What is abdominal separation?
Some females find their stomach muscles separate and weaken during and after pregnancy. This condition is known as abdominal separation, recti divarication’ or “diastasis recti”. This is a common situation and often improves in the first eight weeks of the baby’s birth.
If your abdomen is swollen and you appear to be pregnant months after giving birth, you may have recti divarication. When medically diagnosed, the treatment includes physical therapy. Abdominal separation is common in postnatal women, but it can affect anyone. Mothers with diastasis recti require physiotherapy rather than “mummy tummy” exercise.
Here’s how to prevent, recognise, and treat this type of abdominal distension:
How do you know if you have diastasis recti?
How do you know if your abs are separated, and you don’t want to see them again? Diastasis recti are not painful and are usually not apparent until the postpartum period. You can be sure if you have a DRA by performing this test at home or for more experienced advice with the help of a physiotherapist.
- Assessment by yourself:
If your abdominal muscles are separated after your baby is born, you may feel a gap between the two bands of your abdominal muscles. If you lie on your back and raise your head, you can see this gap.
You may also see a canoe-shaped physical bulge in the stomach’s centre, especially if the abdominal muscles are active.
Some women with isolated abdomen experience low back pain because the muscles in the stomach prevent them from supporting their back.
- With the help of a physiotherapist
The physiotherapist asks you to lie on your back and feel your abs while relaxing. When you activate your abs (the physiotherapist teaches you to make specific movements for this), they measure the gap between the belly muscles and the upper and lower 2-inch abdominal muscles. You can also run this test yourself by measuring the distance with your finger. What you have to feel is the edge of your abdominal muscles squeezing or hugging your fingers. If you don’t feel it with this number there, add more fingers till you feel a hug.
The gap of one or two fingers is average, and no treatment is required. The gap may or may not close, but it is unlikely to interfere with healthy functioning unless accompanied by other problems such as incontinence or back pain. If so, or the gap is more significant than two fingers stronger core facilitates subsequent pregnancy and postpartum recovery. It’s the right time to see a physiotherapist, particularly if you plan to have more children. A stronger core facilitates subsequent pregnancy and postpartum recovery.
How does Physiotherapy help in Diastasis Recti?
Diastasis recti are treated with targeted physiotherapy, especially abdominal exercises. Clinical studies have shown promising results for both the prevention and alleviation of diastasis recti with targeted exercise.
At SA Wellness centre, physiotherapists assist patients with diastasis recti by creating an exercise program that focuses on improving pelvic alignment and toning and flattening the abdominal wall. Effective physiotherapy works by shortening muscle fibres and developing dynamic stability that can improve function between the outer and inner layers of the abdominal wall.
For less than four finger separations, corrective exercise is the best front-line approach to pull the two rectus abdominis together. Exercise is usually performed for 2 to 6 weeks until the separation closes or the finger width is less than 2.
Corrective exercises must include strengthening the internal core muscles and support muscles.
Basic physiotherapy protocols for RDA include:
- An abdominal exercise program that includes strengthening of rectus abdominal muscles and transverse abdominis
- Do not ignore posture training, muscle strengthening, and rectus muscle stretching.
- It is strengthening the pelvic floor muscles. Over 70% of females cannot undergo pelvic floor contraction in the presence of diastasis recti in the rectum, resulting in incontinence, pelvic pain, and prolapse.
- Abdominal taping and bracing
- Exercises to enhance diaphragm efficiency
If the separation is more than the width of four fingers, it is usually advisable to use a corset or binder combined with exercise. It is usually worn 24 hours a day and removed for bathing and exercising. Wrong exercises or wrongly performed exercises can be ineffective or, in the worst case, harmful and counterproductive.
Therefore, it is essential to seek guidance from your physiotherapist for your proper treatment.