abdominal muscle separation
Also known as “Diastasis Recti”, this occurs in almost every pregnancy and is common postpartum.
The connective tissue running centrally down the large abdominal muscle (Rectus Abdominis) is prone to stretch during pregnancy. The position of the most stretch is dependent on where you are carrying the baby.
It’s never too late to repair, but the sooner you begin, the better.
Check in with your physiotherapist early (2-3 weeks postpartum) to have an abdominal assessment
Abdominal Separation answers
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It isn’t always visible, but you may notice a visible bulge just above or below the belly button, and a tenting or doming or your abdominal muscles when using them (eg getting in and out of bed). Some people feel like they still look pregnant for long after delivery.
You may feel weak around the abdominals and have difficulty with lifting.
Most levels of separation has not been connected to pelvic floor dysfunction (eg. bladder leaking) or lower back pain.
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Almost all people who reach the final trimester of a pregnancy will experience some abdominal separation.
Most abdominal separation will recover within the first 8 weeks postpartum, however some will continue for up to 6 months.
The connective tissue (linea alba) that runs between the large abdominal muscles becomes prone to stretch during pregnancy due to:
hormones: act to soften the fibres of the connective tissue, allowing it to stretch
baby growth causing the uterus to move upwards, stretching the linea alba.
The position of the most stretch is dependent on where you are carrying the baby.
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For the first 0-6 weeks it can be helpful to use supportive garments (Tubigrip/high waisted firm leggings) 4-6 hrs a day, and during walking.
Try to avoid movements that cause obvious bulging of your abdominals - you may find it more comfortable to roll to your side to get out of bed.
Book in to see a physiotherapist within the first 2-3 weeks for an assessment and further advice and guidance for your personal recovery.
We will teach you strategies for avoiding strain on your abs, techniques to re-activate abdominal muscle & tissue, and exercises that help reduce ab separation.
Try some of the simple exercises described in the next tab.
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Increasing tension in connective tissue takes time. Most patients notice improvement within 8 weeks and see more significant change in 3+ months. Be patient with your body!
A strengthening program focused on abdominal activation can lead to improvement in abdominal muscle separation. Don’t forget mobility exercises for general comfort.
Strengthening exercises can include: Pelvic tucks (including glute bridge), gentle abdominal bracing & small, controlled crunches.
Mobility exercises can include: Side-lying upper back rotation, upper back extension (with a foam roller or towel), cat/cow.
The safest exercises for you will depend on several factors, including your fitness level and the severity of your separation.
We can become fixated on “closing the gap” between your abdominal muscles. This can have a large impact on body image and confidence during your postnatal recovery.
It is important to recover functional activation and endurance of the abdominal muscles, and this can be done without necessarily changing the separation distance.
Rather than focusing on numbers, focus on building strength and stability around your abdominals.