Why Ab Separation Happens During Pregnancy

What is a Diastasis Recti?

Most of the physical changes that come along with pregnancy are strictly temporary. Unfortunately, some physical issues don’t resolve immediately after you give birth. Abdominal separation, or diastasis recti formation, is commonly seen within the pregnant/postpartum patient population with 2/3 of women experiencing some degree of separation pre or postpartum. Abdominal separation happens when your rectus abdominis or abdominal muscles become lax and disconnects midline at the linea alba. If you recently had a baby, it’s key to know how to identify if you have abdominal separation before returning to any workout routine in order to prevent injury and further separation.

Unbalanced Abs, Unbalanced Body

Abdominal separation is usually something a new mom might not even know she has. However it is important to check seeing how it interferes with the way your core muscles work together, leading to postural deficiencies and increased risk of injury centered around your body having an inability to stabilize your core. These deficiencies can result in or contribute to a variety of symptoms such as:
• Low back pain
• Sacroiliac pain
• Hip pain
• Stress incontinence (urine loss when laughing coughing or sneezing)
• Prolapse (when internal organs fall or slip out of place)

How To Check If You Have Ab Separation?

You can identify if you have a diastasis recti by doing a simple self-test.

• Lie down on your back with knees bent at 90 degrees and feet flat
• Place fingers of one hand horizontally across midline of abdomen at the belly button
• Slowly raise your head and shoulders a few inches off the floor
• If a separation exists your fingers will sink into a gap/ditch with your right and left muscles to the side
• Note the number of finger-widths that can be placed between the muscle bellies
• Check at your belly button, above, and below

If you feel a separation of 2 to 3 finger-widths or greater you are considered to have a mild Diastasis Recti, and 4 to 5 fingers width is a moderate to severe separation.

Healing Your Deep Core

First of all don’t panic or stress if you feel you have an abdominal separation. This is a very common problem where there are specific exercises that can help with the healing process and facilitate for full abdominal closure. To enable healing it is important to limit abdominal stressors involving lumbar flexion. This is characterized as the forward movement of your body such as crunches or when moving from your back to sitting upright when getting out of bed. Movements like this potentially lead to greater abdominal separation rather than closure. Correct movements are targeted towards having strong deep core activation with targeted transverse abdominis activation.

Transverse Abdominis Activation

• Maintain a flat back with a chin tuck and shoulders over wrists
• Keep your hips and toes tucked under
• Inhale while causing for outward and upward movement in your back body/ribs
• Then exhale and pull your ribs up and in from your stomach
• Perform 6 to 7 breaths of 3 sets while being careful to not over breathe to limit any lightheadedness or dizziness

Closing The Gap

Your abdominal separation is something that should be reassessed every 2 to 3 weeks checking for closure with a proper exercise program established.

Experiencing ab separation postpartum is unique to everyone’s body and pregnancy journey. If you feel limited or uncomfortable because of the weakness in your core, don’t hesitate to contact us if you have any questions. Although some cases may be mild enough to solve on your own, some cases may need to be seen by a physical therapist who specializes in women’s health and pelvic floor therapy.

By Whitney Braswell Fedor, PT, DPT, Specialized Woman’s Health Physical Therapist via Herman and Wallace Institute, Kineticore Dry Needling Level 1 and 2 certified practicing at Therapydia NOLA in Metairie. She can be reached at (504) 324-8345.