First of all, you are NOT broken. Maybe your belly sticks out and your hair is shedding and your skin is going nuts, but you are not broken.
You are magic and you created a miracle.
Now that that’s settled, let’s talk DRA or diastasis recti abdominus, which is a separation of the rectus abdominis or six-pack muscles. Please note that this separation happens to every woman late in her pregnancy. The abdominals have to separate to make room as baby grows.
So what happens when the DRA sticks around postpartum?
MYTH: don’t do abs with a DRA! You’ll make it worse.
FACT: The biggest thing that worsens a DRA is doing nothing and expecting it to heal. The next, is using your muscles unsafely.
In this first photo, the patient has been cued to do a sit-up. Note that her rectus abdominis (6-pack) is activated and the abs actually knit themselves closer together (NOT apart). There is separation visible but it is controlled.
In this second photo, see as she has been cued to lift both legs into a table top position. Now you see pressure loss that can lead to hernia (a hole in the abdominal wall). You can physically SEE this loss of pressure manifest in what we term “coning” or “doming.”
So how do we knit the abs back together and keep her working out safely?
We cue the transverse abdominis muscles that act like an internal corsette around the abs and spine). We cue them by asking the patient to “zip up” her lower belly as if she’s putting on a tight pair of jeans. (FYI: this is a huge way to combat the mom pooch!)
We also have the patient simultaneously exhale which engages the obliges and similarly protects by bringing the abs closer together.
See these strategies engaged in this third photo:
Basically, the 6-pack abs are cute, but dang, they can’t do much. The transverse abdominals and obliques can handle way more load without a potentially hernia-inducing/DRA-worsening pressure loss.
Remember: the safest thing to do with a DRA is get evaluated by a pelvic health specialist so that you can work on a treatment plan specific to you. At OrthoPelvic Physical Therapy, we’re here to help!
Call or email us to book today.
Be empowered in education!
Dr. Kelly
