13 Tips for Healing Abdominal Separation Post-Pregnancy
By Anna Scammell
Women’s Health Physiotherapist
- Learn how to activate your core muscles correctly
Correctly activating & isolating your transversus abdominis (deep abdominal muscles) and pelvic floor muscles is key to healing diastasis (abdominal separation). This is because activating your transversus abdominis increases fascial tension in the linea alba (the connective tissue that has been stretched between your 6-pack muscles), bringing the rectus abdominis muscle bellies closer together.
To activate your transversus abdominis, imagine you have a string between your hip bones. Gently draw your hip bones together as if you are shortening the string. If you palpate your belly button when you do this, you should feel increased tension under your fingers i.e. more resistance.
I teach this activation & exactly what to feel in my online postpartum program The Postpartum Academy. Your Women’s Health Physiotherapist will also teach you this correct activation at your 6 week postpartum assessment.
- Wear a compression garment
I recommend every new mum wears SRC recovery shorts daily for the first 6-8 weeks post-birth to facilitate abdominal healing. If you are past 6 weeks, compression can still help mums with moderate to severe abdominal separation (4 or more finger width).
I like SRC garments because they are medical grade compression and provide uniform compression over the abdomen & pelvic floor.
- Start safe core exercises within 6 weeks post-birth
There is a misconception that you shouldn’t do any exercises in the first 6 weeks, but in actual fact doing safe exercises during this time is key to optimising and speeding up your abdominal recovery.
On day 1 post-birth you can start gentle isolated core activation exercises. Slowly increase this activation to 10 reps, 3 x day (incorporating slow holds & fast contractions) over the coming weeks. My Free Pelvic Floor Guide explains this in detail.
After 1-2 weeks post-birth (when you feel ready) you can start basic core exercises, which I teach in The Postpartum Academy called “Core Foundations”. In doing so you will re-connect to your stretched muscles, focusing on core activation, control of movement, technique & breath.
- Adopt optimal posture
Be mindful of your posture during sitting & standing post-birth, especially during the hours feeding bub. Make sure you have a supportive feeding chair & use a feeding pillow so you can sit upright rather than slumped.
When you sit with an optimal posture, you can connect & activate your core much easier, which will in turn help your abdominal recovery.
- See a Women’s Health Physiotherapist
At 6 weeks post-birth it’s really important every new mum sees a Women’s Health Physiotherapist. If you’re months/years postpartum, it’s still very worthwhile to still do. We will assess your abdominal separation (width & depth) and pelvic floor; teach you how to activate your core muscles correctly; and give you individualized guidance on which abdominal exercises to focus on & avoid.
We will continue to monitor your separation and progress abdominal exercises as appropriate.
- Re-build from the inside out
Core activation and basic core exercises (as mentioned above) is the starting point to rehabilitating your abdominal separation. From here, it’s important to build in oblique exercises like trunk rotation and side bending into positions that won’t create too much intra-abdominal pressure i.e. standing, lunge positions, high kneeling, all 4’s, long sitting.
As you get stronger and can maintain tension through your midline (linea alba), you can start to challenge superficial muscles (rectus abdominis) more with exercises such as controlled curl ups, curl ups + side bends, table top, single leg planks etc.
The Postpartum Academy has a complete recovery exercise program that guides you through this.
- Do Postnatal Pilates 3 x week
At 6 weeks postpartum, I recommend doing regular Pilates. You can move up to Level 1 in The Postpartum Academy and start attending Postnatal Pilates classes.
Since Pilates focuses on core activation, alignment, technique & control of movement, it’s an essential form of exercise to heal abdominal separation and re-gain strength safely.
The instructor needs to have solid knowledge of abdominal separation so they can give you suitable exercises for your specific degree of separation.
- Do appropriate ab exercises for you
During abdominal exercises you need to feel tension & control through your midline (linea alba). If the exercise is too hard, it can actually slow your recovery or worsen your diastasis.
The following signs indicate the exercise it TOO much for you:
- Any slight abdominal doming or bulging along your midline
- Deep caving in along your midline that you can visibly see or feel with your finger (your finger will sink in)
- Inability to maintain the correct alignment or technique (e.g. unable to keep your lower back flat to floor during table top exercises)
- Inability to engage your core muscles (transversus abdominis & pelvic floor)
- Holding your breath
- Excessive shaking during the exercise indicating muscle fatigue
- Any back pain or strain indicating your back is taking too much load due to abdominal weakness/fatigue
Advanced abdominal exercises can take time to return to (commonly >3 months PP). These include sit ups, crunches, planks, table top exercises, double leg lowers, boat pose (or V sitting) etc. In saying this, each woman’s body is different so you may be ahead or behind the “norm”.
- Implement progressive overload
Some women plateau with abdominal recovery because they are not challenging their abs enough. This is why getting individualized feedback from a Women’s Health Physio is so helpful.
As you get stronger, it’s important to increase sets and add in resistance, like a theraband & light weights, to the exercises you’re currently doing. As these get easier and you can maintain tension through your midline, try more advanced abdominal exercises.
- Perform low-impact cardio exercise
As well as Pilates, you need to do cardio exercise 3 x week. For early postpartum (<3-4 months) stick to low-impact exercise options like fast-pace walking, swimming & cycling. Pram walking is a great option with a baby.
If you are further along your journey & have the desire to return to running or HIT exercise obtain clearance from your Women’s Health Physio first to make sure your abdominals & pelvic floor can handle the increase in intra-abdominal pressure.
- Incorporate muscle stretching & release work
When one part of your body changes structure or weakens, such as with diastasis, it can influence other areas, causing muscle/joint imbalances, tightness or tension. Stretching & releasing your hips, pelvis & spine will help to restore balance and facilitate recovery. Your Women’s Health Physio can do manual therapy based on their assessment findings.
- Prioritise optimal nutrition
Let’s not forget the essential role nutrition plays in recovery and healing. Make sure you are eating an abundance of wholefoods (vegetables & fruit) and good quality proteins & fats during postpartum. Eating more protein increases the production of collagen, which is important for tissue repair. Good sources of this are bone broths, slow cooked stews and casseroles that incorporate animal meat. Supplementing your diet with a good quality collagen powder is worthwhile also.
Reducing inflammatory foods is also essential to do. These include refined sugar, refined carbs, processed food, junk foods, poor quality diary etc.
- Be patient & consistent!
Abdominal recovery doesn’t just take a casual 6 weeks! In some cases it can take 12+ months so be patient. Your hormones levels postpartum are different to normal so this impacts muscle strength, meaning rebuilding muscle takes longer than normal.
You can’t expect results without putting in consistent effort. This means implementing the above tips for several months to start seeing obvious results.
No matter how many weeks/months/years postpartum you are, know you can always improve your separation so don’t give up!
Anna Scammell is a Masters-trained Women’s Health & Pelvic Floor Physiotherapist in Sydney, and Founder of The Whole Mother. Anna specialises in pregnancy, postpartum & the pelvic floor, offering home visits, clinic consults and online consults. She is also the Founder of The Pregnancy Academy and The Postpartum Academy- online educational & exercise programs teaching women how to have a healthier pregnancy, smoother birth and an empowered, stronger recovery.
Connect with Anna:
Email: anna@thewholemother.com
Website: www.thewholemother.com
Social: @the.whole.mother
Online Pregnancy Program: The Pregnancy Academy
Online Postpartum Program: The Postpartum Academy