Mind the gap: diastasis / abdominal separation

The most common concern of moms joining my postnatal classes is whether pregnancy has left them with a separation of their “6-pack muscles”, or a diastasis recti as it’s more formally known. I think this is largely due to the positive focus of many professionals now on female core and pelvic floor muscles, but also due to the associated confusion and scare stories that tend to come from the internet and social media.

For those of you not familiar with the term diastasis, the phrase literally means “separation of normally joined parts” referring to the two sides of your “6-pack muscles”. It’s kind of misleading though, because whilst they are absolutely connected by fascia and tissue, they were never actually joined in the way that many women think. And as most of us never assessed/had our abs assessed pre-pregnancy we don’t even have a “before photo” or baseline measurement to compare our postnatal bodies to.

Approximately 2/3 of postnatal women return to a gap near their normal baseline measure, leaving c. 1/3 with a larger gap & some level of dysfunction. (See references 1, 2 and 3) 

Most conversations understandably focus on the gap, but what’s equally important is the tension, or lack thereof, in the muscles in this area when contracted. It is entirely possible to have a smaller gap and to need rehab whilst other women (with a larger gap), don’t need the same kind of focus and attention. We’re all different. It’s also worth noting that many professionals in this area don’t consider a gap of two fingers/2cm or less to be a diastasis.

And the reason this whole topic is important is because if your abdominal muscles remain weak you are more likely to suffer from back pain, an increased risk of hernia and prolapse and, from an aesthetic perspective, you may have a “pooch” or a “doming” of your stomach muscles that you simply can’t get rid of. I often hear people talk about this as their “mummy tummy”.

So the message I’m trying to get out there is that a gap between your abdominal muscles isn’t necessarily something for you to worry about and it may not be biologically possible for you to close it entirely either. But a weak core is equally not something to ignore. I believe that your focus should instead be on be on how well your body and core muscles are functioning – so having muscles that activate when you need them to and for there to be no pain/discomfort/negative consequences of the movements that you make on a daily basis.

So, in my humble opinion, you should instead be focusing on:

  • Reconnecting to your deep core muscles (it might feel slow and unexciting, but it gets results!)
  • Correcting any dysfunctional breathing and posture
  • Eating well and staying hydrated to help re-build the collagen that the connective tissue in question is made of
  • Ensuring that the movements you make / exercises that you do don’t create unnecessary pressure or strain on your core (so stop doing anything that makes your stomach bulge or dome or any exercises that cause leaking or pain). You can’t strengthen muscles that aren’t functioning properly.

Any if you’re feeling bewildered by the whole thing, come along and join one of my postnatal classes and we can take it from there.

(1) Mota PG, Pascoal AG, Carita AI, Bo K. Prevalence and risk factors of diastasis recti abdominis from late pregnancy to 6 months postpartum, and relationship to lumbo-pelvic pain. Man Ther. 2015; 20: 200-205. http://dx.doi.org/10.1016./j.math.2014.09.002
(2) Boissonnault J, Blaschak MJ. Incidence of Diastasis Recti Abdominis During the Childbearing Year. Physical Therapy. 1988; 68: 1082-1086.
(3) Lee D, Hodges PW. Behavior of the Linea Alba During a Curl-up Task in Diastasis Rectus Abdominis: An Observational Study. J Orthop Sports Phys Ther. 2016; 46(7):580-9.

(Image courtesy of Burrell Education.)

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