Split Abdominals or Diastasis Rectus Abdominis (DRA) is a very common condition, which varies from woman to woman. If it is not recognised and treated it will interfere with the supportive function of the abdominal wall (your internal ‘corset’) and potentially lead to back and pelvic pain. It can arise during pregnancy or be caused by the bearing down during the second stage of labour.
DRA can be easily picked up and treated so if a health professional has not checked you here’s how you do it yourself.
Lying on your back, with your legs bent up (feet flat onto the floor/bed) and one pillow under your head.
Place the fingertips of one hand, width ways on your abdomen, just above your belly button.
Raise your head off the pillow and reach towards your knees with the other hand. (I am not doing this in the picture as my other hand is taking the picture!!)
The two edges of the muscle will then be felt, measure the distance between the two edges of the muscle in number of finger widths.
Repeat this again just below your belly button and lastly at the top of your tummy just under your ribs.
** I had a gap of 2 finger widths after the birth of my first son however with care not to make it worse, pilates and progressive exercise my abdominals are now normal and I can do high intensity exercise with no problems! **
Now remember if you do have a gap this is not dangerous and nothing will fall out, however it is important that this is treated so that a. it does not get worse, b. you can try to close the gap and c. other muscles are strengthened to compensate.
Ideally it is best to see a physiotherapist who can measure and take note of the gap, provide specific exercises for you depending on how big your diastasis is and review you to check that it is improving.
However there are some things you can do to help:
-- Do not overuse these muscles until things are improved e.g. DO NOT ATTEMPT SIT UPS or any strenuous exercise and use your upper body when getting out of bed or the bath.
--Wear an abdominal belt immediately postpartum to allow your tummy to heal with some support. (I will be posting a separate blog on the use of a postpartum support and will soon be offering belts to purchase)
--Exercise your Transversus Abdominus (TA) muscles with TA Setting- Lying on your back with your knees bent. Place one hand on your belly, and with your other hand press your fingers in the area 2 inches in and 2 inches down from your hip bone. Now pull up your pelvic floor (as if stopping yourself from a wee midstream) and GENTLY draw in your lower tummy. The hand on your belly should not feel much of a change as your upper abdominals should remain relaxed, while the hand down from your hip bone should feel a gentle tightening (your fingers do need to be pressed in fairly deep to feel this). If you are not sure what you should be feeling cough while your hand is in this position, and you should feel the tightening then.
The most important thing while doing this exercise is that the rest of your body remains relaxed and you DO NOT HOLD YOUR BREATH!
Aim to hold this muscle for 10 seconds and then relax. Repeat this 10 times if possible. If you feel the muscle under your lower hand is not working, stop and try again later or tomorrow.
Do this as often as you can through the day. Once you have grasped what to do you can do this standing/sitting, but it is useful to get the hang of it lying down first.
Although easy once you get the hang of it the TA setting it is very tricky to master, if you think you may have a separation I would recommend an assessment with Fit Bumps and Mums, to check, advice and teach you the exercises correctly. Once the separation is under control you can build up your abdominal strength, as well as your general fitness, by attending the Fit Mums 8 week postnatal rehabilitation class. The hour long class combines pilates, pelvic floor, stretching and high intensity exercise to gain a full body workout.