The definition of diastasis recti is a separation of the two rectus abdominal muscles through a weakening of the linea alba, the connective tissue that runs down the front of the abdomen. While diastasis recti abdominis is more prevalent in the pregnant population, it can also arise in postmenopausal women as well as in men.
The abdominal muscles play an integral role in posture and movement during physical activities. Diastasis recti may contribute to pelvic instability, pelvic pain or discomfort, lower back pain, poor posture and a lack of correct form and control during exercise. With the absence of control and understanding of how to engage the deeper transverse abdominus (deep support muscle) the characteristic abdominal bulge can appear during physical activities.
The separation of the linea alba in diastasis recti results in the forming of a space. The linea alba helps with maintaining the stability of the abdominal wall. Its tension is controlled by muscles in front of the rectus abdominis muscles and above the pubic symphysis (front join of the pelvis). Pregnancy influences the shape of the abdominal muscle’s, the position of the pelvis and the shape of the lumbar spine. These changes lead to an elongation of the abdominal muscles along with challenging the functional strength of the muscles. This can lead to a stretching and lack of resilience in the linea alba, resulting in diastasis recti.
MEN ARE NOT IMMUNE. Abdominal separation is not just a pregnant woman’s plight. It also occurs in men, during weight fluctuations throughout life, weightlifting and full sit-ups with poor abdominal engagement and control. It can also occur through inherited weakness of abdominal muscles or family history of hernia and increasing age.
TREATMENT. The most common therapies to begin healing abdominal separation, are strengthening of the transversus abdominis muscles through breathing techniques along with specific myofascial release techniques in order to better engage the abdominal muscles. Training and education around good form posture throughout pregnancy and post pregnancy is also very important.
If you have pelvic floor concerns, consult your GP or pelvic health specialist.
REFERENCES
Sperstad, J. B., Tennfjord, M. K., Hilde, G., Ellström-Engh, M., & Bø, K. (2016). Diastasis recti abdominis during pregnancy and 12 months after childbirth: prevalence, risk factors and report of lumbopelvic pain. British Journal of Sports Medicine, 50(17), 1092–1096. https://doi.org/10.1136/bjsports-2016-096065
Michalska, A., Rokita, W., Wolder, D., Pogorzelska, J., Kaczmarczyk, K. (2018). Diastasis recti abdominis, a review of treatment methods. Ginekol Pol 2018;89(2):97-101. https://doi.org/10.5603/GP.a2018.0016