Dominic Stone
Abdominal muscle separation, also known as diastasis recti, is a common condition, especially in pregnant women. It occurs when the left and right abdominal muscles separate, causing the abdomen to stick out or bulge. While it usually occurs during pregnancy, abdominal muscle separation can also happen to men and athletes due to various factors such as yo-yo dieting, incorrect weight lifting, and certain exercises like sit-ups. So, does a separated muscle rejoin? The answer is yes, and there are several treatment options available, ranging from special exercises to surgery.
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What You'll Learn
Abdominal separation during pregnancy
Abdominal separation, or diastasis recti, is a common condition that occurs during pregnancy. It happens when the two long, parallel abdominal muscles, also known as the rectus abdominis muscles or ""six-pack" muscles, separate due to the growing uterus and baby. This condition typically develops in the later stages of pregnancy and can cause the belly to stick out or bulge.
The separation of these muscles can create a gap of more than 2 centimeters, which is considered diastasis recti. It is characterized by a bulge in the midsection that persists even after weight loss or exercise. While the condition itself is not painful, it can lead to weakness in the core and cause side effects such as lower back pain, pelvic pain, and constipation.
To manage and treat abdominal separation during pregnancy, it is recommended to:
- Consult a doctor, midwife, or physiotherapist for guidance and to receive a special exercise program to strengthen the deeper abdominal muscles.
- Avoid activities that can worsen the condition, such as sit-ups, oblique curls, and certain yoga poses.
- Strengthen the transverse abdominus muscle through gentle exercises, such as lying on your back, lifting your head off the ground, and holding for a few seconds.
- Wear a supportive brace or compression underwear to provide additional support to the abdominal muscles.
In severe cases where the condition persists, surgery may be considered. A tummy tuck procedure, performed by a board-certified plastic surgeon, can repair the abdominal muscle separation by stitching the muscles back together, resulting in a flatter abdomen and reduced belly pooch.
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Diastasis recti
The muscle opening often shrinks after giving birth, but in some studies, the muscle wasn't back to normal even a year later. Healing diastasis recti after childbirth is about knowing what not to do. Everyday activities that put pressure on your core, such as bearing down during a bowel movement or holding your breath when you pick up your baby, can exacerbate the abdominal separation.
There are exercises that can help improve the condition. After the connective tissue has healed, some Pilates or other exercises may help strengthen and rely more on your transverse (deep core) belly muscles instead of the outer ones.
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Surgical treatment
One example of when surgery may be warranted is in the case of an acute skeletal muscle injury. In such cases, the general principle is to carefully remove the entire hematoma and all necrotic tissue from the injured area. If the gap between the ruptured stumps is exceptionally long, surgical means can be employed to bring the retracted muscle stumps closer together, reducing the likelihood of permanent denervation and atrophy of the muscle.
Surgical haematoma drainage is another procedure that may be indicated when nerve and/or vascular compression is detected, or when haematoma infection is clinically relevant. Muscle repair can be considered for partial or complete tears in the muscle belly when more than half of its volume is compromised and associated with functional disability. However, the fragile nature of muscle tissue makes repair technically challenging, and it can be difficult to achieve a mechanically strong end-to-end repair with appropriate tension.
In the case of abdominal muscle separation, or diastasis recti, surgery is rarely performed and typically only recommended when physical therapy and exercise are insufficient for the muscles to naturally repair. Diastasis recti surgery involves joining the previously separated muscles using non-dissolvable sutures at varying depths. The umbilicus is then reconnected to the outer skin, and the abdominal skin is drawn back to the pubic area and closed with sutures. This procedure can be performed in conjunction with abdominoplasty, or a "tummy tuck", in cases where the removal of excess fat and skin is desired.
Overall, while surgical treatment for muscle injuries can be beneficial in certain cases, it is important to exercise caution and carefully consider the potential risks and benefits.
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Non-surgical treatment
Healthcare providers will often recommend physical therapy or at-home exercises to help heal diastasis recti. These exercises focus on strengthening the deeper abdominal muscles and improving core stability. It is important to avoid certain activities and movements that can make the condition worse, such as sit-ups, crunches, oblique curls, and some yoga poses. Instead, pelvic tilts and abdominal bracing exercises are recommended. Wearing a supportive brace or special underwear can also help provide support to the back and abdomen during the healing process.
In addition to exercises, healthcare providers may suggest modifications to daily activities to prevent further separation and promote healing. During the postpartum period, it is advised to avoid lifting anything heavier than your baby, roll onto your side when getting out of bed or sitting up, and use your arms to push yourself up. It is also important to be mindful of your posture, as poor posture can be a side effect of diastasis recti.
While most cases of diastasis recti can be managed non-surgically, it is important to consult with a healthcare professional, such as a doctor, midwife, or physiotherapist, to determine the best course of treatment for your individual situation. They can provide guidance on specific exercises, recommend movements to avoid, and refer you to a specialist if needed.
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Symptoms of separated muscles
Abdominal muscle separation, or diastasis recti, is a common condition that occurs during and after pregnancy. It can also occur in men and infants. The condition is caused by the stretching of the abdomen during pregnancy, creating a gap in the abdominal muscles. While the condition itself is not painful, it can lead to several symptoms, including:
- A bulge or "pooch" in the midsection: This is one of the most common signs of diastasis recti, and it may be noticeable even after losing weight or exercising.
- Coning or doming of the abdomen when contracting the abdominal muscles or leaning back in a chair.
- Lower back pain: This is due to the abdominal muscles also supporting the back. When these muscles are stretched and separated, they may not function optimally, leading to back pain.
- Pelvic pain: Diastasis recti can weaken the core, resulting in pelvic pain when performing everyday tasks.
- Urinary incontinence: Leaking urine when coughing or sneezing can be a symptom of diastasis recti.
- Constipation: This may be another symptom associated with the condition.
- Poor posture: Changes in posture can occur due to the weakened core and increased strain on other body parts.
It is important to note that diastasis recti can often go unnoticed during pregnancy and may develop in the second or third trimester. If you suspect you have diastasis recti, it is recommended to consult a healthcare professional for an accurate diagnosis and appropriate treatment plan.
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Frequently asked questions
Abdominal muscle separation, also known as diastasis recti, is when the left and right abdominal muscles separate, causing the abdomen to stick out and creating a "pooch". This condition can be caused by a variety of factors, including pregnancy, yo-yo dieting, incorrect weight lifting, and certain exercises like sit-ups.
The most common symptom is a visible bulge or gap in the middle of the stomach. Other symptoms include lower back pain, constipation, urinary incontinence, frequent bloating, and changes in posture.
In many cases, abdominal muscle separation can improve or heal on its own over time, especially with specific exercises that help close the separation. Wearing a supportive brace or special underwear can also help manage the condition. However, in more severe cases or if non-surgical methods are ineffective, surgery may be recommended to rejoin and repair the separated muscles.
Yes, abdominal muscle separation can occur in men, although it is more commonly associated with pregnancy and postpartum women due to the growing uterus and abdomen stretching the abdominal muscles.
