Diastasis RectiHow Pilates can help cure it

Maya EpsteinLos Angeles, CA

BASI Training 2015

1

Abstract:

Diastasis recti (also known as abdominal separation) is commonly defined as a gap of

roughly 2.7 cm or greater between the two sides of the rectus abdominis muscle. This

condition has no associated morbidity or mortality. The distance between the right and

left rectus abdominis muscles is created by the stretching of the linea alba, a connective

collagen sheath created by the aponeurosis insertions of the transverse abdominis,

internal oblique, and external oblique. In pregnant or postpartum women, the condition is

caused by the stretching of the rectus abdominis, and by the growing uterus. It is more

common in women that have more than one child due to repeated episodes of stretching.

When the defect occurs during pregnancy, the uterus can sometimes be seen bulging

through the abdominal wall beneath the skin. Women are more susceptible to develop

diastasis recti when over the age of 35, who have had a child with high birth weight,

multiple birth pregnancy, and multiple pregnancies. Additional causes can be attributed

to excessive abdominal exercises after the first trimester of pregnancy. The condition can

also happen to men, and small children, but is definitely more common in postnatal

women. The majority of cases can be corrected or greatly improved through a specific

and conscientious exercise routine. Pilates is an ideal program for women experiencing

Diastasis Recti due to the precise training and focus on transverse abdominis (TA)

strength. In my paper I will discuss how Pilates can help minimize the separation in a

very safe and healthy way.

2

Table of Contents:

Title Page…………………………………………………...Page 1

Abstract Page……………………………………………….Page 2

Table of Contents…………………………………………...Page 3

Anatomical Description…………………………………….Page 4-5

Case Study………………………………………………….Page 6-10

Conclusion………………………………………………….Page 11

Bibliography………………………………………………..Page 12

3

Anatomical Description:

Diastasis Recti occurs as a result of excessive intra-abdominal pressure or loading, and is

common in the later stages of pregnancy. It occurs in the abdomen and relates to the

abdominal muscles. During Pregnancy the rectus abdominis muscles can end up

separating due to internal pressure and growth of the fetus. The rectus abdominis muscles

run parallel to each other and lengthwise along your abdomen. The diagram below shows

a normal Rectus Abdominis, compared to a separated Rectus Abdominis (Diastasis

Recti):

The Linea Alba (connective tissue) also separates and thins which reduces the support of

your organs and overall trunk stability.

4

The majority of cases can be corrected or greatly improved through a specific and

conscientious pilates routine.

5

Case Study:

Alyssa has two sons, ages 5 and 2, and after her second pregnancy she discovered that

she had diastasis recti. She had no idea what it was and was in complete shock that her

doctor did not know that she had it. Moving forward, a couple of months later, she joined

a pilates studio in Westlake Village called Daily Breath Pilates. Alyssa has trouble

feeling her abs working right behind her belly button and finds that when she is

exercising a lot of the work is going into her lower back creating a lot of back pain. Her

TA(transverse abdominals) are weak so it is not helping her bring her abdominal muscles

closer together creating the back pain. We need to get her TA stronger so that she can

start rebuilding her abdominal wall. I take classes with her at Daily Breath Pilates and the

owner of the studio Renata has been wonderful with Alyssa in regards to helping her get

rid of the gap in her abdominal wall. I observed Renata while she worked with Alyssa

during a couple of her private sessions. After a lot of observation I came up with a great

workout for her. The exercises I have listed below will provide Alyssa with a routine so

that she can rebuild her strength and flexibility while also protecting her Diastasis Recti.

6

BASI Block System

Warm Up

● Roll down 3-5 to start and get your body moving

● Pelvic Curls

● Supine spine twist

● Chest lift

● Chest life with rotation

● Leg lifts/Leg changes

Foot Work on the Wunda Chair

● Parallel heels

● Parallel toes

● V Position toes

● Open V heels

● Open V toes

Footwork on the Wunda chair is especially beneficial for establishing trunk

stability while working your core.

7

Abdominal Work on the Avalon Chair

● Roll up

● Mini Roll Up

● Mini Roll Up with Oblique emphasis

Hip Work on the Avalon Chair

● Frog

● Circles Up

● Circles Down

● Leg Openings

● Extended Frog

Spinal Articulation on the Reformer

● Bottom Lift

● Bottom Lift with extension

● Short Spine – be very careful and don’t flare your ribs when going up on the

lift. It’s a great exercise to work on muscle activation thru the entire body without

overworking the abdominal muscles.

8

Stretches on the Reformer

● Standing Lunge

● Side Split

Full Body Integration on the Reformer

● Scooter: Maintain Lumbar Flexion and the C-curve of the spine. Focus on hip

disassociation and pelvic stability. Avoid elevating the shoulders.

● Knee Stretch Series: The knee stretch series provides a place to use the

abdominals and focus on the in phase drawing the carriage in using your

abdominals. Round Back and Flat Back will help develop trunk stabilization.

● Elephant: Great for trunk stabilization.

Arm Work on the Reformer

● Arm Supine Series: Extension, Adduction, Up Circles, Down Circles, Triceps

● Shoulder Push: Engage back extensors throughout and reach elbows out to sides

as they bend. Make sure to establish scapular stabilization prior to movement.

● Shoulder Push Single Arm Work: Great for scapular control working with the

trunk stabilization.

9

Leg Work

● Hamstring Curl: Keep back extended and abdominals engaged throughout

movement while maintaining hip extension.

● Single Leg Skating: a great exercise to work on pelvic and lumbar stabilization.

Lateral Flexion/Rotation

● Mermaid: To increase spinal mobility and develop oblique abdominal and

shoulder control.

● Side Over on Box: When doing side overs you need to focus on keeping

abdominals in and moving body on same plane. The side overs are a good place to work

on lifting your pelvic floor.

Back Extension on Wunda Chair

● Swan Basic

● Swan on Floor

-Roll Down to complete workout

Conclusion:

10

Alyssa does Pilates 3 days a week now and her gap is almost closed. She is working

extremely hard and loving every second of it. She has really noticed a change in her

body, especially in her diastasis recti after doing the exercises that I have put together for

her and by using the different apparatuses. Her transverse abdominals have really

strengthened and she has started to heal her connective tissue. Pilates is incredible and

provides a wonderful environment for rebuilding your body’s alignment and really

gaining strength. The majority of diastasis Recti cases can be corrected or greatly

improved through a specific and conscious exercise routine. Pilates is such an ideal

program for woman experiencing Diastasis Recti due to the precise training and focus on

transverses abdominis strength. Alyssa is extremely pleased and so much happier with

her body now that her abdominal wall is starting to form back to the way it used to be.

Bibliography:

11

Isacowitz, Rael. Study Guide: Comprehensive Course. Costa Mesa, California: Body Arts

Science International, 2013.

Isacowitz, Rael. Pilates: Your complete guide to mat work and apparatus exercises.

Champagne, IL: Human Kinetics, the premier publisher for Sports & Fitness, 2006.

Johnson, Traci M.D. Webmd.com: Abdominal Separation (Diastasis Recti). September

16, 2014.

Long, Robin. Thebalancedlifeonline.com: Pilates and Diastasis Recti. September 22nd,

2014.

12