Updated: Sep 8, 2019
Do you struggle with a tummy bulge or a donut roll, aka mommy tummy? Do you get asked if you are pregnant when CLEARLY you are not, but it looks like it? So frustrating… especially if you lose weight and you feel like it gets worse. If so, you may have diastasis rectus abdominus (DRA). This is a fancy term for your abdominal wall got so large and stretched out during pregnancy, that the linea alba (the fascia that connects the 6-pack muscle, rectus abdominus) never quite healed back together. Men can even get this injury after heavy weight lifting.
Oftentimes moms are diagnosed with DRA from their OB/GYN, or their primary care physician, and that’s it. Period. So then what do we do… we look on social media and search the internet for the exercises to fix it, and … WTF (What To Fix) am I supposed to be doing here with my abs?
During pregnancy your abdominal muscles get stretched out and then sometimes they heal. But, sometimes they do not and there is this lack of stability or control within your abdominal wall (core). There has been a study that found that there is significant closure between day 1 and weeks 8, but without intervention (i.e. exercises or physical therapy) there was no further closure.1,3 Majority of women get DRA at the end of their pregnancy, but 30-40% of women have DRA that does not go away, and majority of these women end of with a pelvic floor dysfunction (stress urinary incontinence, pelvic organ prolapse, fecal incontinence)1,4
All these studies are indicating that women can get DRA, then never recover, and this can lead to lack of core stability that is crucial when lifting baby, lifting weights, lifting dishes, running, etc. It is crucial to get the load transfer between the ribs/thorax and the pelvis to prevent pelvic organ prolapse, pain, or incontinence.
So… now what? Below are activities to AVOID, and tips to improve your DRA.
THINGS TO AVOID only for NOW… until we get better control
Don’t Do Planks, Push-ups, Crunches or sit-ups – these activities can create more pressure on your pelvic floor and abdomen, leading to more of a bulge your DRA. You can’t really make it worse unless you get long-term pressure… like
Don’t hold your breath! Make sure you breathe when you are working out, at home with baby, or lifting any objects in your home.
Don’t suck in your tummy… oftentimes we are trying to create stability but, we are sucking in and breath holding, this can but lots of pressure on your pelvic floor and lower back.
TIPS TO IMPROVE
Breathe with your diaphragm– it is important to learn how to breathe again as a mom. You want to make sure you are breathing with your lower ribs, and then your belly should rise. Find a comfortable position, breathe in through your nose and let your ribs expand, then belly rise, and chest should follow at the end.
Wake up your pelvic floor… infamous “Kegels”- (it’s important to note that if you have pelvic pain to be assessed by your OB/GYN and/or pelvic physical therapist prior to performing these, not because they are dangerous, but that it could lead to further pain). When you “lift your vagina”, or “hold in your urine”, you want to perform on your exhalation when breathing deeply.
Blow and Go before you lift baby or lift any heavy objects. This will engage your deep core muscles and your pelvic floor.
DRA is very common, but does not have to be normal. This is all about balancing your core with breath (excursion of your abdomen) and control with use of the deep core muscles and pelvic floor. If you are struggling and need help now please check out the course we offer, ReStore Core Fitness Classes For Moms.
It’s important to seek out a physical therapist that knows how to assess accurately for DRA and how to treat it so you CAN start working out again, return to your workout routines, and get a stronger core without hurting yourself. Not only will a PT find the root cause of the problem and help heal the DRA, but also prevent injuries to your pelvic floor and further into your low back, hips, or knees. Don’t wait for the DRA to disappear – act now and get back to your workout routines. We know how important an active lifestyle is to you, and we’re here to help.