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Helene Wilsgaard Vabø is an active fitness profile on Instagram, works as a personal trainer, and is pursuing a master's degree at NIH. She is one of many with abdominal muscle separation after childbirth who participated in Sandra Gluppe's research project.

Helene has abdominal separation, but can still lift heavy weights

Many new mothers are anxious about strength training. Helene Vabø Wilsgaard doesn't feel that her abdomen is an obstacle to heavy strength training, and this is supported by new NIH research

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“It's wonderful to lift heavy weights and feel that I am strong and can achieve what I want,” Helene Vabø Wilsgaard says.

She has been involved in CrossFit for many years and has had seperated abdominal muscles since 2008.

Wilsgaard is one of many mothers who participated in the research project on diastasis recti (DR), which means having a gap between the abdominal muscles after childbirth.

She states that her curiosity and desire for more knowledge on the subject are the reasons she chose to participate in the study.

Separated abdominal muscles

Separated abdominal muscles are seen when a gap forms between the vertical abdominal muscles. In medical terms, this is called diastasis recti abdominis. This usually occurs towards the end of a pregnancy, but it can also happen in connection with significant weight gain in non-pregnant individuals and in some cases when weightlifting. The abdomen stretches both lengthwise and in width.

For most people, the abdominal muscles come back together within a few weeks after giving birth, but for some, the gap between the abdominal muscles persists.

(Source: NHI (link in Norwegian))

Social media gives mothers the wrong impression

Although many participants who signed up for the study believed they had separated abdominal muscles, Wilsgaard was one of the few who were actually diagnosed.

Over 70 per cent of the women who signed up for the research project believed they had DR, but this was refuted when they came in for screening.

The women also stated they most often used social media and websites to get advice on treatment for DR.

“Many women get the impression from social media that it's very common to have DR. But many haven't been informed that there is a natural healing process in the body after childbirth," doctoral fellow Sandra Bjordal Gluppe says. 

She explains that for some, the gap closes immediately, while a study from Ahus Hospital has shown that it can take up to a year for others. 

“You have to give it time, and you don't need to worry right away,” she adds.

Changes in the abdomen are normal

Gluppe is also a physiotherapist. She has examined separated abdominal muscles after childbirth in multiple different studies.

One study found that many of the 460 first-time mothers who participated were concerned about the appearance of their abdomen after childbirth. 

Those who reported having a bulging abdomen, characteristic of DR, were also less satisfied with their appearance than those who did not.

“Many have questions about their abdomen and are afraid of making mistakes. It's important to convey that it's completely normal for the abdomen to change after childbirth, and that it is nevertheless still possible to use the abdominal muscles,” Gluppe says. 

A study examined the effect of an abdominal muscle training programme consisting of head lifts, curl-ups, and oblique curl-ups. 70 women participated.

According to Gluppe, very few have what can be classified as a significant degree of seperated abdominal muscles, meaning over 5 centimetres. There have been few of these cases in the studies, and unfortunately, research on this group is lacking. 

Sit-ups are not dangerous

One of the main findings of one of Gluppe's earlier studies was that sit-ups/curl-ups are not dangerous or worsen separated abdominal muscles.

Meanwhile, many mothers have heard and read on social media and the internet that they should not do sit-ups and other similar exercises.

Many women are unnecessarily afraid

Helene Vabø Wilsgaard is an active fitness profile on Instagram and also noticed that there is a lot of misinformation circulating on various platforms.

“Absolutely! I work with this myself as well and find that many women are unnecessarily afraid of their abdomen. Many are afraid of natural movement, training, and using their abdomen. It's great to have more studies to refer to, and that the knowledge in this area is improving,” she says. 

But for knowledge to improve, Gluppe believes that postpartum follow-up care must also improve.

Women with DR tended to have weaker abdominal muscles, reported more abdominal pain, but there was no higher occurrence of pelvic floor issues, lower back and pelvic joint pain compared to women without the condition.

She believes it is high time that all women are offered at least one check-up appointment with a physiotherapist specialising in women's health after childbirth.

Among other things, to check the pelvic floor muscles, the separated abdominal muscles, and to get guidance on training and activity.

“To think that we in Norway, one of the world's richest countries, have such poor follow-up care of women after childbirth. More is definitely needed. Today, women have to pay to get the right information about, for example, DR. This should be a public service. The benefits would be substantial," Gluppe believes. 

Get active

She specifically thinks of women who are afraid that exercise will worsen the situation. The physiotherapist recommends physical activity.

“Of course, there is a vulnerable period after childbirth where you have to figure things out. But it is very important to get started with physical activity and exercise. It doesn't have to be sit-ups or intense strength training; all activity is positive," Gluppe says.

As an example, she mentions going for walks with the baby in its stroller.

"You can resume training gradually. It might be a good idea to consult with a physiotherapist or an exercise physiologist for guidance,” says Gluppe.

For Helene Vabø Wilsgaard, three years have passed since she last gave birth. Today, she works as a CrossFit instructor, a personal trainer, and is taking a master's degree in sports psychology at NIH. 

Separated abdominal muscles were not an obstacle for Helene Vabø Wilsgaard when she resumed training after giving birth.

She succeeded by starting gradually with working out and slowly, but surely, building herself up again.

The separated abdominal muscles were not an obstacle.

“I don't think there's any impairment with abdominal muscle separation. The challenge is that your stomach muscles become weak during pregnancy and in the period after childbirth. They must be built up again, as you have to do in all other situations where the body goes through major changes,” she says.

She exercised throughout her pregnancy and right after childbirth as well. 

"I started out very ‘slowly’ and built myself up again. I don't feel that my abdomen is an obstacle for what I'm doing now,” Wilsgaard says. 

Reference:

Gluppe, S.B. Diastasis Recti Abdominis: An issue postpartum?, Doctoral dissertation at the Norwegian School of Sport Sciences, 2023. 

About the research

  • This doctoral project consists of four different studies that examined various aspects of DR after childbirth.
  • Study 1 gave 460 first-time mothers a questionnaire, 6-8 months after childbirth, about how the abdomen is perceived, the occurrence of self-reported strength in the abdominal muscles, and the experience of bulging (a characteristic of DR).
  • Study 2 assessed the acute effect of eight exercises for the abdominal muscles on the distance between the rectus abdominis muscles in 38 women with DR.
  • Study 3 compared the occurrence of pelvic floor complaints, lower back, pelvic joint, and abdominal pain, and strength in the abdominal muscles in women with and without separated abdominal muscles.
  • Study 4 was a randomised controlled study of 70 women with DR 6-12 months after childbirth. The effect of an abdominal muscle training programme, consisting of head lifts, curl-ups, and oblique curl-ups, was assessed on the distance between the rectus abdominis muscles and other possible consequences related to separated abdominal muscles.

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Read the Norwegian version of this article on forskning.no

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