Workout tips: 19 best exercises for repairing diastasis recti postpartum
A growing belly, popped belly button and stretch marks are not the only changes a woman’s midsection goes through postpartum. 1 out of 2 pregnant women experiences diastasis recti or ab separation after giving birth. Health experts share 19 best exercises for repairing it
Diastasis recti is a health condition is which the distance between your rectus abdominis (aka 6 pack) muscles increases at the midline due to the stretching of connective tissue (Linea Alba) and this condition is associated with increased feeling of instability and/or coning/doming/bulging of the abdomen area. It is also called as Mummy Tummy or having a Mommy Pouch where women may look like as if they are “still pregnant” and pregnant women or obese people are susceptible to acquire this condition which increases the intrabdominal pressure.
The connective tissue weakens and thins due to abdominal fat pushing through the connective tissue or growing uterus putting pressure on connective tissue or birthing can also cause a lot of changes in the intra-abdominal pressure. Diastasis recti is also caused due to pregnancy hormones and the expanding uterus where the weight of the foetus is pushed downward to the pelvis hence, it is necessary to skip any exercise that puts strain on the tummy to protrude outwards and avoid heavy lifting exercises which need you to twist your spine or spinal extension movements.
Health experts point out that these can increase stress on your abdominal tissues and suggest to follow correct breathing techniques and exhale properly while exercising. This they say will help avoid creating any compression in the abdominal cavity and there are a few therapeutic exercises that can be performed to rectify diastasis recti, build better core muscles and strengthen abdominal muscles.
In an interview with HT Lifestyle, Dr Shilpi Sachdev, MBBS, DNB, DMAS, Consultant Obstetrics and Gynecology at Apollo Cradle & Children’s Hospital in Delhi, shared, “A growing belly, popped belly button and stretch marks are not the only changes a woman’s midsection goes through postpartum. 1 out of 2 pregnant women experiences diastasis recti or ab separation after giving birth. Visually, diastasis recti can appear like a bulge or pooch in the abdomen but physically, it can cause abdomen weakness, backache and poor posture.”
She advised, “Instead of rushing into weight loss or heavy lifting exercises, women should start with recti-friendly exercises that accelerate healing and strengthen the core. Targeted exercises designed to heal diastasis recti can help close the gap and strengthen the abdomen muscles.”
She revealed the best exercises for repairing diastasis recti postpartum:
1. Abdominal compression - Sit upright with knees bent at 90 degrees and spine lengthened. Place hands on the abdomen and breathe normally. Try squeezing the abs and pelvic floor up and into the spine as you emit a tiny exhale. Relax on the inhale and repeat in a slow and controlled rhythm.
2. Pelvic tilts - Lie down with knees bent and feet flat with hands on the side as the palms face upwards. Gently rotate the hips toward the face, engaging the core by tilting the pelvis up so the entire spine is against the floor. Hold the position for a second and then relax.
3. Glute bridge - Lie down with knees bent and feet hip-width apart with heels close to the butt and arms by the side. Push through the heels to lift the hips and lower back off the ground, squeezing glutes at the top. Hold for a second, then relax. Avoid overextending the lower back.
4. Toe taps - Lay flat on the back with arms on the side and bring the legs to a 90-degree bend in the air. Open the legs while lowering the toes towards the ground. After tapping the toes on the ground, hold for some time and return to the original position.
5. Knee planks - Kneel on the ground with shins resting on the floor and place the shoulders directly above the wrists. Tuck in the pelvis to engage the core and hold the position for 15 seconds. Gradually increase the timing, working your way up to 30 seconds and at least 2 repetitions.
According to Binita Kar, Premium Coach at MyHealthBuddy, to begin healing Diastasis Recti it is important to first understand breathing, core muscles and posture. She listed workouts that can help you heal DR:
1. Practise Diaphragmatic Breathing - This may seem really simple and easy but many people aren’t able to practise proper breathing pattern. Practise taking slow, deep breaths while expanding Ribs 3D. While inhalation the diaphragm contracts and moves downwards while lungs expand. Breathing into our diaphragm helps bracing functional core and render trunk strength. Inconsistent or improper breathing can add additional pressure to your abdominal muscles worsening Diastasis Symptoms.
2. Practise Good Posture - Aligning our body by placing pelvis stacked under ribs is important to recruit our core muscles. An anterior or posterior tilt affects our ability to properly strengthen core muscles under load and causes the feeling of instability.
3. Dead Bug - This is a very helpful exercise which activates your transverse abdominis, Pelvic floor muscles and Erector Spinae to give you stable and strong core.
4. Glute Bridge - This is an excellent workout to integrate core activation and stabilization into lower body. This works on glute muscles, hip flexors and also lower back muscles.
5. Functional Movements - Practising functional movements like lifting baby, squatting down to pick something is important. Its important to be able to brace core and maintain tension as mothers you will be doing a lot of carrying and lifting and squatting.
She cautioned, “Few workouts that you should avoid are crunches, leg raises, jumping, hopping, running as this increase intra-abdominal pressure and cause more bulging in the connective tissue. Its important to understand that a particular set of exercises won’t help heal DR, instead entire body needs to be worked upon starting from breathing to how your body responds under load.”
Dr Ranjana Dhanu, Consultant, Gynaecology and Obstetrics at Khar's PD Hinduja Hospital and Medical Research Centre, highlighted, “During the course of pregnancy due to the uterus stretching almost to the size of a watermelon, the recti get separated and the connective tissue adjoining the two recti muscles weakens. Simultaneously with the excessive abdominal stretch in the 3rd trimester the transverse abdominus muscles on either side of the belly fall apart. With the decompression of the abdomen postpartum the rent between the muscles is palpable and looks cosmetically compromised. Most of our patients today have this innate desire to get back in shape during the post-partum period. Besides cosmetic effects, diastasis recti can also manifest with lower backache and an uneasy feeling. Simple exercises have been tailored for women suffering this condition and have helped women regain their abdominal tone.”
She added that these exercises can be done at home, do not require any fancy equipment and can be performed on an empty stomach (preferable at least 2 1/2 hours of fasting as the gastric emptying time is approx. 2 hours) and can be done on a yoga mat:
Exercise no 1: Stomach vacuum
Exercise no 2: Stomach vacuum with march
Exercise no 3: Stomach vacuum with bridge
Exercise no 4: Side planks
She said, “This exercise routine if adopted within 3 weeks of a normal delivery and 6 weeks post C section have proven to be very effective. For optimum results it is advisable to be consistent, regular and carry on the daily routine for a period of 6 to 8 weeks. Certain prerequisites for optimum results are to indulge in healthy foods, portion control with ghee loaded lactagogues, keep thyroid levels and sugar levels in check, and maintain normal levels of haemoglobin, vitamin B12, D3 and calcium.”
Listing five different exercises that you can try at home, Dr Kavita Pujar, Senior Consultant - Obstetrics and Gynaecology at Bengaluru's Kinder Women’s Hospital and Fertility Centre, shared:
1. Pelvic Brace – Lie on your back. Bend your knees. Create a triangle with your hands by keeping them on the hips. Exhale and contract your pelvis muscle from the back to the front. While doing so, create tension in your lower abdominal muscles and hold for about 3-5 seconds. Repeat 15 times for at least once or twice a day.
2. Closing the Gap – While lying on your back, bend your knees and keep your feet flat. Lift your head as much as you can while pressing your lower back on the floor and tucking your hips. Exhale during the process. Inhale while you release your lower back and keeping your head back. Repeat this for 10 to 20 times, for at least twice a day.
3. Chair position – Lie on your back. Keep your calves on a chair with your hips and knees positioned at 90-deree angle. Inhale and get ready to move your calves. Exhale while you lift your calves and create tension in your abdominal muscles. Hold for 10 seconds. Repeat this for one to four times a week.
4. Toe Dips – Lie on your back with your knees bent and arms by the side. Lift your legs and keep in chair position without any chair. Inhale. Next, while you exhale, lift your head using your shoulder blades or not, and hold the position. Now, gradually dip your right leg tow down while bending it. Repeat the process with left leg.
5. Bird Dog – Position yourself on your hands and knees, keeping your spine on neutral position. Inhale, then exhale and lift right leg and left arm while maintain pelvic brace and keeping spine neutral. Inhale and release your arm and leg to bring them back on ground. Repeat this for 10-15 times on each side.
After allowing the body adequate time to heal, women with diastasis recti can incorporate these exercises to repair and rebuild their core. Women practising these exercises should begin to see improvements within 6 to 8 weeks. Remember, patience is the key to success.