You've had your six-week postpartum health check and you're keen to work off that mummy tummy, stat. Not so fast, mama! Before you do a single sit-up, you need to check you don't have abdominal separation. The condition, formally known as Rectus Abdominis Diastasis (RAD), occurs when the connecting tissue that knits your abdominals together has been stretched out during pregnancy (thank you, relaxin!), leaving you with a gap between your abdominals.
It's believed to affect a third of first-time mothers and a whopping 70 percent of mothers who have had two babies or more. Although RAD is generally perceived as a cosmetic problem due to the tell-tale paunch sufferers often sport, the weakness in your abdominal wall can lead to a whole host of ailments, including back pain, pelvic floor dysfunction and even prolapse.
Keep reading to learn more.
Who is at Risk of RAD?
The condition is caused by excessive pressure inside your abdomen and pelvis, so while men, children and women who have never been pregnant can also suffer from RAD, it's commonly noticed in the latter stages of a woman's pregnancy when the body is trying to make room for a growing baby. Every single pregnant woman is thought to suffer with some degree of separation during their third trimester, but for many the gap closes by itself during the days and weeks that follow childbirth.
"All women will have some degree of RAD immediately post-birth, but it is the women with the abnormally wide ones that we are more concerned about," says Lyz Evans, a physiotherapist specialising in women's health, noting any separation generally ranges from 1–8cm wide.
What Happens if it Goes Untreated?
If you still have abdominal separation at eight weeks postpartum, it's likely that treatment will be required to help bring your stomach muscles back together and get your body back into alignment. "The abdominal wall plays a crucial role in the body as it transfers load from our legs and pelvis up to our thorax and arms, so if it is not functioning in an optimal way it can lead to all sorts of issues, such as low back pain, pelvic girdle pain, issues returning to exercise and pelvic floor issues," says Lyz, who is also the founder and director of Bondi-based practice, Women in Focus Physiotherapy. "In fact, we know that 66 percent of women that have an RAD will also have stress urinary incontinence or pelvic organ prolapse, and we believe this is due to the loss of support with in the deep system."
How Do I Test Myself For It?
- Lie down on back with your knees bent.
- Place your fingers at your belly button and allow them to sink in.
- Do a chest lift so your head, neck and shoulders lifts up off the floor.
- Using your fingers, feel for how much distance there is from the two sides of the muscles. You're also testing for the condition of your connective tissue (the Linea Alba) that runs between your separated muscles, so feel for the depth of the gap to.
A diastasis gap is measured in finger widths. A 1–2 finger width gap or less is fine, but anything more means that your core is in need of some attention.
Okay, I Have It — What Next?
The good news is, RAD is easy to test for and, in most cases, can be treated through exercise alone. However, it's important to understand that treating RAD is a whole body fix, and not just about closing "the gap". After all, the separation is a symptom of a core not working properly because it's malaligned. While Lyz recommends sufferers see a specialised trainer or women's health physiotherapist, there's plenty you can be doing at home. "If you can learn the correct posture to hold your body in — for example, avoiding an arched back where the chest bone comes behind the line of the pubic bone — then this is a great starting point," says Lyz, who notes that focusing on core exercises, such as planks and sit-ups, often increases the separation. "Then by learning to engage the deep abdominals throughout the day, such as when pushing the pram or lifting your baby, then you will have a training affect on the abdominal muscles without even doing a work out!"