Physiotherapy & Pilates


Abdominal Separation - Rectus Diastasis

There has been some new insight into the way we look at the separation of the abdominal muscles after giving birth. The abdominal muscles are connected in the middle by a piece of tissue called the linea alba and rectus diastasis is the term given to the separation which most commonly occurs in women during and after pregnancy as the abdomen stretches with the growth of the baby. A recent study (Sperstad et al., 2016) showed that rectus diastasis was present in 45.4% of women at 6 months post partum and 32.6% of women at 12 months post partum.


Traditionally the focus has been on ‘closing the gap’ between the abdominal muscles; recent thinking though, is that it is more important to be able to generate tension along the linea alba (Lee & Hodges, 2015). By creating tension along the linea alba, you are creating a firm attachment point where the abdominal muscles can work from and therefore improving the function and efficiency of the muscles.


Integrity of the abdominal wall is important for posture,  stability of the trunk and pelvis and support of the abdominal organs. The abdominal muscles also work with the pelvic floor muscles, and one study found that in women with a rectus diastasis - 66% of them also had certain pelvic floor dysfunctions, such as - pelvic organ prolapse, stress incontinence and faecal incontinence (Spitznagle et al., 2006). So we know it’s important to look after those abdominal muscles after giving birth!


To create tension along the linea alba, it is necessary to be recruiting your transverus abdominis muscle (the deepest abdominal muscle, see here). Without this contraction, the linea alba may feel soft or sunken, or you will be able to see doming (see picture below), this can happen, even with a narrow gap. When contracted correctly the linea alba will become taut and thereby increase the efficiency of all the abdominal muscles and provide support to the abdominal organs. 

Doming along the linea alba, even with a narrow separation.

Doming along the linea alba, even with a narrow separation.

To prevent problems down the track, be very mindful when doing your abdominal exercises after having a baby. And remember the abdominal muscles are used in a lot of exercises apart from sit-ups (for example: planks, mountain climbers, push-ups etc.). If you’re not sure, best to see a physiotherapist with experience in this area.

Join us in our next post natal Pilates mat course! A six week course consisting of mat based Pilates exercises. Our post natal Pilates class will include individualised abdominal exercises depending on your level of strength and degree of abdominal separation.

Feel free to contact me if you have any questions.

Vanessa :) 


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