Diastasis Recti is a separation in the abdominal wall caused by an excess of intra-abdominal pressure. Movements that we know create such excessive intra-abdominal pressure include crunches, sit ups, v-sits and supine leg lifts. These movements are contraindicated.
While rehabilitating a DR, front loaded positions are avoided because the abdominal wall does not have the strength to support the weight of the organs. Once the core is functional, plank position can be reintroduced as a “go-to” for core strengthening.
A functional core is one that creates enough tension to support the abdominal wall through meaningful movements as well as exercise. In order to support plank position the core must have both the strength to create tension and the endurance to maintain it with the extra weight of the front loaded position. Core strength and endurance exercises to prepare for plank include upright isometric holds and modified front loaded exercises.
In order to plank you must be able to “set” your core and hold it in a front loaded position. A proper core “set” must be done before every transition into plank. A core “set” includes Core 4 recruitment (diaphragm, pelvic floor, transverse and multifidus) followed by a “bracing” of the entire abdomen. You must be able to breathe while holding core set and plank.
- Inhale, relax your core
- Exhale and pick up your floor, lift it up towards the top of your head and pull the cable between your hips
- Brace anterior core maintaining four point standard with no forward flexion- visualise bracing to be punched in the stomach.
- Grow tall, keeping head neutral and create space between thoracic and abdominal cavities
- Push heels towards back wall and flex glutes- this will lift your knees off the floor
- Lift into plank holding four point standard
- Continually check and cue your core during plank set
- Feel your back “firing” before you lift into plank
- Hold deep core through entire set- if you lose it, drop and reset
Elbow Planking from knees is the first fully front loaded position. You must be able to hold an elbow knee plank for 10-30 secs with no shaking prior to progressing. The next step is elbow knee plank “up downs” which build upper body strength and pelvic stability control in plank.
Once the core is strong enough to support full planking from toes, more dynamic movements can be introduced. Here are three exercises to target the abdominals comprehensively:
- Plank Knee Tucks– from plank position bring knee to opposite elbow underneath. Return to four point standard plank. Alternate Sides, 20 reps total
- Reptiles– From plank position bring knee to same side shoulder outside with a clamshell movement. Twist to look at your knee. Return to four point standard plank. Alternate Sides, 10 reps total
- Running Mountain Climbers– From pike position (bum in the air and feet together) bring one knee to chest and run. 30 reps total
These three exercises alone can take years to master, building endurance, increasing repetitions and applying higher intensity interval training to the circuit.
Monitor for core symptoms and pelvic girdle pain or discomfort when doing these movements which involve a front loaded weight load transfer through the core and pelvis. For example, if movements aggravate the pubic symphysis, cause the abdomen to distend, or cause tension in the hip joints, modify the movement. Planking with your feet together reduces the weight load transfer through these movements and the feet can slowly inch out into full four point standard as the core strengthens to support it.
Progressing plank involves adding instability under the hands and/or feet. Try an inverted BOSU under your hands or a BOSU dome under your feet. Combo both for increased instability. Hands on the mat, feet on a ball is a challenging plank variation for knee tucks, leg lifts, pikes and reptiles. Planking with the feet suspended in a trx is a very difficult position for knee forwards, pikes, saws, and push ups.
When progressing plank listen to your back- the posterior core! Once the anterior core is strengthened, the lower back will typically “tell you” if you are progressing too fast. If your back is sore, take it back a notch and build up. It takes years to progress through 10 levels of core, so train smart, get strong, and stay uninjured.