Diastasis Recti and Pilates

Illu_trunk_muscles.jpg

Diastasis Recti can be both helped or worsened with Pilates. Here's how Pilates can help.

Diastasis Recti as defined by the NIH:

Diastasis recti is a separation between the left and right side of the rectus abdominis muscle, which covers the front surface of the belly area.

Most diastasis is seen in pregnant women, where the muscle separates as the woman's belly expands. I have also seen it in men after abdominal surgeries.

But at the moment I am working with many women who worsened their diastasis through improper exercise techniques during and after pregnancy.

Basically, it is crucial that the transverse abdominis and pelvic floor muscles be strengthened to help hold everything together. The rectus will typically also start to pull back together. Sometimes it will stay, and sometimes need to be sewn.

Diastasis is typically measured in "fingers" - literally how many fingers will fit in between the two muscle halves. I have personally worked with women who have had between four finger and ten finger diastasis with great success.

In terms of exercise, the approach to both diastasis prevention and diastasis repair are similar.

During and after pregnancy, until everything is working properly, avoid exercises that cause an increase in abdominal pressure that will push against the abdominal wall:

  • traditional crunches
  • overhead presses
  • heavy weight lifting
  • intense abdominal exercises (in Pilates this would mean ab series, teaser, backstroke, short box, etc.)

If the muscle has already separated, it can be helpful to wear an elastic abdominal brace to physically hold the muscles together (which is what we visualize while doing exercises).

I encourage people who have a diastasis to try Pilates to strengthen your internal abdominal brace. Please make sure that your teachers are familiar with what diastasis recti is and how to properly manage it. If they ask you to do the hundred with your head up first thing, you are in the wrong place.

If you hear more about breathing, pulling "in and up", and not bulging at your abs, you are in the right place.

Remember that even if you do require surgery to repair the separation, proper abdominal and strength training will help you maintain your abdominal corset of support after.

As an illustration, a new client came in to see me about 6 months ago with a four finger diastasis after her second pregnancy. She had been seeing a personal trainer at her gym, who was giving her crunches and overhead presses to build up strength. Unfortunately, this made the diastasis worse.

It had been about a year, and her OB wanted her to see a surgeon for repair.

After just a few months of steady, twice a week Pilates sessions, she went to the surgeon. He told her there "was nothing to repair." Success! Just proper Pilates training.

If you live in NYC and have a diastasis recti that you would like some help with, please contact me directly. If you live downtown, you can also come see me at Real Pilates.

Seriously, I can help you!