Well, everyone’s stomach feels like a postpartum sponge. But if you notice that you’re experiencing severe back pain, your stomach makes a dome or cone shape in the middle when you move, or it feels softer around your belly button than it does anywhere else, it could be diastasis recti. Diastasis recti, a separation of the abdominal muscles, is very common — 60 percent of births will experience it, according to the Cleveland Clinic. It may take a few months of consistently doing diastasis recti exercises to help it heal, but you won’t deal with the symptoms forever.
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If you’ve heard about diastasis recti on social media—on Tik Tok, the hashtag #diastasisrectiexouts has 89 million views—the experts want you to know you don’t have to buy an influencer’s own workout plan to treat your abs.
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“There’s a lot of fear circulating around now about extraversion and it can seem really scary. The number of self-referrals I’ve been getting has increased, and patients who go to their OB are asking for referrals. But I hate the fact that it’s fear-driven, because it’s the last thing a person needs after giving birth. The benefit is that People are hearing about this and there are exercises we can do to help you feel your best postpartum,” says Valerie Adams, PT, DPT, board-certified clinical therapist in women’s health naturopathy at Duke Health.
Experts say some of these exercises can be done at home.
What is rectal sagging?
Do you know what we call a six pack? Technically those are called the rectus abdominis muscles. During pregnancy, these muscles divide down the middle along a strip of tissue called the linea alba, says the Cleveland Clinic. After childbirth, some people’s muscles retract and heal on their own along this line. But for some, they stay separated, which can lead to some unwanted health things later, like hernias.
How do I know if I have rectal sagging?
Adams says that many people with diastasis recti report feeling bloated or having more dog in the abdomen after delivery. “People may complain of feeling more bloated or more bulging after childbirth, and that they feel weak, controlled, or bloated with certain movements, such as sitting down or lifting heavy objects.”
The Cleveland Clinic also notes pain during sex, a feeling of tenderness in the abdomen, lower back pain, or a jelly-like feeling around your belly button as red flags for the condition. If you are concerned that you may have diastasis recti, you can check it yourself at home.
“You can check yourself for diastasis by lying on your back on the floor, placing two fingers in your belly button and pressing on it. While you keep your fingers in place, gently lift your head and shoulders off the floor and you will feel this separation,” says Brook Orvis, PT, DPT, specialist. Physical therapy at Duke Health.
When do diastasis recti exercises start?
Orvis and Adams agree that as long as you’re not experiencing any pain or discomfort, it’s safe to start exercising gently as soon as you feel like it after giving birth (but don’t rush it, you’ve got as much rest as you want).
“One of our deepest core muscles, called the transversus abdominis, forms a corset around our body. It’s safe to do this starting from the first day after birth, assuming there is no pain,” says Adams.
Rectal diastasis exercises
Before you dive in, you should know that diastasis recti exercises are not the same as a regular core exercise. Adams notes that there aren’t two or three specific exercises that will cure everyone either. The only universal thing that will help you is to strengthen the transverse abdominal muscles, which work kind of like a corset on the body. Here’s how to find out what to engage in:
“Try exhaling and pretending to zip up a pair of leggings, or gently roll your belly button up your spine,” says Adams. “Master engaging them this way in all positions, such as sitting, standing, walking, and lying down.”
Once you know you’re using the right muscles, just practice engaging them a few times throughout the day. “Activate the transverse abdominal muscles three times a day, 10 reps each time,” says Caitlyn O’Sullivan, PT, DPT, physical therapist at Baptist Health Jacksonville. “Sit with your hands on your stomach just above your hipbones. Think of bringing your belly button back toward your spine. You should feel the muscles contract in your fingers. This is not a vigorous movement but a gentle stretching and hold without holding your breath.”
All three experts advise people with diastasis recti to avoid movements such as crunches, including sitting up straight from a supine position, or lifting heavy weights. Anything that makes your stomach conical is something to put off until the abdominal separation has healed.
When to see a physical therapist for sagging rectum
If you’ve been trying to strengthen your transverse abdominis muscles at home but aren’t seeing much progress, or if you’re having a hard time deciding if you’re getting them right, it’s time to make an appointment with a physical therapist.
“With diastasis, the thing we worry about the most is developing a hernia, so I often tell people if you’re lowering your activity level because your belly is dominating or getting sucked in when moving, that’s when I would go in to see a physical therapist. Usually within a week,” Orvis says. Six appointments and you’ll notice some improvement in your symptoms.”
“If you’re experiencing persistent pain, pelvic floor problems like incontinence, or vaginal pressure or pain, there may be little more going on than just basic weakness,” Adams adds. “There are a lot of changes that happen during pregnancy as muscles change. Sometimes just one session is enough to make sure you can reacquaint yourself with your muscles. Even if you aren’t having major problems, it’s great to work with someone to get you on the right track.” .
So whether you’re a fitness fanatic unsure of how to safely get back into your postpartum routine, or just a new parent trying to remedy that weird feeling in your belly, there’s support for you. And who knows, maybe doing a little transverse ab exercises around the house will get you a better crunch in no time.
Experts:
Valerie Adams, PT, DPT, is a board-certified clinical therapist in women’s health naturopathy at Duke Health.
Brook Orvis, PT, DPT, WCS, PRPC, CLT, physical therapist at Duke Health
Caitlyn O’Sullivan, PT, DPT, physical therapist at Baptist Health Jacksonville