What do I do if my abs separate during pregnancy?
What is a diastasis recti?
Diastasis recti (DR) is when your abdominal muscle called the rectus abdominis, or “six pack” muscle, separates. This muscle is held together by a connective tissue called the linea alba. DR happens when the linea alba is stretched and weakened resulting in a gap between the muscle. This happens during pregnancy, when someone puts a lot of strain on their abdomen, or if someone has a lot of abdominal adipose tissue.
During pregnancy it actually is normal for your stomach muscle to separate. Your muscle separates to allow your baby to grow without putting too much pressure on your pelvic floor. It is truly amazing how our bodies know exactly what to do.
What are symptoms of a DR?
Some common symptoms of diastasis recti include a visible bulge or ridge going down the abdomen, especially when the muscles are contracted, such as during a sit-up, crunch, or plank. Other symptoms include low back pain, digestive issues, a “mama pooch”, and leaking urine (incontinence).
Should you be concerned if you have a diastasis?
Since it is normal to have a DR during pregnancy, you don’t need to be concerned if you have a separation. However, you can help prevent the separation from getting worse. If you see a bulge while exercises, modify the exercise that is causing the bulge. Try to roll to your side before getting out of bed rather than just sitting up.
There is a deep abdominal muscle called the transverse abdominis. This muscle is your main “core” muscle. It is important for posture and overall stability. If you engage this muscle with activity, it will also help decrease the separation.
While, a DR is normal during pregnancy, it is not normal to have one after 12 weeks postpartum. The separation should close on its own. However, some people need to give some extra guidance to their muscles to make sure it closes.
What should you do if you have a DR postpartum?
First, it is important to know that you can still exercise with a DR. In fact, performing certain core exercises targeted specifically at the transverse abdominis muscle are important to help strengthen and support the DR to help it close. However, doing sit-ups with a DR, or really anytime for that matter, is not the best idea.
Second, having good posture is beneficial to help the DR close. Try to sit and stand upright without rounding your back and shoulders or overarching your back.
Third, having good body mechanics and being mindful of how move is important. When you get out of bed, roll to your side first and use your arms to push yourself up, rather than sitting straight up.
Fourth, during pregnancy, your body changes. For example, you ribs expand out to allow room for your baby. If they stay out, it is hard for your abdominal muscle to heal back together. (Check out the video below to see a video for an exercise we often give to our clients to help their ribs return to their pre-pregnancy position).
There are other changes that can also cause the diastasis to not heal. These include the fascia (layer of tissue under the skin) of the abdomen and the back as well as the position of your organs. We check for these changes with our clients. You should ask your PT to check for these as well.
What about adominal binders?
Some people are given an abdominal binder at the hospital (especially if you had a c-section). Other people have been told to use an abdominal binder to help their DR. Abdominal binders can actually do more harm than good. They put excess pressure on your pelvic floor and they allow your muscles to “be lazy”.
There are some abdominal supports that we do recommend. However these are soft and just remind the abdominal muscles what they should be doing, rather than do the work for them. After your muscles have been “stretched out” from pregnancy, it can feel good to have some abdominal support. Another option we recommend is to use kinesiotape to help remind the muscles what they are supposed to do. We do this in our clinic and teach our clients how they can do it themselves.
