Research on Diastasis Recti: Are Curl-Ups Safe & Effective?
For years, women with Diastasis Recti Abdominis (DRA) have been told to avoid traditional ab exercises like curl-ups and crunches. But recent research is challenging this long-held belief, offering new hope and clarity for postpartum recovery. This blog breaks down two pivotal studies to give you reliable, evidence-based guidance.
Summary of the Key Research Findings
Let's dive into the two interesting studies and see what they can add to our rehab protocols for DRA and exercise.
1. The 12-Week Curl-Up Program: Building Strength Without Harm
What They Did: This high-quality randomised controlled trial followed 70 postpartum women (6-12 months after birth) with DRA. The experimental group performed a 12-week, home-based program of head lifts, curl-ups, and twisted curl-ups for 10 minutes a day, 5 days a week. The control group did no specific abdominal training.
The Results:
- Inter-Recti Distance (IRD): The curl-up program did not worsen the separation. There was no significant difference in IRD change between the exercise and control groups.
- Abdominal Strength & Thickness: The exercise group saw significant improvements in both abdominal muscle strength and the thickness of the rectus abdominis muscle.
- Pain & Pelvic Floor: The program did not change the severity of pelvic floor disorders, low back, pelvic girdle, or abdominal pain—it didn't help these issues, but it didn't make them worse either.
Limitations & Generalisability: The exercises were unsupervised, which might have affected technique. The study focused on women with mild-to-moderate DRA 6-12 months postpartum, so results may not apply to those with severe separations or in the immediate postpartum period.
2. The Immediate Effect Study: Corrective Exercise vs. Curl-Up
What They Did: This cross-sectional study directly compared the immediate effects of a "corrective exercise" (similar to the Noble technique, involving a curl-up with manual approximation of the abdominals) against a standard curl-up in 23 women with DRA.
The Results:
- Narrowing the Gap: The corrective exercise was superior to both rest and the standard curl-up in immediately reducing the IRD both above and below the umbilicus.
- Linea Alba Tension: Both exercises increased Linea Alba distortion (an indicator of tension), with the corrective exercise creating a greater increase than rest.
Limitations & Generalisability: This study only measured immediate effects. We don't know if performing this corrective exercise over several weeks leads to a permanent reduction in IRD. However, it provides a crucial snapshot of which muscle contraction is most effective in the moment.
The Bottom Line: What This Means for You
Combining these findings gives us a powerful, nuanced understanding:
- Curl-ups are not the enemy. For women with mild-to-moderate DRA, a structured program of curl-ups may be safe and effectively build abdominal strength and thickness without worsening the separation.
- There's a more effective alternative. If your primary goal is to actively narrow the gap, a specific corrective exercise that combines a curl-up with drawing the abdominal muscles together is significantly more effective than a curl-up alone.
Your Action Plan: How to Use This Research
Based on this evidence, here’s how you can apply these findings to your recovery journey. Always consult with a healthcare professional or physiotherapist before starting a new exercise program, especially if you have DRA.
1. To Build Foundational Strength Safely: The 12-Week Approach
If your goal is to rebuild core strength without fear, the long-term study provides a safe blueprint.
Safe Strength-Building Protocol
Frequency: 5 days per week for 12 weeks.
Exercises: Head lifts, standard curl-ups, twisted curl-ups.
Progression: Start with 2 sets of 10 repetitions for each exercise and gradually increase as you get stronger.
Key Focus: Perform movements slowly and with control, ensuring your core is engaged and you are not holding your breath.
2. To Actively Narrow the Gap: The Corrective Exercise Technique
For a more targeted approach to reducing the separation, integrate the corrective exercise from the second study.
Corrective Exercise How-To
- Starting Position: Lie on your back with your knees bent and feet flat on the floor.
- Manual Approximation: Cross your hands and place them on your abdomen, so each hand is on one side of your midline. Gently draw your two rectus abdominis muscles together towards the midline.
- The Movement: While maintaining this gentle pressure to keep the muscles approximated, slowly perform a small head lift (curl-up), exhaling as you lift.
- Return: Inhale as you slowly lower back down.
- Repetition: Aim for 2 sets of 10-15 repetitions, focusing on the quality of the movement over quantity.
3. Key Takeaways for Your Recovery Journey
- Ditch the All-or-Nothing Mindset: Curl-ups are not forbidden. When performed correctly and consistently, they can be a safe and effective tool for postpartum women with DRA.
- Define Your Primary Goal: Use the standard curl-up protocol for building general strength. Use the corrective exercise for actively working on closing the gap.
- Listen to Your Body: Never push through pain. If you experience coning, doming, pain, or pressure in your pelvic floor, stop and consult a physiotherapist.
- Be Patient and Consistent: Recovery takes time. The 12-week study showed that consistency is key to seeing changes in strength and muscle thickness.
Need Personalised Guidance?
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