Postpartum Abdominal Separation – a careful approach to Postpartum fitness

The first time I heard about abdominal separation I was shocked. The first time I saw an abdominal separation I knew exactly what it was.

Pilates for abdominal separation

(Diastasis meaning separation of two body parts that are supposed to be together and Recti meaning the two sides of the rectus abdominis) The class was a group reformer class and my client was about two years postnatal. When I spoke to her about it, it was the very first time she had heard about it. She felt there was something wrong with her and I could tell she disliked her postnatal body. Later, she told me that after she had her baby, she was coached by the postpartum physiotherapist to do sit ups. Unfortunately, unless you have the correct technique for working the abdominals you can push the abdominals further apart creating a larger gap, making the client more vulnerable to lower back pain, and possible abdominal hernia. She was very thin and I wondered if part of her thin state was due to feeling like her abdominals were pouching out and flabby and thus dieting and exercise has become part of her daily ritual.

The first time I felt a diastasis I was a little horrified feeling like my whole hand was sinking into the stomach of my client. I tried to hide my horror, and I felt the confused pain and shame of the petite-framed woman I was working with.

If you have an abdominal separation and are wanting to close the gap, please contact me here or go to my studio website here.

Group mat Pilates is generally not the best place for postpartum abdominal separation as these sessions contain many exercises with excessive intra-abdominal pressure. These include legs 90/90, Planks, half curls, the abdominal series and lots of abdominal work in an open Kinetic chain. Doing exercises with excessive intra-abdominal pressure can actually push the abdominals apart further. Group Pilates mat classes should be specific to postpartum fitness.

Clients need special attention to work towards getting this gap closed by drawing the two sides of the abdominals together with very little intra-abdominal pressure. So just drawing the tummy in while lying flat, then side lying, seated, 4 point kneeling and standing. As the client becomes more competent then closed kinetic chain exercises can be introduced such as single leg toe taps, heel slides, single leg stretch with the head down and one foot on a fit ball and the other on the floor. Single arm work with a 2kg hand weight has less intra-abdominal pressure than holding two hand weights so working with single arms supine, and side lying before seated, four-point kneeling and finally standing. Exercises that are last to be introduced are planks, hovers, sit ups and side sit up.

When you work with Abdominal separation or diastasis recti, you have to change your entire approach to Pilates and abdominal cueing. The more experience you get with doing a rec check and also cueing your client during their session will increase your physical knowledge and understanding of this complex issue. I say complex as it can have effects on the esteem and confidence of your client, as well as physical issues such as making your client more vulnerable to lower back pain and pelvic instability.

Have you worked with Abdominal separation? What was it like? What is your experience in working with Abdominal separation? You are welcome to share your experiences.