I'm going to say it - You should still train your core if you have diastasis recti abdominis (DRA). It might be even more important to directly train core if you have DRA...
Diastasis recti abdominis (DRA) is the widening and thinning of the connective tissue (linea alba) between the six pack ab muscles (rectus abdominis). DRA is not exclusive to pregnancy, but we hear a lot about it during pregnancy + postpartum because DRA is a NORMAL and NECESSARY change in your abdominal wall to accommodate pregnancy. When we see the widening persist beyond 2cm of separation in postpartum - that is when we identify DRA.
How can we heal DRA? From research, around 60-70% of women have under 2cm of separation by 6 months postpartum without any intervention. Which is considered a normal space between those muscles. Your body does a lot of healing on its own! From there - we can add in rehab to help address core strength and function.
Is DRA always a problem? Nope. But for some, it can be. You might see that DRA can cause back pain, prolapse, and leaking but the limited research there is does not support this. DRA can certainly affect how you feel and function. For others, it is more concern about the appearance.
We can get strong AF despite having DRA. You do not have to do low level/low pressure core exercises for the rest of your life if you have DRA. Even if it is a significant DRA, getting your abdominal muscles as strong as possible DESPITE a gap should be a key focus, even if you know surgery is in your future.
You might see a lot of emphasis on training "deep core" for DRA. While these muscles are (of course) important and we want them to be drop - we know through imaging that activating this muscle group actually causes more widening between the six pack ab muscles. This DOES NOT mean that training deep core makes DRA worse, but makes us consider - what movements should we actually be doing?
The exercise that actually approximates the six pack ab muscles the most are crunches and movements that involve spinal flexion. Crunches have also been shown to add the most muscle bulk on to your six pack ab muscles. So yes, if you have DRA you can and SHOULD train your core, even your 6 pack muscles. You are going to be working it even if you aren’t, so you might as well focus on strengthening that area too.
If you need more guidance or have questions - respond to this email! I am always happy to provide guidance.
With peace and love,
Dr. Ellyn Halley, DC, Doula, Coach
Doc Halley Solutions
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**Disclaimer: The content in this email is not intended to be medical advice. The content here is for informational purposes only. Please consult with your healthcare provider regarding any medical or health related diagnosis or treatment options.
