One of the most common reasons clients present to us in their postnatal period is because they are concerned about their abdominal separation. Some of the concern may relate to a fear that they a ‘separation’ may have functional implications and others may be concerned about the look or feel of their abdominal wall.
Abdominal separation is a common occurrence during pregnancy where changes to your hormone levels coupled with a growing and changing abdomen, cause a stretch to the linea alba - a prominent connective structure between your abdominal muscles.
This stretch is necessary to create plenty of space for the growing uterus and baby and it is considered completely normal to have a degree of separation which develops during pregnancy and can often still be seen or felt after giving birth. Studies on the prevalence of abdominal separation show that 80-100% of pregnant women will experience some degree of abdominal separation by the end of pregnancy.
There are many misconceptions out there regarding abdominal separation. Some include: having a separation will directly cause lower back pain, prolapse, urinary incontinence or that your degree of separation will impact your function in the long run.
The truth is there is little evidence to support these claims. Some women will experience abdominal separation along with other conditions such as back pain, prolapse or incontinence but the abdominal separation cannot be deemed to be causative. There is no need to panic!
In clinical practice it is common to see that in the early post-partum period, abdominal separation will start to gradually resolve unassisted. It is quite possible that some degree of separation will remain beyond the early post-partum period and that parous women may always have a greater degree or abdominal separation than they did pre-baby. This may or may not have an impact on return to activity. Most often, in women presenting to physio, their ongoing concerns relate to perceived poor posture, reduced abdominal strength or stretched skin rather than the degree of linea alba “separation”.
Whilst important to be aware of the degree (including width and depth of separation) of greater concern to us as therapists, (and within our ability to influence), is the function of the abdominal wall as a whole - and how it can support the rest of the body during everyday activities plus or minus the return to high level exercise.
In the first 6 weeks following birth it can be beneficial to wear recovery shorts to keep the tissue supported and to discourage postures that may increase strain on the abdominal structures as they recovery. An assessment by Women’s Health or Pelvic Health Physiotherapist will provide a detailed overview of the function of your abdominal wall including the surface and deep layers and different muscle groups such as obliques and the upper and lower portions of the rectus abdominis. Following your individualised assessment a treatment plan with specific whole body functional exercises including abdominal loading exercises will be developed to focus on rehabilitating your whole body back towards your goals.
One of our favourite methods to support the recovery of abdominal muscle strength and control is through Pilates! Pilates is a form of exercise that can be modified to beginner or advanced levels and can be influenced to target the abdominal wall in conjunction with other muscle groups in functional positions.
If you have any concerns about your abdominal muscles after your pregnancy or are keen to begin pilates in the pre or postnatal phase we would love to welcome you into our Clinical Pilates studio on Keilor Rd. As our Pilates is conducted by trained Physiotherapists, Private Health Insurance rebates are possible. Your starting point is a 1:1 assessment with one of our trained staff.
Book online or get in touch for further information!
Thanks to Divya Koujalgi, Women’s Health Physio and Pilates Instructor and our guest contributor for this blog!