If you have had twins or triplets, had a pregnancy soon after the last or a pregnancy past the age of 35 you are at greater risk from abdominal separation. This condition also referred to as “diastasis recti” is common, occurring both during the second half of pregnancy and afterwards. The “Rectus Abdominis” muscles are part of the muscle group known as your abdominals. They run from the bottom of the ribcage to the top of the pelvis at the front. The control of these muscles in linked with the muscles in the pelvic floor and low back and proper function of these is important for the popular concept of “core stability”.
In abdominal separation, these recti muscles separate down the midline resulting in the baby “pooch” or sticking out tummy. This can cause problems in the tummy but also with your core stability.
How To Tell If You Have Diastasis Recti
Try this simple test:
- Lay on your back, with your left hand placed behind your head, bend your knees but keep the soles of your feet on the floor. Use the first finger on your right hand to press gently on the midline of your abdomen at a point about half way between the bottom of your ribcage and your navel.
- Raising your head just enough to ‘engage’ your abdominal muscles a little, can you feel any separation in the middle, between the muscles on the right and the left of your abdomen?
- Do you feel a separation into which you can put two fingertips across the gap? If so, you almost certainly have abdominal separation.
- By repeating the exercise in several places down your midline, you will be able to assess your whole abdomen for diastasis recti.
The quick and simple check described above can help you decide whether your “baby belly” results from abdominal separation.
The Causes of Abdominal Separation
During pregnancy, pregnancy hormones and the pressure exerted by the uterus against the stomach wall can result in abdominal separation. A little separation is normal during pregnancy but it is important that muscles return to normal, closing any gap between the muscles before another pregnancy.
When the degree of abdominal separation is larger, (two centimetres or above), it can cause problems if it goes untreated and does not return to normal on its own post-pregnancy. This is because it makes stomach muscles less effective in supporting internal organs including the bowels and uterus. During pregnancy, this could cause problems for a normal vaginal delivery. Other problems can include pelvic instability and consequent pain in the lumbar region, weakness of the pelvic floor, symptoms of which can include constipation, and varying degrees of urinary incontinence.
How Chiropractic Can Help With Pelvic Floor Function
Pregnant mums can be reassured of the safety and effectiveness of Chiropractic care both before and after their baby is born and can help to correct any problems with pelvic alignment and control of muscles.
In addition, Chiropractic will significantly benefit the function of the muscles that form a sling that supports the organs within the pelvis and are vital in avoiding problems with opening the bowels and urinary incontinence.
Women who have Chiropractic treatment throughout their pregnancies, are more able to relax these powerful pelvic floor muscles. This is important not only, because it could make a vaginal delivery easier, but also because it helps to prevent the problems mentioned above, including urinary incontinence.
Treatment during and post-pregnancy may include:
- Chiropractic adjustments to pelvic joints and lumbar spine
- Chiropractic techniques on soft tissues to restore muscle tone and release ligaments
- Advice on posture, ergonomics and exercises that can be done at home to prevent tightening in muscles of the pelvis
Beware – Exercise Can Make Matters Worse!
Just be aware that a lot of the information on the topic of abdominal separation consists of myths, half-truths and misconceptions. This can be a worry as most women turn to popular media and online searches for ways to get rid of that baby “pooch” as quickly as possible after their baby arrives.
Exercise can be hugely beneficial but it needs to be the right kind of exercise. Some yoga poses, gym exercises including crunches and press-ups, and swimming, can make abdominal separation worse. Heavy lifting or straining on the toilet can also exacerbate the problem.
The Benefits of Chiropractic Care for Abdominal Separation
Consulting your Chiropractor before contemplating any sort of exercise plan will avoid any worsening of the problem from the wrong sort of exercise. After a thorough assessment of ‘where you are at’, in terms of pelvic alignment and control, and the strength (or otherwise) of your abdominal muscles, they will be able to advise you on a safe plan of action for healing that combines Chiropractic care with exercise. This can reduce any need for surgical intervention and the possibility of scarring, infection and other problems as a result.
Dr Rachael Veronesi is a Sydney Chiropractor who focuses on the care of pregnant mums. She is the owner and principal chiropractor at NeuroBalance Chiropractic.