Abdominal separation, also known as Rectus Abdominis Diastasis, is a common problem that Osteopaths see in pregnant and post-natal patients.
Two in three pregnant women have some degree of abdominal separation.
How does Rectus Abdominis Diastasis occur?
The female body is designed to stretch and move apart when the baby starts taking up more space above the pelvis. The abdomen is made up of the Rectus Abdominis muscle and a line of connective tissue down the middle called the Linea Alba. As the baby grows, the Linea Alba starts stretching and the Rectus Abdominis muscle move apart from each other increasing your chances of developing Rectus Abdominis Diastasis.
Although there is some natural recovery after childbirth as the uterus and abdominal organs settle back into their pre-pregnancy position, usually after 8 weeks a specific exercise program should be carefully considered and modified to close any remaining Rectus Abdominis Diastasis.
Ongoing Rectus Abdominis Diastasis causes insufficient support in the abdominal cylinder and ‘core’, and is highly associated with pelvic floor muscle dysfunction (including vaginal prolapse and incontinence), abdominal hernia and back pain.
How can you manage Rectus Abdominis Diastasis?
Exercises should be specifically tailored for a person and usually will focus on improving core stability, strengthening pelvic floor muscles and improving abdominal muscle tone. Breathing exercises can also help to retrain the diaphragm to relearn how to descend after childbirth. During pregnancy the diaphragm is pushed upwards by the growing uterus and loses its ability to descend during inhalation. Since the diaphragm forms the top of the core muscles, it is important to retrain it to function with a full excursion again.
Abdominal Support in addition to a specific exercise program, abdominal muscle support (compression garments) is essential for the management of abdominal separation. The combination of compression and a tailored program will help to manage and assist in recovery. It is important that the correct type of compression garment is worn. The garments that achieve best results have gentle (medical graded) compression which promote supporting pressure to the pelvis, back and abdominal muscles. This stimulates strengthening of the abdominal muscles facilitating muscle recovery.
Early intervention is a very important part in helping you gain optimal strength. Although it is important to keep the abdominal muscles strong during pregnancy, make sure you are not doing this in a way that pushes the abdominal contents into the weakened midline, such as crunches or planks.
It is highly recommended to seek your health practitioner both during pregnancy and after childbirth, to prevent and manage the inevitable abdominal muscle separation that occurs.
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This post was written by Dr Georgina Fisher, who is a very experienced pregnancy osteopath in Melbourne.