What is abdominal separation?
Abdominal separation or diastasis recti is when your abdominal muscles have been split in the middle. This may cause a bulge within your stomach. The linea alba is the connective tissue that runs vertically through the middle of your belly, and joins your abdominal wall, keeping both bands of muscles together. When your linea alba is overstretched, this causes abdominal separation. Abdominal separation is usually known as diastasis recti.
The green line represents your linea alba.
What causes abdominal separation?
Abdominal separation is most common in new mothers, due to the bulge from an infant growing within the belly stretching the linea alba. Pregnancy also weakens the abdominal core, the abdominals overstretch alongside the belly, and the hormone relaxin relaxes your muscles, ligaments, connective tissue and tendons, making you more prone to abdominal separation. Your abdominals are likely to separate in the third trimester of pregnancy, during labour, or if you’ve had a C-section. Having twins or triplets puts you at high risk of abdominal separation.
However, abdominal separation isn’t just exclusive to mothers, men can also get this condition. Other causes of abdominal separation include:
- Weight gain, obesity or having a ‘beer belly’.
- Rapid weight gain and weight reduction.
- Separation can occur from having poor or uneven core strength.
- Heavy lifting.
- Poor muscle recruitment during exercise. For example, core strength is needed to support your back during heavy lifting.
A simple test to check for abdominal separation:
- Begin by lying on your back. Have both knees bent, with your feet flat on the floor.
- Raise your head and shoulder blades off the floor. You may support your head with one hand. This position should somewhat resemble the ‘crunch’ exercise. Note: Do not complete any crunch exercises if you do have abdominal separation, this movement is only okay for checking for separation.
- Looking at your stomach/abdominal wall, draw an imaginary vertical line from your bellybutton to your chest.
- Lightly press the tips of your fingers along this imaginary line on your stomach, with your fingers pointing directly downwards.
- If your fingers ‘fall’ through or you can feel/fit your fingers in a gap, it is likely you have diastasis recti/abdominal separation.
If you are newly post-partum, you can expect this gap to narrow as your muscles return to strength. If you suspect that you have diastasis recti you should seek professional assistance on reducing your abdominal separation. An Exercise Physiologist or a Soft Tissue Occupational Therapist can both help to rehabilitate your diastasis recti.
Abdominal exercises to avoid
If you are experiencing abdominal separation, you will need to avoid exercises that stretch the abdominals. The exercise to avoid are: sit ups, planks, push ups, press ups, double leg raises, cat/cow, crunches, bicycle crunches, Russian twists, jack knives, boats and upward facing dogs.
If you have abdominal separation, these exercises will cause further injury to your abdominal wall.
Tip: When you wake up in the morning, roll out of bed instead of sitting up to avoid extra strain on your abdominals.
Abdominal separation exercises
Bracing involves strengthening your deeper abdominals. Your traditional abdominal workouts such as sit ups and crunches only work your outer abdominal wall – and are currently harmful for you. If you have recently given vaginal birth, this exercise is safe 1 week post-natal. If you have had a C-section birth, please consult with your Exercise Physiologist to check the safety of this exercise.
Gently draw in (you may also think of this movement as a suction) your lower abdominal wall to your spine and slightly upwards. Hold this position for as long as you can, continuing to breathe. You should not feel any pain during this exercise.
Here are some tips to check you are doing this correctly:
- You are targeting the abdominals below your belly button. If you feel you are pulling up into your ribcage, you are too high.
- If you are holding your breath as you do this exercise, you are pulling too hard.
- This tip is for new mothers: You should feel no additional pressure on your pelvic floor. If your pelvic floor lifts slightly, that is okay.
- These exercises can be done in sitting, lying or standing.
- As you slowly improve in strength, aim for 10 repetitions of this exercise, for 10 seconds at a time. While you are just starting, begin by aiming for 10 repetitions for 5 seconds at a time, 4 times a day.
If you are having any difficulty, get in touch with an Exercise Physiologist. They are experts in the rehabilitation of abdominal separation and will provide you with safe effective advice and a comprehensive exercise program.
See an Exercise Physiologist
Exercise physiologists use exercise as therapy, in other words, prescribe exercise as ‘medicine’. They will assist with preventing injury, managing injury, and improving physical functioning. Their therapy is ‘hands-off’ as they provide you with appropriate exercises and stretches individualised to your needs. For abdominal separation, they will prescribe abdominal separation exercises through a graduated strengthening program that will prevent further injury to your abdominals. They are experts within this area and will provide you with expert advice to help you speed your recovery.
If you would like a personalised rehabilitation exercise program, book in to see our friendly and experienced Exercise Physiologist at Urban Health HQ. You can make an appointment today or contact us by calling 0411 563 391 or Tim@urbanhealthhq.com.au