Abdominal Separation: Ensuring optimal core health in pregnancy & beyond

If you have met me in person, you have likely heard me speak a lot about abdominal separation, or diastasis recti.  Abdominal separation is caused by intra-abdominal pressure, resulting in a separation of the rectus abdominals into left & right halves.  Typically, this will begin in the second trimester of pregnancy and persists into the 3rd trimester.  The degree of separation can vary and is often measured in finger widths, with 1 being normal to low and 4 or more being a high risk separation.  However, length and depth of the separation should also be evaluated as well as a consideration for how long the separation has been present.

Although the condition of abdominal separation is not detrimental to your health (meaning you won't die), left untreated, it can negatively impact your quality of life.  The greater the separation, the more likely you are to suffer from organ prolapse (uterine, bladder and rectal prolapse being most common).

At FITMOM, we recommend that you & your care provider check for abdominal separation once in the first trimester, twice in the second and three times in the third. By doing so, you create an awareness of the condition and can rehabilitate your core correctly in the post partum period.  Engaging in effective abdominal exercises during pregnancy can keep your core strong and reduce/limit the degree of separation.  Avoiding crunches during pregnancy is a good start!

Am I at risk?
Anyone who is pregnant is at risk for some degree of separation.  However, some other factors may increase your risk:

• Genetics
• Carrying multiples
• Previous undiagnosed or untreated separation caused by previous pregnancies
• Engaging in sports or movement where your torso torques (Tennis, ultimate Frisbee, or any activity that causes you to repeatedly cross the midsection)
• Short midsection

After you give birth we recommend that you do a self-assessment at 2 weeks post partum to get a baseline and again at 6 weeks.  In many cases, the separation will close on its own, however one should not make any assumptions.

It is vital that you have your abdominals assessed again prior to starting any traditional core exercises.  Engaging in inappropriate core work can cause further separation and deterioration of your core muscles, leaving your midsection unsupported and at greater risk of prolapse.
Women with a high risk separation will need physiotherapy and in some rare circumstances, surgery.
In most instances though, women with low risk separation can often see full recovery when following certain protocols.  Review our handout on best practices "Core Restore Tip Sheet".

If you are concerned you have a separation and would like to close the gap, please contact me.  I would be happy to help you improve your core strength, rebuild your confidence and improve your overall conditioning.