Research on Diastasis Recti prevention
A new study of 63 AFAB people came out that suggested that targeted transverse abdominus (think deep core) and rectus abdominis (think superficial 6 pack muscle) exercises did not impact diastasis recti postpartum more than general exercise without abdominal focus. At first glance, I wonder if this makes the case for not doing preventative core work during pregnancy as a way to reduce potential diastasis recti. In some ways, this makes sense to me–I think of diastasis recti as both a product of core mechanics, and hugely impacted by genetic and contextual factors like connective tissue quality, where the baby sat during pregnancy, how a person breathes, rib cage and pelvic floor mechanics, etc. So if we as pelvic floor therapists say: if you’re doing core exercises during pregnancy, you won’t have diastasis postpartum, it’s just blatantly untrue.
When I sit back and look at this study from a wider perspective, a few more questions or comments come to mind:
-Most pelvic floor therapists would bias TA exercises (think: controlled bird dogs) vs Rectus Abdominius exercises (think crunches) during pregnancy. Since most pregnant people do have some degree of diastasis already, we don’t want to put too much undo pressure on the linea alba (the thin piece of connective tissue that connects both sides of the RA), and rectus dominant core exercises like crunches, bicycle kicks, mountain climbers, etc. might do that. This study design is slightly confusing to me, and I’d be curious to see if the results were the same if the participants were just doing TA exercises and not RA exercises.
-The researchers use this information to say that we shouldn’t discourage people from doing TA and RA work during pregnancy, aka it’s kind of value neutral when it comes to diastasis healing.
-Participants were not cued for a pelvic floor contraction during TA contraction, which is how I cue TA engagement with most of my clients. So we don’t know how that might impact the presence of diastasis postpartum as well
-My conclusion: Just because TA and RA training during pregnancy did not negatively or positively impact DRA postpartum, doesn’t mean that we shouldn’t explore it during pregnancy. Having prior experience being able to engage the TA properly allows postpartum people to return to deep core work without having to learn a new skill from scratch. I think there’s a psychosocial benefit to training the core in pregnancy, both in terms of a feeling of self-efficacy and self-care, and also in terms of not having to develop a new skill postpartum when you’re already tired and depleted.
