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 or torn stomach muscle could be to blame. This article 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 tummy tuck as an abdominal separation surgery, available treatment to target this problem.
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 torn stomach muscle 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.
Separated abdominal muscles 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 abdominal separation surgery. There are several reasons why torn stomach muscle 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 per cent of women who’ve been pregnant experience torn stomach muscle 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.
Torn Stomach Muscle Symptoms
- Back pain – mainly in the lower back
- Pelvic pain
- Muscle weakness
- Bloating and digestive issues
- Urinary leaking
After pregnancy, a key giveaway that you have torn stomach muscle 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 (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
- Petite frame
- Heavy birth-weight baby or multiple babies have
- Poor posture
What Does Diastasis Recti Look Like?
You can check yourself whether you have a separation of abdominal muscles 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.
How to Tell If Abdominal Muscles Are Separated | Self Testing Diastasis Recti
Follow these 4 steps to find out weather you are experiencing ab 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 feel soft and spongy, not tight and strong.
Separated Abdominal Muscles Exercise
If you’ve determined that your muscles have divided, you may be looking for a way to fix it. There are exercises for torn stomach muscle 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 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 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 has eligibility to have tummy tuck Medicare rebate. The cosmetic goal of this surgery is to create a firmer and smoother profile of the tummy area.
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 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.
Frequently Asked Questions
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
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