Core Training For Expecting Moms: Diastasis Recti Exercises

Pregnancy is an exciting time for a woman, as well as, a time of many physical musculoskeletal changes as the body prepares for birth. Both during and after pregnancy the abdominals will actually separate at the midline; this is called diastasis recti and it’s absolutely normal and occurs to some degree by the third trimester in every pregnancy.1 There are exercises that you can do both during and following pregnancy to lessen the width of abdominal separation, as well as restore balance to your core and reduce incidence of urinary frequency and pelvic pain.

Breathing

Any effective core stabilization program should always start with breathing exercises. Focusing on deep, intentional breathing has been shown to reduce stress, promote muscle relaxation, lower heart rate, and even reduce nausea during scenarios that normally induce motion sickness2. On top of all of these benefits, deep breathing helps to normalize intra-abdominal pressure and the relationship between the respiratory diaphragm and the pelvic floor musculature. The breathing diaphragm is closely related to the pelvic floor muscles in that they form the ceiling and floor diaphragms for the abdominal organs. As you take air into the lungs and the diaphragm lowers the pelvic floor relaxes to allow space for organs. When there is dysfunction in either the diaphragm or the pelvic floor there is increased pressure and sometimes pain on the pelvic organs. Try this diaphragmatic breathing exercise to get you started with finding your own deep breath:

• Lie on your back on a comfortable surface with your knees bent and your feet planted flat.
• Use pillows or blankets to cushion your head and neck so you can truly relax.
• Gently place your left palm on your lower left rib cage just below your heart and your right palm on your right lower belly just to the right of your navel. Close your eyes.
• Breathing through your nose, take a deep breath in and feel your ribs expand as your lungs fill with air.
• Pause for just a moment, then exhale completely and feel your abdominals engage as your ribs relax and your lungs empty.
• Continue to inhale and exhale at a slow pace and focus on relaxing any other tension in your body as you breath – relax your face, your jaw, your shoulders and your clenched glutes.
• If you’re feeling dizzy, which can sometimes happen, just lessen how deep of a breath you’re taking but still feel the ribs and abdominals engage.

TA Bracing In Hooklying With Movement

Next we’ll activate the transverse abdominus (TA) muscle with abdominal bracing.  The TA is a deep abdominal muscle that wraps horizontally around the abdomen to the posterior spine. Because of this horizontal muscle fiber orientation the TA is often referred to as the body’s natural corset. Strength in the TA supports the spine to reduce low back pain, as well as provides support to the other core muscles and organs.

• Lying on your back with your knees bent and your feet planted on the floor.
• Move your right and left palms to your low abdominals to the right and left and inferior to your naval.
• Take a deep inhale through your nose and as you exhale through your mouth feel your abdominals tighten and engage under your palms to “corset” your trunk.  
• Maintain this muscle activation as you take another inhale, and exhale.
• Repeat this pattern for 5 rounds of breath while holding your TA abdominal contraction.

A simple movement that you can add to this exercise to further challenge your TA muscle contraction is the bent knee fall out (BKFO). As you inhale slowly lower your bent right leg to the right. Keep your trunk stable to avoid rocking and control the leg movement so it’s smooth. Perform 5 repetitions with the right leg, then 5 repetitions on the left.

ADL and Sport Specific TA Strengthening

Now that you’re proficient with deep breathing and transverse abdominus activation, it’s time to progress to sport and ADL (activity of daily living) specific training. A physical therapist can design a home exercise program specific to your needs and goals. Whether it’s competitive cycling, weight lifting, casual running, or Pilates, our PTs at Therapydia are experts at getting your body in top shape to perform. We’d love to help you be your best.

  1. Fernandes da Mota PG, Pascoal AG, Carita AI, Bo K. Prevalence and risk factors of diastasis recti abdominis from late pregnancy to 6 months postpartum, and relationship with lumbopelvic pain. Man Ther. 2015 Feb;20(1):200-205.

2. Russel MEB, Hoffman B, Stromberg S, Carlson C. Use of controlled diaphragmatic breathing for the management of motion sickness in a virtual reality environment. Appl Psychophysiol Biofeedback. 2014; 39: 269-277