Do you have a tummy gap? How can you check?
Updated: Oct 30, 2018
A tummy gap? What is that? Is it normal? Do I have one? I often hear these questions when I am doing a mummy MOT post-natal check. A tummy gap, or a diastasis recti, is an abnormal gap between the 2 six-pack muscles of the tummy. It often occurs after childbirth, but not always.
So, let’s start at the beginning. There are 4 layers of tummy muscles, the external obliques running down and inwards, the internal obliques running upwards and inwards, the rectus abdominus (the six pack), from the top down to the pelvis, and the deepest layer the transverse abdominus (TVA) running horizontally around like a corset. The right and left side muscles never touch. They are separated by the linea alba, a strong connective tissue called fascia that holds the 2 halves together and closes the midline.
During pregnancy the abdominal muscles separate and the linea alba becomes stretched. This is normal. After pregnancy the muscles usually come back together, if they don’t then there is a tummy gap remaining. The current research on the size of a normal gap is inconclusive, anything upto 1-2 cm can be normal, the latest research suggests that the tension that can be generated in the linea alba is much more important than the size of the gap.
Imagine your abdomen as a balloon. Any increase in pressure within the balloon, for example from bending over or coughing, will distort the balloon. A stable abdomen can disperse and withstand the increase in abdominal pressure without bulging out forwards or down into the pelvis.
If there is a weakness in the abdominal muscles you will see the tummy ‘doming’ in the middle when you lift your head or leg(s) off the bed, or when you lift your baby off the floor which means that the tummy gap cannot withstand the increase in abdominal pressure.
HOW TO TEST YOUR TUMMY GAP
lay on the bed with 1 pillow under the head and your knees bent feet on the bed
relax your tummy muscles
inhale and feel the tummy lift slightly and then flatten on the out breath
using one hand, place the pads of your fingers on the midline of your tummy, so that the palm is facing up towards you. Keep the fingers together and place them just above your belly button.
gently push the fingers down into the abdomen, this should not be painful, if it is use less pressure or change the angle of your fingers slightly
feel what happens as you lift your head up slightly off the pillow, keeping the shoulders on the bed, do not do a crunch or sit up
do you feel a soft space between your muscles? how wide is it? how many fingers can you fit into the soft spot?
what is the tension like? Can you push your fingers further in or is there resistance like a trampoline?
re-test the separation and linea alba tension 5cm above and 5cm below the belly button
If the deep layer of tummy muscles, the core, are working correctly and at the right time this will help to strengthen the linea alba and reduce the size of the tummy gap. We know that the ‘core’ is made up of the diaphragm above, pelvic floor below, TVA in front and spinal muscles behind. This is the deepest part of you, the innermost layer of your muscular system.
Now try this in the same position as above
take an in breath to prepare
on the out breath contract the pelvic floor muscles from the back to the front
you should feel a slight tensioning in the lower abdomen just inside your pelvic bones, this is the TVA switching on
do not brace or fix with your tummy muscles
then lift your head off the pillow
breathe normally, don’t hold your breath
re-test the tummy gap and depth/tension
If the tension and/or gap improves you need to do core strengthening exercises. If you are unsure how to contract your pelvic floor muscles correctly sign up to download my e-guide or get yourself booked in for an assessment with a Women’s Health Physiotherapist. Pelvic floor exercises can be overdone or done incorrectly, remember to let go and release fully once you have finished exercising.
If you have any questions please get in touch.