Diastasis Recti & Core Training Guidelines

Recti Abdominis Information:

Abdominal weakness, weight gain and hormonal changes can cause muscle separation during pregnancy, this is known as Diastasis Recti. This will happen to some degree to all pregnant ladies, the key is to try to minimise the damage and also strengthen the other muscles which may be weak because of pregnancy.

Normally your body will recover and Diastasis Recti should be 'fixed' normally 6-8 weeks post-partum, however after pregnancy the muscles will always lie slightly apart. In pregnant ladies we have to assume that muscle separation may have started to occur after the first trimester therefore it is important to stop certain abdominal exercises like curl ups going into your second trimester.

Pelvic floor/ Kegal exercises

Pelvic floor/ Kegal exercises can be done throughout pregnancy.

You can also start to rehabilitate the pelvic floor muscles within the first 24 hours of giving birth, these should be done intensively (preferably a few times a day) for at least 8 weeks post-partum.

You should aim for 10 Slow contractions, building up to 10 second holds and 10 Fast contractions.

These can be done standing, sitting or lying (unless more than three months pregnant), and done as many times as you can during the day. 

How to Perform Kegal Exercises

  • Lie/ sit/ stand with your feet slightly apart.

  • Draw up and tighten the muscles around your back passage and hold, then take the feeling around the front, lifting up through the vagina.

  • For slow contractions hold for a count to six, release with control, repeat for desired reps.

  • For fast contractions hold for a count to one, release with control, repeat for desired reps.

Abdominal hollowing

Aim to build up to 10 sets of 10 second holds and repeat three times a day or as often as possible.

Seated with Correct postural alignment pull your belly all the way in and up at the naval without moving the rib cage, pelvis or spine. Relax half, then relax half again so you are at about 30% of the maximal voluntary contractions. This is abdominal hollowing. Hold this for ten seconds then relax and get back to that 30%, hold for ten seconds and repeat. You should be able to hold this contraction and breath through it at the same time. This can be done seated, standing or lying (no lying after the first trimester in pregnancy).

Lying pelvic tilts (First trimester and a post-partum progression only)

Aim for 1-3 sets of 8-15 reps.

Lie flat looking up with your feet flat on the floor a little less than hip width apart and your knees bent.

While maintaining abdominal hollowing posteriorly rotate your pelvis so your lower back is touching the floor. Hold and count to six while still breathing.

Modified trunk curl (First Trimester only)

The abdominal wall should be held flat with the umbilicus drawn towards the spine, if this is not possible and doming occurs when curling up then the exercise is too demanding. Aim to work towards 3 sets 10-15 reps. 

  • Lie facing up and posteriorly tilt your pelvis.
  • Curl up as far as you can without doming occurring.
  • Grip your thighs and pull yourself 1-2 inches higher, slowly and controlled.
  • Hold for 1-2 seconds, eventually building up to 10 seconds for 10 reps. Your abdominals should remain flat with no doming.
  • If you are unable to hold for 1-2 seconds go up then try and slowly lower back, when you can lower with it being able to take 10 seconds you can move to the full holding position.

4 - point kneeling

As explained above you should aim for abdominal hollowing but on all 4’s. Hips should be above the knees and your shoulders above your hands.

One you can achieve abdominal hollowing in this position you can lift and lower one arm or leg and then move on to the opposite arm and leg, all whilst performing abdominal hollowing.

If you suffer from carpel tunnel syndrome this may not be the best option for you.

Flexibility training

When stretching throughout pregnancy and post-partum all stretches should be maintenance stretches and not held for any longer than 10-15 seconds.This is due to hormonal changes particularly the hormone Relaxin, holing a stretch for longer than this could lengthen the ligaments around the joint.

Abdominal stretches should also be avoided.