Pelvic Health Physiotherapy
Review due: 2025
Contact details
01592 648106
What is Diastasis Recti Abdominus (DRA)?
Your main tummy muscle is called the Rectus Abdominus (Also known as your “six pack” muscle). This muscle has a left and a right side, joined together by a thin band of tissue called the linea alba. DRA is the stretching of the linea alba and widening of the area between the left and right sides of your tummy muscle during pregnancy.
DRA & Pregnancy
Women’s bodies have been designed to expand to allow your baby space to grow. Your tummy muscles become stretched out during pregnancy because of your expanding uterus and growing baby. Studies have shown that 100% of women will have stretching and widening of their tummy muscle during pregnancy. The degree of widening may vary from person to person, but treatment can be very similar!
What does it look like?
Why does DRA matter?
You might be asking yourself if DRA is a normal part of pregnancy, why does it matter? Your tummy muscles play an important role in supporting your body during movement (eg. sitting, standing, getting in/out of bed); and holding organs in place. DRA leads to weakness of your tummy muscles which can cause things like loss of coordination, low back pain, and pelvic girdle pain.
How can exercise help?
DRA is treated through targeted exercises that help to maintain and optimize strength and function of your tummy muscles during your postpartum recovery. The goal of exercise is NOT to close the gap, but to create good tension over your tummy to get stronger.
Exercise program
Stage 1: Strengthening you deep tummy muscles
Safe Exercise transitions
It is important that you don’t put too much strain on your tummy muscles when changing exercises or getting up off the floor.
1. When lying on your back with your knees bent, roll on to your side keeping your tummy muscles engaged.
2. Breathe out as you push up from your elbow.
3. Get onto hands and knees to transition to your next exercise or stand up.
4. Do the same in reverse for getting down onto the mat.
Diaphragmatic Breathing/Belly Breathing
- Lie on your back with your hands on your tummy.
- Breathe in through your nose towards your hands so that your belly rounds like a balloon. Breathe out through your nose so that ‘the balloon’ deflates.
- Focus on breathing 'into your belly' instead of upper chest.
- Practice for 5 minutes, 1-3 times per day.
Lateral Breathing
- Sit towards the front of your chair with feet flat on the floor. Place your hands on the sides of your ribs.
- Breathe in through your nose towards your hands. Feel your lower chest expanding outward.
- Breathe out through your nose. Feel your hands lowering.
- Practice for 5 minutes, 1-3 times per day.
Cat Cow
- Start on your hands and knees.
- Round your back up like a cat. Hold for 3-5 seconds.
- Return so your back is flat (not arched).
- Do this 3-5 times daily.
Deep Core Squeezes
- Lie on your back with your hips and knees bent.
- Tighten your tummy muscles by bringing your belly button towards your spine.
- Hold for 3-5 seconds as you exhale and relax as you inhale.
- Do this 3-5 times daily.
Core compressions in Quadruped
- Start on your hands and knees. Shoulders rolled back away from your ears with your back flat.
- Inhale, and then as you exhale, gently tighten your tummy muscles. Feeling your tummy draw in closer to your spine. Hold for 5 seconds while gently breathing and then relax.
- Repeat this 5 times. Complete 3-5 sessions per week.
Wall Plank
- Place your hands flat on the wall with elbows straight in line with your shoulders. Position your body on a slight angle.
- Tighten your tummy muscles. While holding the first contraction, perform a second, feeling your tummy draw in closer to your spine. Hold for 2-3 seconds then relax.
- Do this 5-8 times, 3-4 times per week
Pelvic floor exercises
Lie on your back or on your side with knees bent and relax your back, buttocks, legs, and abdomen.
Start from the back by tightening the muscles around your anus and continue by tightening the muscles around your vagina and urethra as if trying to stop yourself passing urine. It should feel as if something is lifting upwards inside your pelvis. Breathe calmly.
Pelvic Floor Exercises (youtube.com)
Long Squeezes
Squeeze your pelvic floor muscles for 5- 10 seconds.
Relax for 3-5 seconds.
Repeat the contract/relax cycle up to 10 times
Short Squeezes
Squeeze your pelvic floor muscles for 2 seconds and relax for 2 seconds.
Repeat the contract/relax cycle up to 10 times
Why are Pelvic Floor Exercises Important?
Your tummy muscles work alongside the pelvic floor muscles. When your tummy muscles become stretched out, they don’t work as well with your pelvic floor muscles and can lead to pelvic floor dysfunction or urinary incontinence.
Additional resources
Your post-pregnancy body - NHS (www.nhs.uk)
20818-POGP-PelvicFloor.indd (thepogp.co.uk)
References
THABET, A., ALSHERHRI, M., 2019. Efficacy of deep core stability exercise program in postpartum women with diastasis recti abdominis: a randomised controlled trial. Journal of Musculoskeletal and Neuronal Interactions, vol. 19, pp. 62-68.
LEOPOLD, M., SANTIAGO, K., CHENG, J., KELLER, L., ABUTALIB, Z., BONDER, J., SHARMA, G., TENFORDE, A., CASEY, E., 2021. Efficacy of a Core Strengthening Program for Diastasis Rectus Abdominis in Postpartum Woman: A Prospective Observational Study. Journal of Woman’s Health Physical Therapy, pp. 147-163.
Accessible formats
If you require this information in a community language or alternative format such as Braille, audio, large print, BSL, or Easy Read, please contact the Equality and Human Rights Team at: email: fife.EqualityandHumanRights@nhs.scot or phone 01592 729130. For people with a hearing or verbal impairment you can also contact the team through the NHS Fife SMS text service number on 07805800005.
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