Diastasis Recti

Diastasis Recti

If diastasis recti occurs, the straight abdominal muscles expand, resulting in abdominal wall hernias. These are very often due to abdominal wall weakness caused by obesity or pregnancy. As part of a therapy, the abdominal muscles are strengthened, in some cases a rectus diastasis must also be operated on.

What is diastasis recti?

In the context of a rectus diastasis, also known as a midline fracture or out of alignment, the connective tissue seam that runs vertically along the abdomen widens. As a result, a deviation of the left or right straight abdominal muscle occurs, and a gap also remains. The connective tissue suture normally has a width of one to two centimeters and is created when the connective tissue structures of the abdominal muscles intertwine. For hiv treatment, please visit bestitude.com.

A diastasis recti is not a real hernia, it is most pronounced in the navel area, where it can grow up to ten centimeters long. Diastasis recti occurs more frequently in women than in men because the straight abdominal muscles are often overstretched during pregnancy. If the abdominal muscles are very weak, the muscle strands separate, which impairs the carrying, supporting and holding function. Even after pregnancy, a bulge on the front of the abdominal wall remains.

Causes

Many diastasis recti are caused by pregnancy. During pregnancy, the child grows, the abdominal muscles are stretched and lose tension as a result. In addition, the pregnancy hormone relaxin also has a relaxing effect, which promotes stretching of the connective tissue. Diastasis recti usually occurs in the last months of pregnancy. It is therefore important that women do not put too much strain on their stomachs during this time.

The risk of diastasis recti occurring is further increased by multiple pregnancies or repeated pregnancies, and obesity can also lead to diastasis recti. In rare cases, a midline fracture also has congenital causes. Then the course of the abdominal muscles is not parallel, but there is a deviation upwards. The connective tissue seam enlarges and the abdominal wall bulges forward.

In addition, rectus diastasis can also occur in infants or newborns, since the distance between the abdominal muscles is still relatively large in them. However, as soon as the children walk, the rectus diastasis disappears again.

Symptoms, Ailments & Signs

In most cases, there are no symptoms with diastasis recti. A gap forms in the middle of the abdomen, which can also be felt. Visible bulging occurs when strained. During pregnancy, stress often causes pain in the hips, buttocks and lower back. The symptoms occur especially in women who have already given birth to several children, since the muscles have been stretched very much as a result.

Excess skin and tissue protrude in the front area of ​​the abdomen, and in the case of a severe rectus diastasis, the outlines of the child are often even visible. This can also make childbirth more difficult because the woman giving birth cannot use her abdominal muscles to the right extent. In this case, strengthened back muscles and an upright birthing position can help.

In most cases, there are no symptoms with diastasis recti. A gap forms in the middle of the abdomen, which can also be felt. Visible bulging occurs when strained. During pregnancy, stress often causes pain in the hips, buttocks and lower back. The symptoms occur especially in women who have already given birth to several children, since the muscles have been stretched very much as a result.

Excess skin and tissue protrude in the front area of ​​the abdomen, and in the case of a severe rectus diastasis, the outlines of the child are often even visible. This can also make childbirth more difficult because the woman giving birth cannot use her abdominal muscles to the right extent. In this case, strengthened back muscles and an upright birthing position can help.

Diagnosis & course of disease

If there is a suspicion of a midline fracture, a general practitioner or a gynecologist should be consulted. After anamnesis, the doctor can determine a rectus diastasis based on a palpation. To do this, the person concerned must lie on their back and tense their abdominal wall.

This tightening allows the doctor to easily feel the gap in the abdominal wall. When the patient coughs or laughs, a “bulge” appears between the abdominal muscles. In rare cases, an ultrasound examination is also necessary. This can determine how far the midline hernia has progressed.

Complications

Diastasis recti is usually harmless and rarely leads to complications. Only the abdominal muscles become weaker and the straight abdominal muscles move away from each other more and more. Diastasis recti can usually be treated with physiotherapy. However, in the case of a palpable diastasis recti, the abdominal muscles should not be strained because this makes successful treatment more difficult or the abdominal muscles are even further apart.

The tension in the abdominal muscles, which occurs, among other things, when standing up directly from a supine position, is considered to be a strain. In rare cases, however, an operation may also be necessary if the abdominal pressure becomes progressively worse and the risk of a abdominal wall hernia increases. Fractures in the midline and around the umbilicus often occur.

Such fractures are potentially dangerous because they can result in the entrapment of organs or parts of organs. The trapped organ parts die off when they can no longer be pushed out of the fracture. Parts of the intestine in particular are pinched in the course of the rupture.

This is a life-threatening situation that requires emergency surgery to prevent intestinal obstruction and subsequent peritonitis. People with diastasis recti are also prone to incisional hernias that occur after abdominal surgery. Incisional hernias are also very dangerous and often lead to the pinching of parts of internal organs.

When should you go to the doctor?

Diastasis recti should be treated by a doctor. In most cases, treatment proceeds without complications and leads to complete healing. However, in severe cases, surgical interventions may be necessary to treat the symptoms of diastasis recti. In general, early diagnosis and treatment always have a very positive effect on the further course of the disease.

A doctor should be consulted if the person concerned suffers from severe pain in the hip or buttocks. The pain can also occur in the form of rest pain and have a very negative effect on the patient’s everyday life and sleep. The back can also be affected by pain. You should also see a doctor if you experience severe pain in your abdominal muscles. The symptoms should be examined by a doctor, especially if they occur after pregnancy. Diastasis recti can usually be treated by a general practitioner.

Treatment & Therapy

Diastasis recti is treated with abdominal muscle training. If necessary, existing excess weight must also be reduced. However, as long as a diastasis recti can be felt, the rectus abdominal muscles should not be strained, as it could otherwise enlarge. A variety of exercises can be performed to reduce the gap. The exercises by Angela Hellers, for example, are well suited for this.

The muscles are contracted diagonally while the physical therapist holds the diagonal abdominal muscles together. In addition, the shoulders are pulled up and pressed against the resistance. The training begins two days after birth, which means that the rectus diastasis recedes and then usually only has a width of one centimeter. If the midline fracture is only an inch or two long, it will heal on its own. Normally, no surgery is performed for diastasis recti.

However, if the symptoms increase or if there are fractures in the navel area, an operation is advisable. Internal sutures are applied and the abdominal muscles are fixed. Additional stabilization is provided with the help of plastic nets. After the operation, the patients have to wear an abdominal belt or special compression underwear and are not allowed to exercise for about four weeks. However, complications are rather rare and only occur if organ parts or organs are pinched due to a fracture.

Prevention

Postnatal exercises are very important after childbirth, as they also serve as a preventive measure. The straight abdominal muscles are not strained, but the training concentrates on the oblique muscles of the abdomen. Since obesity can also contribute to the development of diastasis recti, care should also be taken to maintain a normal weight.

Aftercare

If diastasis recti is treated surgically, follow-up care is required. It is basically similar to a tummy tuck. The effort involved in aftercare for diastasis recti depends on the findings and the effort involved in the surgical intervention. With minor surgeries, recovery is achieved more quickly than with major surgeries. Sometimes complications have to be treated, which prolongs the healing time.

The patient wears a drain for the first two to five days. In addition, he has to take it easy physically and avoid sporting activities for about six weeks. It is also recommended to wear corsetry during this period. In addition, a slightly bent posture of the body is to be adopted. In this way, the tension in the abdominal wall can be reduced.

This in turn has a favorable effect on the stability of the seam. In addition, the seam must not be put under too much strain, otherwise there is a risk of stretching. Therefore, it makes sense to sleep on your back. Standing and walking should also be done in a slightly bent position.

Stool regulation also plays an important role in aftercare. There is a risk that constipation or flatulence will negatively affect the outcome of the surgical procedure. Consuming foods that cause bloating or constipation is therefore not recommended. If constipation occurs, it is advisable to use a mild laxative.

You can do that yourself

Diastasis recti is treated conventionally with targeted exercise therapy, especially abdominal muscle training. Clinical studies are not yet representative, but exercise promises both prevention and reduction of the disease. It’s important to realize that no exercise is inherently “bad” during or after pregnancy. Whatever exercise you choose, it’s important to make sure you’re able to create good tension in your abdominal area.

Consultation with a physiotherapist can also be beneficial. For example, a pelvic floor physiotherapist can find creative and individualized ways and exercises to engage the inner muscles during exercise. These exercises can then be repeated at home. Muscle strengthening is thus the most beneficial goal and has been the focus of most clinical studies to date.

The regeneration of the pelvic floor muscles is another important treatment area. More than 70 percent of women are unable to produce a pelvic floor contraction when present with this condition and are therefore more likely to experience incontinence and pelvic pain. That’s why it’s important to improve poor posture and do pelvic floor exercises to help reduce the causes.

Diastasis Recti