Abdominal Muscle Separation

Jan 10th, 2022 / Nicki Chick

If you are pregnant or have had a baby, you’ve probably heard of the term “abdominal muscle separation”.

But what actually is it? Is it something you should be worried about? And is there anything you can do about it?

Today, we want to ‘debunk’ some of the myths and misinformation about abdominal muscle separation and help you have a clearer understanding of this common condition.

So, first things first; let’s get to understand your abdominal muscles a little better. Your abdominal muscles consist of four layers of muscle that run in different directions attaching from the ribcage to the pelvis. The top layer is called the rectus abdominis and is divided into a right and left half that are separated by a ligament in the middle called the linea alba.

When the distance between the two halves of the rectus abdominis increases beyond 2cm at the level of your belly button, it becomes known as “abdominal muscle separation”. It is estimated that up to 68% of postpartum women will experience abdominal muscle separation in the first year after having a baby. As the uterus starts to grow and moves higher in the abdominal cavity, greater stretch is placed on the linea alba. The position that you carry your baby can often influence which part of the linea alba is stretched the most.

Pregnancy hormones such as estrogen, progesterone and relaxin also play a role in stretching the linea alba. Estrogen acts to soften the collagen fibres in the linea alba, making them “stretchier”. Collagen fibres vary from person to person and this is thought to be one of the reasons why different people have different amounts of abdominal muscle separation.

Some tips to help with managing discomfort of abdominal muscle separation during pregnancy include:

• Wearing and abdominal support such as Tubigrip, SRC pregnancy ‘Over The Bump’ leggings or other high waisted/supportive leggings.
• Minimise any movements that cause you discomfort or that you notice your stomach bulging/ coning with or change the way you move to minimise this happening (eg rolling on side to get out of bed)
• Chat to a Women’s Health Physiotherapist about appropriate pelvic strengthening exercises

When it comes to the best way to manage abdominal muscle separation unfortunately there is a lot of conflicting information out there, which can often make it a tricky topic to navigate. During the first six weeks of postpartum recovery, gentle pelvic mobilisation exercises such as pelvic tilts, bridges and clams can be a great way to safely regain some movement and work on core control. While often overlooked, practicing deep belly breathing is another great way to “prepare” the abdominal muscles for strengthening later on.  Thinking about “engaging” the core muscles with day-to-day tasks such as picking up your baby or when squatting up/down can also be a great way to start to train the brain/core connection.

At 6-8 weeks postpartum we recommend seeing one of our Women’s Health specialists for a more in-depth assessment of your abdominal muscle strength and function. During this appointment, your physiotherapist will:

• Perform a detailed assessment of your separation width and depth
• Ask you to perform some functional movements such as curl-ups, planks and side planks
• Use Real Time Ultrasound to help you identify whether you are activating your core correctly
• Help design an individualised abdominal muscle strengthening program with you