The internet is a fantastic resource for many of life's questions. However, when it comes to how to strengthen your abdominals when you have diastasis recti (DRA), there seem to be more questions than answers. One of the most common questions our patients ask is whether it is safe to plank with a DRA.
Like many questions about health and fitness, the answer is "it depends." We should instead be asking ourselves what we're trying to accomplish with a plank, or any other abdominal strengthening exercise.
If a patient comes to us with a DRA, our goal is to improve the ability of the deep abdominal muscles to hold the two sides of the separation together when she moves through her day. Over time, we hope that consistent, appropriate exercise will improve the tension and thickness of the ligament that runs down the middle of the abdomen (the linea alba) to keep the gap closed in the long term.
With any strengthening exercise, we have to provide a challenge to the muscle we are targeting to cause it to change in strength. As strength improves, the difficulty of the exercise must also increase to provide a new and appropriate challenge. Exercises that are too easy will not cause any increase in strength, and exercises that are too challenging will cause compensations in the surrounding muscles and bypass the weaker muscle we are trying to target. In the case of a DRA, an exercise that is too challenging will cause the person to compensate by holding their breath, bulging their abdominals, and actually widening the separation in the moment.
A plank is safe for you if you can do it while using your deep abdominals to generate good tension in the linea alba, while breathing and with good form throughout your body.
So, when a patient comes to us for guidance in a strengthening program to treat DRA, we need to determine whether any exercise (plank or not) is the appropriate challenge. For many, we need to start simply by practicing recruiting the deep abdominals in positions such as hands and knees, sitting, and standing. For others, we start with a plank or even planks with moving arms or legs. The key is determining what their abdominals look like when they are performing the exercise; all of these patients may be equally challenged by their respective exercises but start at vastly different points.
Most people need an outside opinion on how their abdominals are performing during an exercise, and even using a mirror may help you determine objectively what your body is doing. If you are unsure of which exercises are right for you, we strongly recommend consulting with a qualified postpartum physical therapist or exercise instructor.