A diastasis rectus abdominis (DRA) is the term used to describe the separation of the abdominal muscles from the midline (linea alba). This most commonly occurs during and after pregnancy in women, but it can also affect men. Prolonged stress at the midline of your abdominals during pregnancy as your baby is growing creates this tension. Research shows that most women have a diastasis by 35 weeks gestation.
Once your baby has been born, this DRA can resolve on its own. If the DRA does not improve by 8 weeks postpartum you may need to consider doing something to help it. Sometimes it does not improve on its own because of tissue trauma, weak abdominals, or imbalance between muscles, breathing, and/or pressures in the body.
Many women begin their own workouts and exercise routines at home to help resolve their DRA on their own. When it comes to strengthening our abdominal muscles, a common go-to exercise is crunches or sit-ups. However, there is some confusion about whether crunches and sit-ups are safe to perform when you have a DRA. It is believed that performing these kinds of exercises can make DRA worse because it causes more stress at the midline, thus preventing healing.
More and more research is now showing this might not be the case. More importantly, research is showing that performing crunches and sit-ups with good technique which includes correct breathing, good form, and activation of your transverse abdominus first could actually make these exercises more beneficial in resolving your DRA.
So how do I breathe correctly? Breathing should come naturally, one would think. However, when your breathing pattern has been altered for a while, such as when you are in the third trimester of your pregnancy and your baby is pushing up into your lungs and ribcage things can change. If your body does not return to normal or does not know how to get there on its own, you may need to retrain good breathing habits which use your chest muscles and diaphragm in a symmetric pattern. Without restoring normal breathing patterns, you may put stress on other parts of your body or find yourself holding your breath and straining (Valsalva).
Also, knowing how to correctly activate, or tighten your transverse abdominis muscle is important. Place your fingertips over the front of your pelvis on the bones that stick out in the front. Once you locate this bone, slide your finger inward towards your belly button and down (see picture below for hand placement). Keep your fingers here as you try to gently draw your belly button inward as if you are shrinking your waistline. You should be able to do this without tightening your upper abs or holding your breathing. This takes some practice.
Once you learn normal breathing and activation of your transverse abdominis muscle, you are ready to add in your crunches and sit-ups. If this does not come naturally to you, seek out the guidance of a pelvic health physical therapist. Your muscles can forget what to do and may need some help learning how to work again. Katy at The Fit Pelvis can help teach you exercises to help your abdominal muscles activate properly, teach you good breathing mechanics, and progress you back into your exercise routine after having your baby.