If you’ve searched pregnancy or postpartum fitness to any degree, you’ve probably come across plenty of fears surrounding coning, ab separation, and Diastasis Recti. Let’s break down the facts on Diastasis Recti, including exercises that can improve it.

What is Diastasis Recti?

A Diastasis is a naturally occurring separation of the left and right side of the abdominal wall at the midline (the linea alba). The tissue of the linea alba is designed to stretch during pregnancy and sometimes it just stays a little more stretched out postpartum.

When looking at Diastasis, you test for both the width and tension of the linea alba. Anything up to 2 fingers wide with good tension is considered normal. If you have a slightly wider gap but are able to generate tension in the tissue, that’s not likely an area of concern from a functional standpoint.

But what if you want to close the gap? Keep reading to see what options you have to help improve your diastasis.

Is surgery needed to help repair ab separation?

While surgery can be an option to help bring together the rectus muscles, it’s not the only option nor does it address underlying strength or pressure management concerns.

If you struggle with pressure management and core strength prior to surgery, you’re likely to continue those struggles after surgical intervention. It’s important to progressively build core strength in all ranges of motion as well as learn to manage intra abdominal pressure in order to help improve your diastasis recti symptoms.

If you are opting for surgical correction of the abdominal wall, it is highly recommended that you visit a pelvic floor professional both prior to and after your procedure.

Can Diastasis Recti be corrected with exercise?

Exercise can be an excellent, non-invasive way to help manage and even improve Diastasis Recti.

To help improve your Diastasis Recti, you will want to focus on progressively building strength within the entire core to help strengthen the abdominal wall and approximate the rectus, including, but definitely not limited to, your deep core muscles, the transverse abdominis and obliques.

Pressure management is also very important when considering Diastasis Recti improvement. Excess pressure on the abdominal wall can lead to an increase in stretching and weakening of the linea alba.

What exercises should I avoid with diastasis recti?

There is no do or don’t do list when it comes to exercises to avoid with Diastasis Recti. Sit-ups, leg lifts, and heavy lifting could all be considered safe for someone with Diastasis Recti.

Instead of marking certain exercises as automatically off limits, we look at how you’re performing the exercise, if you’ve properly progressed to the exercise, and how you’re managing load and pressure within the exercise.

When we talk about Diastasis Recti, we often discuss coning as a sign or symptom. Coning is a term used to describe an increase in pressure and extension of the abdomen at the linea alba.

If you see coning present and the coning is soft to the touch, that may not be as much of a concern. If the area of coning is more firm to the touch, that may indicate excess pressure being pushed into the midline which warrants adjustments in your exercises.

How do I stop coning with exercise?

Sometimes we can help to manage the excess pressure associated with coning with form shifts, breathing pattern changes, or by activating the deep core muscles.

For example, if you have excess pressure into the midline with overhead movements such as snatch, pull up, or overhead press, are you able to bring your ribcage down a bit and not thrust out? This helps to better engage the core and help to lessen the pressure into the abdomen.

Adjusting your breathing patterns can also help to reduce pressure out into the abdomen. We do this by timing the exhale with the exertion phase of an exercise. With a sit-up, for example, you could exhale through the entire movement from start to finish. With a pull-up, you may want to exhale as you pull yourself up and inhale as you lower.

An intentional activation of the deep core muscles, the transverse abdominis, is another strategy that can help to increase core stability and reduce tension into the linea alba. For exercises like a plank or push-up, engage and contracting the deep core muscles can decrease the width of the linea alba and reduce pressure on the midline, alleviating the coning. We’re not looking for a strong contraction here. Think 10-15% engagement. 

3 exercises to help you improve your Diastasis Recti

As mentioned, while there aren’t any exercises inherently off- limits for someone with Diastasis Recti, there are movement patterns that you can be performing to help improve your diastasis and overall core strength.

Listed below are three exercises that take you through rotation, anti-rotation, and flexion movement patterns to help you progressively build strength within your entire core.

1. Half Kneeling Band Rotations

The addition of a band provides extra tension to help you engage those deep core muscles. You can also sub a light dumbbell, cable machine, or landmine here.

2. Bird Dog

The bird dog is an excellent anti-rotational exercise for both pregnant and postpartum people. The goal here is as little movement within the trunk as possible which not only helps to strengthen the abdomen, but also helps to improve pelvic floor strength.

3. Banded Pull Downs

While sit-ups can be safe for diastasis recti, they may not be appropriate for you for now depending on your level of strength and ability to manage pressure. Let’s work up to sit-ups with a flexion exercise like this banded pull down.

Diastasis recti doesn’t have to limit you inside or outside the gym. By learning strategies to manage pressure and rebuilding strength in your entire core, you can help to improve your ab separation from Diastasis Recti.

If you’re ready for strategic, relatable programming that bridges the gap between core and pelvic floor rehab and the fitness you want to do, join the thousands of other athletes rebuilding core strength inside the 8-Week Postpartum Athlete Training Program.

Casey Thomas-Hardesty, MS

Casey is a P&PA coach and owner of Two Peas Wellness. She specializes in core and pelvic floor health as well as returning to fitness after pregnancy loss.

Read More: 3 Tips to Exercise

While we often think of the core and pelvic floor in terms of pregnancy and early postpartum, your core and pelvic floor are so much more. Understanding your core and pelvic floor basics, your tendencies, and how to counter those tendencies can help you reduce symptoms, minimize risk of complications, and have a positive impact on your athletic performance.

What is your core?

Your core is more than your rectus (or 6 pack abs). Rather, your core is a system of muscles that work together for optimal function. Think of your core as a canister, including:

• Diaphragm – syncing and managing pressure from the top
• Transverse abdominis – deep corset muscles
• Pelvic floor – supporting your pelvic organs (uterus, bladder, and bowel)

When you inhale, your diaphragm naturally contracts allowing your lungs to fill with air. At the same time, your pelvic floor lowers or lengthens, and your belly relaxes.

On exhale, your diaphragm relaxes, pushing the air out of your lungs. In other parts of your core, your transverse abdominis contracts and your pelvic floor contracts and lifts. These are super gentle contractions that you may not even feel happening, but the system is important to be aware of when it comes to counter any tendencies that you may have and decrease symptoms in your athletic endeavors.

It looks like this:

Core, Pelvic Floor, and Athletic Performance

Maintaining an appropriate level of tension in the pelvic floor allows you to have the strength necessary to hold the pelvic organs in place while also allowing the relaxation necessary for urination and bowel movements.

That’s important both inside and outside of the gym.

While it may seem that you want a strong pelvic floor, it’s more important to have a coordinated system, one that’s responsive to the task at hand. Ex: deadlift, sneeze, or run. Too little strength, too much tension, or too much pressure generated in one area can lead to potential issues like incontinence, pelvic organ prolapse, or diastasis.

A Coordinated Pelvic Floor

You want awareness, not hyper awareness of your pelvic floor. When you’re hyper aware of your pelvic floor, as often happens after a prolapse diagnosis, with leaking, or during pregnancy, you’re more likely to try to hold everything tight, ending up with excess pelvic floor tension. Your pelvic floor can’t hold that much tension, especially when adding impact or load, likely leading to an increase in symptoms.

Once you have awareness of your system and tendencies, you can translate that into your lifts. 

Using Exercise to Help Your Core and Pelvic Floor Symptoms

Breath holding

Are you someone that holds their breath all the time, bearing down, or sending pressure to the midline? If so, how can we redistribute that pressure using your breath so it’s not concentrating in one spot?

Try breathing into your lats. That’s a cue that works well with athletes to get you to have full ribcage expansion at the start of your exercise which helps to prevent you from collapsing at the top of your core and bearing down into your pelvic floor.

Click here to watch this video.

You can also play around with exhaling either through the whole exercise or through the portion of exertion in a lift. By timing this exhale, you’re allowing your body’s natural system to take place where the pelvic floor slightly lifts on exhale. You’re not looking to have to do this with every rep of every exercise. The goal is to make it automatic so you’re not thinking about it forever.

Tension

Do you have a tendency to constantly suck in your abs, grip your glutes, or clench your jaw?  Tension isn’t isolated. Holding tension in your core, glutes, and jaw means tension in your pelvic floor too.

You’ll want to downtrain and lengthen the system in that case. That may look like reducing tension in your workout by not squeezing your glutes when you squat or at the top of a deadlift, not doing a kegel while you’re jump roping, or relaxing the belly in a run. 

What about coning and diastasis?

Coning along the midline of your belly doesn’t automatically mean diastasis.

A diastasis is a naturally occurring separation of the left and right side of the abdominal wall at the midline, linea alba. The tissue of the linea alba is designed to stretch during pregnancy. Sometimes it just stays a little more stretched out postpartum.

When looking at diastasis, you test for both the width and tension of the linea alba. If you have a slightly wider gap but are able to generate tension in the tissue, that’s not likely an area of concern. Likewise, if you see coning present and the coning is soft to the touch, that may not be as much of a concern.

If the area of coning is more firm to the touch, that may indicate excess pressure being pushed into the midline. Sometimes we can help to manage that pressure with form shifts or breathing pattern changes. Ex: if you have excess pressure into the midline with snatch, pullup, or overhead press, what happens if you bring your ribcage down a bit and not thrust out? The pressure is still there but it’s likely less.

This is also an area that you may need to play around with either more or less core engagement. That doesn’t mean an all out contraction. Instead, look for gentle 2/10 effort.

Your core and pelvic floor play an important functional role within your body. Understanding the core and pelvic floor basics and becoming aware of these tendencies, as well as learning how to manipulate pressure and tension, will help you be able to use this system for positive impacts in your athletic performance.

Want to learn more beyond core and pelvic floor basics? Join us for the FREE Workshop below to learn the strategies you need to prioritize your safety + performance while being mindful of your core + pelvic floor system.