condition has become a “buzz word” for women having kids as it becomes more talked about in maternal care. So I thought I would address this topic for anyone in this position and hopefully give you some helpful information and tips and dispel any fear here.

What is Diastasis Recit (A recap on DR):

Diastasis recti | BabyCenter
What happens to the outer muscles during DR

First of all, what is Diastasis Recti? I have mentioned this condition in other posts and I have an online training program written specifically for it (Mom Core Challenge). Diastasis Recti is when the outer abdominal wall separates as the muscle tissues spread in pregnancy while the belly is growing. The linea alba is a the connective tissue that holds the two ab sides together (these abs are considered our “six pack abs” or Rectus Abdominis). The linea alba thins and loses tensions as the belly expands. Sometimes it thins so much that feels like there is a big gap between the abs. Behind these outer ab walls is another abdominal muscle layer called the Transverse Abdominals. These muscle fibers run like corset around the front of the body and are very important for spine protection, posture, hip stability, etc. These muscles spread and lose a little tension but do not separate like the outer muscle group. (We will address the Transverse Abdominals/ TAs in another post for some exercises).

Here are common questions I get about DR in pregnancy:

  1. Is DR “bad” when you are pregnant? The short answer is “no, the separation itself is fairly common and an expected compensation of the body as the baby grows.” However, with a DR you are more vulnerable to injury so there are some movements that can be avoided and some cautions you can take to better protect your body in this vulnerable season.
  2. How do I know if I have DR when I am pregnant? You may notice if you have DR in pregnancy if you notice a “coning shape” of the stomach when you sit up or move into certain positions. Some women even can feel the separation with their fingers when they push into the abs. Many women expecting have no idea if they have an ab separation or not.
  3. Can DR be helped when pregnant? Correct core and breathing exercises that are safe for pregnancy can prevent DR from getting much worse during pregnancy, protect you from other injuries, assist the core in a better healing after baby is born, and sometimes (rarely) even heal the DR to some extent.

I Realize I have DR…now what? 

If you have realized you have Diastasis Recti during pregnancy it is important to first know what to avoid and how to support this vulnerable area so you don’t make it worse without knowing.

**Note: it is normal for the DR to get wider as baby and belly grows, however, some movements and habits can cause pressure on the DR causing it to spread in a way that can be avoided.

1.Avoid crunches and sit-ups: This can mean exercising, but also daily movements. If you are reclined on your back (sitting or supine) and you crunch or sit full up without support, you are likely putting pressure out on your ab separation. Instead of this movement, try rolling to one side, using an elbow to prop yourself up, and then lifting the body up sideways.

2. Practice good posture as much as you can: Posture habits definitely can make you susceptible to ab separation. If you are over-flaring your ribs (pushing the rib cage out) or have an over exaggerated curve in your low back, you are probably making your body more vulnerable to injury. Pregnancy brings some unavoidable postural changes. A few you can intentionally work on even while pregnant. Try not to let the low back arch too much (tilt pelvis back a little). Also, place a hand on the front of the ribs and try to bring the upper body forward a little (without hunching) to bring the ribs together and down if they are very flared.

4 Common Posture Myths – Posture Makeover
Flared ribs position

3. Don’t hold your breath! Holding your breath while lifting, pushing, pulling can put pressure out on the abdominal wall and down on the pelvic floor. Both can suffer injury. Instead, try to inhale as you prep for a movement and then exhale gently (forcefully if it is a very hard movement) as you push, pull, lift. As you exhale, draw the pelvic floor up (contracting it) and the abs “in” engaging the core.

4. Don’t twist excessively: Twisting can definitely hurt the already stretched abdominal muscles. Twisting will be difficult at a certain point in pregnancy anyways. Don’t twist diagonally (like the Triangle Pose in yoga) if you know you have DR and be cautious when twisting more than is comfortable while very pregnant. Obviously you have to twist to some degree (like when driving a car and looking in your blind spot) but try to move the whole body together to avoid pressure on the abs.

How to Do Triangle Pose (Utthita Trikonasana)
Triangle Pose in yoga

5. Don’t do back extensions or “core holds”: Back extensions (such as the Cobra Pose in yoga) will push out on the abs. “Core holds” (such as a “Boat Pose” in yoga) where the core is holding the body up and the back is vulnerable can also put pressure out on the separation. To release the low back try a forward lat stretch, modified child’s pose (with wide knees), or hands and knees rocking. Cat/cow rotations can be practiced as long as you are very conservative with the amount of “swooping” in cow pose.

Pregnancy Exercises - Yoga Shoulder Stretch with Swiss Ball - YouTube
Forward lat stretch

6. Do engage the core in movements: Engaging your core (drawing the lower abs in…talked more about in the next post Prenatal Core Exercises) is a great way to protect your separation, back, and hips while pregnant. When lifting, squatting, pushing, etc, draw the abs and pelvic floor in to create a support system for the core and pelvis.

7. Do practice prenatal core exercises: These exercises should be gentle and safe for pregnancy but effective in strengthening the inner core muscles of the abs (the TAs) to not only protect the body but to support your baby in a good position. My next post will include these!

8. Use a belly binder support if helpful: There are a million different belly supports, sleeves, and binders on the market for pregnancy. Using one could add some extra support to the core and back as the baby grows and protect your DR as you get bigger. Look for one that adds support but doesn’t restrict breathing or feels too tight (not a corset). Something adjustable could be beneficial as you get bigger but isn’t usually as discreet as cloth sleeves. One of my favorite options is to use KT tape to tape the belly and protect the DR/add support to the back. Your chiropractor, physical therapist, or trainer may be able to show you how to do this. It is not noticeable under clothes but adds support and protection to the belly.

Pregnancy Tape - Helps with Pelvic, Belly and Back Support – Cozy Bump
KT taping belly in pregnancy

If you think you have Diastasis Recti during your pregnancy, don’t be anxious, it is an acceptable response of the stomach muscles to make room for baby. However, it is important to let your OB/midwife/healthcare provider know and practice safe movements and exercises to protect the area.

Check out my next post on Prenatal Core Exercises to strengthen the inner core and protect your DR even more!

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