Diastasis Recti Abdominis (DRA)
Diastasis Recti Abdominis (DRA) is the normal separation of the six-pack abs at the Linea alba (connective tissue that connects the six-pack abs) during pregnancy. This separation is a normal adaptation to pregnancy and required to allow baby’s growth to not be impeded.
With DRA, the tissues and muscles of the abdominal wall are all stretched and thinned throughout pregnancy, so may be less likely to maintain its shape under pressure or loading.
So, how can we address rebuilding the tension and density of the core so that we can return to functional activities postpartum? Let’s explore it together!
Transverse Abdominals: Side-to-Side Connection of the Core
The transverse abdominals (TA), also known as your corset abs, run horizontally around the core. When the TA activates, it brings the six pack abs closer together, so it decreases the width of a Diastasis Recti DRA! Activation of the TA can also increase the density of the tissue!
Notice in the image below the difference between activation of the rectus abdominis (six pack abs) only compared to activation of BOTH the TA and rectus. You can see with the RA only, there is more coning or tenting of the center of the abdomen. This means there is more distortion at the linea alba during this supine core exercise. This distortion is due to the increased pressure in the abdominal cavity. This increased pressure is pushing forward into the weakened connective tissue, causing it to put outwards.
This could be problematic if the cone is hard to touch and done under exertion (in this case it is), as it could be damaging the linea alba more (aka causing a worsening in Diastasis Recti DRA or inhibiting the healing).
When we activate the transverse abdominals with the six pack abs, you can see there is a flatter appearance of the abdominal wall. The gap is brought closer together AND the density is increased so there is less distortion against the linea alba. AKA the linea alba is able to withstand the increased pressure due to an increased density of the tissue.
Tips to Turn on the Transverse Abdominals
Focusing on things such as core activation with exhalations, squeezing a Pilates ball between the hands, or even squeezing a Pilates ball between the thighs, can all help activate the transverse abdominals.
A cue to bring the hip bones closer together could even be helpful!
This mini-course guides you through the first month postpartum as you begin your recovery after birth! This program includes weekly guidance on how to reconnect with your core and pelvic to support your healing.
- Breathing and Core Connection Exercises
- Mobility Exercises to Relieve Common Discomforts
- Gentle Core Exercises
- Watch on Mobile Device
Diastasis Recti: Decrease the Gap or Increase the Density?
The width of the diastasis gap is not the only thing that is important when it comes to healing Diastasis Recti DRA postpartum (or minimizing the damage if you are pregnant).
We also want to increase the density, or how far you can press into the gap. If the tissue and core musculature increase in thickness, then this is a great sign that the diastasis is functional and healing!
Think about a comparison between a balloon and a thick ball. Both can change their shape based on pressure distribution and management.
However, the thicker ball is less likely to pop under increased pressure or loading, and more likely to maintain its general form.
While the balloon is much thinner, and more likely to pop or have huge changes to its shape.
This is why the thickness or density of our tissues and muscles matters when it comes to diastasis healing! We want our abdominal structure to become thicker and denser so that it can withstand increased demands in the postpartum.
The Obliques: Diagonal Connection of the Core
The transverse abdominals are not the only player in increasing the density of the abdominal wall! The obliques, or our side abs that run diagonally, also play a huge role!
When we choose rehab focused exercises, we want to do more than heel slides and unloaded supine movements. The way we increase density of our core is to increase the demand!
How can we do this?
- Resistance Training: Use weights, bands, external loading!
- Resist Gravity: Choose upright, more demanding positions such as all fours or standing!
The key to many of these movements is we want opposite sides to move together: so, the right upper body with the left lower body, and vice versa. This will help with the diagonal connection ACROSS the linea alba.
Let’s explore some exercises together that are both more beginner and early postpartum, and how we can progress those to more advanced movements!
Basic Exercises for Diastasis Recti DRA
These exercises listed below are still challenging, but they are floor based and tend to be more manageable for someone starting their rehab journey.
You will notice that each of these exercises has several progressions, as well!
Strating with the bridge with lateral resistance. The most basic version is the supine pallof press. The hips remain on the floor, and we press a band directly forward aligned with the middle of the chest. As you exhale, we can engage the TA, and the anti-rotation movement helps to turn on the obliques. Watch the breakdown video to see several advancements of this movement!
Next up is the floor press with knee press. This floor-based chest exercise involves the arm pressing a weight with the opposite leg lifting up and resisting a push downward of the same side arm. This activates the core diagonally!
Option to advance would be to elevate the hips into a bridge or see the tabletop marches in the advanced section.
The quadruped rotational pull starts to introduce rotation to the core, a primary movement of the obliques. You can adjust the leg positioning to increase the challenge of the movement.
Both knees down would be the easiest, while a bird dog position would be the more challenging.
Advanced Exercises for Diastasis Recti DRA
We can begin to advance the movements by increasing the resistance!
One of my favorites is the dumbbell press with a banded leg resistance. Placing the band around the ankle will be more challenging, but you will really feel the diagonal pull across the core!
We can advance the floor press movement with a table top press and march. In this movement, we have to engage the core more to keep us from arching in the back!
We can transition the quadruped to a Copenhagen plank! This will involve the adductor even more!
Summary
Diastasis Recti is a normal adaptation of pregnancy: we need our core to stretch and separation in order to accommodate for our baby’s growth!
Diastasis healing involves both decreasing the width of the gap AND increasing the density of the tissues and core musculature! We need both to support a functional core.
Focusing on both the transverse abdominals AND oblique activation can help increase the density of the core both laterally and diagonally.
Our postnatal fitness programs incorporate cross body movements starting from floor based, minimal loading, and progressing towards upright, more demanding movements to help you return to fitness and function postpartum!
Our programs are offered both as traditional lifting programs, where it is a list of exercises with demo videos, AND we now have an on-demand workout program that you follow a video as you exercise.