Healing Diastasis Recti: How Hypopressives and Functional Core Training Can Help
What is Diastasis Recti? Diastasis recti (DR) is a separation of the rectus abdominis (the "six-pack" muscles) due to excessive intra-abdominal pressure, often occurring during pregnancy, improper core training, or prolonged pressure dysregulation. This gap can lead to core weakness, back pain, pelvic floor dysfunction, and a ‘doming’ appearance in the abdomen.
At the center of this condition is the linea alba, a band of connective tissue running down the midline of the abdomen. This structure stretches and weakens with increased intra-abdominal pressure, leading to the separation seen in DR. The linea alba plays a crucial role in core strength and function, as it helps transmit force across the abdominal wall and stabilises the torso. Healing DR involves restoring the tension and integrity of the linea alba, rather than merely bringing the muscles back together.
The Role of Progressive Loading in Healing Connective Tissue
To truly restore function to the abdominal wall and core, progressively loading the connective tissue is essential. As Anthony Lo, a leading physiotherapist and expert in strength-based core rehabilitation, states: “Connective tissue needs load to adapt and strengthen. If we avoid loading it, we miss out on its capacity to heal and become more resilient.” By integrating both transverse abdominis AND oblique activation, we can improve core function laterally and diagonally for greater core stability.
This means that while gentle foundational exercises like breathwork and deep core activation are crucial, progressive resistance and functional movement must also be introduced in a gradual, controlled manner. Increasing load over time through safe and intentional movement encourages the linea alba to regain tension, allowing for improved force transfer, stability, and overall function of the core.
Many traditional abdominal exercises, like crunches and sit-ups, can exacerbate the issue by increasing pressure inside the abdomen, making the gap worse over time. Instead, a functional and pressure-aware approach is needed for true healing.
Diastasis Recti and Its Connection to Pelvic Floor Dysfunction
Diastasis recti and pelvic floor dysfunction often go hand in hand. Since the core and pelvic floor work together as a unit, a weakened core due to DR can lead to pelvic floor issues such as incontinence, prolapse, or chronic tension. When the deep core is not functioning properly, the pelvic floor muscles may compensate by becoming either too weak or overly tight, both of which can lead to dysfunction. Addressing DR with a holistic approach, including breathwork and functional core exercises, supports pelvic floor health by restoring proper pressure management and muscle coordination.
Diastasis Recti vs. Abdominal Hernia: Understanding the Difference
While DR involves a separation of the abdominal muscles due to excessive stretching of the connective tissue, an abdominal hernia is a more severe condition where internal organs push through a weakened area in the abdominal wall. Some key differences include:
Diastasis Recti: A functional issue that can often be improved with corrective exercises and postural adjustments.
Hernia: A structural issue that may require medical intervention, especially if pain, bulging, or complications arise.
If you’re unsure whether you have DR or a hernia, it’s always best to consult a healthcare professional for an accurate diagnosis.
How Hypopressives Can Support Healing
Hypopressives focus on low-pressure breathing techniques and postural engagement to help recruit the deep core and pelvic floor muscles without straining the abdominal wall. Unlike conventional ab exercises, hypopressives work by:
✔️ Reducing intra-abdominal pressure, allowing tissues to approximate naturally.
✔️ Activating the transverse abdominis (your deep core stabiliser) without excessive strain.
✔️ Improving postural alignment, which plays a key role in core function.
✔️ Encouraging fascial tensioning, which supports the healing of connective tissue between the abdominals, including the linea alba.
Exercises from two amazing practitioners I have trained with: Sarah Duvall and Tom Waldron for Diastasis Recti Recovery
Both Sarah Duvall and Tom Waldron emphasise a functional, whole-body approach to core rehabilitation, focusing on breath, alignment, and progressive strengthening. All of these exercises can be combined with Hypopressive apnoea breaths, I always find combining methods an amazing way to get even better results. Here are some key exercises:
1. 360° Breathing & Deep Core Activation - this will be familiar to all my clients!
How it helps: Helps reset proper core function by engaging the diaphragm, pelvic floor, and deep core in harmony.
How to do it: Sit or lie down, place hands on your ribcage, and inhale slowly and steadily through your nose, expanding through the ribs (not the belly). Exhale slowly and steadily bringing awareness to the contraction in the deep abdominal muscles and the drawing in of the pelvic floor.
2. Dead Bug Variations (Pelvic Floor Safe)
How it helps: Strengthens the core without increasing intra-abdominal pressure.
How to do it: Lie on your back with knees bent at 90 degrees. Slowly lower one arm and the opposite leg while keeping the core engaged and back neutral. Return and repeat on the other side.
3. Heel Slides with Core Engagement
How it helps: Encourages deep core activation and trains the body to maintain tension without overloading the rectus abdominis.
How to do it: Lie on your back with knees bent, engage the lower core, and slowly slide one heel away while keeping the pelvis stable. Return and switch sides.
4. Bear Hold (Modified Quadruped Core Activation)
How it helps: Strengthens deep core muscles while maintaining a functional, neutral spine.
How to do it: Start in an all-fours position, engage your core, and gently lift your knees an inch off the floor while maintaining stability. Hold for 10-15 seconds.
5. Seated or Standing Pelvic Tilts
How it helps: Improves core and pelvic floor coordination, crucial for DR healing.
How to do it: While seated or standing, gently tilt the pelvis forward and back, engaging the deep core as you exhale.
The Role of the Obliques: Diagonal Connection of the Core
The transverse abdominals aren’t the only muscles responsible for rebuilding core density! The obliques, which run diagonally along the sides of the torso, also play a crucial role in core function and healing diastasis recti.
When choosing rehabilitative core exercises, we need to do more than just heel slides and unloaded supine movements. To increase core density, we must also increase the demand through progressive loading.
How to Build Oblique Strength for Core Integrity:
✔ Resistance Training – Use weights, resistance bands, or external loading to challenge the obliques safely.
✔ Resisting Gravity – Opt for more demanding upright positions, such as all fours or standing, rather than only lying on the floor.
✔ Cross-Body Engagement – The diagonal connection between the right upper body and left lower body (and vice versa) strengthens the linea alba across its full range.
Exercises to Engage the Obliques for Diastasis Recti Healing
1. Supine Pallof Press
How it helps: Trains anti-rotation strength and activates the transverse abdominis and obliques.
How to do it: Lie on your back with knees bent. Press a resistance band or light weight forward in line with your chest while exhaling, engaging your deep core to resist rotation.
2. Floor Press with Knee Press
How it helps: Activates diagonal core engagement between the upper and lower body.
How to do it: Lying on your back, press a weight with one arm while simultaneously pressing the opposite knee upward against light resistance. Alternate sides.
3. Quadruped Rotational Pull
How it helps: Introduces rotation and anti-rotation control through the obliques and deep core.
How to do it: From an all-fours position, hold a resistance band anchored to one side. Pull across your body while maintaining a stable core. Adjust the leg position for increased difficulty (e.g., bird dog stance for advanced variation).
Integrating These Methods for Effective Healing
A comprehensive approach that includes Hypopressives, breath training, and progressive functional core exercises can significantly aid in diastasis recti recovery. Consistency and proper technique are key! Additionally:
Avoid movements that cause doming or coning in the midline.
Prioritise alignment and posture, ensuring pressure is distributed evenly.
Be patient—connective tissue healing takes time and responds best to gentle, consistent work.
If you're navigating diastasis recti and want a smarter, pressure-aware way to rebuild your core, integrating Hypopressives, Sarah Duvall’s functional movement approach, and Tom Waldron’s neuromuscular strategies can set you on the right path. 🌟
💬 Have you tried any of these methods? Let me know your experiences in the comments below!
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