Exercise Program Reduces Inter-Recti Distance in Female Runners Up to 2 Years Postpartum

Supplemental Digital Content is Available in the Text. Background: Pregnancy and childbirth are associated with increased inter-recti distance (IRD)/diastasis recti abdominis (DRA), pelvic joint laxity, and decreased physical activity levels. Recreational running is an accessible, popular form of exercise that may challenge pelvic stability in postpartum women. Objectives: To assess the impact of an 8-week abdominal muscle retraining program on IRD and pelvic running mechanics in women up to 2 years postpartum. Study Design: Pre/posttest single-arm intervention study. Methods: Thirteen postpartum women (32.8 ± 2.7 years of age; 1-3 pregnancies; 7 weeks to 2 years postpartum) who were recreational runners participated. Ultrasound imaging measured IRD above and below the umbilicus. Thickness of the internal oblique (IO) and transversus abdominis (TrA) muscles was assessed with ultrasonography at rest and during performance of an abdominal draw-in maneuver. Participants underwent an 8-week abdominal muscle retraining program utilizing ultrasonography as biofeedback. Running gait was assessed with 3-dimensional motion capture at study enrollment (baseline), end of the intervention, and 6-week follow-up. Results: Inter-recti distance below the umbilicus decreased from baseline to end of intervention (P = .013) and remained stable at follow-up (P = .459). Inter-recti distance above the umbilicus, IO and TrA activation ratio, and running mechanics did not change (P > .05). Women reported increased running speed following the intervention (P = .021). Conclusion: An 8-week abdominal muscle retraining program reduced IRD below the umbilicus in recreational runners up to 2 years postpartum, suggesting therapeutic exercise may be part of conservative management for DRA.