Postnatal Exercise Percautions [Diastasis Recti/Abdominal Separation]
Yoga is a great way to help your body and mind heal from the physical and mental stresses of childbirth. Just as every woman has different needs while pregnant and uses different prenatal yoga modifications based on her own body’s needs, recovery from childbirth is a very individual thing as well. Women recover from childbirth at different rates depending on their labor experience, length of pushing, trauma to the perineum, physical condition before childbirth and type of birth (vaginal or cesarean).
Diastasis Recti/Abdominal Separation
Diastasis Recti is the separation of the Rectus Abdominis muscles (also known as the 6 pack muscles). This separation does not occur in every pregnant woman but it is not uncommon to see it postpartum. The hormone Relaxin that is responsible for lubricating and loosening the connective tissue of the pelvis and allowing it to open up for the baby to pass though, also loosens and lubricates the connective tissue of the Rectus Abdominis muscles allowing them to stretch more and potentially leading to their separation.
It is very important that a postpartum woman not do any abdominal exercises until she has checked her rectus abdominis muscles for diastasis!
If she strengthens the muscles too much while they are separated they may not come back together effectively.
Here is how to test for abdominal separation (diastasis recti):
- Have her lie on her back with her feet on the ground and knees up.
- One hand should be behind the head to support the neck
- With the other hand place two fingers on the Linea Alba (the midline connective tissue that links to the Rectus Abdominis muscles) at the waistline, three fingertips above the navel
- Gently lift just the head until you feel the abdominal muscles engage and notice how much space is between the muscles
- Repeat this with the fingers one to two inches below the navel as well
- The gap your fingers are in should be no more than 2 fingertips wide otherwise she probably has diastasis recti.
- If you suspect she has diastasis recti have her check with her health care provider before doing ANY abdominal exercises.
If diastasis recti has been diagnosed her are a few guidelines to follow:
- DO NOT do crunches or any other aggressive abdominal strengthening exercises until abdominals come back together to two fingertips apart or less.
- Stay away from backbends including wheel, supported wheel with a ball, full cobra, upward dog, or any other poses that drastically stretch the abdominals
- Twisting while engaging abdominal muscles
- Lifting anything heavy
Returning to Yoga
Here are some guidelines for practicing yoga after giving birth.
- Only gentle stretching should be done until there is a substantial decrease in bleeding. (Usually about 2 to 4 weeks postpartum after a vaginal delivery)
- If bleeding increases with activity, the woman should decrease intensity
- If a woman has diastasis recti, she should consult a health care provider and avoid poses that will make it worse
- She should start off doing five to fifteen minutes a day and gradually build up her practice
- If a woman has had a cesarean birth additional consideration should be taken. Here are some guidelines for yoga after a cesarean birth:
- It is best to abstain from all but gentle stretching until 6 to 8 weeks after cesarean.
- Poses that stretch the area of the incision should be avoided until incision is healed. (i.e., backbends)
- As with all prenatal and postnatal yoga if a pose doesn’t feel good, it should be avoided.
- The woman should remember that although cesareans are a type of birthing, they are still major abdominal surgery and the body’s healing process should be observed and respected.
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I developed diastasis recti during my second pregnancy and 18 months later am still fearful of making it worse by doing certain exercises. At this point, is it safe to return to aggressive abdominal strength training without the worry of making the diastasis worse? When I test for the diastasis, there is only one finger width gap if I don’t engage my transverse before lifting my head. If I engage my TvA,I have about 2.5 finger widths of separation.
Hi Jennifer,
I am so happy to come across your site. You are very clear on the dont’s of a yoga practice for moms with iastais recti. I have a 3 finger seperation below my belly button and a lesser seperation close to the rib cage and look 5 mths pregnant. I would like to avoid a tummy tuck as much as possible but still want to practice yoga. I used to practice a lot of Yoga prior to the baby and now want to get back to it. You have given a good sense of the asanas that must be avoided. What’s your take on the strenuous pranayama’s like kapal bhati or agnisara dhouti? If you can give some pointers on that, it will be great.
On that note, do you by any chance have a practice -along dvd for those with diastasis recti? That would be great. A few sequesces that can be practiced catering to various levels would be my dream come true!
Hope to hear back from you soon. Thank you for your time and energy
Be Well,
Deepta
Hi Amanda, Sorry for the late reply!
From my understanding, not being a physical therapist, 2.5 finger widths is borderline to do a normal abdominal routine, many people say 2 fingertip separation is as far as you should be. Since everyone is individual, measures themselves differently, and can have different reactions (ie back pain etc.) to different separation levels, I would recommend seeking the advise of a physical therapist or doctor who is knowledgeable in this area.
Namaste,
Jennifer
Thanks for your response Deepta,
I don’t have a DVD that deals specifically with postnatal issues such as diastasis recti but I will definitely include it when I make one.
That feeling that you look 5 months pregnant can be caused by diastasis and doing the exercises to correct it can be very helpful! My advise is to seek the assistance and support of a physical therapist and follow a diastasis recovery exercise program before adding anything new. I would avoid the strenuous pranayamas such as Kapalbhati until your diastisis is healed unless your physical therapist says it’s ok based on their assessment of your particular body. Let me know how it goes!
Namaste,
Jennifer
Thx Jennifer! We really need such a specific product to address a regular yoga routine for those with an abdominal rip. I have just started getting some help on this and will keep you posted.
Namaste,
Deepta