abdominal separation

What is diastasis recti (abdominal separation)?

Many clients I see are really keen to get back into shape and exercise after having baby, but steps should be taken to protect the pelvic floor and core prior to engaging in any high impact or high intensity exercise. As Accredited Exercise Physiologist’s we can help support new mothers regain their fitness and strength through safe, functional and effective training and rehabilitation.

Women who suffer from abdominal separation, are more likely to experience back-ache, hernias, pelvic girdle pain and pelvic floor dysfunction so it’s essential to rehab these muscles after pregnancy.

About diastasis recti (abdominal separation)

Diastasis Recti, or abdominal separation, is the widening of the gap between your ‘six pack’ (rectus abdomius) muscles. The connective tissue (aponeurosis) that joins all the musculature of the abdominal sheath begins to stretch to accommodate the increased intra-abdominal pressure. Basically this means the material down the center of your ‘six pack’ muscle widens apart to accommodate the growing uterus. Abdominal separation can affect 2 out of 3 mums post partum, so it’s very common, and very treatable.


Some Stats and Figures

  • For many women, abdominal separation remains widened at 8 weeks postpartum, and if left untreated or without rehabilitation, the gap at 8 weeks remains unchanged at 1 year postpartum. (Coldron et al 2008, Liaw et al 2011)
  • 50% of women have some degree (symptomatic or asymptomatic) of pelvic organ prolapse (POP) postpartum.
  • Of those postpartum women who have some (stress urinary incontinence) SUI at 12 weeks post partum 92% will still be at 5 years post partum.

 

Exercise Prescription:

 

What not to do – exercises during pregnancy and post partum.

  • Crunches, sit-ups, planks, and some Pilates moves like straight leg lifts, basically anything that places strain and sheering force on the abdominals. These moves can cause widening of your diastasis, pressure and strain on your already weakened pelvic floor and lower back pain.
  • High impact or contact sports are also not advised.

If you experience leaking whilst exercising after pregnancy, seek help from a women’s health exercise physiologist or a women’s health physiotherapist.  Incontinence is common – but not normal – and 100% treatable.

What to do

  • You can help to both protect and heal your diastasis aka abdominal separation through good nutrition, good posture and exercises to connect with your abdominals.
  • Eating protein and zinc rich foods, such as meat, fish, nuts, beans or eggs, and vitamin A rich foods like kale, broccoli, sweet potato can provide your body with the nutrients it requires to heal and repair. Eat plenty of fibre rich foods daily and drink an adequate amount of water to maintain healthy bowel habits – and don’t delay the urge to empty your bowels!
  • Being mindful of your posture (when you are nursing your baby, carrying other children or shopping etc) is also important in your recovery of your abdominal muscles. No matter how much fantastic work you are putting in at the gym, if you carry poor posture for the other 12 hours of the day, you will undo all your hard work!

 

5 great exercises that are appropriate for abdominal separation and pelvic floor safe for pregnancy and post partum:

 

  • Aerobic work such as bike, walking, deep water running, aqua aerobics, swimming and step classes
  • Glute bridges
  • Squats (can be to a chair or with assistance from a swiss ball)
  • Side planks from knees
  • Belly breathing

 

Pssst – what is Belly Breathing?

Briefly, belly breathing is getting your pelvic floor, transverse abdominus, deep lower back muscles and diaphragm all moving together in sync. These 4 muscles make up your ‘core’.

Inhale – let your belly expand and pelvic floor relax
Exhale – gently draw up your pelvic floor and imaging drawing your two bony hip points at the front of your pelvis closer together.

This can take some guidance to get right but integral to learning to re integrate the pelvic floor and strengthen your core.

For help with abdominal separation, find your local Accredited Exercise Physiologist or Women’s Health Physiotherapist.