ABDOMINAL MUSCLE SEPARATION: POST BIRTH

When does abdominal muscle separation usually occur & what exercises can help?

Abdominal muscle separation (also known as diastasis recti) is the stretching or weakening of the abdominal muscles from a line running down the middle of your abdomen, between your navel and pubic area. This separation of the muscles occurs during pregnancy. Abdominal separation is very normal. Your uterus is making space for a growing baby. However, not all women have some degree of abdominal separation by the end of the pregnancy. This muscle separation usually happens during later stages of pregnancy and sometimes doesn’t go back together post birth, which is why you may have that ‘mummy tummy’.

Abdominal muscle separation can however be an issue if it doesn’t heal post-birth. It reduces the integrity and functional strength of the abdominal wall and can aggravate lower back pain and pelvic instability. Symptoms can include back pain and the feeling of abdominal weakness.

Abdominal muscle separation usually happens during the later stages of pregnancy.

Steps in assessing yourself for abdominal muscle separation:

1. Lie on your back with your knees bent and feet flat on the floor.

2. Walk your hand along the midline of your belly to get a sense of the tension from navel to the pubic area. You can start from just under your sternum and work your way down towards your pubic bone. Feel if there are areas that are softer than others. Can you press your fingers deeply into your belly? Does the tissue feel supportive when you press into it?

3. Using the fingers of one hand, press straight down into your belly just above the navel and feel how wide the gap is, using your finger width as a guide. Then exhale, lift your head off the floor as if you are doing a mini crunch to feel if there is any gap and to determine how deep it may be.

4. Repeat this along the line from the sternum towards the pubic bone.

A gap of two fingers after childbirth is quite normal. But please note, it’s not just about how wide the gap is but also how deep it is too. What is important is how strong the connective tissue is and if it can withstand the intra-abdominal pressure. It’s not about closing the gap but making the core functional.

Be selective when exercising. Your abdominal wall needs a degree of loading to heal, but it requires the right kind of exercise and the correct amount, at the right time.

When you start exercising again, avoid;

• Exercises that put too much pressure on your abdominal wall.

• Exercises like sit-ups, planks and push-ups.

• Heavy lifting or anything with high impact on the abdominal muscles.

Listen to your body and observe what’s happening to your tummy while you perform any movement, even the regular day to day movements, such as picking up your baby for instance.

We are all individuals and what might be safe for one person, might not be for another. If you can see your tummy bulging when performing a movement or that it causes you pain, it is an indication that this movement is too much for you at this stage.

It is important to check with your doctor or a women’s health physiotherapist. They can check if you have abdominal muscle separation and give you a personalised program to help to strengthen your core.

Magdalena Hawley is a Qualified Personal Trainer and Food & Wellness Coach. She is a founder and head trainer of Mums Going Strong Fitness group and personal training company specialising in postnatal fitness with a focus on core and pelvic floor recovery. Creator of Busy Fit Mums online program.