November 21, 2009

Abdominal Muscle Separation; What you need to know

Pregnancy brings on many changes to your body.  When I treat women during or after pregnancy, many ask me about their abdominal muscles.  When assessing the abdomen postpartum, I always check for the possibility of a separation between the right and left most prominent abdominal muscles, the Rectus Abdominus muscles which run vertically along the abdomen.  Most of you know these muscles as the “six pack” muscles. This type of separation commonly occurs during pregnancy and has the medical term of Diastasis Rectus Abdominus.  This occurs during pregnancy as your baby grows and increases pressure on the abdominal wall.

You can assess this on yourself by lying on your back, knees bent and feet flat on the floor.  As you exhale, lift your head slightly with chin towards the chest and if possible lift the top of your shoulders off of the floor.  As you are doing this, place one hand with the fingers just above the navel.  As you lift up, your fingers may sink in.  If this is greater than 2 fingers, proper exercises are required and some exercises such as crunches, sit-ups and spinal twisting should be avoided.

Such a separation may be the reason you are unable to flatten the belly postpartum.  Additionally, it can cause back pain, increase chances of urinary or fecal incontinence (leaking), weakened pelvic floor muscles and pelvic organ prolapse.

One correction exercise that can be beneficial is a crunch with towel/sheet.  This is performed in the assessment like position, on your back with knees bent and feet flat.   Place a towel or sheet around your waist crisscrossed in the front.  Grip the towel in each hand and pull outward as you exhale and lift your head and top of shoulders, with chin tucked to chest.

Niva Herzig, MS PT, BCIA-PMDB is the owner and physical therapist of Core Dynamics Physical Therapy, LLC in Englewood, NJ, where she specializes in treating pelvic floor disorders such as pelvic pain (Vaginismus, Vulvodynia, Interstital Cystitis, etc), urinary incontinence, pelvic organ prolapse, pre-natal and postpartum musculoskeletal disorders. For more information, visit us at www.coredynamicspt.com

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