Many women who are pregnant or who have just had a baby are concerned about the impact of having a baby on their core muscles. This is a valid concern, and sometimes moms are confused or misled about how to get help. There are so many misconceptions out there about how to “get your abs back” and how to train to minimize any negative and long-lasting effects of pregnancy.
One of the most common concerns is abdominal separation. You may have heard of it as splitting of the abs in pregnancy. This sounds pretty scary! It’s actually a natural process that occurs in pregnancy, and your abs don’t actually split apart.
Your abdominals are already in a separated state before you even get pregnant. The rectus abdominis muscles in the front, which are often referred to as the six pack muscles, are two separate bands of muscle held together by a strong fibrous sheath of connective tissue. During pregnancy, this tissue naturally stretches to accommodate the growing baby. This causes the rectus abdominis muscles to move apart from each other. The degree to which this distancing from each other occurs varies in every woman, and it depends on a variety of factors. When the distancing of these abdominal muscles becomes unnatural, it is diagnosed as diastasis recti.
In diastasis recti the connective tissue becomes too stretched and thin, and subsequently the tissue often fails to regain its tension postnatally. This results in a loss of stability within the whole “core” system, and often results in low back or pelvic pain, and unwanted bulging outward of the belly. Unfortunately, just doing conventional abdominal exercises doesn’t help. These exercises often make the condition worse, as they can but unwanted force on the connective tissue and stretch it even further. The reason for this is that your “core” is not just your superficial abdominals. I often put the term “core” in quotations because the term has often been misused and misunderstood. When I talk about core muscles, I’m talking about the ones that are actually at the deepest level within your trunk. These are the muscles that support your spine and pelvis, and they are a container for all of your abdominal contents. They include the diaphragm at the top, the pelvic floor at the bottom, and deep core muscles wrapping around providing the walls of your container.
Any program that aims at fixing abdominal separation by offering a series of exercises targeted at the abdominals is missing the mark. We need to move away from trying to ‘spot reduce’ and just doing endless ab work. Treating diastasis requires a whole body approach. Getting your whole system working and functioning in a more optimal way will have a far greater impact on your core, and your whole body health. The whole body approach takes into account things like: alignment, breathing, pelvic floor function, foundational core strength, previous injuries or muscle imbalances unique to you, as well as forces created through everyday movement patterns that could be contributing.
One more thing as food for thought: your diastasis recti may not actually be the primary problem. It may just be the symptom of something else going on in your body. In this case, as with anything else, continuing to treat the symptom rather than getting to the root of the problem will never produce optimum, long-term results.
All of this may sound a bit daunting or overwhelming. How do you know where to start? With all of these factors how can you determine which ones apply to you? What it takes is a bit of detective work, and that’s where a physiotherapist with experience treating diastasis recti will come in handy. A physiotherapist will assess you and determine where to start, based on your individual body. You won’t be getting a one-size fits all approach. This will allow you to target your efforts for optimal results.
If you’re concerned about diastasis recti, talk to your doctor and make an appointment for a physiotherapy assessment. If you’re pregnant, a physiotherapist can help you with ways to optimize your core function during your pregnancy, and to take steps to avoid diastasis recti. If you’ve already had your baby, start working with your physiotherapist as soon as you can. Taking the time to learn how to restore your body is invaluable. It will help you avoid future problems and create greater whole body strength and awareness so that you can get back to being active and doing the things that you love.
Here’s a way for you to check yourself to see if you might have diastasis recti.
You need to be lying on your back to do this test. One of the first things to point out is that if you do have diastasis, you should avoid doing any kind of sit up motion. For this reason, when you get down onto your back, make sure that you come down on your side first, and then roll over onto your back.
First, walk your fingers along the midline of your abdomen, starting from your sternum at the top, and going all the way down to your pubic bone. Do you feel like there are some areas that are softer or squishier than others? Can you press your fingers way down into your belly at certain points, or does it feel fairly supportive? In diastasis recti we’re not only measuring the distance between the abdominal muscles, but the tension in the connective tissue between the muscles.
The distance between your abdominal muscles is measured in finger-widths, so you’ll need to place three fingers of one hand on your abdominals. Start above your belly button, pointing your fingertips down towards your pelvis.
Pick your head up to look at your toes while pressing your fingertips down into your abdomen.
Wiggle them from left to right slightly, and see if you can feel the edge of the muscles at each side of your fingers.
Repeat above and below your belly button to get an accurate test.
If you find you can fit more than 2 finger widths in this gap, or if you feel that there is very little tension generated at your midline, then you should book an appointment with a Women’s Health Physiotherapist.