21 answers

Advice on Split Abs After Cesarean

Hi there. I have a huge gap right down the middle of my rectus abdominus. We had an emergency c-section 11 months ago, so I didn't get back to exercising quickly! In fact, I am just now getting back in the gym this week. The gap is so wide in my abs that I can easily put a couple fingers in between the two muscles where the linea alba usually holds it together. Does anyone know if it would be unwise to do ab work at this point or would it actually benefit it? I can do core work just fine, but I don't have full ab capability- I need to use my elbows to sit up, etc. Any input would be great!

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My best friend had the same issue - she has used exercise to get it back (although it is not all the way back) She said polates and yoga were showed the best results. Even if you can't keep up in the beginning it will get better, she did!

I had the same thing after my c-section and had to have an abdominal incision repair (that included a mesh patch) to sew my abs back together again. You should see a dr.

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Hey, K.! Funny that this was the first question I saw. I was going to just call you and tell you this, but figured some others might be interested in the answer (and I myself needed to look it up to start getting rid of my own pooch sometime soon!) The pregnancy bodywork class I took this fall had some specific prescriptions for fixing diastasis recti - here's the info on abdominal exercises:

*Before* doing regular curl-ups or other abdominal exercises, you need to fix the separation. Doing regular curl-ups before the split in the muscles is repaired can actually make them separate further.

Modified curl-ups:
1. lie on your back on the floor with knees bent and feet on the floor.
2. do a pelvic tilt (flatten the curve in your lower back by posteriorly tilting pelvis - like the pilates "neutral spine")
3. cross your hands over the abdomen and grab the lateral borders of the rectus abdominus.
4. while breathing out, slowly raise your head while pulling your hands together.
5. stop before the abdomen starts to bulge.
6. inhale while returning slowly to start position.

Should be repeated daily, up to 50 repetitions, in sets of 10, until the separation is closed.

Hope that helps!

1 mom found this helpful

I would see your doctor about this...as said here it was your pregnancy that caused the vertical split of the abdominal muscles. But you say you had emergency c-sec? Is your incision vertical instead of horizontal at the bikini like? You may be able to correct that with surgery if it give you trouble.

Have you tried doing isometic exercises (where you don't actually move, but just contract or tighten the muscle) for your abs? I would probably start with isometrics, trying to minimize the gap in one stable position (commonly laying down in the traditional abs exercise position.) Once you can tighten the muscles to the point of minimizing the gap, then you can start adding an abdominal curl. When you add the abdominal curl, it simply be raising your head and maintaining the minimal gap in the linea alba. You can gradually do more of a curl/sit up as your muscles get stronger, maintaining the minimal gap the whole time. If your gap in the muscles becomes large, back off the exercise and do the previous level of difficulty that did not cause the gap to widen.
You could ask you obgyn to send you to a Physical Therapist for some muscle retraining, since your abdominal muscles are crucial in preventing injury to and supporting your back.

Hi K.,

It is common for women that have had a child to have separated abdominal muscles. Since your son is 11 months old, it should be safe to do ab excercises by now. Those muscles may be weak, because you haven't worked on them. They should get stronger once you work them.

You may want to consult a doctor to make sure that you do not have a hernia, before you start working out. Also, if you ever consider cosmetic surgery, the Abdominoplasty (Tummy Tuck) procedure consists of sewing the separated abdominal muscles back together in addition to the removal of the extra skin.

I am not a physician, but I do have medical knowledge. Hope this helps.

Warmly,

S. P.

-----------------------------------------------
"You'll never be Wealthy working for someone else. You may become rich, but there is a difference between being rich and being weathy. Wealth is something that you can pass down to generations. It is when you make as much money as you want, and have the time to enjoy it whenever you want." S.L.P

To find out how to obtain Wealth, go to http://www.joindollardiva.com

When I became pregnant with my first baby my mom lent me a book "Maternal Fitness" by Julie Tupler which deals with this diastasis issue as well as other maternal fitness issues.

To quote: "Pregnancy naturally separates a mother’s outermost abdominal muscles to make room for her growing uterus. Called a diastasis, this separation does not close up in most new moms. With each pregnancy this separation gets larger, which is why women show earlier with each pregnancy.

When the muscles separate the connective tissue that joins them stretches sideways and becomes thinner. The mummy tummy is thus the protruding organs against this thin connective tissue. To lose the mummy tummy it is necessary to close this separation so the muscles are supporting the organs—not the thin connective tissue!"

You might want to check out her website www.maternalfitness.com to check out more info. She also has a book "Lose your Mummy Tummy" for after having a baby which has excercises to heal a diastisis.

Try pilates, but go easy.....

If you're really worried about it, call your ob/gyn.

Hi K.,
I had the same thing happen to me after cesarian, although I think it split just from pregnancy. I am an exercise physiologist and I work with physical therapist. It is safe and beneficial to do some ab work, but not all. Don't do any full sit-up. Do small crunches or even just pelvic tilts (pushing the small of your back to the floor while tightening your ab muscles and hold for 3-5 seconds). Here's the trick, try to hold your split muscle together while you are contracting. This will eventually bring the muscle closer together, however probably not solve your problem. Just always be aware of your muscles when your exercising. If something feels wrong, don't to it. It takes time and patience, don't over do it.

S.

I have given birth to 6 kids, 3 of which were c-sections. Mine do the same thing, and in my case no amount of sit ups will ever make them go back. I'll require surgery, which is an option for me because I'm done with childbearing. However, if you are not done, surgery is not an option.

It won't hurt to do the exercises, but don't be suprised if it doesn't work. It happens sometimes.

I think if I was you I would ask your doctor to maybe do skin grafts to encouragae the skin the over lay. Plastic surgeon should know and because it is so critical, your insurance should take care of it.

I have that same issue which is pretty common, although I hadn't heard of it before it happened to me. I'm still looking for all the answers, but I do know you can exacerbate the problem by doing certain ab exercises. Anything that makes a "ridge" come up is not good to do. Does that make sense? I think there is some healing that comes with smart toning, but I also think sometimes (if bad enough- probably not us) it requires surgery - keep asking your doctor or anyone at the gym until someone finally really seems to know about safe exercises. careful though, some trainers know little about this but give advice anyway. Common sense will go a long way, obviously anything that hurts or makes it worse isn't helping. sorry not more helpful.

hey Kristi,

I'm a physical therapist and this is something we addressed in school. Hannah is absolutely right. You have to fix the seperation 1st or regular crunches will pull your abs further apart. Do a pelvic tilt and hold while doing any ab exercise. Also just hold your abs tight through out the day but not so tight that your back tightens up

K.,
I still have that gap, and it has been 3 years since my last C-section. I was actually beginning to think I had a ventral hernia!!! 11 months post-op should be plenty long enough to begin exercising. I would check with your doctor to see if the gap needs to be repaired. I have actually been considering a tummy tuck and thought they could put mesh down the center to fix this problem. Best to see a doctor.

Your doctor would be the best person to ask... but I can say that my doc advised waiting 6 months to work out after a c-section.
Your abdominal muscles actually split b/c of the expansion of your uterus, not because of a c-section, or even labor.
good luck

I have had to deal with the gap after each pregnancy. I believe the best explaination came from my midwife after my last pregnancy. Unfortunately, I can't remember the details of "why," but she did encourage me to only lift my head/some shoulder off the floor until I was up to 100. She said working that muscle before it's closer together would actually be counterproductive, and that's the part I forget--why? But she did explain it to me, and it made sense then. I have also gently worked my abs (with the gap) while holding a hand on each side, kindof pushing/holding the sides in place. That tip came from my doctor.

I had a vaginal birth, but still had a large gap. My midwife recommended that I start ab exercises lying on my stomach. Lie on your stomach with your arms beside you, palms down. Press into your palms and raise your head slightly. DO NOT SQUEEZE YOUR BUTT MUSCLES!! Work towards raising your head and your entire chest. If you are breastfeeding, do this immediately after nursing, so there is no pressure on the breasts.
You can also work in the same position raising the legs. Start with one leg at a time. Again, the work happens in the abs, NOT the back or the butt. Squeeze your ab muscles and imagine that strength moving into your toes and lifting your foot off the ground. Work towards being able to raise the leg straight, getting even the knee off the ground. Be very careful not to squeeze your butt. Once you can do one leg at a time comfortably, try both.

These are yoga poses, so if you can find a qualified yoga instructor to help you with poses that involve lying on your stomach, you'll be closing that gap in good time.

I didn't have a c-section but this did happen to me during both of my pregnancies. I read up on it on the internet and from what I could find this is completely normal. Your abs will begin to separate to make room for your baby. After delivery it will just take a while for them to come back together. I'm no doc but I believe it would be safe and beneficial for you to go ahead with your ab workouts. This should help move the recovery along.

My best friend had the same issue - she has used exercise to get it back (although it is not all the way back) She said polates and yoga were showed the best results. Even if you can't keep up in the beginning it will get better, she did!

I had both of my girls Vagianlly but I went through the same abdominal spilt issue. they will join ack together over time. I had to get back into shape very early after my girls were born because of the physical fitness requirements of my military career. The best thing you can do is just get started. Be careful when pushing yourself. It is imperative to feel the muscles burning i.e. the good hurt., However it is very easy to tear or get a hernia when the organs you abs normally protect are mor exposed. Try standing ab exercises which engage lower left abdominal muscle and the upper right at the same time and then of course switch. This may be a bit more effective than the up on the elbows appoach think like knee to elbow while stand but make sur you are engaging the abs and not as much the quads and biceps. Hope this help best of luck:)

My understanding (this happened to a very good friend of mine) is that no amount of ab work will help you. The only thing you can do to go back to the way you were is plastic surgery. You can certainly try the exercise route but ultimately your muscles/ligaments have torn and cannot come back together. I would definitely speak to your doctor about this to get the full and accurate scoop before you get too frustrated.
Good luck!

Your condition is called diastasis recti. If you do ab work try crossing your hands across your abdomen and push the abdominal muscles together during the exercise. Hopefully they will reapproximate on their own, but if they don't you may need to have them stitched back together. Hope this helps.

I had the same thing after my c-section and had to have an abdominal incision repair (that included a mesh patch) to sew my abs back together again. You should see a dr.

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