What is abdominal separation and why does it happen?
Abdominal separation is a stretching of the fascia (linea alba) between your abdominal muscles, which are called rectus abdominis. This is common in pregnancy and postpartum due to the growing fetus inside a women’s body as well hormonal changes that occur during pregnancy.
It is more common in women over the age of 35, having multiples, or smaller framed women who are having larger babies. Commonly, you will notice in the first 8 weeks after birth, the gap between the abdominal muscles will reduce but this is not always the case, as 1 in 3 women still report problems with abdominal separation 12 months post-birth.
How do you know if you have abdominal?
You may notice coning or doming in the central part of you abdominal when moving or sitting up. Feeling the centre of your abdominal, you may notice it is softer than it use to be, and your fingers may sink down into your abdomin rather than meeting resistance.
A qualified women’s’ health physiotherapist can assess the separation and give you guidance on appropriate exercise and treatment.
What does treatment look like for abdomminal separation after pregnancy?
Initially avoiding activities and movements that could make your abdominal separation worse, such as heavy lifting, sit ups, or anything that will increase pressure within the abdominal cavity will be important. Try avoiding lifting anything heavier than your baby after pregnancy. It is important to see your women’s health physiotherapist to measure the amount of separation and track its progress overtime using real time ultrasound. Getting treatment early is important to reduce the separation as well as improve activation of your abdominal muscles to improve function and prevent future complications. You may be fitted with compression underwear/pants if necessary to help improve the muscle separation and support your back. Advice and education regarding safe exercises for core stabilization, lifting technique and movements to avoid initially will be important.
Your physio may also check your pelvic floor post-birth and get a thorough history of what you do day to day and activities you want to get back to doing postnatally. This will allow them to create a tailored program specific to your needs so you can get back to day to day activities, safely.
