5 Exercises to Heal Diastisis Recti and/or Umbilical Hernias

One thing I’m passionate about is women’s health. I could get on my soapbox of hours and go on about how I think if men had to deal with half the “female” stuff we do, the care we currently receive would be so much different. Instead, I’m going to write a very long, and very informative blog post ūüôā

Currently, moms don’t get a lot of extra love and attention after birth in the United States, and as a pre- and post-natal trainer this infuriates me.

I have worked with women 8 weeks after birth and 30+ years after birth who are “just dealing with” the aftermath pregnancy and birth. Most of the questions I ask are brand new to them. I mention things they’ve never learned about and that seriously concerns me, while also exciting me.

Sure, we all have a 6 week check up after birth, but the depth of care we often receive is lacking. Yeah, yeah, yeah. I understand this is a huge blanket statement. Some doctors are awesome, however the majority of women are not receiving the full care they deserve.

While most women could benefit from a session with a pelvic floor specialist, we instead think it’s “normal” to deal with peeing our pants a little when we jump, laugh, or sneeze for the rest of our lives. A lot of women don’t realize they have hernias after pregnancy or birth and instead of trying to heal them, they just become worse and may eventually need surgery. And doctors rarely check for diastisis recti, or an abnormally large separation of the abdominal wall so this too can become much worse and can lead to things like hernias, a belly pooch, back pain, and more.

However, instead of just riding the negative train into the ground, I’ve decided to do something about this current trend: I’m going to help change it!¬†The great news is there is information out there and I’m so grateful to have the opportunity to help other women feel empowered as they learn how to help themselves too.

Identifying Diastisis Recti

Separation of the abs is a completely normal part of pregnancy and can also occur when someone is overweight or has undergone a major abdominal surgery. In the case of pregnancy, the abdominal wall loosens and separates to make room for a growing baby. There’s a lot you can do to minimize this separation while pregnant, or even heal diastisis recti during pregnancy, but wherever you are in the journey–maintaining this separation after childbirth can be downright uncomfortable and dangerous. So, how do you identify if you have a gap that is considered “too wide” (ie. diastisis recti)? And if you have diastisis recti, how do you fix it?

Diastisis recti is identified by observing a gap in your rectus abdominal muscles, or the “6 pack” layer of your core. This is the top most layer of your abs. To measure your abdominal separation you will do two quick tests (and don’t worry–you don’t have to be able to “see” a 6 pack to do this test!).

First, observe the separation of your abs above your belly button.

Lie on your back and bend your knees. Gently place a hand behind your head for support and lift up off the ground. As you settle into this slight “crunch” position, use your fingers to palpate and measure the distance between your upper abs. Measure finger widths. Anything more than 2 fingers width of separation between your ab wall (more than your pointer finger + middle finger) is considered diastisis recti.

Next, observe the separation of your abs below your bellybutton. Lie on your back and bend your knees. Keep your head down on the ground this time and instead gently lift your feet off the floor. Palpate below the belly button and measure the distance between your lower abs. Anything more than 2 fingers width of separation between your ab wall (more than your pointer finger + middle finger) is considered diastisis recti.

A third test can be done around your bellybutton to observe for an umbilical hernia, another common issue to follow pregnancy. Hernias can be accompanied by other symptoms like bulging or pain, but you can still check for a hernia like you check for DR. Go back to the first test, but this time palpate around your bellybutton. More than 2 fingers width can indicate a hernia. Or you may notice you have a larger, hollow “hole” that your belly button fall into as you pick your head up.

Healing Diastisis Recti and/or an Umbilical Hernia

Now, if you have DR or a hernia, there is loads you can do to help yourself before things get worse. And even if things have already gotten worse, you can still make major improvements!

True story: I had DR after I had my first daughter. Despite having my pre- and post-natal corrective exercise certification, after lots of miscarriages I exercised more cautiously during my full term pregnancy and was afraid to try some of my training. I also thought i was doing some things correctly, and I wasn’t. Once my core was separated I really understood how I needed to improve a few things and add to my routine. Postpartum, I had 3 fingers of separation, but within a few weeks of doing a few exercises, I closed my gap to just 1 finger. After having my second daughter I had 1 finger gap when I checked 3 weeks postpartum (though I did experience an umbilical hernia so worked hard to close it as much as possible again using a few key exercises. My doctor was impressed at my 6 month check up!).

Both DR and umbilical hernias are the result of a weakening of the connective tissues in your core. So, while you can identify DR in your upper most layer of your abs, you want to heal the condition by strengthening the deepest layers of your abs like your transverse abdominis, obliques, and your pelvic floor.

Truthfully, every single person–man or woman (and women who have had kids and haven’t) can benefit from training their core in the way I’m going to show. It literally strengthens the deepest layers of your core and therefore provides tons of strength, stability, and stamina.

One last VERY¬†important note before I show you some great exercises: train¬†your pelvic floor as part of your core!¬†This is perhaps the most important part of your healing process. Kegels alone aren’t going to strengthen or heal your issues, despite this being the only remedy many doctors recommend. Instead, you want to learn to use your pelvic floor, engaging it as part of your deep core unit.

Too often, people are holding their bellies and pelvic floor “tight” all the time. But a tight belly or pelvic floor doesn’t mean it’s strong. It’s just tight! So, when doing the exercises below, be sure to activate your pelvic floor. To find your pelvic floor, do try to stop the flow of urine when peeing, but then when your bladder is empty just try to relax that muscle. Then try to lift or “flex” the muscle and then return it to a resting position. I’ll admit, this takes serious practice but it is life changing! Your pelvic floor helps you pee and move your bowels, because both types of waste exit through a passage in the pelvic floor, but your PF is also responsible for supporting (or holding up) your bladder, uterus, and bowels so learning how to use this muscle properly is critical and can help you avoid serious issues like prolapse in the future.

5 Exercises to Heal Diastisis Recti and/or an Umbilical Hernia

1. Belly wrapping, belly pumping, or transverse abdominal breathing

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  • This exercise can be called so many things, but regardless of what it’s called, in this exercise you are literally trying to wrap your abs together and close the gap.¬† By learning to do this you are strengthening the weakest connective tissue and healing your problem for good! And perhaps the best news: this is an exercise you can do before, during, and after pregnancy! It is helpful all the time and can be nearly anywhere, even when you’re driving in the car!
  • You can and should try and eventually succeed at this movement lying down, sitting, and standing because you want to be able to apply it to all types of movement. The ultimate goal is being able to belly pump when doing all exercises.
  • If difficult, you can assist this movement by using your hands, a towel or a band to help pull your muscles closed.
  • To do this exercise: Breathe into your belly. This alone can be challenging since many people are accustomed to breathing into their chest. Fill your belly with air, relaxing your stomach muscles and letting your belly expand out. when you exhale lift your pelvic floor (the most important step!) and then wrap your abs together. If you’re looking in the mirror you should see your belly button lift a little and then tuck in. The lift is coming from the activation and engagement of your PF. Repeat.

2. Foot slides

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  • While doing this exercise, try to keep doing your belly pumping.
  • Exhale with your leg extension, wrapping your abs as your extend your leg straight. Inhale as you bring your foot back in, pumping your belly out.
  • Eventually you can try this exercise with both legs or use gliders.

3. Hand/Quad Pressure Pushes

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  • No, this is not a technical name, but this is an excellent exercise to strengthen the deepest stabilizers in your abs.
  • While doing this exercise, try to keep doing your belly pumping.
  • Exhale as you gently lift your head and one leg off the floor, supporting your head with one hand. At the top, push your other hand into your leg (on the same side) and your leg into your hand, creating “pressure” on both your hand and leg. Exhale all the way through and wrap your abs here as much as possible. Inhale as you return your head and leg back down.

4. Overhead band reaches

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  • While doing this exercise, try to keep doing your belly pumping.
  • Exhale as you pull your band straight up over your head. Inhale as you bring your arms back toward your belly button (though be sure to maintain some resistance in the band when you return to “center”)
  • Eventually you can try this exercise with your head lifted off the ground

5. Side planks with oblique “twist”

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  • While doing this exercise, try to keep doing your belly pumping.
  • Inhale as you extend your arm straight up, looking up at your hand as you extend your arm.¬† Exhale as you wrap your arm under your body, literally wrapping your abs together though try not to drop either of your hips down toward the ground. Make your core wrap together and do the work instead of putting the work into your hips and lower body

Happy healing and exercising! Leave questions or concerns in the comments section below. No one should ever have to struggle with these kinds of issues postpartum, or ever and I’d love to help!

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