Diastasis Recti and the CrossFit Athlete
By: Dr. Kaitlyn Smith, PT, DPT
Diastasis recti, a separation of the abdominal muscles, can occur in both men and women, including CrossFit athletes. It is considered (+) positive to have a diastasis recti if you have more than a 2 finger width separation down the midline of your abdominal wall, whether that be above, below or at the level of the belly button. If you are in the CrossFit community you may have heard the terms coning, doming, or bread loafing! This is when we see the center of the abdominal wall cone or push out or forward.
This does NOT always mean you have diastasis! This can also be a lack of overall motor control. Although, if we continue to “cone” with certain movements, that can increase our chances of developing a diastasis recti or possible hernia!
Here are 3 things that I have found in my practice as a Pelvic Floor Physical Therapist that can contribute to diastasis recti, specifically in the CrossFit community:
Improper Pressure Management: This can be breath holding at inappropriate times or seen with high intensity movements. Examples of this would be: breath holding during a sit-up, breath holding as you pull for your pull-up or press for your overhead press, and breath holding with weighted squats and deadlifts.
Difficulty Isolating the Transversus Abdominis(TA) Muscle or Lower Abdominal Muscle: Although most CrossFit Athletes are extremely strong, I find that due to the intensity of the workouts a lot of athletes can have a disconnect to their lower abdominal muscles. It is important to be able to activate the lower abdominal muscles properly to prevent and decrease coning and pressure on the abdominal wall.
Position of Rib Cage and Hips: Whether it be an overhead movement, squat, or deadlift, ribs and hips should always stay the same distance apart throughout the movement aka stacked! If our ribs are too far forward or flared or our booty is too far back, your abdominals cannot engage as well leading to increased pressure on the abdominal wall!
One misconception that we hear a lot as Pelvic Floor Physical Therapists is “I was told or I believe I have diastasis recti, therefore I cannot perform any core exercises or I’ll make it worse”. That is the complete opposite. If we have a diastasis recti or what appears to be a diastasis recti, core exercises are exactly what we SHOULD be doing. The exercise just has to be the RIGHT load/type of exercise for where the athlete or individual is at.
For example, if a client or CrossFit athlete is coning during sit-ups, maybe we modify that exercise just a little bit to focus on controlling the deceleration of the sit-up with a band and proper engagement of the TA with breathing. Then also utilizing the band to assist upward WITHOUT any coning and again proper TA engagement and breathing. This will allow the body to work up the strength and coordination to perform a regular CrossFit style sit-up without coning or increased risk for diastasis recti, hernia, or pelvic floor symptoms.
Unmanaged diastasis recti can increase your risk for hernias, low back pain, hip pain, urinary leakage, prolapse, and even testicular pain!
If you are experiencing diastasis recti or feeling like your core might not be quite right, schedule an appointment with a Pelvic Floor Physical Therapist!
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