If you want to flatten out a rounded postpartum belly, it stands to reason that you should hit the gym for a relentless regimen of crunches, right? Wrong! An abdominal condition called diastasis recti could be the cause of that rounded—even still pregnant-looking—abdomen months or years after giving birth. And crunches will not only fail to improve it, but can actually make it worse.
Before you even think about doing an abdominal exercise, perform a simple self-test to determine whether you do have diastasis recti, a gap in between your right and left abdominal wall muscles that can result in a protruding pooch-like shape. If so, keep reading to find out which exercises you should skip—and which ones can help heal that abdominal separation.
Skip any movement or exercise that places strain on the midline or causes the belly to bulge outward, like sit-ups and planks. "When this action is repeated forcefully, and frequently, the degree of separation can actually worsen," says Kevin Brenner, M.D., F.A.C.S., a board-certified plastic and reconstructive surgeon based in Beverly Hills.
Also, avoid heavy lifting, and any exercises that involve twisting the spine or work the abdominal wall against the force of gravity, says Helene Byrne, a prenatal and postpartum health and fitness expert and founder of BeFit-Mom. These no-no exercises include most traditional ab work such as crunches, oblique curls, reverse curls, and roll-ups.
Backbends and other spinal extension movements are also out, because they increase stress on the abdominal tissues, says Ben Butts, P.T., director of rehabilitation services and Performance Therapy at Providence Saint John's Health Center in Santa Monica, California. "Traditional exercises to get a six-pack are not going to give you the benefit you are looking for," he says.
So what exercises should a new mom with diastasis recti do? Byrne suggests abdominal compressions, pelvic tilts, toe taps, heel slides, single-leg stretches, and bridges with belly scooping. Always keep the belly pulled in, rather than doing any movement that pushes it out (and causes the telltale bulge on the midline).
Ilaria Cavagna, a New York-based pilates instructor, suggests starting with the oblique muscles as a means of bringing together the separated muscles. "Only working the oblique muscles will bring the two abdominal walls back together," she says. "Think of your abs as a corset that goes from the hip bones up the ribs, and think of the action that you would do to tighten the corset: Both hands pull towards the center from the sides, like the obliques do."
It's also important to know the correct breathing techniques. "To avoid creating a compression in the abdominal cavity, it is fundamental to exhale during moments of effort," Cavagna says.
Several at-home exercise programs, like the Mutu System, Tupler Technique, and The Dia Method, which are specifically designed to help (and not hurt) moms with diastasis recti, can help ensure you're doing the proper exercises.
Some approaches to healing diastasis recti can be more controversial. Some suggest that wearing a split, or abdominal binder, can flatten the stomach. And it may—but only temporarily. Most experts say it's not a sustainable solution.
"Simply doing basic ab exercises with the midline splinted closed is not effective. Neither is wearing any kind of external support device for long periods," says Byrne. "Both of these common, yet less effective, methods do not teach the transverse abdominis to do its job—stabilization—properly. Wearing an external support device for long periods can [even] inhibit [the muscles'] proper functioning."
As with all postpartum decisions about your body, consult with your doctor about when your body may be ready for an exercise regime. Butts says the general recommendation is to wait about six weeks post-pregnancy.
When your doctor clears you and you feel ready, get right to work. "For some patients with mild diastasis, regular exercise in the form of a core abdominal work out can improve the integrity of the muscles and reduce the amount of separation," says Dr. Brenner. "I have found this to be most effective during the first six to 12 months following delivery."