Are you struggling with weak ab muscles, back pain or excess stomach skin? If so, a postpartum abdominal separation condition called Diastasis Recti or torn stomach muscles could be to blame. This blog explains separated abdominal muscles in detail and gives you all the information you need to tell if your abdominal muscles were torn during pregnancy. You will find abdominoplasty (tummy tuck) as an abdominal separation surgery, an available treatment that may repair this problem.
What Is Abdominal Separation?
Abdominal Separation or Diastasis Recti is caused when the outer layer of the abdominal muscles separates through the centre 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, such as a hernia. Most women who are experiencing torn stomach muscles during pregnancy will find that they can get better in the first 8 weeks after having the baby, especially with the help of abdominal separation exercises. But, unfortunately, many women don’t get diagnosed with this condition until the damage is far too advanced to be treated.
Separated abdominal muscles are a common complication of childbirth. It causes the core to destabilise, causing lower 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. Generally, diastasis recti can make it nearly impossible to regain your ‘post-pregnancy’ stomach shape and size without the help of abdominal separation surgery. There are several reasons why torn stomach muscles may occur. It’s important to understand why this happens and how it can be corrected.
Abdominal Separation: Causes and Symptoms
Diastasis recti is a very common condition during and following pregnancy. In fact, 60 – 70 % of women who’ve been pregnant may experience torn stomach muscles 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 abdominal 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.
Torn Stomach Muscle Symptoms
- Back pain – mainly in the lower back
- Pelvic pain
- Muscle weakness
- Bloating and digestive issues
- Urinary leaking
- Constipation
After pregnancy, a key giveaway that you have torn stomach muscle is that your stomach protrudes and still appears pregnant, despite your increasing efforts with diet and exercise. If you find yourself struggling to remove your protruding belly after pregnancy, surgery may be a suitable option. Fleur De Lis Abdominoplasty is a surgical option available for postpartum as it helps to firm and tighten the stomach. Learn more about the benefits of tummy tuck surgery (Abdominoplasty).
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
- A petite frame
- Heavy birth-weight baby or multiple babies
- Poor posture
What Does Diastasis Recti Look Like?
You can check yourself to see whether you have separation of the abdominal muscles, you can ask your GP or your 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 a healthy diet and exercise to determine whether or not your body will change naturally.
Muscle separation from 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 are still experiencing the above symptoms, you may consider trying the below self-assessment technique.
How to Tell If Abdominal Muscles Are Separated | Self-Testing Diastasis Recti
Follow these 4 steps to find out whether you are experiencing abs separation or not.
- Lay on your back with your knees bent at a 45-degree angle. Tuck your pelvis and relax your spine. Take some deep breaths.
- Contract your pelvic floor muscles, lift your head and tuck your chin toward your chest.
- 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.
- If you feel a gap, press down. Diastasis recti will generally feel soft and spongy, not tight and strong.
Separated Abdominal Muscles Exercise
If you’ve determined that your stomach muscles may be divided, you may be looking for a way to repair your stomach muscles. There are exercises for torn stomach muscles that you can perform to improve abdominal separation, but they are 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
For any exercises that you do, you must ensure 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 Specialist Plastic Surgeon, they will be able to determine whether you have notable pregnancy abdominal separation. They will also advise you on torn stomach muscle treatment, giving you the best chance of recovery without surgery.
Tummy Tuck Surgery: Abdominal Separation Treatment
If you’ve waited months or years for your stomach to regain its shape and strength, and your diastasis recti has not recovered, surgery may be the next best, recommended step.
Abdominoplasty surgery, performed by a specialist plastic surgeon, can rejoin and repair separated muscles and also alleviate any hygiene issues caused by loose excess skin. Diastasis recti has eligibility to have Abdomoplasty (tummy tuck) Medicare rebate.
How to Fix Split Abdominal Muscles
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 post-pregnancy 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 you have ceased breastfeeding.
Before committing to surgery, you must be aware of all the risks associated with your surgery. All surgery carries risks, whether it be 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’s best if you’re already close to your ideal weight for surgery as a higher BMI can cause a higher risk of complications. However, this surgery can remove excess skin. If your main goal is to remove excess fat alongside excess skin and your diastasis recti stomach, your surgeon may offer to combine your procedure with liposuction. This is something that can be determined in your initial consultation.
Frequently Asked Questions
What Happens If Diastasis Recti Goes Untreated?
The first step in treating post-pregnancy abdominal separation is to determine whether you need surgery or physical therapy. In some cases, ab separation exercises can improve diastasis recti.
If you want to leave the problem as it is, it may get worse over time and as a result, you may have other issues such as severe back pain, painful sexual intercourse, 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 the 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 (abdominoplasty) surgery to correct diastasis recti.
About Dr Mark Doyle FRACS (Plas) – 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 fully qualified Specialist Plastic Surgeon with over 30 years of experience performing breast, body, face and nose surgery. He has completed all required training and only carries out approved surgical practices. There are NO undertrained doctors or cosmetic doctors acting as surgeons at Gold Coast Plastic Surgery.
