How to Tell If Your Abdominal Muscles Were Torn During Pregnancy

what happens to abdominal muscles during pregnancy

Do you still look pregnant months after delivery? Are you struggling with weak ab muscles, back pain and an ever-growing belly bulge? If so, a postpartum abdominal separation condition called Diastasis Recti (torn or separated abdominal muscles) could be to blame. This article explains diastasis recti in detail and gives you all the information you need to tell if your abdominal muscles were torn during pregnancy.

What is Abdominal Separation?

Abdominal Separation or Diastasis Recti is caused when the outer layer of the abdominal muscles separates through the center of the abdominal wall. It usually occurs during pregnancy, but can also occur in men and athletes. This condition can be a sign of other issues as well, like a hernia. Most women’s who are experiencing ab separation in pregnancy will get better in the first 8 weeks after having the baby, specially with the help of ab separation exercises. But, unfortunately many women don’t get diagnosed for this condition until the damage is far too advanced to be treated.

Diastasis recti is a common complication of childbirth. It causes the core to destabilize, causing low back pain, poor posture, and muscle injuries. A woman with this condition may experience a wide, asymmetrical abdomen and back pain. The condition can also affect the lower back and cause chronic lower back pain. This condition is unfamiliar to many mums, with most assuming it’s their fault they can’t return to their pre-baby belly. In fact, diastasis recti can make it near impossible to regain your ‘normal’ belly shape and size without the help of tummy tuck surgery. Some symptoms of diastasis recti include discomfort in the abdomen, a loss of body weight, and a lack of flexibility. There are several reasons why abdominal separation may occur. It’s important to understand why this happens and how it can be corrected.

What Are the Diastasis Recti Symptoms and How It Happens?

Diastasis recti is a very common condition during and following pregnancy. In fact, 60 – 70 per cent of women who’ve been pregnant experience muscle separation after birth to some degree. Whilst pregnant, your connective tissue, the linea alba, thins out due to changing hormone levels while your uterus expands to accommodate your growing baby.

As your baby grows during pregnancy, the uterus expands and pushes against the abdominal wall. While this occurs, your pregnancy hormones allow the connective tissues to soften and relax. This widening occurs in the connective tissue between your ab muscles, the linea alba, and causes a gap or separation to occur. This is most common in the third trimester of your pregnancy but can also occur after childbirth when there’s no baby to support the weakened abdominal muscles.

Diastasis Recti Symptoms

  • Back pain – mainly in the lower back
  • Pelvic pain
  • Muscle weakness
  • Urinary leaking

After pregnancy, a key giveaway that you have diastasis recti is that your belly protrudes and still appears pregnant, despite your increasing efforts with diet and exercise. If you find yourself struggling to remove your bulging belly after pregnancy, surgery may be a good option. Fleur De Lis Abdominoplasty is one of the best surgical options available and can be life-changing for those concerned about their postpartum body as it helps to firm and tighten the belly similar to how it once was. Learn more about the benefits of tummy tuck surgery.

Who Is More Likely to Get Diastasis Recti?

ab separation in pregnancy is common however, some are more prone to the condition. Typically, women who have had more than one baby and women who have had a direct relative experience diastasis recti are more likely to have it themselves. Women who have the highest chance of this include those who have:

  • Multiple pregnancies
  • Previous pregnancy which caused muscle separation
  • Pregnancy soon after a previous pregnancy
  • Poor abdominal muscle tone are overweight or obese
  • Petite frame
  • Heavy birth-weight baby or multiple babies have
  • Poor posture

How to Tell if Your Abdominal Muscles Are Separated?

You can check yourself whether you have a diastasis recti muscle separation or you can ask your GP or midwife for a medical assessment. Before beginning self-assessment, there are some recommendations to ensure your body has recovered fully from the pregnancy.

It’s important to allow an adequate period of time for your body to adjust. This can take between several months and two years. It’s also important that you’re making an effort with diet and exercise to determine whether or not your body will change naturally.

Muscle separation pregnancy is measured by the number of fingers that fit in between the inner sides of the rectus abdominis muscle. Two or more finger widths is considered diastasis recti. Typically there are three key signs to identify if your abs were damaged, torn or separated throughout your pregnancy. These include:

  • There is a visible gap (more than 2 finger-widths) in the middle of your abdomen.
  • This gap does not get smaller as you contract your ab muscles.
  • There is a visible mound that sticks out along the length of your midline.

If you’ve spent more than six months eating healthy and exercising but you’re experiencing the above symptoms, you may consider trying the below self-assessment technique.

Self Testing Diastasis Recti

Follow these 4 easy steps to find out weather you are experiencing ab separation or not.

  1. Lay on your back with your knees bent at a 45-degree angle. Tuck your pelvis and relax your spine. Take some deep breaths.
  2. Contract your pelvic floor muscles, lift your head and tuck your chin toward your chest.
  3. Walk your fingers down from your rib cage towards your belly button. If there is a division where your muscles separate, you should be able to feel it.
  4. If you feel a gap, press down. Diastasis recti will feel soft and spongy, not tight and strong.

How to Fix Abdominal Separation with Exercise?

diastasis recti during pregnancyIf you’ve determined that your muscles have divided, you may be looking for a way to fix it. There are exercises for diastasis recti you can perform to improve abdominal separation, but it is usually not repairable without the help of surgery.

Pilates, yoga, cardio and strength training may help improve your abdominal muscle strength, but it’s recommended that you discuss this with your physio or fitness coach first. Before attempting to perform difficult core exercises, it’s important to be aware of the risks. Planks and crunches, if attempted too early, may actually make your bulge appear worse. Instead, Pilates exercises are a great way to begin if your condition is mild and not severe. These include:

  • cat cows
  • pelvic tilts
  • toe taps and,
  • leg extensions

Any exercises that you do, you must make sure that your navel is contracted (pulled in) rather than expanded (pushed out). This is really important to ensure that you aren’t worsening your condition.

It’s important to note that although these core exercises may help to strengthen your ab muscles, they will not repair and rejoin torn abdominal muscles on their own. If you struggle to perform these core exercises due to back pain or muscle weakness, it’s recommended that you stop and book a consultation with a healthcare professional. Whether it’s your GP, Gynaecologist, Physiotherapist or Plastic Surgeon, they will be able to determine whether you have suffered notable muscle separation during pregnancy. They will also advise you on how to prevent your muscle separation from worsening, giving you the best chance of recovery without surgery.

Tummy Tuck Surgery for Abdominal Separation

diatasis recti surgery cost australia

If you’ve waited months or years for your tummy to regain its shape and strength, and your diastasis recti has not recovered, surgery may be the next best step.

Abdominoplasty surgery, performed by a specialist plastic surgeon, has the power to restore separated muscles and also alleviate any hygiene issues caused by loose excess skin. Diastasis recti is also an eligibility criterion to have a partly Medicare-funded tummy tuck surgery. The cosmetic goal of this surgery is to create a firmer and smoother profile of the tummy area.

*Important Update*

A new MBS item number for Abdominoplasty (tummy tuck) surgery has been announced. This is for diastasis recti repair following pregnancy.

The inclusion of this surgery in the MBS is a wonderful step that will benefit many women at a difficult period in their lives.

The Government has indicated that as part of the 2022/23 budget, it will invest $6.6 million to return Abdominoplasty to the MBS, in response to proposals from the Independent Medical Services Advisory Committee (MSAC).

This is a significant victory for ladies who suffer from postpartum rectus diastasis.

From July 1, 2022, item number 30175 will be accessible on the MBS.

The criteria will be as follows (this is correct at the time of writing (May 2022), but is subject to change in accordance with the MBS):

a) the patient

  • i) has a diastasis of at least 3cm measured by diagnostic imaging prior to this service; and
  • ii) has symptoms of at least moderate severity of pain or discomfort at the site of the diastasis in the abdominal wall during functional use and/or low back pain or urinary symptoms likely due to rectus diastasis that have been documented in the patient’s records by the practitioner providing this service; and
  • iii) has failed to respond to non-surgical conservative treatment including physiotherapy; and
  • iv) has not been pregnant in the last 12 months

This new item number will provide patients more access to diastasis recti treatment and result in better health outcomes for new mums suffering this condition.

Diastasis Recti Surgery considerations

If you do decide to undergo diastasis recti surgery, it’s important that you wait at least a year since your baby was born. This gives your body sufficient time to heal and your muscles to return to their original place. This also allows enough time for your exercise, diet and physical therapy to work and for you to notice results.

It’s also important to consider the effect that breast-feeding may have on your abdomen. Hormone levels when breastfeeding may interfere with your abdominal muscles and prevent them from regaining their shape. Because of this, you should wait a few months after your baby is done breastfeeding.

Before committing to surgery, you must be aware of all the risks pertaining to your surgery. All surgery carries risks, whether it be undesirable scarring or poor recovery. You can read more about this on our general risks of surgery page.

Finally, you must have realistic expectations about what abdominoplasty surgery can achieve. It is not a weight loss surgery and may not help you to remove excess fat. It needs you to be close to your ideal weight for surgery. However, It will remove any excess stretched skin and your ‘mummy tummy.’ If your main goal is to remove excess fat alongside excess skin and your bulging diastasis recti belly, your surgeon may offer to combine your procedure with liposuction. This is something that is determined in your initial consultation.

FAQs

What Happens if Diastasis Recti Goes Untreated?

The first step in treating pregnancy abdominal separation is to determine whether you need surgery or physical therapy. In most cases, ab separation exercises can cure diastasis recti.

If you want to leave the problem as it is, it may get worse in time and as a result you will find more dramatic issues such as sever back pain, painful sex, urinary incontinence and umbilical hernia.

When to Start Diastasis Recti Exercises?

Abdominal separation can cause pain and ineffective core mechanics. While many of us lift our legs with the help of our hip flexors and lower back, the best way to improve your posture and use your core is to perform diastasis recti exercises. These exercises will strengthen your abdominal muscles and re-educate your body to make use of your abs in a more effective way. You will find it most effective in first 6 to 12 months following delivery.

Is Diastasis Recti Surgery Covered by Medicare Australia?

Yes, as of July 1st 2022, MBS item number 30175 will provide a rebate for women seeking tummy tuck surgery to correct diastasis recti.

About Dr Mark Doyle FRACS (Plast) – Queensland Plastic Surgeon

Servicing patients in Gold Coast, Brisbane, Sunshine Coast, Cairns and New South Wales NSW – Northern Rivers, Byron Bay, Ballina, Lismore and more.

Dr Mark Doyle is a Specialist Plastic Surgeon with over thirty years of experience performing BreastBodyFace and Nose surgery. Dr Doyle is a fully qualified Specialist Plastic Surgeon with 30+ years of experience. He has completed all required training and only carries out safe surgical practices. There are absolutely NO undertrained doctors or cosmetic doctors acting as surgeons in our clinic.

As a highly esteemed plastic surgeon, Dr Mark is driven by an intense passion for helping patients achieve a happier, more beautiful self through advanced cosmetic surgery procedures. He maintains a strong commitment to achieving the best possible results for all his breast, body, face and nose patients, both men and women.