Abdominal muscle separation
Diastasis of rectus abdominis muscle
What is an abdominal muscle separation?
An abdominal muscle separation is a separation of the rectus abdominis muscles or ‘six-pack
muscles’ on the front of your abdomen.
What causes this separation?
A separation in the centre of these muscles can occur during pregnancy as the hormones
soften your abdominal muscles and as your baby grows bigger.
What might it mean to you?
It can be associated with weaker pelvic floor muscles. You might notice a bulge through the
gap near your belly button with some movements.
No gap in the
rectus muscle
Gap in the
rectus muscle
What can be done to help?
The separation will usually improve on its own over time but sometimes the gap in the muscles
may not go away completely. A gap of 2 fingers or less is normal.
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Start pelvic floor exercises, as instructed by your physiotherapist/midwife.
Avoid doing things that increase the muscle separation or make the bulge appear.
When you are getting out of bed, roll onto your side first, then sit up.
Minimise lifting anything heavier than your baby or anything that causes your tummy to
‘bulge’.
Avoid doing ‘sit-ups’ or abdominal crunches until the separation resolves.
Wear an abdominal support belt such as a Tubi-grip or firm compressive underwear/shape
wear for the first few weeks after birth.
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Pelvic floor strengthening exercises
This exercise can be done when you are sitting, standing, lying down or walking around.
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Sit, stand or lie down with the muscles of your thighs, buttocks and stomach relaxed.
Breathe normally.
Gently squeeze the muscles around the back passage (anus) and the vagina as if you
are trying to stop passing wind or stopping the flow of urine.
Now relax these muscles.
Gently squeeze and let go a couple of times until you are sure you have found the right
muscles. Try not to squeeze your butt muscles.
Gently try to keep the pelvic floor muscles tight for as long as possible.
Release them when you feel the muscles starting to let go, relax them for a few
seconds.
Repeat this process up to ten times.
Over time gradually increase the time you can hold to 10 seconds. It doesn’t matter if
you cannot hold for 10 straight away. Practise.
You should try to do this exercise at least 3 times a day.
If you can remember to do the exercise more often, you are likely to get more benefit.
Try and link the exercises to things you do during the day like changing your baby,
preparing a meal or washing your hands. Or, try sticking little ‘reminder notes’ around
the house, to help you remember to do your exercises.
You can monitor the recovery of your abdominal muscle separation by:
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Lie on your back with your knees bent up. Place one hand at the level of your belly
button with fingers pointing into your belly. Now lift up (curl up) your head and
shoulders.
You should feel the muscles come together on either side of your fingers.
Check this no more than once per week.
If the muscle separation is still more than 2 fingers wide:
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Continue to avoid/minimise the things that make the muscle separation or bulge worse.
Keep doing the exercises outlined above and contact your physio if you need further
advice.
If the muscles are together or less than 2 fingers apart and the bulge is gone:
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Stop wearing any elastic stomach support as the muscles are back to
normal.
This document was developed by the Physiotherapy Department, Barwon Health.
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