Abdominal separation or “diastasis recti” to give its medical term, is quite common during and after pregnancy. It is a condition in which the left and right halves of the stomach muscles, the Rectus Abdominis separate at the midline of the abdomen, the Linea Alba. This results in a ‘pooch’, the tummy sticking out. Carrying twins or triplets, having a large baby, pregnancies close together, or being pregnant over 35 are all risk factors that make this separation of the abdominal muscles more likely.
Do You Have Abdominal Separation?
Sydney Chiropractor, Rachael Veronesi DC, suggests a simple and very quick check that you can do at home to determine whether your baby ‘pooch’ results from abdominal separation.
- Lie on your back on the floor with your knees bent and your feet on the floor.
- Place one hand behind your head.
- Place the index finger of your other hand on your midline in the area between your ribs and your belly button.
- Raise your head, slightly crunching your stomach muscles.
- Do you feel a separation between the left and right abdominal muscles? If you can place two fingertips or more, side-by-side in this separation, this is a good indicator of diastasis recti.
- Repeat from (3) above at several points along your midline (between your starting point and your pubic bone), assessing any muscle separation at each point.
What Causes Abdominal Separation?
Dr. Veronesi DC, explains that the separation of the abdominal muscles is caused by the force of the uterus pressing against the wall of the abdomen in combination with the action of pregnancy hormones that soften connective tissue. A small amount of widening of the mid-line happens in all pregnancies but when the separation reaches two centimetres (two finger widths), or more, it is referred to as Diastasis recti. This is a condition that is regarded as problematic if it does not shrink back by itself after giving birth.
Abdominal separation can occur anytime during the second half of a pregnancy although it is most common after the birth of the baby. Problems occur because this separation reduces the strength of the abdominal muscles. This can result in insufficient support for the bowels, uterus, and other internal organs. If this occurs during pregnancy, it could make a vaginal delivery more difficult. It can also lead to pelvic instability, causing lower back pain. Moving normally can become difficult; other symptoms such as pelvic floor weakness, constipation, and leakage of urine are also common. In the most severe cases, a tear may occur that allows internal organs to poke out – (a hernia).
While some mothers are prepared to accept a small degree of abdominal separation, it is very important to ensure that the gap between the abdominal muscles is closed again before contemplating another pregnancy.
Chiropractic and Pelvic Floor Function
Chiropractic care is safe and effective, both during and after pregnancy, for pelvic alignment, muscular control and the rehabilitation of the pelvis and abdominals.
There is good evidence to show that Chiropractic care can improve pelvic floor function. The pelvic floor is the group of muscles that acts like a hammock, supporting the organs of the pelvis. These muscles attach to the pelvic bone and the sacrum (at the bottom of the spine, above the tailbone). They also wrap around the vagina, urethra and rectum, so having strong pelvic floor muscles is vital in preventing stress urinary incontinence, problems with bowel movements and with intercourse.
Women who choose Chiropractic care during their pregnancy have a greater ability to relax the muscles of their pelvic floor at rest. This is significant as it may help women to have a natural vaginal delivery as well as helping to prevent incontinence and other issues mentioned above.
The holistic care offered to women at the NeuroBalance Chiropractic Clinic, (both during and after their pregnancies), is designed so that each treatment program is specific to individual needs.
Treatment may include:
- Work on the soft tissues (the muscles and ligaments), restoring tone and function to core muscles and ligament release techniques
- Chiropractic adjustments of the sacroiliac joints and the pubic symphysis
- Advice on maintaining good posture to reduce pressure on the bladder and pelvic organs and simple exercises you can do at home that help to avoid muscle spasms and tightening of the pelvic muscles.
Some Exercises Can Make Things Worse!
Dr. Veronesi DC points out that there are a lot of myths and misconceptions about abdominal separation – especially as a major concern for most women is finding the best, safest and fastest way of restoring that pre-baby tummy after pregnancy!
While exercise is important, it is only one way of addressing any problems with the abdominal muscles. In fact, some exercises, such as abdominal crunches, sit-ups and press-ups, any exercise done on your hands and knees, yoga poses such as ‘Downward Dog’ Perhaps and even swimming can all make the problem worse. Before healing is complete, it is vital that you do not lift heavy things (including your kids!) and that you try to avoid becoming constipated and straining to pass a bowel movement.
How Chiropractic Can Help You
Getting advice from your Sydney Chiropractor before beginning any exercise program can prove invaluable and will prevent you inadvertently making the problem worse by doing the wrong type of exercises. Dr. Veronesi will conduct a careful assessment of your abdominal muscles, pelvic control, and alignment and explain what is safe for you at each stage of your healing.
Chiropractic care, in conjunction with appropriate exercises, may correct abdominal separation, without the need for a surgical procedure called a tummy tuck or abdominoplasty where the weakened midline is folded, and sewn together, thus avoiding any potential side effects such as scarring or infection that may result.
Whether or not you have done the home check described above, if you have any concerns about the problem of abdominal separation, either during or after pregnancy, call your Sydney Chiropractor at the NeuroBalance Chiropractic Clinic now on 02 9938 5456 (Brookvale) or 02 9420 1474 (Riverview) to discuss the options and treatment alternatives available to you.