By: Dr. Nichelle Gurule DC, CSCS, Webster Certified
There are many issues that women in the prenatal or postpartum period can face. Commonly women experience diastasis recti, which is an unnatural distancing of the rectus abdominis muscle. This is also frequently described as a separation of the abdominal wall. Diastasis recti is a naturally occurring process during pregnancy where the rectus abdominis (6 pack muscle) will separate to accommodate the growing baby and occurs in every woman to some degree during pregnancy.
The separation should naturally return to its normal distance and abdominal tension within 8 weeks postpartum, but commonly the separation will remain wider than usual or with less tension due to a variety of circumstances. Often what can prevent healing is the added stress on the midline of the abdominal wall from how we move throughout our day.
The transverse abdominis is the deepest abdominal layer and is considered to be one of the deep core stabilizers. All of these abdominal muscle insert and or have a direct relationship with the linea alba, which is the connective tissue of the midline of the abdominal wall that is stretched during pregnancy.
Diastasis Recti is a common dysfunction experienced postpartum. Here is why it matters:
Why obliques should be done with caution!
Much of the healing of diastasis recti is about movements to avoid or modify, as to reduce the stressors on the weakened connective tissue of the linea alba (midline of the abdomen). The movements that typically can cause excess stress on the weakened tissues are:
- sit up/jackknife movements (ex: getting up out of bed, sit up exercises)
- isolate oblique movements (ex: Russian twists, side crunches)
- excessive intra-abdominal pressures (ex: heavy weight lifting, straining at stool)
- quadruped/gravity positions (ex: plank, push-ups)
When someone has diastasis recti, it is best to use oblique exercises and movements with caution. The linea alba connective tissue is created by and also an insertion point for all the abdominal wall muscles. The contraction of the obliques pulls along the midline, which creates more of a shearing force than the other abdomen muscles. This force and shear often do not allow for a diastasis recti to heal. If we want healing to occur, we need to give the region as many opportunities to succeed as possible.
To assist in the healing process, it is also important to reduce the tension in the obliques, which can be done through a light stretch and also through manual muscle work. These muscles are commonly tight in prenatal and postpartum patients and loosening the tension can help reduce the continuous pull along the weakened midline tissues.
While oblique movements are a great exercise, it is best to reduce the amount of oblique work you are performing when you are in the process of healing a diastasis recti. This includes:
- isolated oblique exercises (ex: Russian twists, side dips, side crunches)
- everyday habits requiring lots of oblique work (ex: carrying a car seat)
- sport activities (ex: rock climbing, golfing)
It is important to remember these modifications are just during the healing process! They can be added back when you have healed your core!
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- Paige and Brice’s Birth Story June 21, 2016
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