6 Exercises to Help Heal Diastasis Recti

During pregnancy, your body goes through profound changes. One of the most visually apparent changes is your expanding abdomen, making room for the fetus as it grows inside your womb. This expansion often causes a phenomenon called diastasis recti (DR).

While it is common in pregnancy, it can cause issues, including back pain, pelvic floor dysfunction, and muscular imbalances. Keep reading to learn more about diastasis recti, how exercise can help, and what to try.

What Is Diastasis Recti?

Diastasis recti (DR) is the separation of the rectus abdominus from the linea alba. Up to 100% of pregnant people will have diastasis recti by middle to late pregnancy, and 30% to 68% will have it after delivery.

DR occurs due to the stretching and thinning the connective tissue that joins the two sides of the rectus abdominis (RA), known as the six-pack muscles. It isn't a hole, hernia, or tear in your abdomen and it isn't an inflammatory condition.

To diagnose DR, the width of the gap between the RA would be two finger widths or more during a crunch. This is equivalent to about 20 millimeters or more at any point 4.5 centimeters above, at, and 4.5 centimeters below your belly button. A gap of four finger widths is considered severe DR while two finger widths is mild.

Prenatal diastasis recti likely cannot be avoided since the connective tissues need to stretch as the fetus grows. This is a natural physiological adaptation. There aren't any exercises or methods you can likely take during pregnancy that will minimize the chances of having DR. However, exercise can help heal it once you have given birth and have recovered enough to be cleared for physical activity.

How Exercise Can Help

Exercise can help mild and moderate cases of diastasis, but it is still wise to see a physical therapist for help and diagnosis. Exercise can help increase the tension of the connective tissues, which is more important than trying to "close the gap."

Experts are less concerned with reducing the width of the gap and, instead, focus on improving abdominal muscle activation and regaining strength in your abdominal wall. In fact, analysis of the research on programs for narrowing DR gap width shows little evidence that exercise is not more effective than minimal intervention.

However, exercise during pregnancy and postpartum will increase your strength and stability, and decrease back pain and other common issues postpartum. Exercises that increase the tension of the connective tissues and abdominal wall help improve the adverse effects of DR, such as pelvic floor issues, and back pain, and increase the quality of life.

Best Exercises for Diastasis Recti

The best exercises for diastasis recti improve strength and stability in the abdominal wall while preventing DR from worsening. Below are six exercises that can help increase the tension of the stretched and thinned connective tissues and prevent further widening of the gap.

Connect Your Core and Pelvic Floor

The first step toward improving DR is to connect to your core and pelvic floor muscles. Contracting your core muscles may be challenging for you after the stretching and thinning of the connective tissue and the resulting weakening of your abdominal wall. You might even feel disconnected from these muscles altogether. Try the following exercise to increase your connection.

1. Inhale and imagine your breath filling your vagina and rectum with air while your sit bones are pushed apart.
2. Exhale and feel your breath emptying from your pelvis, stomach, and rib cage.
3. Focus on the sensation of your vagina and perineum pulling upward and inward, tightening as you exhale. 
4. Complete one to two sets of 10 repetitions daily.
   

Heel Slides with Alternating Arms

Heel slides combine the connecting breath with your deep core stabilizing muscles. This exercise can be done soon after giving birth but still provides a challenge for building strength in your abdominals. Perform this movement slowly with intention.

1. Lie on your back with knees bent, spine neutral, and arms laying by your sides.
2. Inhale deeply.
3. Exhale and gently contract your core.
4. Extend your right leg while sliding your heel lightly along the floor. Simultaneously, extend your left arm straight up over your head and backward.
5. Inhale and reverse the motions to return to the starting position.
6. Repeat with the opposite arm and leg.
7. Aim for 6 to 8 reps per side for three sets.

Pallof Press

Pallof presses can be done standing or half-kneeling. They will activate your entire core as you fight against the rotational pull of the cable (an anti-rotation). You will need to control the movement, keeping your body from swaying or being pulled back. Because rotational strength is so crucial and is weakened with DR, the pallof press is an excellent exercise to address this need.

1. Stand with your left side next to a cable machine positioned at chest height.
2. Hold the handle in your left hand, standing with feet shoulder-width apart, core engaged, and spine neutral.
3. Grasp the handle in both hands and push it out in front of you.
4. Notice the tension in your core muscles as you work against the pull.
5. Hold this position while counting slowly to five, then release slowly, bringing the handle back to start.
6. Repeat three sets of five repetitions on each side.

Glute Bridge

Glute bridges are an excellent core strength and stability exercise. Your glutes, hips, back, and abdominals work together to perform them.

1. Lie on your back with bent knees, feet flat on the floor.
2. Exhale and contract your glutes, raising your hips upward slowly, lifting your spine off the floor one vertebra at a time.
3. Continue until your shoulders, hips, and knees form a straight line.
4. Inhale and lower your body back down to the floor.

Bird Dog

Although bird dogs are in a front-loaded position, putting pressure on the abdominal wall against gravity, they are safe and effective for DR. Bird dogs will help build stability and strengthen your transverse abdominus, the deep core muscles that act like a girdle. Ensure you keep your hips level throughout the exercise.

1. Get on your hands and knees on an exercise mat and stack your hands directly underneath your shoulders, knees underneath your hips.
2. Maintain a neutral spine with a slight curve in your lower back, neck in line gazing down and slightly forward.
3. Inhale, then exhale and gently contract your core, extending your right arm and left leg.
4. Keep your hips level and don't allow your chest or lower back to drop.
5. Inhale and reverse the movement to the starting position.
6. Repeat with the left arm and right leg.
7. Try working up to 10 reps per side for one set.

Side-Lying Abduction

Side-lying abductions activate the hips and core to build stabilization, reduce injury risk, and improve posture. Make sure your hips stay stable by placing one hand on your top hip.

1. Lay on your side on the floor with hips and knees bent at 90-degree angles. Your head, shoulders, and hips should be in-line.
2. Maintain the 90-degree angle of your hip and knee while you lift your top leg and open your hips.
3. Lower your leg to return to the start, bringing your knees back together.

When to See a Healthcare Provider

If you believe you have diastasis recti, you should contact a healthcare provider. Get a professional to measure your DR gap and see whether care from a physical therapist might be recommended.

If you feel you cannot contract your abdominal muscles or see bulging in your abdomen, seek medical care. It's also crucial to let a provider know if you are experiencing incontinence of any kind.

A Word From Verywell

Pregnancy and postpartum are physically demanding and come with a lot of new challenges. Diastasis recti is very common both in late pregnancy and after birth and can heal on its own.

However, exercising to increase the tension and stability of your abdominal wall is an excellent way to help you heal. Seek the care of a medical professional if you are concerned about diastasis recti and before attempting any exercises.