Abdominal Separation – Diastisis Recti

Did you know that during pregnancy your abdominal muscles can stretch by up to 50%!

It’s not surprising then, that about one third of all pregnant women experience separation of the superficial abdominal muscles known as diastasis recti in the second or third trimester.

The muscle affected is the rectus abdominis, otherwise known as your ‘six-pack’ muscle, which runs vertically down your stomach. In between the two halves of the rectus is connective tissue called the linea alba which forms the midline of your stomach.  During pregnancy this connective tissue softens, and as you grow not only does it stretch but your uterus pushes up against the abdominal wall, causing the left and right sides of the rectus to pull apart.

How to check for a diastasis recti:

–        Lie on your back with your knees bent and feet flat on the ground

–        Place your fingers just above your belly button pointing down towards your pelvis

–        Lift your head and shoulders up off the floor to contract to abdominals while feeling for separation under your fingers, you should be able to feel the left and right edges of rectus abdominis

 

Some degree of separation occurs in all pregnancies and a one to two finger gap is usually not problematic. However, significant diastasis recti can cause problems such as low back or pelvis pain and if it is not controlled prior to a subsequent pregnancy you can be at risk of umbilical hernia.

The good news is that some simple exercises that focus on the deeper layer of abdominal muscles can help to prevent and lessen the effects of the separation while you are pregnant and reduce the gap postpartum.  Clinical Pilates is one great way of safely strengthening your abdominals while pregnant, so if this sounds like you don’t hesitate to contact your Bend + Mend Sydney CBD Physiotherapist for more information.

8 Comments

  1. Kylie
    May 5, 2013

    Hello. I am 4 months post partum with my 4th baby and have diastisis recti, and really really want to fix this problem. I didn’t realise I had it, and have been doing sit-ups with huge difficulty. I do get some back pain, but its more of a cosmetic problem I think. It looks gross and makes me feel awful.
    Just wondering how you can help me 🙂
    regards
    Kylie

    Reply
  2. Michelle Gall
    May 8, 2013

    Hi Kylie
    Thank you for your enquiry regarding you rectus diastasis following your 4th baby.

    This is a really common condition during pregnancy and can vary from just a slight split to quite severe which as you mentioned can cause some back or pelvis pain as well as not looking so good!

    It is really important to get the appropriate exercises to strengthen the deep, lower abdominals and pelvic floor first before pushing on to harder abdominal exercises like sit-ups etc as these can actually worsen the split. The appropriate exercises will help you gain tone on that lower part of your stomach which is usually where women find they feel ‘softer’ post pregnancy. Once we get these stronger and more stable we can progress into working the more superficial muscles which can help reduce the size of your split.

    Depending on how severe your diastasis is we can also trial some ‘binding’ around the abdomen to support the area while you do exercise to avoid the split from worsening.

    Hope this helps!

    Michelle

    Reply
  3. Delphine
    May 13, 2013

    Michelle,
    I just found out that I still have a separation of around 1cm to 1.5 cm, still after the birth of my daughter 18 months ago. I did a lot of exercices and 1 / 1 sessions with the Physio and I was almost sure that I “repaired” everything but with huge disappointment I just discovered it. Could you please let me kow if I can fix it without surgery ? I may have re-opened it in doing too many abdo exercices or in carrying too much weight, I am not sure. I trained 3 times a week at the sport centre. I hope you can come back to me soon, thank you so much for your help!
    Delphine

    Reply
  4. Michelle Gall
    May 16, 2013

    Hi Delphine,
    Thanks for your query.

    It sounds like you did all the right things getting Physio sessions early on to activate the deeper, lower abdominals first before kicking into too much rectus strengthening. Unfortunately, what people often don’t realise is that the hormones that are increased throughout pregnancy that cause the softening of the linea alba (the soft tissue in between the two rectus muscles) can still be present for up to 6 months post-natally, so those exercises you learnt early on need to be continued even as you start increasing your other abdominal work at the gym.

    It’s also a good idea to palpate your rectus abdominis (or get your trainer or Physio to) while you are doing a harder exercise for the first time to ensure it is not pulling apart and, if it is, perhaps leave that exercise for a bit longer.

    What I would suggest is coming in for a consultation so we can check your split and current exercise regime. From here, we can either add some appropriate core exercises to you routine that encourage closing of the separation or even get you in to the studio to do some Clinical Pilates, which is a great way of working out the muscles that don’t get as much attention at the gym.

    Michelle

    Reply
  5. Candida
    August 23, 2016

    Hi Michelle,

    I’ve had ab separation with both my pregnancies. I did get the separation checked post my last pregnancy and it was at 1.5cms. However, my belly hasn’t gone down at all. It’s still sticking out. Any recommendations on exercises?

    Reply
    • Kirsty
      August 25, 2016

      Hi Candida
      There are definitely exercises you can do for your separation, to give a flatter appearance and possibly bring the edges together. I would love to ask you a few more specific questions though, like how long ago your pregnancies were? You had the separation checked, did the Physio give you, or have you been doing pelvic floor work already? If you would like to email me or call the clinic I would love to talk to you about this in a little more detail.
      Kirsty

      Reply
  6. Alana
    November 11, 2016

    Hi it has been almost 7 years since my second birth which separated my muscles. I have had a hernia just over a cm wide above my belly button since then. I never done any core or pelvic work post partum. I am quite slim & do have abs from other physical activities. I am at the point of considering surgery for the bulge but am interested in trying to bring them back together if this is possible considering the hernia.
    What is your opinion? Kind regards

    Reply
    • Kirsty
      November 14, 2016

      Hi Alana
      I think with specific exercise you could improve the appearance of the hernia and separation. It’s difficult without seeing it, as to how much it will improve, but considering you haven’t done any pelvic floor/core work, I think it would be worth trying before going down the surgical correction options.
      I would suggest seeing a physio to assess the separation, your pelvic stability and pelvic floor strength. Then they can start with teaching you how to activate your pelvic floor and transverse abdominus. It may be from you current activity level that you do have strength, but it might even be a timing issue with the muscles.

      If you have any further questions, feel free to give me a call at the clinic or you can email me directly on kirsty@bendandmend.com.au
      Kirsty

      Reply

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