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Diastasis Recti

Abdominal muscles & diastasis

The abdominal muscles are crucial to keep the pelvis stable and to allow the pelvic floor to function properly. And youll have to exercise them for strength
and endurance. Even six weeks after delivery, with every activity exerting your abdominal muscles, youll notice that theyre not back to full strength yet. Leading an active lifestyle and exercising your muscles will ensure that your abdominal muscles recover as best they can.

Diastasis recti

During pregnancy, the abdominalwall in the centre of the abdomen between the two halves of the midline abdominal muscle is weakened.
The abdominal wall is made up of supporting and binding tissue, including collagen fibres. Due to the pregnancy hormones, the tension of the fibres decreases and they begin to stretch. After delivery, this process will redress itself and the collagen fibres will regain their normal tractive force. However, long term stretching or ever tearing of the fibres can lead to the binding tissue not being able to recover fully. The two halves of the abdominal wall will thus remain separated, which, in medical terms, is referred to as diastasis.

The chances of diastasis recti are increased by substantial weight gain during pregnancy or by a twin pregnancy. Three out of ten women will suffer from a mild form of diastasis following their first pregnancy. In addition, the likelihood of diastasis, as well as its severity, increase after multiple pregnancies.

Diagnosing diastasis recti

You can check the degree of diastasis using the following exercise. Lie down on your back with your legs pulled upwards, letting your arms rest on either side of your body. Raise your head in the direction of your knees.

The elongated bulge which becomes visible on your abdomen is the diastasis. It is the stretched binding tissue, which, upon tensing the muscles between both halves of the midline abdominal muscles, bundles up, forming a bubble.

 

Diastasis can also be diagnosed using your fingers, applying pres- sure 2 cm above your belly button. You will then feel an empty space between the midline abdominal muscles.

The time it takes to recover from diastasis recti after delivery can be gauged by its degree of severity. Do not start training your midline abdominal muscles until the diastasis has been corrected adequately:

  • Minor diastasis recti (± 5 cm in length, 1 cm in width) will generally correct itself naturally once you gradually start stimulating your abdominal muscles.
  • Mild diastasis recti (up to 10 cm in length, 2 cm in width) will not be able to be fully corrected, however, this may not necessarily lead to complaints. Abdominal exercises may help prevent any health issues from arising.
  • Severe diastasis recti (longer than 10 cm, wider than 2 cm) will not correct itself and must be corrected surgically; it’s comparable to an umbilical hernia. Elevated pressure and tension in the abdomen can no longer be absorbed by the abdominal muscles, even when highly trained.

 

In the first weeks after childbirth you can already start doing some mild exercises to strengthen your pelvis and abdominals

 

Belly breathing, active and low

This is a good exercise to start strengthening your abdominal and pelvic floor muscles.

1 Lie on your back with your knees up and towards you and place your hands on your belly.

2 Pull your belly button inwards and push your back towards the ground.

3 Keep this position for 10 seconds and then relax.

Repeat 3 times for 10 seconds.

Active belly breathing on your side

This is a good exercise to let your straight abdominals move towards each other again, without using too much power.

1 Lie on your right side with your knees up and pulled towards you and support your head with your right hand.

2 Pull your belly button inwards and keep on breathing well.

3 Keep this position for 10 seconds and relax your belly afterwards.

Repeat 3 times for 10 seconds on your left and your right side.

 

Leg bending & stretching

This exercise helps with good blood circulation in your legs. It also strengthens your pelvis and your abdominals.

1 Lie on your back with your legs stretched out and your arms straight alongside your body.

2 Bend your right leg towards your breast and stretch your leg out again. Your back stays flat on the floor.

Repeat this exercise 6 to 8 times with each leg.

Bridge exercise

Making a bridge

This is a very good exercise to strengthen the stability of the muscles of your torso. You also strengthen your pelvis.

1 Lie on your back and place your feet on the ground with some space in between and your knees bent. Let your arms rest beside your body.

2 Pull your belly button inwards and tense you’re abs. Lift your pelvis. Your body is now a straight line from your shoulders to your knees. Hold this position for 5 seconds.

Repeat this exercise 6 times.

Use the Stage 2 abdominal exercises on pages 74 and 75 to stimulate and rebuild your abdominal muscles in the right way (see below!). If the space between the abdominal wall clearly remains wider than 2 cm and longer than 10 cm, then please contact your doctor before continuing to exercise your abdominals.

 Ankle reach

Ankle reach

This exercise trains the deeper muscles and oblique abdominal muscles, for a slim waist.

1 Lie down and pull your knees up, letting your arms lie stretched out beside your upper body.

2 Raise your body slightly, from the shoulders, and reach for your right ankle with your right hand. Then reach for your left ankle with your left hand. Repeat this 5 times alternating sides.

Repeat this exercise 3 times.

 OUter abdominals

Outer abdominals

This exercise will strengthen the outer oblique abs.

1 Lie on your side, leaning on your right forearm for support. Then bend both knees backwards at a 90 degree angle. Keep your upper legs in straight line with your upper body.

2 Raise your hip as high as possible and hold this position for 5 seconds. Then lower slowly.

Repeat this exercise 3 times on both sides.

Knee plank

Knee plank

This exercise strengthens the core transverse abdominals.

1 Get down on your hands and knees, supporting yourself with your hands or forearms.

2 Contract your abs and make sure your head is positioned in one straight line with the rest of your body. Pay attention not to let your torso sag or raise your buttocks. Hold this position for 5 seconds.

Repeat this exercise 5 times.

 Core

Lateral core strengthening

This Thera-band exercise is very effective for strengthening your back and abdominals.

1 Sling the middle of the Thera-band around a pole or a door handle. Stand with both feet at hip distance and bend your knees ever so slightly. Grap the doubled band at either end with both hands.

2 Bring your arms forward, stretched at shoulder height. Subsequently pull the band 90 degrees to the right with both arms stretched and then slowly return to your original position without lowering your arms.

Pull the band to the right 8 times and then repeat pulling to the left 8 times.

 Lateral core

Strong core short

Another variation using the Thera- band to strengthen the back muscles and abdominal muscles.

1 Sling the middle of the Thera-band around a pole or a door handle. Stand approximately 1 meter away from the pole, feet placed at hip distance and knees bent slightly, holding enough tension on the band. Grap the doubled band on either end with both hands.

2 Bring your arms forward, stretched at shoulder height. Keep your arms stretched out and pull the band ever more toward the right using short tugs. Do this for 10 seconds.

Repeat this exercise twice both for the left and right hand sides.