Diastasis recti is a partial or complete separation between the left and right sides of the rectus abdominis muscle. It is commonly seen in women who have multiple pregnancies, because the muscles have been stretched many times. Women with diastasis recti have to be cautious during exercise because the condition may lead to diminished muscular force production and even more rectus abdominis separation during physical exertion. Diastasis recti has also been associated with increased risk for umbilical hernia and chronic low-back pain.
Pelvic floor (Kegels), abdominal compression exercises and curl-ups in a semi-recumbent position may be helpful for strengthening the rectus abdominis in this situation. Movements that involve subtle contractions of the deep abdominals (i.e., pulling the belly button in toward the spine) are best for women with this condition. Manual splinting by drawing the abdominals together with the hands along the sides of the body during semi-recumbent core work can also be effective.
Stabilization exercises on both hands and knees (quadruped position), such as the cat/cow and bird-dog are good choices. Pelvic tilts while lying with the back and feet on the floor with the knees bent will help engage the lower abs and transverse abdominis. Also in this lying position, leg slides can be performed where the lower back is held to the floor using abdominal stabilization while one heel at a time slides out and back in.
Any exercises that put extra stress on the abs or cause them to stretch, including twisting exercises and hyperextension of the back (e.g. cobra stretch or arching over an exercise ball) and crunches, should be avoided as they may cause further separation. Lastly, heavy lifting, straining or intense coughing without support that can cause you to press outward with the abs should be avoided until the muscles are strong enough to resume their original anatomical position.
Commonly, diastasis recti is treated with surgery, but the exercises described above can prove effective in lessening the condition’s severity and building strength and integrity in the abdominal wall. Additionally, sagging skin is a problem best discussed with your physician, as building muscle mass through resistance exercise will only minimally improve the appearance of the area.