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Our experienced pelvic floor physiotherapists can help you regain control of your body and return to your daily life with confidence! We have been successful treating this problem both in-clinic and online. |
WHAT IS DIASTASIS RECTI?
WHAT CAUSES IT?
HOW CAN PHYSIO HELP?
WHAT IS DIASTASIS RECTI?
Diastasis recti is a separation of the rectus abdominis muscle causing stretching of the linea alba, a band of connective tissue in the abdominal midline. It is formed by the right and left attachments of the abdominal muscles (the external and internal obliques, the transversus abdominis and the rectus abdominis) and spans vertically from the xiphoid process to the pubic bone. A separation can occur along the linea alba’s entire length, just above, or just below the umbilicus. When it occurs, a bulge may be seen in the midline and the abdominal content can sometimes be palpated through the gap. Commonly, diastasis recti is considered when the separation between the muscles is over 2.5cm. This distance is usually measured using finger width (number of fingers necessary to fill the space), but ultrasound or a measuring tape may also be used.
The transversus abdominis is the deepest abdominal muscle. It plays an important role in lumbopelvic function and works by generating tension in the abdominal fascia to stabilize the lumbar spine and the pelvis. With diastasis recti, the muscles’ midline attachment is stretched and the support mechanism is disrupted leading to problems such as weaker abdominal muscles, low back and/or pelvic pain or difficulty moving normally. Other issues such as constipation and urine leakages can occur or be aggravated by diastasis recti, as the abdominals become less effective at managing intraabdominal pressures
The transversus abdominis is the deepest abdominal muscle. It plays an important role in lumbopelvic function and works by generating tension in the abdominal fascia to stabilize the lumbar spine and the pelvis. With diastasis recti, the muscles’ midline attachment is stretched and the support mechanism is disrupted leading to problems such as weaker abdominal muscles, low back and/or pelvic pain or difficulty moving normally. Other issues such as constipation and urine leakages can occur or be aggravated by diastasis recti, as the abdominals become less effective at managing intraabdominal pressures
WHAT CAUSES IT?
The most common cause of diastasis recti is pregnancy. In the second and third trimesters, the abdominal walls expand as the baby grows and the inter-recti distance increases. This is facilitated by a pregnancy hormone called relaxin that increases ligament laxity and muscle relaxation in preparation for delivery. About two thirds of pregnant women have a separation. In most cases, the abdomen accommodates to the stretching of the skin, fascia and muscles, but sometimes those structures may be damaged or overstretched. Rarely, the tissue tears and causes an umbilical hernia.
HOW CAN PHYSIO HELP?
The inter-recti distance reduces most significantly in the first 8 weeks postpartum and diastasis recti resolves by then for most women. The rectus abdominis and linea alba can continue to recover their normal shape and width after that time, however in some cases, the muscle is not back to its original shape even one year postpartum.
Some things should be limited when having a diastasis recti. Straining, such as during stool evacuation or when lifting heavy objects, stresses the stretched linea alba and should therefore be avoided or done as carefully as possible. Certain abdominal exercises or routine fitness moves can worsen the separation if they are not done correctly or increase the intraabdominal pressure and encourage pelvic organ prolapse or urinary leaks. It is therefore recommended to consult a physiotherapist that will teach you how to move and perform daily activities in a way that minimizes abdominal straining, show you which exercises are appropriate and make sure these are performed and progressed correctly. Learning how to effectively activate and use the transversus abdominis during daily movements and abdominal exercises is very important for optimal abdominal function.
Strengthening the deep abdominal and pelvic floor muscles before and during pregnancy is the best way to ensure a better recovery of the abdominal muscles postpartum. Although it may not prevent diastasis recti, it will help support the baby during pregnancy and facilitate abdominal function recovery postpartum. It is strongly recommended to try to reduce the separation before a second pregnancy.
If physiotherapy exercises fail to improve normal abdominal function, surgical abdominoplasty to repair the linea alba may be recommended to reduce the abdominal separation. This is usually only necessary if significant damage has occurred to the linea alba and the person is no longer able to generate sufficient tension through the abdominal wall to move and function properly.
Some things should be limited when having a diastasis recti. Straining, such as during stool evacuation or when lifting heavy objects, stresses the stretched linea alba and should therefore be avoided or done as carefully as possible. Certain abdominal exercises or routine fitness moves can worsen the separation if they are not done correctly or increase the intraabdominal pressure and encourage pelvic organ prolapse or urinary leaks. It is therefore recommended to consult a physiotherapist that will teach you how to move and perform daily activities in a way that minimizes abdominal straining, show you which exercises are appropriate and make sure these are performed and progressed correctly. Learning how to effectively activate and use the transversus abdominis during daily movements and abdominal exercises is very important for optimal abdominal function.
Strengthening the deep abdominal and pelvic floor muscles before and during pregnancy is the best way to ensure a better recovery of the abdominal muscles postpartum. Although it may not prevent diastasis recti, it will help support the baby during pregnancy and facilitate abdominal function recovery postpartum. It is strongly recommended to try to reduce the separation before a second pregnancy.
If physiotherapy exercises fail to improve normal abdominal function, surgical abdominoplasty to repair the linea alba may be recommended to reduce the abdominal separation. This is usually only necessary if significant damage has occurred to the linea alba and the person is no longer able to generate sufficient tension through the abdominal wall to move and function properly.
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