Logan Steele
Abdominal separation, also known as diastasis recti or 'DRAM' (diastasis of rectus abdominis muscle), is a common condition that occurs during pregnancy. It is caused by the expansion of the uterus and the stretching of the abdominal muscles to accommodate the growing fetus. This can result in a gap between the left and right sides of the rectus abdominis muscle, which may cause a bulge or pooch in the abdomen. While it usually resolves within eight weeks of delivery, some women experience it for longer, and certain exercises and physical therapy can aid in healing. In rare cases, surgery may be required.
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What You'll Learn
Exercises to fix muscle separation
Abdominal muscle separation, or diastasis recti, is a common condition that occurs during and after pregnancy. It happens when the two long, parallel rectus abdominis muscles (the "six-pack" muscles) in the abdomen separate from each other due to the stretching and growth of the womb. While some abdominal separation is normal during pregnancy, in cases of diastasis recti, the gap between the muscles is more significant and may require targeted exercises to heal.
To fix diastasis recti, it is recommended to perform gentle movements that engage and strengthen the abdominal muscles, specifically the deep core muscles such as the transverse abdominis and pelvic floor. These exercises can help close the separation and improve core stability. It is important to avoid exercises that create too much pressure on the abdomen, such as crunches, sit-ups, and planks, as they can worsen the condition, especially during the early weeks after delivery. Instead, focus on exercises that strengthen the deeper abdominal muscles, such as pelvic tilts and abdominal bracing exercises.
- Lie on your back with your knees bent and feet flat on the floor. Lift your head and shoulders away from the floor and feel for the sides of your abdominal muscles coming together. If you can feel a gap wider than one finger, you may have diastasis recti.
- Lie on your back and raise your hand straight in front of you. Put your legs up in the air and bend your knees as if mimicking sitting on a chair. Stretch one leg straight and slowly bring it down.
- Contract your abdominal muscles by drawing your belly button towards your spine, creating a cinching sensation in your core. Hold this contraction for up to a minute in various positions, such as squatting or taking a stroll.
It is important to consult with a healthcare professional, such as a doctor or physiotherapist, before starting any exercise program for diastasis recti. They can provide guidance on the best exercises for your specific condition and ensure you are performing the movements correctly. Additionally, consider wearing a supportive brace or special underwear to help support your back during the healing process.
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Surgery to fix muscle separation
Diastasis recti is the medical term for the partial or complete separation of the rectus abdominis muscle, commonly known as the "six-pack" muscle. This condition is prevalent during and after pregnancy, with an estimated 60% of women suffering from it. However, it can also occur in men, especially those who lift heavy weights improperly, and newborns.
Diastasis recti surgery, also known as divarication repair, is a surgical procedure to repair the separation of the rectus abdominis muscle. The procedure involves bringing the separated muscles together and tightening the gap using sutures. In some cases, an abdominoplasty may be performed simultaneously to remove excess skin and fat.
Good candidates for diastasis recti surgery are individuals who have a bulge that persists despite diet and exercise or those with a slim frame who still have a bulge. The condition can cause symptoms such as lower back pain, abdominal weakness, and a bulge in the middle of the abdomen.
The surgery is typically performed under general anaesthesia, with an incision made horizontally between the navel and the pubic area. The separated muscles are then stitched back together using non-dissolvable sutures, and the umbilicus is reconnected to the outer skin. After the surgery, patients must wear an abdominal support garment for six to eight weeks and avoid strenuous exercise or lifting during this period.
It is important to note that surgery may not be the first course of action for muscle separation. Conservative treatments, such as rest, cold therapy, and physical therapy, are often explored first. Surgery may be considered if these treatments do not provide sufficient improvement or pain relief. Additionally, arthroscopic surgery may be an option for minimally invasive repair if the damage is not extensive.
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Signs and symptoms of muscle separation
Muscle separation, or abdominal separation, is a common condition that occurs during pregnancy. It happens when the left and right sides of the rectus abdominis muscle, or "six-pack" muscle, become separated by an abnormal distance. This condition can also occur in men and newborns due to activities such as lifting heavy weights or incorrect abdominal exercises. While it is not painful, muscle separation can cause various signs and symptoms, including:
- A soft, jelly-like bulge in the middle of the tummy where the two muscles separate, which may be more obvious when lying down and lifting the head.
- Lower back pain due to the strain on other parts of the body to compensate for the separated abdominal muscles.
- Weakened core, making it difficult to perform everyday tasks such as lifting children.
- Constipation, urinary incontinence, frequent bloating, and changes in posture.
If you suspect you have muscle separation, it is recommended to consult a doctor, physiotherapist, or trained professional for a proper diagnosis and treatment plan. They may recommend specific exercises, such as pelvic tilts and abdominal bracing, to help heal the separation and restore abdominal strength.
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How to test for muscle separation
Diastasis recti is a common condition in pregnant and postpartum people. It occurs when the rectus abdominis muscles (six-pack ab muscles) separate during pregnancy from being stretched. The separation can make a person's belly stick out or bulge months or years postpartum. It is usually painless, though it can cause an abnormal sensation or discomfort.
To test for muscle separation, you can perform a basic physical self-assessment. Lie on your back with your knees bent and feet flat on the floor. Lift your shoulders slightly off the ground, keeping one hand behind your head for support, as if you are doing a sit-up. Look down at your belly. Move your other hand above your belly button area, palms down and fingers towards your toes. If you feel a gap between your muscles where you can fit more than one finger width, you likely have abdominal muscle separation. This self-assessment can be undertaken regularly to track the progress of your muscle separation.
You can also use two fingers to gently push down into the centre of your stomach just above your belly button, at your belly button, and just below. If you feel more than two fingers-width of space between your abdominal muscles, you likely have diastasis recti.
Other common signs of diastasis recti include a bulge in your midsection that doesn't go away, even after exercising or losing weight gained during pregnancy. Your belly may also dome when you lean back on a chair or get up out of bed.
If you are experiencing symptoms of diastasis recti, it is recommended to consult a healthcare professional for a diagnosis and treatment plan.
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Preventing muscle separation
Diastasis recti, or abdominal separation, is a common condition in pregnant and postpartum people. It occurs when the rectus abdominis muscles (the "six-pack" muscles) separate during pregnancy from being stretched to accommodate the growing baby. While it usually improves or heals on its own after giving birth, there are steps you can take to prevent or reduce the risk of abdominal separation:
Exercise with Caution
During pregnancy, continue to strengthen your core with pregnancy-safe exercises. Avoid exercises that can worsen abdominal separation, such as sit-ups (crunches), oblique curls, certain yoga poses, ab twists, and heavy lifting. These types of exercises can also make the condition worse postpartum. Instead, focus on exercises that strengthen your deeper abdominal muscles, such as pelvic tilts and abdominal bracing exercises.
Wear Supportive Garments
Consider wearing a supportive brace or special underwear that can help support your back and hold the muscles together during daily activities, reducing strain on the abdomen.
Seek Professional Guidance
Consult with a doctor, midwife, or physiotherapist who can guide you on the best exercises for your condition and provide a specialised treatment plan. They may refer you to a women's health physiotherapist specialising in pregnancy and childbirth, who can offer a tailored exercise program.
Maintain a Healthy Weight
Frequent and rapid weight changes and obesity can contribute to abdominal separation. Aim to maintain a healthy weight through a balanced diet and regular exercise.
While complete prevention of diastasis recti during pregnancy may not always be possible, following these steps can help reduce the risk and severity of the condition.
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Frequently asked questions
Muscle separation, or diastasis recti, is a condition where the abdominal muscles, or the "'six-pack' muscles", separate along the midline of the abdomen. This usually occurs during pregnancy as the muscles expand to accommodate a growing uterus.
Some common signs of muscle separation include a protruding or "poochy" belly, a gap or bulge when pressing down on the belly, and lower back pain. To check for muscle separation, lie down on your back with your knees bent and feet flat on the floor. Lift your head and shoulders and feel for a gap between the sides of your abdominal muscles. If the gap is wider than one or two fingers, you likely have muscle separation.
Yes, muscle separation often improves or heals on its own within weeks or months after pregnancy. However, targeted exercises that activate the deep core muscles can aid in healing and reducing symptoms.
It is recommended to focus on exercises that strengthen the core and deep abdominal muscles, such as pelvic tilts, planks, bridges, and heel slides. Abdominal bracing exercises and the abdominal draw-in maneuver can also help. Avoid exercises that put excessive pressure on the abdominal muscles, such as crunches, sit-ups, and oblique curls, especially during pregnancy and while the muscles are separated.
