"I have a quick question. How long is normal for abdominal separation to heal? I still have 1.5 fingers width of separation despite avoiding sit ups etc and doing exercises to try and heal it. My daughter is 7 months old now and I'm wondering if it's something a physio or someone can help me with or if I need to look at having it repaired surgically." Lucy (not her real name)
Unfortunately Lucy, this isn't a quick answer, but let's break it down so we can cover all our bases. Also, I am sharing here what I have learnt through my postnatal trainer qualifications and personal experience but I am not a medical professional and strongly encourage all women to see a women's health physiotherapist or their GP if they have concerns about their abdominal separation (diastasis recti).
I am not going to go through the ins and outs of anatomy in this post (there is plenty on the internet). But in a nutshell, separation of the rectus andominis muscles (see picture below) happens in most women during pregnancy to accommodate the growing baby (kind of essential don't you think?). In some women it comes back together quickly after birth and for others (like me) it does not. Diastasis can be a cause of back pain and have an impact on your pelvic floor function as it is part of your core. It can also make you look pregnant when you are not (which can be distressing for some mums). You can click on the picture below for a more detailed explanation of diastasis recti.
1. How long is normal for abdominal separation to heal?
It depends. That is annoying right! Each person's recovery will differ depending on factors such as genetics, how many kids they have had, how wide their separation is, the tension of their connective tissue (see pic above), their diet, their posture, how they exercise and even how they breath.
2. I still have 1.5 fingers width of separation despite avoiding sit ups etc and doing exercises to try and heal it.
First off, good job on avoiding the sit ups. They aren't your friend when you have abdominal separation and neither are planks so it is always a good idea to see a physio, postnatal pilates instructor, exercise physiologist, or personal trainer for diastasis friendly core exercises. Poor exercise selection can definitely prevent healing, increase the gap or cause a hernia so it is important to move wisely.
Women can get pretty obsessed about 'closing the gap' but I have good news. You don't have to completely close the gap to have a functioning core and no symptoms, but you do need to know how to manage the pressure that is generated internally when you move in order to prevent further damage. This largely goes back to the breathing, posture and exercise selection factors we mentioned in point 1.
For you Lucy, a 1.5 finger gap is considered pretty small and probably won't prevent you from doing the exercises you love in the future. It is best to see a women's health physio that specialises in diastasis recti though for a full assessment of your core function and advice going forward.
3. My daughter is 7 months old
Congratulations on surviving the new baby stage! In terms of abdominal healing this isn't actually a long time. They say it can take up to two years for a woman's body to fully recover after childbirth so don't feel you should be further along in your recovery than you are right now.
It is also never to late to improve core strength and improve a diastasis so any mums out there who are further down their postnatal journey, you can start now! However, in some women, no matter what they do, they will never be able to heal their diastasis without surgery (see below).
4. I'm wondering if it's something a physio or someone can help me with or if I need to look at having it repaired surgically.
Yes, see a physio!! I recommend to all my clients that they have an abdominal and pelvic floor assessment with a women's health physio at around 6 weeks postpartum or at any time they are concerned about their recovery/pelvic floor health. Knowledge is power! Knowing your own body, how it is currently functioning and how it should be functioning will help you identify when something doesn't feel right and prompt you to seek specialist help.
As for surgery, I recently went to see a surgeon about my umbilical hernia and while I was there I quizzed him about all things diastasis recti. It is major surgery with a long recovery time and requires the insertion of mesh to hold the two sides together. If you have a significant diastasis that hasn't responded to exercise, a hernia, or are experiencing pain due to your diastasis then surgery might be for you. By the sounds of it Lucy, your not a candidate for surgery but your physio can provide further advice on this.
So Lucy, I hope that has helped to answer your question, even if I can't give you a definitive answer.
What you can do if you have diastasis recti
Here are some quick tips to help your recovery process:
- See a women's health physio early and ask lots of questions. Different physios have different approaches and areas of expertise so find one that suits your needs. You can view a list of physios we know in Brisbane here and a Google search of your area will find more.
- A support garment such as SRC Recovery shorts might be useful for you early on (but they are not a long term solution).
- Roll onto your side to sit up or lie down so you aren't jack-knifing out of bed.
- Get professional advice on your exercise selections so you can not only get exercises to help strengthen and restore but also to avoid exercises that may aggravate and delay the healing process.
- Be consistent in your recovery efforts. If you are using lifestyle modifications and exercises to try and close your gap, you need to be consistent and persistent. And if it does come together it may not be a case of set and forget. Maintaining diastasis friendly posture, breathing and exercise selection will ensure we don't relapse later on.
If you have a question you would like answered then please get in touch. If we can't answer it directly, we will get on our local experts to answer it for you. You can also use the search function on our site to look for more blog articles on diastasis and core strengthening.
About the Author
Christine holds a Cert III and Cert IV in Fitness and has undergone specific training in exercise for pregnancy, postnatal pelvic floor and abdominal recovery and group exercise instruction. Christine is registered with Fitness Australia (Reg No. 095064) and a member of the Continence Foundation of Australia. She also holds a Master of Business Administration (MBA), a Bachelor of Leisure Management and volunteers as President of Friends of the Birth Centre to advocate for improved maternity services for women in Queensland.