Diastasis Recti in Gymnasts is a Full Body Issue
How a person moves, breaths and loads the body all contribute to whether or not a diastasis forms, or whether or not it sticks around after it's developed. Learning the best loading techniques when working the midline of the abs is super helpful. There is unfortunately no list of "safe" and "unsafe" diastasis exercises since every case is different. It depends on how your body looks at the midline of the abs while doing the exercise.
That said, the most common exercises that cause difficulty for a diastasis are ones that are heavily front loaded, such as:
- front planks
- Rolling in a ball shape
- Pike ups on a ball
- Leg lifts
- Crunches or sit-ups
Additionally, some exercises are front loaded indirectly such as:
- Rope climbs
Yoga transitions such as chaturanga as well as cardio such as running and swimming can also be difficult on a healing diastasis.
However, have faith! You will likely be able to return to these activities one day. If you can fix your breathing and turn it into a 360 style (for 360 breathing back, front and sides of ribs all move) that will go a long way. If you can improve your posture so that your ribs are stacked over your pelvis that will take you even farther.
You may notice that a lot of gymnasts stand with archy backs, hips that jut forward and hyperextended knees. This posture is the exact opposite of what you want to do to heal a diastasis since that type of posture puts all the pressure in your system out into your belly, which simply exacerbates the diastasis and prevents it from healing. And if you stand that way, chances are you do a lot of your skills that way too! Besides the strain on a diastasis as well as on your lower back and knees, you’re inviting deductions from the judges on body line!
Exercises to support good stacked posture will be helpful. That is something a corrective exercise specialist can teach you, and you should see the benefit in your symptoms as well as how you look and feel as you perform skills. I know my scores went up across the board when I improved my posture with some of these corrective exercises! You will want to make sure to do exercises that work the pelvic floor, external obliques, internal obliques, rectus and transverse abdominus to help with posture. Once learned, you can incorporate the principles into your gymnastics conditioning and skill work so that you won’t have to maintain two different sets of exercises forever.
Depending on how your diastasis formed, different strategies of how to fix it will be necessary - and that is where a professional comes in! For example, a woman who is a shallow breather who has never been pregnant can form a diastasis, just as a woman who is an all-belly breather. The two women will each need different exercises to overcome their diastasis and allow it to heal. Our bodies are designed to heal on their own when the right circumstances are in place. Once you stop putting pressure out on your diastasis, it will have the optimal condition to heal.
Healthy breathing has other benefits, too. It has the power to protect our spine by providing appropriate intra-abdominal pressure. It even helps to lower our stress hormones! Healthy breathing will be your best friend when it comes to calming competition nerves or feeling confident before trying that new skill. Good breathing techniques can promote tissue healing by bringing more oxygen to all of our cells. That’s something that gymnasts for sure need. 😊
The last piece to this puzzle is that some of us have a wider rib angle and others have a more narrow one. You can evaluate your rib angle by feeling for the underside border of your ribs. It can help to draw a line on the border to be able to easily determine the angle. We want that angle to be as close to 90 degrees as possible. There are particular abdominal exercises that will help bring your rib angle back to the ideal. If you use the wrong ones, you may inadvertently make your problem worse!
When looking at posture, a simple tip is to think of is lifting up through the pubic bone. This helps support the spine much better than drawing in the abs does. The lower portion of your transverse abdominus must maintain a low level of continuous contraction to help support standing posture, and it also will have concentric and eccentric contractions while breathing. This means that you can actually strengthen your abs all day long and all practice long just by breathing correctly!
The abdominal area should move while breathing. Holding your breath is easy to fall into if you are trying to be tight and hold perfect form. However, there is no way you’ll get through a challenging routine if you never take a breath! Work with your coach on finding places in your routine to get a good breath, such as during a squat on on bars or during choreography on beam and floor. By holding in the belly button, you stop natural transverse abdominus function! The more we can bring natural abdominal function to the table, the better our pelvic positioning will be as well.
Having great pelvic positioning takes away some of the sway back you often seen in gymnasts and also helps take a ton of pressure off the hip joint which is helpful for minimizing hip injury, SI joint difficulties and back pain. Many athletes have to learn to use their hamstrings more to help with pelvic tilt as well, since most of gymnastics conditioning and skills prioritize working the quads and hip flexors over the hamstrings. A cool thing is that, by building up hamstrings, you will find that it helps reduce knee pain and injury too! Building better hamstrings also will allow overactive back muscles take a bit of a break, which can help with chronic back pain and tightness. There are many payoffs to working on posture and balance in the body!
I want to finish up by explaining that there are different types of diastasis as well. Some athletes have a wide but firm diastasis. Others have a narrow but squishy one. You can also have a wide and squishy diastasis. Then there is the matter of where. Is the diastasis above, at or below the belly button? All of these things affect which exercises work best to heal it.
No matter what, mastering 360 breathing will pay dividends for all types of diastasis recti.
Try it with me right now. Place your hands around your ribcage right now so that the thumbs are in the back. Do you feel all of your ribs move, or do they just move in the front? This is an example of how you can measure 360 breathing.
Improving posture and rib angle will also go a long way. Once these basics are
in place, we need to add strength to help the changes hold. Finally, we need to
incorporate the newfound movements into our gymnastics conditioning and skills.
Once this has occurred, the new ways of moving will feel like second nature and
the athlete won’t even need to think about it anymore!
Sometimes something that
seems unrelated such as resting head position can also be the culprit. That's why a
full body assessment is needed whenever someone is working on fixing a
diastasis. Healing a diastasis with corrective exercise is possible for the majority of women and girls. For
others, they might not heal it completely, but they can still feel better and get
back to doing what they love. Surgery is available, but it's not foolproof and
it doesn't excuse you from working on everything mentioned above!
If you have surgery and simply return to the faulty patterns that allowed the diastasis to develop (remember, a lot of women naturally heal from theirs postpartum) then the condition is at risk to come back. The process and timeframe to heal from
surgery, build back base strength and then return to sport is very similar to the process and timeframe to heal from a
diastasis with corrective exercise. For this reason, I personally would never try surgery for a
diastasis until I had worked on corrective exercise first. In fact, I have a large defect in my abdomen due to two emergency abdominal surgeries that left me with a scar the width of a ruler and about 5 inches long on my abdomen. I had a hernia in the area before beginning corrective exercise. Less than six months into doing the exercises (keep in mind, my scar made a C section scar look like child's play) my hernia was completely gone via ultrasound! My doctor had told me that the hernia would only continue to get worse and worse unless I got a Total Abdominal Wall Reconstruction with mesh, but happily that turned out not to be the case.