Friday Q&A: Abdominal Separation

Q: As I work with yoga students who are mid 50's -60's I am learning about abdominal separation that in most cases occurred during their child bearing years. In women's classes we often explore how the breath informs the pelvic floor muscles and communicates with transverse abdominis, obliques & rectus.

What are other causes of abdominal separation or "split abdominals"? What do I need to consider in working with women (and men?) who have abdominal separation? What poses to gently explore and what to avoid now that they are grandparents?

A: This condition, known technically as diastasis recti, occurs in two groups: newborns and pregnant women.  It is a separation of the midline of the most superficial layer of the abdominals, the rectus abdominus, at the vertical line known as the linea alba. This can happen anywhere from the lower tip of the breast bone all the way down to the pubic bone. It is more common in women who have had several children over time.  It is most noticeable as a midline buldging that occurs when the pressure in the belly increases, such as when coughing, sneezing, laughing, or suddenly carrying something heavy. It could be mistaken for an abdominal hernia, although it can be a much longer than your typical hernia.

There are specific techniques that have been developed to help improve the condition short of doing a cosmetic surgery to tighten up the two sides of the rectus that move away from one another with abdominal separation. They are known as the Tuppler Technique exercise. One of them sounds a lot like Plank pose on the forearms, with lower belly engaged to the spine as in Uddiyana Bandha.  The other one I was able to find was basically Constructive Rest pose (lying on the back, with knees bent and soles of the feet on the floor) with the same abdominal action, drawing the upper and lower abdomen towards the spine and holding that position for about 30 seconds. It would seem, then, that yogic pranayama techniques of engaged bandhas, with Viloma holds, could be very beneficial. In addition, the Kriya technique of Nauli might also be of benefit.  This usually done standing in a slight forward fold, like Utkatasana, with the hands on the thighs, and actively drawing the abdominal wall and contents back toward the spine. Nauli is not a practice I do regularly, but you can ask a local teacher about it if you want to learn more.

Poses to avoid include any that increase intra abdominal pressure, such as deep forward bends, where you might not ordinarily think to draw belly back towards the spine, arm balances, such as Heron or Crow, and Boat pose (Navasana). Also, deep backbends, where you are lengthening the abdomen could result in widening of abdomen as well, could worsen things.

—Baxter