Anyone who has been pregnant will be very familiar with the term, abdominal separation, or DRAMS (Diastasis Rectus Abdominal Muscle Separation). There is a lot of fear surrounding DRAMS, but the reality is that just about anyone who goes through pregnancy will experience some degree of muscle separation and will be completely unaffected by it.
As your belly grows during pregnancy, your stomach muscles stretch and naturally the connective tissue that joins the two sides of your rectus abdominus (RA) muscle becomes quite thin. RA is your ‘6 pack’ muscle and beneath this you also have your external oblique, internal oblique and transverse abdominus muscles.
There are ways to minimise the degree of abdominal muscle separation you experience and specific exercises you can do to help reduce the separation after giving birth.
During pregnancy it helps to avoid movements or activities that put your RA muscle under load. Movements such as roll downs, crunches, sit ups and planks will cause RA to contract and can tug at the connective tissue, causing a greater separation. In addition to modifying the way you exercise, it helps to be mindful in the way you move in your day to day life. Roll onto your side when getting out of bed, try not to sit forward from a reclined position and reduce any heavy lifting.
You can also do pregnancy-safe core strengthening exercises to keep your deeper abdominal muscles strong and active so that your recovery is faster and more effective. These are exercises done in 4 point kneeling, side lying and supported by your elbows or a bolster. We have plenty of core strengthening classes in our prenatal catalogue to guide you through your pregnancy.
After giving birth, your midwife will assess your abdominal separation using their finger width as a guide. Any separation of 2 fingers or less is considered normal and you can proceed with your regular postnatal strengthening program. A separation of greater than 2 fingers requires a little more attention and specific training, but can reduce to a normal width with the right guidance.
Regardless of your degree of separation, you will ideally use some compression around your abdomen to help with healing. This can be in the form of a tubi grip, postnatal leggings or or postnatal shorts, or a combination of all three. Aim to wear your compression quite consistently through the day for the first 6 weeks.
So, how do you strengthen your stomach muscles if you have a separation of greater than 2 fingers?
My first recommendation would be to see a women’s health physiotherapist for some specific guidance and a more thorough assessment than the midwife will have done. It can take a few weeks to get in with your physio, so in the meantime, it’s perfectly safe to start some core strengthening exercises to target those deeper muscles (TA, IO, EO). The following exercises are a great way to start for anyone who is unsure about what they can do to help their abdominal muscle separation post pregnancy.
Core plus breathing:
- Start lying on your back with your knees bent and feet flat.
- Place your fingers tips on the pointy bones at the front of your hips, then slide your fingers about 2 cm inwards.
- Breathe in then as you breathe out, draw inwards and upwards through your pelvic floor as if you are trying to stop yourself from passing wind.
- You should feel a very gentle firmness under your fingertips.
- Relax as you inhale and feel that your stomach goes soft again under your fingers. Repeat x 10
Scissors:
- Start lying on your back with your knees bent and feet flat, with your hands resting on your pelvis bones.
- Breathe in then as you breathe out, engage your pelvic floor as above and raise one knee to 90 degrees.
- Place your foot down as you inhale.
- Raise your other leg as you exhale.
- Feel that your weight stays right on the centre of your tailbone as you raise your leg.
- Repeat x 5 on each side.
4 Point kneeling leg slides:
- Start on your hands and knees, with your hands under your shoulders and your knees under your hips.
- Press your left hand and right knee firmly into the mat and feel that your left knee lightens a little.
- Engage through your pelvic floor and deep abdominals and slide your left foot out along the mat until your knee is straight.
- Keep the top of your foot in contact with the mat.
- Slide your leg back into your starting position.
- Repeat x 10 on each side.
Cues to think about when working through these exercises to help maximise their effect on your abdominal separation:
- Think of drawing your ribs in towards your hips. Imagine there are a couple of springs connecting your lower ribs to your pelvic bones and these springs, creating some tension across your stomach wall.
- A slight tuck of your pelvis will help so think of pulling your pubic bone towards your belly button just a little.
- Picture a cross with the vertical line running from your breast bone to your pubic bone and the horizontal line running from one pelvis bone to the other. When you do your core work, picture everything drawing into the centre of the cross.
- Exhaling on the effortful part of the movement will achieve a slightly deeper and stronger connection to your TA muscle.
Technique is key with any core strengthening, but particularly when recovering from pregnancy and giving birth. I suggest trying to find a quiet 10 minutes each day to practise your exercises for the best results.
In summary,
- Nearly everyone will experience some abdominal separation after pregnancy.
- We do not need to fear this, as there is plenty we can do to strengthen our muscles again.
- By strengthening the deeper abdominal muscles, we can minimise the separation of RA.
- Technique is important so don’t skip the early stages, begin with exercises that build awareness and wake your muscles up.
- If you are concerned about your abdominal separation, see a women’s health physio for a thorough assessment and management plan.
As always, I would love to hear from you so if you have any questions or need any guidance around our platform, just reach out!
Han x