
Ana Carvalho
Strengthen your Core, Close the Gap: Reformer Pilates for Diastasis Recti
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- , Female Health, Injuries
Diastasis Recti, is the widening of the inter-recti distance (IRD) the distance between the right and left side of rectus abdominis. Diastasis Recti is a natural part of pregnancy – with the stretch accommodating the space needed for the growing foetus. In the months after the delivery the gap will slowly close. In ~33% of women this process is compromised over the first 12 months, and depending on the degree of separation they may be diagnosed with mild, moderate or severe diastasis recti. Reformer Pilates for diastasis recti can significantly accelerate the recovery.
1 Understanding Diastasis Recti in Pregnancy
Experts use different measurements to classify diastasis recti. A common reference used is:
• Normal (no diastasis recti): less than 2 finger breadths (1.7 inches)
• Mild: 2-3 finger breadths
• Moderate: 3-4 finger breadths
• Severe: 4+ finger breadths
For many women diastasis recti resolves on its own. In our experience however the sooner a woman deals with it the better as she will feel confident to move and exercise afterwards. Traditionally the focus of diastasis recti protocols has been to close the gap (IRD). Based on the ultrasound research however from physiotherapist Diane Lee and Paul Hodges the focus should be more on increasing the tension of linea alba and less on the gap.
2 Move safely with diastasis recti
2.1 Debunking myths about exercising with diastasis recti
There are 3 main misconceptions regarding diastasis recti:
a. Because the gap exists in the Transversus Abdominis, only this muscle needs to be trained.
b. That the IRD gap and not the tension of linea abla is the problem.
c. Diastasis recti always correlate with pelvic floor problems.
2.2 Safe vs. harmful exercises for diastasis recti
All exercises will be safe to perform for someone with diastasis recti provided they experience no pain and the gap does not increase by more than ~20% during the exercise.
The later advise comes as a surprise to some students who expect every repetition to help them close their gap. As pointed already though, the tension of the linea alba is as important as the gap. For that reason exercises that may not close the gap can still contribute to a faster recovery.
2.3 How to adapt exercises, to avoid further separation
If an exercise causes pain you can try the following modifications:
• Shorten the range of motion
• Reduce the reps
• change the angle
• Lighten the load
3 Reformer Pilates exercises for Diastasis recti
3.1 Benefits of reformer pilates for Diastasis Recti recovery
It is common knowledge that pilates and in particular Reformer Pilates is one of the best ways to tighten the core without adding extra inches around the waistline. What many people don’t know is that there are different exercises in pilates to target different layers of the abdomen. This can be extremely helpful for those with diastasis recti, as the gap may be in the upper, middle or lower abdominals. Equally important an pilates instructors can identify weakness in the Transversus Abdominis, Obliques, or Rectus Abdominis and adjust the protocol accordingly.
3.2 Reformer pilates vs regular pilates for Diastasis Recti
Both Mat and Reformer Pilates can benefit those with abdominal separation. On the reformer machine you can perform all the mat exercises while the use of springs and straps can make the exercises easier or harder if needed.
Realistically, there is no better way to target the core than Reformer Pilates and given the nature of the problem, reformer training should be the go to option of every woman with it.
3.3 Should you focus on pelvic floor control and breathing?
The pelvic floor works synergistically with the abdominals so practically it is impossible to train one without the other. If you experience problems in the pelvic floor (ie. Incontinence, prolapse) additional pelvic floor exercises will be needed.
Learning how to control your breathing can be very useful when it comes to core exercises. There are a few different breathing techniques which can help, but priority needs to be on recruiting the core muscles and not manipulating the breath.
3.4 Stretches and mobility exercises for diastasis recti
Diastasis recti can benefit from flexibility work in the lower back, hip flexors, glutes, hamstrings and even the shoulders!!! The mobility work however needs to be accompanied by strength work as “loose” joints can increase the demands in the core and aggravate any pre-existing problems in the area.
3.5 Best exercises for diastasis recti
A rehab program for diastasis recti can be organised in 3 stages. Each stage will progressively involve more complex exercises, integrating muscles other than the abdominals.
In the early stages of rehab the exercises one should do are: isolated core activation, closed chain exercises with the use of short levers, low load and slow movement. In the 2nd stage the breath can be integrated, the load increase and open chain exercises can be introduced. The 3rd stage should include dynamic / ballistic movements, heavier loads and long levers.
4 Non-pilates habits for optimal diastasis recti recovery
Besides any exercises you practice to restore abdominal function, it will be useful to adopt some healthy daily habits that will also help the recovery. The most vital of all is walking. Walking will not only support good posture but will help the muscles coordinate resulting safely other movements.
A common pattern I see among many new mothers is that they ignore themselves resulting in fatigue, and even anxiety. Stress management techniques such as craniosacral therapy can be extremely useful which is why in some sessions I do combine reformer training and Cranio.
To sum up
Abdominal separation common as it may be it deserve special treatment and Reformer Pilates is by far the best way to address it. Of course I may be biased but that’s what +20 years of teaching experience tells me.