Abdominal Wall Separation (Diastasis Recti)
What is Diastasis Recti?
Diastasis Recti is another name for abdominal wall separation something that I often refer to in my mums and bubs fitness sessions.
Abdominal Separation seems to be a hot topic at the moment. Every time I get a magazine or email newsletter it seems to be featured. And why shouldn’t it be, it is a rather important topic after all and I think in the past not enough attention has been given to it.
Abdominal wall separation is the separation of the connective tissue that joins the rectus abdominis (the two strips of muscle down the abdomen). The Hormonal changes, weight gain, abdominal growth, due to the growing baby and abdominal weakness are what cause the muscles to separate.
My personal experiences with Abdonimal Wall Separation
I myself after giving birth to three (oversized) babies have had to re-build my abdominal strength. A few years ago after reaching my goal weight and greatly improving my fitness post-baby, I was extremely frustrated with my lack of abdominal strength, still struggling to complete a single sit-up.
Not happy with the general consensus that it is just something that I’m going to have to live with, I pressed fellow fitness colleagues and allied health professionals on their advice and experience. Taking this all on board, I realised the key to successful core strength recovery lied in nurturing the abdominal muscles through achievable core exercises, designed to strengthen and pull the muscles back into place. This was in contrast to my initial attempts to ‘overwork’ the abdomen in an attempt to improve core strength.
Following this advice resulted in better core strength, a stronger lower back, better posture, improved pelvic floor and low and behold, I can now do sit-ups again. It is important to remember that everyone heals at a different rate.
How can you tell if you have an Abdominal Wall Separation?
You can ask your trainer (that would be me), to check for you. This is important if you’re all of a sudden thinking, Oh! That’s me! Don’t stress, you can leave your clothes on. It really is very simple. If you do still have a separation we will need to make sure that we give you exercises that are going to help you and not make the separation worse. If the separation is still quite big, I will refer you to a physio that specialises in this area. It is also good to remember that I’m talking about anything (a separation) that is more than 2 cm.
Checking yourself for Abdominal Separation
The steps below outline a simple self-test that will help you work out if you have diastasis recti or abdominal wall separation.
- Lie on your back with your knees bent, and the soles of your feet on the floor.
- Place one hand behind your head, and the other hand on your abdomen, with your fingertips across your mid-line, parallel with your waistline at the level of your belly button.
- With your abdominal wall relaxed, gently press your fingertips into your abdomen.
- Roll your upper body off the floor into a “crunch,” making sure that your ribcage moves closer to your pelvis.
- Move your fingertips back and forth across your mid-line, feeling for the right and left sides of your rectus abdominis muscle. Test for separation at, above, and below your belly button.
Use correct form for an accurate assessment: make sure that you don’t simply pull your head off the mat. To effectively contract your abs, you need to move your ribcage closer to you pelvis (similar to doing a crunch with your feet down). If you don’t adequately activate your abdominal wall, you might assume that you have abdominal separation. But for most, as the rib cage moves closer to the pelvis and the contraction deepens, the width of the gap at your mid-line will decrease.
Don’t panic if you feel a “hole” in your belly in the first few postpartum weeks. Everyone’s connective tissue at the mid-line is lax after childbirth. As you recover, your mid-line will slowly regain its former density and elasticity, and the “hole” will become shallower, and if you do the right exercises, more narrow too.
So what are the signs of Diastasis Recti/Abdominal Wall Separation
Some of the things that may indicate that you have abdominal wall separation are:
- A gap of more than 2 1/2 finger-widths when the rectus abdominis is fully contracted.
- The gap does not shrink as you contract your abdominal wall.
- You can see a small mound protruding along the length of you mid-line.
If at any time you see a round, hard, or painful bulge protruding from your belly button area, or along your mid line, consult with your Obstetrician.
Why do something about Abdominal Separation?
Not doing anything to correct the separation is not a good idea. The Weakening of the rectus abdominis can have an impact on deeper abdominal muscles and pelvis. Long term this can affect core stability, contribute to pelvic floor issues and back and pelvic pain.
Some common myths about Abdominal Wall Separation
Experiencing this condition myself and having spoken to and worked with many women in post natal recovery, below is a list of some of the more common misconceptions that I have come across concerning abdominal wall separation.
- Abdominal Wall Separation requires surgical repair.
- Abdominal Wall Separation causes permanent bulging of the abdomen i.e. “mummy-tummy.”
- Abdominal Wall Separation causes pain.
- The abdominal muscles will always be weaker after childbirth.
- All women should wait for at least six weeks after delivery before beginning any abdominal exercises or postnatal reconditioning program.
What exercise should I avoid?
- Double leg lifts
- Push ups
- Jumping, skipping, running
You need to give your body a chance to heal and the above list of exercises will place pressure on the muscles and causes them to bulge and separate further. In an upcoming article I will post some short videos along with an overview of what you can do to help heal you abdominal separation. Please let me know if you think you have an abdominal separation and we can check it out and start working on putting it back together.
So how about you? What is your experience with abdominal wall separation? Are you still struggling? Feel free to leave your questions and comments below.
By Belinda Salan