Separation Anxiety….

There is no magic pill to cure an abdominal separation also known as mummy tummy and diastasis rectus abdominis (DRA) to name a few.

Preet our resident Physiotherapist specialising in women’s health answers your question’s…

 

What is an abdominal separation?

It is when the connective tissue (linea alba) that connects the 2 muscle bellies of the rectus abdominis muscle (the 6 pack) stretches and weakens giving the appearance and feeling of the abs being separated.

 Image: Jenny Burrell Education

Image: Jenny Burrell Education

Why does this happen?

There are many reasons as to why this can happen, but commonly it is due to

  • excessive intra-abdominal pressure
  • poor alignment
  • poor technique when performing abdominal exercises
  • being pregnant

It can happen in babies and men too.

 

What are the symptoms of an abdominal separation?

The separation itself is not usually painful, but the consequence can be back or pelvic pain. The first time many people notice they have a separation is when they sit up from the floor or bed and notice a doming through the middle of their tummy. If it is a large separation sometimes the internal organs can be seen at work.  Some folk can also suffer from incontinence too.

 

What is incontinence?

Incontinence refers to the involuntary loss of bladder or bowel function. It may be a small leak of urine or faeces or wind to a full gush. The 2 most common urinary incontinence's are stress and urge. Stress incontinence occurs when there is an increase in intra-abdominal pressure as in when we exercise, cough, sneeze or laugh resulting in a leak. Whereas urge incontinence refers to a sudden and strong need to urinate.

 

How can I assess for a separation?

Lay on the floor with your knees bent and feet flat. Place one hand behind your head and gently roll your head and neck off the floor as if you are performing a small crunch. Place your free hand around your belly button and feel for a separation. You should feel the 2 firm edges of your abdominal muscles and with a small dip (a bit like the skin between 2 knuckles on your hand).  But I do recommend that a Physiotherapist specialising in women’s health be engaged to accurately assess this for you, as they will also look at the factors that may be contributing.

 

I’ve just had a 6 week check up with my Obstetrician/Gynaecologist and he has given me the green light to exercise again. What are some safe forms of exercise?

What I like to remind my patients is that the body is still recovering. Childbirth itself is one of the most traumatic experiences a female’s body will undergo. In no way should you jump straight back into pre-pregnancy level exercise such as bootcamp, F45, Crossfit etc at this point in time.

You don’t shoot a cannon from a boat. We can use the same analogy when speaking of returning to exercise- lets make sure the core and floor muscles are working well and there are no other injuries from childbirth that need to be addressed before performing more strenuous forms of exercise.

If patients haven’t already started on activating their core and pelvic floor muscles, that is where I start them off and also encourage light exercise such as walking, swimming, post-natal classes, low intensity gym workouts with emphasis on posture, breathing, core and pelvic floor activation.

 Image: movemami

Image: movemami

When should I seek further advice?

In 60% of women the separation heals itself within the first 2 months after having a baby. But if you find that your gap is more than 3 finger widths, the midline feels soft and deep and or you are suffering from ongoing back and pelvic pain you should have a Physiotherapist specialising in women’s health assess you.

 

What to do next?

Follow up with a Physiotherapist specialising in women’s health that can specifically assess and individualise a program for you.

If you have any more questions, or would like to be seen by Preet call the IFC clinic on 8721 9972 or email info@ifcpt.com.