What is an ab separation?
In the fitness and post pregnancy culture it is known as, “rectus diastasis or distasis recti, “ meaning separation of the rectus abdominis muscle. These muscles are also referred to as the 6-pack muscles.
An individual will most commonly experience this separation during and after pregnancy, but it can occur in individuals whom are over-weight as well.
Having an ab separation can be problematic for proper core activation and can increase the risk of low back pain, pelvic pain, urinary leakage, pelvic organ prolapse, constipation and general appearance of the tummy.
How do you know if you have one? Firstly, you may notice a bulging or ballooning of the tummy when you try to use your abs or when you place your fingers between the muscles you feel a gap. What I recommend is actually having it tested by a physiotherapist trained in pelvic health because it’s not just about how separated the muscles are.
Here are 10 things to consider when treating an ab separation. This information was presented by Jenny Burnell from the Birth Healing Summit, which I am summarizing for you.
- Nutrition and Hydration.
- Healing happens at a cellular level. Cells need good nutrition and protein in order to build new collagen and heal your abs. As a physiotherapist I can general say eat whole foods, lots of veggies and variety of fruits, but my recommendation is to see a Naturopathic Doctor to look closely at your diet. An assessment gives you so many benefits, not just for healing your abs but optimizing your overall health.
- It was also noted that, especially for women after a baby, we need more vitamin A and C because we are using these vitamins at a faster rate due to the new demands on our body and all the other stresses involved after a baby is born. These vitamins are not stored in the body, so we need to get them from food or supplement. Again, DO NOT TAKE SUPPLEMENTS WITHOUT A PROPER CONSULTATION from a Doctor or Naturopath.
- Hydration: In order for stretched fascia (connective tissue) to heal it needs water. The space between the fascia is made up of mostly water. So hydrate ladies to keep the fascia healthy. If you are leaking urine…please do not stop drinking water to prevent leaking! See a Pelvic Health Physiotherapist
- Breathing
- A proper breathing technique helps the abdominal wall stretch and contract. It is this movement back and forth that helps the muscle and connective tissue to move and heal. Most people breathe into their upper chests and hike up their shoulders to breath deeper. We re-training breathing into a more optimal movement pattern.
- Posture
- How we position our body can cause the muscles or connective tissue to get stuck or can put pressure on the abdominal muscles and therefore the gap.
- Appropriate Loading vs strengthening
- For the abdominal muscles and connective tissue to strengthen, they need the right amount of pressure and force. If you are doing sit ups or hardcore core classes this may be too much for the muscles initially and might actually make the separation worse. So we start with connecting you to those muscles and applying just enough force to activate and then building strength slowly.
- Bowel Function
- Addressing constipation is of utmost importance because it unknowlingly puts pressure on the abdominal wall. There are a number of things to consider when improving bowel function which includes being taught toilet positions, exercises and abdominal massage techniques by a pelvic floor physiotherapist. Seeing a Naturopathic Doctor is important for your gut health and bowel function. This is especially important for women with c-sections and women who were given antibiotics.
- Learning to Manage load Daily
- Using proper form and breathing is not just for exercise in fitness class. You need proper techniques for lifting your kids up, picking up groceries, doing laundry, putting the stroller in and out of car. These daily functions need consideration for healing the abs.
- Fascia Tensioning
- In order to have proper muscle function, the fascia that covers and connects the muscles needs to slide and glide freely. A pelvic floor physiotherapist will check to make sure the tissue isn’t stuck and will teach you how to properly apply exercise to this tissue.
- Less stress
- We know that stress is not good for overall health and it also does not help us heal from an ab separation. Stress release a hormone called cortisol. This hormone will cause inflammation in the body, not the kind of immune system response we want for healing and this hormone causes us to use up more nutrients and vitamins, not leaving much behind for healing to take place.
- Soft Tissue Therapy
- Without a therapist actually putting their hands on your abdomen, we won’t truly know if the muscle and connective tissue is tight, stuck or moving well. A proper assessment will help you and the therapist determine what soft tissue work might be needed.
- Down-training the nervous system.
- We need activities to let out the steam and to counterbalance all the day to day demands of life. For example: taking time for self to have a hot bath, meditate, go for a walk or even hang out with friends. If our nervous system is wound up, we will have tension and in all likelihood stress hormones in the blood.
If you just had a baby or recently lost a lot of weight, come in for an assessment so that we can see how your abs are doing and provide you the right advice for day to day activities and fitness.
Written By: Madelaine Golec PT, Pelvic Health Physiotherapist