8 Beginner Exercises for DRA
Hello, hi, and welcome, Bestie. I’m happy you’re here. Today I’d like to go over a few exercises you can do if you are suffering from Diastasis Rectus Abdominis (DRA). We’ve chatted at length about DRA, but if you missed that or just need a review, find that here. To quickly review, DRA occurs when the two rectus abdominis muscles move apart, often times during the later stages of pregnancy when the abdomen makes room for the growing baby. DRA can persist after pregnancy and this can cause low back pain and dissatisfaction with the aesthetics of the abdomen/stomach. As we discussed in our last DRA chat, the most important thing in reducing symptoms of DRA is improving the tension across the linea alba, and this can be done with transversus abdominis (TrA) contraction.
With all of that in mind, let’s dive into some exercises you can perform to improve your symptoms of DRA. In all of the exercises below (and in regular activities, as well), it is important to avoid doming/coning. Doming, also called “coning” is when the center of the abdomen bulges outwardly, creating a dome-like appearance. This occurs when the pressure inside the abdomen presses outward into the laxity of the linea alba when pressure is not managed well or the abdominal muscles are not creating enough tension. If this is occurring, you should discontinue the activity, or modify it so that the doming subsides. Strengthening and properly contracting the TrA helps to manage doming (1).
Remember to talk with your physician or pelvic health specialist before engaging in new activities, to make sure they are appropriate for you. With that being said, these exercises are gentle and mild, and should not cause pain or discomfort. Also, if you’re a postpartum mom, you do not need to jump into these immediately. Take your time before returning to exercise and let your body rest, as often times DRA is resolved on its own during the initial postpartum period.
1. Deep (Diaphragmatic) Breathing: Diaphragmatic breathing is an important place to start when targeting the abdominals as it can help us to draw attention toward the muscles we are trying to activate. Start by lying on your back and bending your knees so that your feet are flat on the floor. Once here, place one hand on your chest and one on your stomach. As you breathe in, let your belly fill with air. You should notice your stomach-hand rising up, while your chest-hand stays relatively stable. As you breathe out, pull your belly button toward your spine and notice your stomach-hand fall. Again, your chest-hand should remain stable. Breathe like this for two minutes at a time and complete a few sets. This type of breathing is also a great stress-relief tool to utilize during the more stressful moments of early parenthood.
2. Transversus Abdominis Draw-ins in Supine: Your TrA is your deepest core muscle. It is this muscle that helps add tension to the linea alba and improve both the function and aesthetics of the abdomen. For this exercise, start in the same position as above—lying on your back with your knees bent and feet flat. Pull your belly button toward your spine and hold it there for ten seconds at a time. Do ten repetitions. During these ten seconds, you should be able to breathe normally, while maintaining the muscle contraction. If you feel like you have to hold your breath, you might be pulling your stomach in too far.
3. Transversus Abdominis Draw-ins in Tabletop Position: This exercise is very similar to above, but now we are just moving the muscle against the force of gravity. Assume a tabletop position, with your hands and knees on the floor. Your arms and legs should be right beneath your body, creating 90-degree angles at your shoulders and hips. Once here, pull your belly button toward your spine and hold this for ten seconds. Complete ten repetitions.
4. Supine Marches: Return to lying on your back with knees bent and feet flat. Draw your belly button toward your spine and hold it there. Now, lift one leg up into a march and set it down while lifting the other leg up. Alternating legs, complete twenty marches. If you notice you are not able to maintain the deep core (TrA) contraction during the marches, make your marches smaller, or complete fewer. It’s okay if you have to start with five small marches—completing them correctly is more important than how many you do. If starting at a lower number, work your way up to twenty marches over a few days or a couple of weeks.
5. Dead Bugs: Go ahead and progress to Dead Bugs if you have successfully completed the Supine Marches Exercise. For this exercise, lie on your back with your shoulders, knees, and hips bent to 90 degrees (so that your feet and hands are floating in the air). Now, pull your belly button in toward your spine and hold it there during the exercise. Move your right arm backward, away from your legs, while moving your left leg forward, away from your arms. Stop moving the leg and arm once they are about ten centimeters from the surface beneath you. Bring them back to the starting position, and now move the left arm and right leg in the same manner. Continue on, alternating arms and legs, until you’ve completed twenty repetitions. If you are unable to complete these while maintaining the TrA contraction, go back to the Supine Marches exercise, or complete fewer repetitions. Be sure to breathe throughout!
6. Crunches with Sheet: If you have DRA, you may have been told to avoid any crunching activities. This is often recommended to help people avoid doming/coning, which is important. However, life activities include crunching (just think about sitting up in bed), and it can be difficult to image avoiding these activities. This exercise is a good way to protect your abdomen, ease back into crunching motions, and coordinate the muscle contractions of both the TrA and the rectus abdominis muscles. Start by placing a sheet or long towel on the surface where you will be performing the exercise. Next, lie on your back on top of the sheet with your knees bent and feet flat. Grab the ends of the sheet and criss-cross them so that your left hand is holding the sheet emerging from your right side and vice-versa. Now, give a small pull to both ends of the sheet to help knit your abdominal muscles together. Pull your belly button toward your spine and, holding this muscle contraction and the tension on the sheet, perform a small crunch. Aim to complete ten to fifteen crunches in total and then take a break. Work your way up to three sets.
7. Bird Dogs: Start in a table top position with your hands and knees on the floor. Pull your belly toward your spine and hold it there. Now slowly bring your right arm up to your shoulder while lifting your left leg and kicking it behind you so that it is even with your back. Hold for up to two seconds and then slowly lower your arm and leg to the starting position. Now, do the same with your left arm and right leg. Continuing alternating arms and legs until you’ve reached twenty repetitions. After a short break, complete one or two more sets. If you notice this hurts your knees, try placing a small pillow beneath them.
8. Hand to Thigh Press: Lying on your back, bend your right knee and place your right foot on the floor while. Now, lift your left leg up so that you are forming a 90-degree angle with your hip and knee. Now, take your right hand and press it into your left thigh. Keep your right arm straight and match the resistance of the hand/arm with the leg. Hold this position for ten seconds before taking a break. Switch to the other side and repeat. Aim to complete five times on each side.
There you have it! These beginner exercises will kick start your postpartum journey and help you move away from the DRA days. You’ve got this!
XOXO,
Your Pelvic Bestie
References:
1. Lee D, Hodges PW. Behavior of the Linea Alba During a Curl-up Task in Diastasis Rectus Abdominis: An Observational Study. J Orthop Sports Phys Ther. 2016 Jul;46(7):580-9. doi: 10.2519/jospt.2016.6536. PMID: 27363572.
*The information contained in this article is for educational and informational purposes only and is not intended as health or medical advice. Always consult a qualified health provider regarding any questions you may have about a medical condition or health objectives.
