Separation of your abdominals during the third trimester of pregnancy is entirely normal and all women will experience this to a degree. Sometimes this problem is described as a 'post-baby pooch or mummy tummy', suggesting it's a harmless consequence of pregnancy but it's actually a medical condition and in some cases, it can have serious consequences.
The medical term for a wider gap between the two 'six-pack' muscles of the abdominals is Diastasis Recti.
When the abdominals are drawn apart like this they are unable to work properly and can't respond to the stresses and strains of the day to support your body as they should. Left untreated this can cause persistent abdominal, back or pelvic pain, poor core stability and pelvic floor muscle problems.
Traditional 'ab work' like crunches or planks will not restore normal muscle activity and can actually cause more harm than good. We often recommend the following exercises instead:
1) Lateral chest and diaphragm breathing
- Place your hands onto your ribcage and relax your shoulders
- Breath in and allow your ribs to expand into your hands as your tummy rises
- Breath out and allow your ribcage to soften and tummy relax again
- Repeat 5 cycles of deep lateral chest breathing daily
Tips: Try not to lift your shoulders or chest bone as you inhale. Do not try and 'suck' your abdominals in as you breathe.
2) Deep abdominals and pelvic floor tightening in sitting
Sit in a chair with your feet flat on the floor and your knees hip width apart
Step: 1 Find your 'neutral' spine position
Tuck your tailbone underneath, flattening your back. Then tip your tailbone out behind you creating a slight arch in the lower back. Move through this pelvic tilt until you find the middle point between these two positions. This is your neutral spine position.
Step 2: Finding your pelvic floor muscles
Inhale to prepare, exhale slowly tighten your pelvic floor muscles by imagining you are stopping yourself from passing wind. You should have the sensation of lifting your pelvic floor off the chair seat slightly.
Step 3: Finding your deep abdominal muscles
Inhale to prepare, exhale slowly and tighten your deep abdominals by drawing your abdomen away from the line of your trousers a little.
Step 4: Tighten your pelvic floor and deep tummy muscles together
- Inhale to prepare, exhale slowly and tighten your pelvic floor and deep tummy muscles to about 50% of their capacity. In other words, don't tighten as much as you can, try to imagine the halfway point between completely relaxed muscles and tightening them as hard as you can.
- Hold at this halfway point and take three gentle breathes into your ribcage and the completely relax.
- Repeat 8 times.
Three helpful tips for general function and healing
- Reduce the load on the abdominal wall by avoiding excessive lifting and twisting. Try log rolling to get in and out of bed:
- Lying on your back, bend your knees and gently squeeze them together. Inhale to prepare, exhale roll onto your side.
- Inhale to prepare, exhale and use your arms to press up into sitting.
- Inhale to prepare, exhale and tighten your pelvic floor muscles and deep abdominals to stand up
- The early days of motherhood can be filled with sleep deprivation and exhaustion. Allow your body to rest as much as possible in the first 4-6 weeks and take the help that is offered. It will serve you and your baby better!
- Keep yourself well hydrated and eat healthily to promote tissue healing.
Don't ignore your symptoms … the earlier you address the problem, the better the result. It's really important if you suspect that you have diastasis recti to get some professional advice and a safe exercise programme designed specifically for postnatal rehab as early as possible.
The best person to see is a women's health physiotherapist and if you live near a physio who's a registered Mummy MOT practitioner then you can be sure they are a postnatal specialist. (Find your nearest here)
This was a guest post by Dr Kathryn Levy, a highly qualified and experienced Women's Health physiotherapist.
Kathryn is a registered Mummy MOT practitioner. She specialises in treating patients with pelvic floor dysfunction, urinary incontinence, pelvic pain, pregnancy and postnatal related pelvic floor and musculoskeletal dysfunction, diastasis rectus abdominis and post-surgical breast care.
Kathryn is a member of the Chartered Society of Physiotherapists and an affiliate member of the Pelvic, Obstetric & Gynaecological Physiotherapy section. She is also a certified classical Pilates instructor with extensive experience in its clinical application in pelvic floor rehabilitation.