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Managing a diastasis postpartum

Managing a diastasis recti postpartum | Annabel Karmel

The natural separation of the abdominal muscles during pregnancy can improve naturally within the first 6-12 weeks after childbirth, particularly with rest and being mindful of the weakened muscles. A lot of women believe performing endless crunches and sit ups post pregnancy will bring their flat tummy back, but this can actually have a harmful affect and do quite the opposite. These exercises should be avoided until you are 100% sure that your abdominis are back together. In fact, performing such exercises when a diastasis is present can cause longer term damage by stopping a diastasis healing or causing further damage, such as a hernia.

During the first 6-8 weeks, I recommend that new mothers take time to focus on the natural healing process of the body and to not rush back into exercise.

Focus on rest, a nutrient rich diet and time with your gorgeous newborn. New mums will naturally feel weak and lack the core strength and foundation they once had but taking time for the body to readjust is the best medicine.

Even if cleared for exercise by the GP (and let’s face it, these checkups aren’t always very thorough or full of bespoke advice for your body!), I would still look to wait until the 8-12 weeks before returning to traditional exercise if no diastasis is present. It’s really important that for the first few months you avoid running or high impact classes, as well as loaded flexion or rotation.

Remember the choices you make now will play a key role in how you heal long term.

During these early weeks, re-educating muscle memory and focusing on key areas such as the pelvic floor, glutes and deep core muscles will ensure a safe return to fitness by building strong foundations.  Avoiding oblique strengthening exercises is also key at this stage as over working these muscles can actually pull your diastasis apart. Again, working on core breath will help to bring the stomach muscles back together and help strengthen the deep core stabilising muscles.

You can then begin to add some more gentle but effective deep abdominal exercises such as:

Pelvic tilts:

Lie on your back, with your knees bent. Breathe in to prepare and on the exhale, connect your pelvic floor (zipping up back to front) and your abdominals. Gently tilt your pelvis drawing your navel to spine and imprint the pelvis and lower back onto the mat. Hold for a breath and on the next breath return to the start position.

Knee drops:

Lie on your back, with the knees bent and feet hip width apart. Zip up your pelvic floor and connect your core.  Maintaining a still and stable pelvis open one leg, releasing the knee to the floor. Allow the foot to roll onto the outer side of the foot. Inhale to hold the position and on the exhale draw the knee back to the starting position using your pelvic floor and inner thigh. Repeat on the other leg.

Leg slides: Lie on your back with the knees bent. Breathe in to prepare and on the exhale, connect your pelvic floor (zipping up back to front) and your abdominals – maintaining a still and stable pelvis lift your toes up so the weight of your leg is on the heels. Exhale and slide one leg along the floor away from the torso. Inhale and on the next exhale remember to connect your pelvic floor and abdominals (wrapping/corset sensation) and draw the leg back in.

Once past 12-14 weeks generally a diastasis will improve, and you should be able to feel the muscles coming together and the separation lessening. Continuing with pelvic floor, core and posterior chain exercises (back of the body including glutes, hamstrings and back) are the building blocks that once mastered, will put you in a stronger place to get back to your optimum fitness and strength.

However, if there is still a large separation present (over 4cm) this can be slightly more complicated and is best to get checked by a professional women’s health practitioner to assess the level of muscle separation, pelvic weakness, pain and postural alignment. This can often be overlooked or not properly understood, leaving it undiagnosed for years and new mums living with unnecessary discomfort or without strength and stability.

If you are in discomfort or feel you may have a diastasis, do not suffer in silence.  Get a proper diagnosis and rehabilitation plan.  Also, remember it is never too late!



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