Are you worried about your tummy muscles separating? 66% of pregnant women will have it, so try these easy tips
Abdominal separation or Rectus Diastasis (RD) is the separation of the most superficial of the abdominal muscles that can occur during pregnancy (or less frequently in anyone, men or women who overtrain their abdominals with too many sit ups). The separation will cause a bulge to occur when the pregnant woman attempts to move, especially visible when going from lying to sitting.
The rectus abdominus muscle is the muscle we typically associate with our bellies - we see them all oiled, sweaty and washboard-like on men's health mags every time we are in the newsagent. Nearly all men would aspire to these 'six-packs', and most women too if to be perfectly honest. This muscle is divided into two, with a thin tissue or fascia which serves to separate and join the halves at the same time. This fascia is called the linea alba.
What does the research say out there about abdominal separation?
In pregnancy, the linea alba becomes overstretched to accommodate for the growing belly. This is a normal part of pregnancy. Research states that 66% of all pregnant women will have a degree of RD in their third trimester of pregnancy. In many women's cases, this separation will improve without any intervention, and that this will be seen mostly from week 1-week 8 after having their baby. Any remaining separation is unlikely to make any further improvements after this time if left alone. Physiotherapy for thorough assessment of abdominal and pelvic floor control and pelvic, spine and rib alignment is highly recommended to assist in reducing the remaining gap.
So, can I prevent abdominal separation from happening when I am pregnant?
The short answer is, no. Your body is adapting this way to handle your growing uterus and baby size. But here are a few tips to make good habits in pregnancy and in those first months post-natally to reduce the pressure on the linea alba fascia. ( I must also make the comment for you non-pregnant folk who have read this far on, that these are excellent habits to adopt when moving and exercising regardless of having had a baby or not).
- Move safely out of bed, through contraction of your pelvic floor and deep abdominal muscles, then rolling like a log and pushing up in a sidewards manner.
- Learn to appropriate hold your pelvic floor muscles. This means in short, the 'lift' of the pelvic floor hammock, not the 'pushing down'.
- Move about through your day without holding your breath. Forgetting to breathe will increase the pressure from the abdomen pushing out into the linea alba. This includes the simple things like getting up out of your chair and bed, to walking up steps, or lifting loads such as little ones or grocery bags. Keep breathing and reduce the tendency to stretch the fascia more!
- Attend to gentle abdominal exercises (like the mat based deep abdominal exercises from The Fix Program) while being safe with your pelvic floor. This means not allowing the pelvic floor sling to bear down in a descending manner. This decreases the pulling or stretching forces of the fascia tissues within the pelvis that are all connected. Talk to our physios about appropriate pelvic floor and abdominal exercises for you.
- Learn 'the knack'. This is another pelvic floor technique which supports the fascia within your pelvis and stops it from over stretching when coughing, sneezing or laughing. Try to contract or lift your pelvic floor before you feel any of coughs or sneezes coming on.
- Support your abdomen with pressure from your hands when you cough, sneeze or laugh.
What problems can abdominal separation cause?
The linea alba fascia is required for good tissue strength and support within the abdominal and pelvic regions. It is known to have roles in back support and posture, continence, breathing and holding the organs in their place. Overstretching of this tissue can therefore potentially lead to:
Why not make the most of our women's health physiotherapist, Heba? She is a specialist in pregnancy and post-natal. If you feel you have abdominal separation in your pregnancy or after having your baby, come in for a thorough assessment of pelvic alignment, strength and stability of the pelvis, pelvic floor control and strength, presence of vaginal prolapse or abdominal separation. We call this our Post natal checkup This is especially important before you start an exercise program.