Diastasis Recti Exercises: What’s Safe and What’s Not?

Diastasis Recti Exercises | Every Mother

Pregnancy impacts every system in the body. While it may be tempting to dive right back into your normal workout routine after pregnancy, it’s a good idea to take stock of what may have changed about your body, and whether you should adjust your exercise routine accordingly.

One of the most affected areas of your body is your core, which includes your abdominal muscles, pelvic floor muscles and back muscles. Pregnancy places a lot of pressure on your abdominal muscles, and it’s very common to have a little bit of a separation between your rectus abdominis muscles (the 6-pack muscles) as a result. For many, this stretching and thinning of the connective tissue that runs along the midline of your abdomen can be challenging to repair, and results in a condition called diastasis recti.

The good news is that a specific, therapeutic exercise routine can help, or even heal entirely, diastasis recti symptoms. But, before doing what you’ve always done before, it’s good to know which diastasis recti exercises are considered safe and effective, and which exercises might hinder recovery.

What are the Benefits of Diastasis Recti Exercises?

What we refer to as diastasis recti exercises are proven to be effective to improve the condition, also known as abdominal separation, decreasing the severity of separation both while the muscles are active and when they are at rest. This has been proven while being measured with musculoskeletal ultrasound in this study published in the Journal of Women’s Health Physical Therapy. Additionally, the same diastasis recti exercises clinically proven to narrow the gap between the rectus abdominis muscles also significantly improve self-reported symptoms of stress urinary incontinence, low back pain, and other diastasis recti symptoms.

What is Unique about Exercising with Diastasis Recti? What to Consider

When exercising with diastasis recti, the core musculature has less stability and integrity. A person with diastasis recti is at greater risk of injury, especially to the back, core, and pelvic floor. Furthermore, many common exercises that people perform to strengthen their core muscles will actually exacerbate or worsen diastasis recti.

If intra-abdominal pressure increases to unsafe levels, the pressure, as a result, strains the overstretched tissue in the front and center of the abdomen, further separating the rectus abdominis muscles. In some cases, the pressure can also exert downward stress on the pelvic floor, contributing to pelvic prolapse and incontinence. To avoid injury, anyone suffering from diastasis recti must incorporate these diastasis recti exercise tips:

Avoid any exercise or body position that bulges the abdominal muscles forward forcefully, causes coning or doming along the midline of the body, or exerts pain or downward pressure on the pelvic floor.
To safely manage intra-abdominal pressure, it is important to consciously exhale and draw the navel toward the spine with every exertion. This means exhaling during the work phase of an exercise, such as the lift or the push.
Avoid lifting both shoulders off the floor from a back-lying position. This means avoiding crunches, sit-ups, and variations of those exercises. The moment both shoulders lift off, it is biomechanically impossible to avoid bulging the abdominal muscles forward.
Also avoid lifting both legs off the floor simultaneously from a back-lying position. Instead, lift one leg at a time as you exhale and flatten your abdominal muscles toward the floor.
Keep spinal extension and chest opener exercises moderate - avoid thrusting the lower rib cage open. When the lower ribs splay apart, the upper abs follow. For instance, instead of performing full back bends, upward facing dog, or full cobra in yoga, opt for poses with smaller ranges of motion that allow you to keep your ribs anchored in a neutral position.
Either keep cardio low impact (brisk walking, cycling, or swimming instead of running or jumping), or train to manage the pressure of impact with proper breathing and core engagement. For example, each time you “land” a jump or hop, exhale and engage both your pelvic floor and core with a conscious lift toward the spine. If you feel any symptoms of pelvic pressure, vaginal heaviness, or leaking urine, then stop and focus on diastasis recti exercises until you strengthen your core and pelvic floor sufficiently to safely manage high impact exercise.

The Consequences of “Wrong” Exercises with Diastasis Recti and Symptoms

If you have diastasis recti and perform the wrong exercises or perform neutral exercises poorly, you can worsen diastasis recti and further separate the abdominal muscles. It is also possible to injure your back and pelvic floor, leading to worse or new symptoms such as low back pain, pelvic prolapse, pelvic pain, and urinary incontinence. The good news is that there are many safe movements to prevent this from happening.

Diastasis Recti Exercises: What’s Safe and What’s Not

Diastasis recti is a condition that affects over 60% of women after childbirth. It occurs when the two sides of the abdominals (your "six-pack" muscles) stretch sideways or separate to accommodate the growing fetus, often damaging the connective tissue in the process. Pregnancy is the leading cause of diastasis recti, but anyone can get it from core-straining exercises or movements that put excessive pressure on the abdominals.

Thankfully, diastasis recti can be minimized and resolved altogether with therapeutic exercise. Here are tips on what to avoid and also some exercises that prevent and heal diastasis recti.

Ab Exercises for Diastasis Recti

Because diastasis recti is focused in your core, we’ll naturally start with ab exercises for diastasis recti. This is the area that requires the most attention and consideration to ensure that you are only doing exercises that will help to heal, and not exacerbate, your diastasis recti symptoms.

First we’ll tackle what ab exercises to avoid with diastasis recti, before providing some modifications and movements that are considered safe for diastasis recti.

To get full explanations about why these exercises should be avoided, and to get step-by-step walkthroughs of the modifications and suggested exercises, read our article specifically about the subject: Ab Exercises for Diastasis Recti: Safely Strengthening Your Core.

Ab Exercises to Avoid

Many of the “traditional” ab exercises that are common in workout routines contain movements and elements that will be detrimental to your progress. The good news is that with a few modifications and changes, there are still plenty of exercises that can help you strengthen your core while also improving, and eventually repairing, your diastasis recti symptoms.

Here are some of the most common exercises to avoid if you have diastasis recti:

Traditional Pushups
Traditional Planks
Traditional Crunches and Bicycle Crunches
Reverse Crunches
Double Leg Lifts

Safe Ab Exercises

While it may be disheartening to discover that some of the go-to core exercises are counterintuitive, there are effective exercises that safely engage your abdominal muscles. Safe core movements coupled with Core Compressions are the golden standard to core integrity and strength. Core Compressions are a movement that activate your transverse abdominis muscle, also known as your natural corset.

The below exercises properly recruit the deep core muscles (transverse abdominis, diaphragm, lumbar multifidus, and pelvic floor), and will help to strengthen the core and reverse the effects of diastasis recti.

Wall Planks
Pushup alternatives
Waist cincher with single-leg lifts
Core compressions with ankles crossed
Tabletop tilts
Pelvic scoops
Waist anchor in semi-bridge
Waist cincher with a twist
Side plank and Modified Side Plank (from the knees)
Obliques pull-ups

Again, to get step-by-step walkthroughs of the modifications and suggested exercises listed above, read our article: Ab Exercises for Diastasis Recti: Safely Strengthening Your Core

Cardio Exercises for Diastasis Recti

Even in certain cardio exercises, there is a risk of worsening diastasis recti. It is also possible to injure your back and pelvic floor, leading to worse or new symptoms such as low back pain, pelvic prolapse, pelvic pain, and urinary incontinence.

Cardio Exercises to Avoid

High impact cardio exercises, such as jumping, running or rebounding, exert forceful pressure on the abdominals and pelvic floor. This challenges core integrity, and in some cases, can re-injure or worsen diastasis recti. Repetitive, high-impact exercises like running and jumping can also contribute to pelvic prolapse and urinary stress incontinence, especially if these activities are performed prior to restoring core strength and function postpartum. For this reason, it is very important to work on restoring core integrity and function before reintroducing high-impact activities into your routine. If you feel pelvic pressure, vaginal heaviness, leaking, or urgency to urinate during or after any cardio exercises, it is best to avoid that activity for now.

Safe Cardio Exercises

The key is to keep cardio low impact (brisk walking, cycling, or swimming instead of running or jumping) or train to manage the pressure of impact with proper breathing and core engagement as you work towards resolving your diastasis recti and becoming stronger.

Here are some safe exercises to incorporate into your cardio plan while you heal diastasis recti:

Low impact cardio
Jogging or Running
Indoor Cycling
Dance Cardio
Swimming

We go much more in-depth about cardio exercises in relation to diastasis recti in our blog: Postpartum Cardio Exercises & Diastasis Recti.

Pilates Exercises for DR | Diastasis Recti Pilates Exercises | Every Mother

Pilates Exercises for Diastasis Recti

Pilates is sometimes considered a fundamental core strengthening regimen. However, the truth is that traditional Pilates can be harmful to your core and worsen abdominal separation. The reason is that traditional Pilates exercises increase intra-abdominal pressure, exerting unhealthy mechanical stress on the connective tissue that runs along the midline of the abdomen.

How to make sure your Pilates exercises are safe

An exercise that lifts both shoulders off the ground from a supine (back lying) position should be modified or skipped altogether. The abdomen tends to bulge or brace forward forcefully when performing this type of movement. The ideal mechanics during a core exercise is drawing the navel toward the spine while exhaling on exertion to activate the transverse abdominis.

While some pilates exercises will need to be skipped altogether, many of them can be modified to avoid the range of motion where you cannot avoid the forward pressure, and they can become safe for those with diastasis recti.

Pilates Exercises to Modify / Avoid

Here are some of the most common Pilates exercises that require modification to make them safe for diastasis recti include:

Hundreds
Roll Up
Roll Over
Teaser (all 3 variations)
Corkscrew
Jack Knife
Swan Dive
Hip Circles
Swimming
Criss-Cross

To learn more about the details of why each of these exercises can be unsafe for diastasis recti, and to get step-by-step walkthroughs of the modifications and suggested movements, read our article: Pilates for Diastasis Recti: Are You Hurting Your Core?

Yoga Exercises for Diastasis Recti

Some traditional yoga exercises can be counterintuitive to building and maintaining core integrity. They may even injure your abdominal connective tissue, exacerbating or inducing an abdominal separation. The good news is that many go-to yoga movements can be modified for all the benefits and core safety that are safe for diastasis recti exercises.

Yoga Exercises to Avoid

Movements or poses that open the lower rib cage compromise the integrity of the upper abdominal wall. As the ribs splay apart, they tug the upper abdominal muscles, including the rectus abdominis, away from the midline. This places stress on the linea alba, the midline that runs vertically between the two halves of the abdomen. Over time, repeated stress on this tissue can cause it to weaken and thin, compromising core strength and stability while widening the waistline.

Here are a few of the most common poses that may do more harm than good:

Full Wheel Backbends
Full Cobra
Full-extension upward dog

Diastasis Recti Safe Yoga Exercises

In some cases, simply decreasing the range of motion of your favorite yoga pose or exercise will be sufficient to maintain core safety. Sometimes it really feels good to stretch the abdominal muscles and front body. To satisfy that need without the risks associated with more demanding yoga exercises, here are some modified poses that can safely stretch the front body without splaying the ribs and upper abs apart.

Modified Cobra (Sphinx)
Bridge
Sumo squat vinyasa

To learn more about the details of why each exercise can be unsafe for diastasis recti, and to get step-by-step walkthroughs of the modifications and suggested movements, read our article: Diastasis Recti Exercises: Is Postpartum Yoga Safe?

Strength Training Exercises for Diastasis Recti

Strength training (also known as resistance training or weightlifting) is a type of exercise that uses resistance to muscular contraction to build strength, anaerobic endurance, and healthy muscle tone.

Strength training is vital to maintain metabolism, build strength, improve posture, and boost bone density. The key to core-safe strength training is to effectively manage intra-abdominal pressure while lifting. How does one do that?

Exhale and engage the deep core on every exertion. If you are performing a biceps curl, the exertion is the “curl” - the muscle contraction that bends the elbow to lift the weight. Inhale as you open the arm to prepare; exhale and engage the deep core by drawing your navel toward the spine as you bend the arm, performing the “work” of the exercise.

For challenging exercises that require a great deal of effort in both directions, such as a knee push-up, I recommend that you exhale in both directions of the movement: exhale and engage your abs toward the spine as you lower yourself to the floor (pause at the bottom, rest and inhale) - then exhale and engage your deep core even more firmly towards the spine as you push up. If you cannot exhale and keep your abs engaged toward the spine throughout an exercise, then lower the weight or decrease your range of motion.

Safe strength training can include bodyweight exercises, free weights, resistance bands – or all of the above. The Every Mother EMbody workouts offer a great combination of resistance and aerobic moves to achieve your health and fitness aims efficiently.

Learn More About Diastasis Recti and Diastasis Recti Exercises

A regular exercise routine can help, or even heal entirely, diastasis recti symptoms. But, before doing what you’ve always done before, it’s good to know which diastasis recti exercises are considered safe, and which might actually make your condition worse.

Check out some of our other articles to learn more about diastasis recti exercises, and begin to reclaim your body today.

Sources

Leopold, Madeline, et al. “Efficacy of a Core Strengthening Program for Diastasis Rectus Abdominis in Postpartum Women: A Prospective Observational Study.” Journal of Women’s Health Physical Therapy, vol. 45, no. 4, 2021, pp. 147–63. Crossref, https://doi.org/10.1097/jwh.0000000000000214.
Sharma, Geeta, et al. “Postnatal Exercise Can Reverse Diastasis Recti.” Obstetrics & Gynecology, vol. 123, no. Supplement 1, 2014, p. 171S. Crossref, https://doi.org/10.1097/01.aog.0000447180.36758.7a.

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