In the final stage of pregnancy you may notice a vertical line of doming down the middle of your bump. If you go to full term, it is normal to have a separation of the six pack muscles (rectus abdominis). This is known as a ‘diastasis recti’ or ‘tummy gap’.
A hormone called ‘relaxin’ is released in pregnancy which does what it says on the tin. It softens or relaxes your ligaments and connective tissue to allow room for the baby and prepares the body for delivery. A line of connective tissue in between your six pack muscles called the ‘linea alba’ stretches in the final trimester to allow extra room for the baby to grow.
After delivery the doming can continue during certain movements or activities for several weeks to months.
How do I improve the tummy gap?
The gap will largely return to normal after about 8 weeks. Try to adapt or avoid any activity that causes doming. For example, avoid doing a sit up action when you get out of bed. Rather, roll on your side and push up into sitting. Avoid heavy lifting and strenuous activity that causes doming. It can be helpful to continue wearing maternity trousers as support.
For the first 6 weeks after delivery, the ACOG Guidelines (American College of Obstetricians and Gynaecologists) advise regular pelvic floor exercises and gentle exercise if comfortable. For example, gradually building up walking and basic abdominal exercises. This is advised to women who have had an uncomplicated pregnancy and delivery.
Pelvic floor exercises should be done 3 times per day (see previous blog for more in depth guidance). Your pelvic floor muscles work together with your deep corset tummy muscle (transversus abdominis). So even just starting with pelvic floor exercises will help to improve the gap.
After your six week check, Pilates is good place to start. This form of exercise strengthens all the muscles that are weakened and lengthened in pregnancy and childbirth. Pilates stabilises the pelvis and lower back by strengthening the deep core muscles that the six pack muscles sit on.
So when can I get back in the gym?
If all is well at the 6 week check then the Guidelines advise gentle exercise. The types of exercise recommended are swimming, cycling (not spin!), Pilates and Yoga. Delay this by 2 weeks for a C-section.
After 3 months you can introduce impact exercise like running or weight training. You must have strengthened your pelvic floor muscles, resolved your tummy gap before impact exercise is undertaken. also avoid if you have symptoms like leaking or vaginal heaviness.
How do I know if I can return to exercise?
Every birth and pregnancy is different so the best way is to see the Women’s Health Physio for a Mummy MOT after your 6 week check.
The Mummy MOT takes a good look at the state of your pelvic floor, tummy and posture and devises suitable exercises for your own needs.