How common is diastasis recti?
Over one third of women will have a gap of two fingers or more after their first baby. After their second or subsequent pregnancies, this figure is more like two-thirds of women- especially if the gap wasn’t closed effectively after the first baby.
When should one expect the recti gap to return to normal?
By 6-8 weeks the recti gap should be approximately 20mm or 1-2 fingers or less. Even when fully recovered the muscles will always lie slightly apart – approximately 1.5-2cm.
If the gap is less than 2 fingers can you begin abdominal curls?
If the gap is less than 2 fingers, you should still work on the low load transverse abdominals and rectus abdominal exercises. Then you can progress to the more demanding exercises such as half-roll backs, reverse curls and then onto abdominal curls and eventually oblique curls.
It is also essential to ensure the abdominals remain hollowed or braced and that doming does not occur.
What if there is a persistent gap of 3 fingers width or more?
When there is a persistent gap of 3 fingers width or more, strong curl up type exercises should be avoided to prevent herniation (protrusion) of the abdominal contents.
Recommended exercises include:
- Abdominal hollowing
- Pelvic tilting
- Low load stability exercises for the abdominal muscle
- Gentle curl ups where only the head and shoulders are lifted to the point before doming occurs
What should be done if doming occurs?
The abdominals should remain hollowed throughout all of the exercises. Doming must not occur. If doming does occur reduce the intensity of the exercise or avoid the exercise until the abdominal wall can be held flat.
Exercises for the oblique abdominals that involve lateral flexion or rotation should be avoided until the abdominals are stronger.
The ACPWH and other sources recommend that those suffering from diastasis recti, where doming occurs during the basic core exercises, should consult their GP or a physio specialising in women’s health.
Testing for diastasis recti
- Lie supine (on the back) in neutral alignment with hips and knees flexed (bent) and feet flat on the floor with abdomen relaxed. Place two fingers of one hand horizontally across the abdomen with the fingertips down the centre of the abdominals below the umbilicus. She should gently press in and out to feel between the two halves of the muscle.
- Place two fingers of one hand horizontally across the abdomen with the fingertips down the centre of the abdominals below the umbilicus. She should gently press in and out to feel between the two halves of the muscle.
- Inhale and draw the umbilicus in towards the spine. Then slowly raise the head and shoulders off the floor, keeping gentle pressure on the abdomen with the fingertips. Hold the position, while continuing to breathe, and register the sensation under the fingertips.
- You should be able to feel the two bands of the rectus abdominis closing in on either side of the fingers, with the soft dip of the linea alba in the centre. If this cannot be felt it may be necessary to curl up a little further.
Repeat the test
If the gap between the two bands appears to be wider than 2 fingers, repeat the test using 3 fingers. Lower back to the start position with control, keeping the umbilicus pulled in. You should check several times to be sure of the result.
It is important to note that this is not a highly specific test because everyone’s fingers will vary.
Progression of core re-conditioning
Essentially the progression of core re-conditioning can be summed up with the following steps:
1) Pelvic floor exercises (PFEs) or Kegel exercises
2) PFEs with abdominal hollowing for transverse abdominals
3) PFEs with abdominal hollowing while performing pelvic tilts
4) PFEs with abdominal hollowing while performing partial curl ups (head and shoulder raise)
5) Maintaining the above sequence whilst layering on more advanced abdominal exercises such as crunches
We can provide adaptions during a class environment or book in for private coaching.