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Abdominal Muscle Separation

Q: Dear Dr. Donnica: I've had 2 C-sections.  Both were vertical cuts -- the last stretching from my navel down past my hairline.  After my 2nd C-section, I started having problems with my abdominal muscles. I'm unable to exercise them properly. My back compensates, and this is leading to back pain and stress.

I recently had someone tell me that they saw a special on TV that said sometimes the muscles can separate, and not heal. How do I find out more about this? How do I find out if this is what's happened to me?

Thank you for your help,


Dr. Donnica:
Dear T.H., I'm sorry you've had this complication.  You may have what's called abdominis rectus separation or diastasis recti.  It is not a common problem, but it can happen, often as a result of a C-section (especially "up and down") or other abdominal surgery.  As you've found out the hard way, this problem generally does not correct itself or respond to exercise.

Most women who have this condition do fine without any intervention.  However, when it interferes with your quality of life, it's time to take action. Consult your obstetrician or primary care physician and ask for a referral to a general surgeon to evaluate your specific situation.  S/he may recommend a course of physical therapy and/or a surgical procedure in which they go in through part of your existing scar (not the whole thing--don't panic!) and put in a few internal stitches to reattach the longitudinal abdominal rectus muscles together.  This may also prevent a potential complication of abdominal muscle separations:  abdominal hernias.

Another possibility is that one or more of the nerves that innervate the abdominal muscles were severed during one of your C-sections.  There is a greater potential for this complication during a vertical incision than the "bikini cut" or transverse incision.  Unfortunately, there is not much that can be done to improve the situation in that case other than patience and physical therapy.

Best regards,
Donnica Moore, MD
President, DrDonnica.com

Created: 4/26/2001  -  Donnica Moore, M.D.

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