Postpartum rib flare is a common physical change where the lower edges of the rib cage appear to stick out or splay outward. This occurs because the body undergoes significant anatomical and hormonal shifts during pregnancy to accommodate a growing baby. While expected during gestation, the lingering protrusion after birth signals a functional imbalance in the core system. Addressing this condition restores optimal core function, alignment, and breathing mechanics. Targeted exercises can guide the ribs back toward a more neutral position.
Understanding Postpartum Rib Flare
The mechanism behind postpartum rib flare starts with the physical expansion of the torso during pregnancy. As the uterus grows, it pushes abdominal organs upward, forcing the rib cage to expand and widen. Hormonal changes, such as the release of relaxin, further assist this widening by softening connective tissues.
The most significant factor contributing to a persistent flare postpartum is the elevated position of the diaphragm, the dome-shaped muscle beneath the lungs. Upward pressure from the uterus causes the diaphragm to sit in a flattened position, pulling the lower ribs outward and upward. This essentially traps the body in a state that mimics a constant inhale.
If the diaphragm remains elevated, it disrupts the coordinated pressure system of the core. The diaphragm, abdominal muscles, and pelvic floor are designed to work together in synchrony during breathing. When the ribs are flared, deep abdominal muscles like the obliques cannot function effectively to pull the ribs down. This muscular imbalance prevents the rib cage from fully returning to its pre-pregnancy position and can contribute to issues like back pain.
Foundational Steps to Prepare the Core
Before attempting dynamic strengthening exercises, establish awareness and restore proper breathing patterns. A simple self-assessment involves lying on your back with knees bent and feet flat. Place your fingers on your lower ribs to notice how far they protrude from the floor. You can also check your infrasternal angle; an angle greater than 90 degrees can indicate a flare.
The next step is to master 360-degree diaphragmatic breathing, which helps relax the diaphragm and encourages rib cage mobility. Lie on your back with your rib cage stacked directly over your pelvis, often achieved with your feet resting on a chair or wall in a 90/90 position. As you inhale, focus on allowing your breath to expand gently into your belly, sides, and the back of your rib cage.
The exhale is important for rib repositioning. On a slow, complete exhale, gently draw your lower ribs down and in toward your center. This long exhale naturally activates the deep core muscle, the transverse abdominis, and encourages the pelvic floor to lift. This preparatory work teaches the body to use the diaphragm and core muscles to control rib position before adding movement or load.
Targeted Exercises for Rib Repositioning
Once foundational breathing is established, targeted exercises can strengthen the muscles responsible for maintaining rib closure, specifically the obliques and the serratus anterior. These exercises coordinate exhalation with movement to actively pull the rib cage down and in. The goal is to build strength while maintaining a stacked alignment of the ribs over the pelvis.
90/90 Heel Slide
The 90/90 Heel Slide integrates core control with hip movement. Lie on your back with your feet on a wall or chair, hips and knees bent at 90 degrees. Place a hand on your lower ribs to feel them draw down as you exhale completely. While maintaining this rib position, slowly slide one heel down the wall, only going as far as you can without letting your ribs flare up or your back arch.
Serratus Punch
The Serratus Punch strengthens the serratus anterior, a muscle crucial for scapular stability and anchoring the rib cage. Start on your hands and knees with a neutral spine. Push the floor away, rounding only your upper back slightly while keeping your elbows straight. This protraction of the shoulder blades activates the serratus, helping to pull the ribs toward the spine.
Cross-Body Crunch with Exhale
The Cross-Body Crunch with Exhale specifically targets the obliques, which are major players in rib closure. Lie on your back with your hands behind your head. Inhale to prepare, then on a full exhale, curl up gently and reach one elbow toward the opposite knee. Focus on the movement initiating from the rib cage drawing toward the pelvis, training the obliques to stabilize the ribs in a downward position.
During all exercises, monitor for signs of abdominal strain, such as coning or doming along the midline, which can indicate excessive pressure. Perform each exercise slowly and with control, prioritizing perfect form and full rib closure on the exhale over the number of repetitions. Consistency in form is how the body learns to recruit the correct muscles for long-term rib repositioning.
Knowing When to Consult a Specialist
While self-correction with dedicated exercises is effective for many, professional guidance is beneficial for full recovery in certain situations. If you experience persistent or increasing pain in your back, neck, or hips after starting a consistent exercise routine, a deeper assessment is needed. Pain often indicates that compensatory movement patterns are still being used.
Lack of noticeable progress after eight to twelve weeks of consistent, targeted work also signals the need for specialist intervention. A pelvic floor physical therapist (PT) can provide an individualized assessment beyond simple visual inspection. They can check the function and strength of your deep core muscles, including the diaphragm and pelvic floor, with greater precision.
If you suspect or have been diagnosed with a significant Diastasis Recti (separation greater than two finger-widths), a specialist can tailor a safe and progressive program. A pelvic floor PT can use manual therapy techniques to improve tissue mobility and provide advanced programming. This ensures core strengthening integrates with daily functional movements, allowing the entire system to heal and work in harmony.