Rectus Abdominis Diastasis
A Rectus Abdominis Diastasis is a separation of the rectus abdominis muscles, which run vertically down the centre of the trunk. During pregnancy, as the baby grows, the abdomen expands and the muscles are stretched. For many women, the rectus abdominis muscles will separate at the midline as the tissue connecting the two muscle bellies stretches and widens to allow for the expanding abdomen. The extent of separation will vary amongst women, as will the location along the midline, although generally the greatest amount of separation is at the navel.
Women may notice a bulge in the abdomen during movements such as getting up out of bed, lifting, or with sudden fast actions such as a cough or sneeze. It is important for women to know whether they have a diastasis as it will potentially alter the muscular control of the trunk and may contribute to lumbo-pelvic dysfunction in the postnatal period.
Presence of a diastasis will also affect the types of movements and exercises that should be performed both during pregnancy and postnatally, since performing incorrect exercises or exercises that are too strong, such as sit-up type exercises may actually increase the extent of the diastasis.
For women who are concerned about the possibility of a diastasis, assessment by a Physiotherapist with experience in the management of such conditions is recommended. Women can then be advised on appropriate exercises. During pregnancy, the extent of the diastasis can be monitored throughout the pregnancy. Postnatally the abdominal muscles can be re-trained to optimize recovery.
In the postnatal period it is also important to know that the pelvic floor muscles are functioning correctly, particularly when performing any type of abdominal exercise. Use of the Real Time Ultrasound is a useful way of assessing correct abdominal muscle activation and how well the pelvic floor and abdominal muscles are working together. Once the correct is achieved, Physiotherapy supervised Pilates studio sessions are a good way of safely regaining the strength and control of these muscles.
It is recommended that women undergo a more detailed assessment from a Physiotherapist with further qualifications inContinence and Women’s Health if they are experiencing any of the following:
• Difficulty in activating the pelvic floor muscles,
• Bladder or bowel dysfunction,
• Signs or symptoms of pelvic organ prolapse,
• Dyspareunia (pain with sexual intercourse).
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