October 03, 2018 6 min read

It is delightful how much has been written about separated or the separation of abdominal muscles in recent years. I am especially pleased that information is now available and that most women who have given birth are aware of this condition and know to seek help where needed.

This was not the case five years ago when I had two children in quick succession. It took me over one and a half years to understand what caused the discomfort and operational problems in my body and realise that I suffered from separated abdominal muscles.

When I learned more about the condition, I soon noticed that mothers were hungry for information. For this reason, I wrote an article about separated abdominal muscles and it was immediately published on the MTV3 Lifestyle and Turun Sanomat newspaper.

Separated abdominal muscles - diastasis recti

After my second childbirth, I felt that “something” had happened in my abdominal muscles and the core, for which reason I had to learn to do several exercises again from the beginning and to re-establish my balance and coordination. For example, lunges were very challenging at the beginning.

There is still not a great deal of research on the separation of direct abdominal muscles, even though, based on estimates, one third to two thirds of women who have given birth suffer from it. In addition to mothers, overweight men and women and athletes who train heavily can also suffer from separated abdominal muscles.

What does it mean in practice?

Pregnancy increases the risk of abdominal muscle separation

During pregnancy, deep abdominal muscles, the entire peritoneum, and the white line stretch as the belly grows. At the same time, direct abdominal muscles are pushed apart to the sides of the belly, and the white line (linea alba in Latin) between them widens. If the direct abdominal muscles fail to restore after childbirth, i.e. there is space between them, activation of deep abdominal muscles is reduced and muscle tension is low. The condition is known as separation of direct abdominal muscles.

Spontaneous restoration of the muscles continues for around one year after childbirth, highlighting the importance of slow progress in training and recovery.

What surprised me was that when I asked the doctor and the maternity nurse about training, abdominal muscle exercises, and starting them again, the only answer I got was that I could keep on training as before if everything was in order in the postpartum checkup. In my opinion, the matter is not this simple, because at least in my own postpartum checkup, the recovery of the abdominal muscles was not tested at all. Too quick or the wrong kind of training can prevent the restoration of the abdominal muscles.

How to test separated abdominal muscles

You can measure and feel the condition of your abdominal muscles when lying on your back. Bend your knees and relax your abdominal muscles. Lift your head and shoulder blades from the floor. Feel your belly above and below the navel between the abdominal muscles with your fingers. Test how deep you can insert your fingers and how long this gap is: in a normal situation, there is no gap at all between the abdominal muscles.

Factors that increase the risk of separated direct abdominal muscles include several pregnancies in quick succession, age of over 34, and e.g. a C-section. The risk of separation is reduced if the deep abdominal muscles are exercised before and during pregnancy.

The risk of separation also increases if expecting more than one child, or when the baby or the belly is especially large. A great increase in weight and lack of exercise can also increase the risk of separated abdominal muscles.

 

Postnatal training of abdominal muscles

In my work as a personal trainer, I see separated abdominal muscles all the time. Surprisingly little is known of this matter also among sports professionals, and the level of knowledge depends completely on the personal interest and activity of each instructor. Every woman who has given birth and suspects that they suffer from separated abdominal muscles and wants to start exercising safely should find a skilled trainer to supervise their training.

The situation of the abdominal muscles must be determined before starting exercising, and when the training progresses and more challenging exercises are introduced, it must be ensured by feeling with the fingers that the separation does not increase when doing the exercises.

We will do this in a controlled way with the help of controlled breathing. Hold the tension for 5-20 seconds. The aim is to later make tension and support part of everyday activities.

In the muscle strength exercises, you should be using less than half of your full strength. Crunches, forceful rotating exercises, and sit-ups should be avoided at the beginning. You should never do direct abdominal muscle exercises until you can feel that your abdominal muscles do not separate when you do them.

How to fix diastasis recti

Training the deep abdominal muscles differs from the training of the outer abdominal muscles. Connection to the target muscles is different, and aim is to focus instead of straining the muscles to the extreme. The below exercises are a safe way to start if everything was fine at the postpartum check-up. Start by doing the exercises three times a week. After a month or two, you can increase the number to five times a week if you wish - however, remember to have a few days off every week. When your muscles have become used to exercising and you have found your abdominal muscles and need more challenges, you can replace exercise 1 with its variation 2.


Deep abdominal muscles – Activation while sitting down
2x8
Breathe in. Start the activation from the pelvic floor muscles when you breathe out and pull the navel in slightly. You can also compress the sides slightly towards the centre line of the belly. Hold for 4-6 seconds, breathe in, and relax. Rest for 2-3 seconds and repeat.
2
Deep abdominal muscles – Activation while lying on your belly
3x10-15s

Start the activation from the pelvic floor muscles and begin to lift your belly from the floor.

Imagine that there is a tunnel between your belly and the floor (it does not matter if you cannot lift your belly from the floor). Hold the back and gluteal muscles relaxed. Concentrate on the movement carefully and hold for 10-15 seconds. Rest and repeat.

3
Deep abdominal muscles – Balancing on one foot
5x both sides

Standing up.

A neutral curve of the spine and good posture. Breathe in. Start the activation from the pelvic floor muscles when you breathe out and pull the navel in slightly. Lift one foot up in the air and hold your balance for a few seconds. Relax as you breathe in and repeat on the other side. Do the exercise slowly and in a controlled fashion.

 

 

Exercise 1, variation 2: Sit on a chair with the soles of your feet on the floor, start activation from the pelvic floor muscles, and pull the navel in slightly. You can also compress the sides slightly inwards. A neutral curve of the spine and good posture. Breathe in and tighten the contraction of the belly slightly when breathing out and lift one heel up off the floor. Return the heel to the floor when breathing in and relax the belly muscles slightly.

Fixing the separation of abdominal muscles through training

The point of training the abdominal muscles is not to get back to the pre-pregnancy weight and personally I am not even bothered by a protruding belly; however, e.g. back problems are a serious problem. One common cause of lower back pain is reduced activation of deep abdominal muscles.

The principal task of the abdominal muscles is to maintain the support provided by the core. If the support of the core is weak, the risk of back problems, urinary and bowel incontinence, and uterine or vaginal prolapse is increased. Abdominal muscles also keep internal organs in their right places. Even if these matters do not seem to be topical at the moment, they may become topical in the future. For this reason, it is important to maintain good muscular strength. Also women who have given birth years ago can suffer from separated abdominal muscles. However, it is always possible to enhance the condition of abdominal muscles and the entire body, and therefore it is never too late to start exercising.

Happy training and enjoy your life!



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