Pregnancy is a wonderful thing. A woman is bringing new life into the world! But it's not easy on the body. After all, a little human growing up to 8 or 10 pounds is in the womb. A person's body needs to change to accommodate this. As the uterus expands to accommodate the baby, the abdominal muscles stretch and sometimes separate.
The separation of the abdominal muscles, or abs, is a condition called diastasis rectus abdominis (DRA) or "diastasis recti". More severe cases of diastasis recti can see the internal organs (but mostly the intestines) to poke through the opening. This obviously isn't an appealing thought, but according to the British Journal of Sports Medicine, about 60% of pregnant women will experience diastasis recti with pregnancy. The more pregnancies a woman has, the higher the risk.
And, while pregnancy is the most common cause of diastasis recti, there are other causes as well. Rapid or frequent changes in weight, advanced age, swelling of the abdomen (as from cirrhosis or abdominal cancer), and abdominal aortic aneurysms are all potential causes. The condition can occur in both men and women.
Why is it important to treat diastasis recti?
It's common knowledge that your abdominal muscles, including the rectus abdominis, transverse abdominals, and obliques, are called the "core" or "core muscles." The core supports posture, helps control movement, and protects the internal organs. The core also supports the internal organs and pelvic to prevent urinary incontinence and pelvic prolapse.
What does diastasis recti feel like?
Generally, separated abdominal muscles do not cause pain, but do cause dysfunction in the body. Symptoms of DRA include:
weakness in the midsection (which may present as low back, hip, or pelvic pain)
A pouch or bulge in the stomach
Pelvic floor muscle dysfunctions
Urinary or bowel problems (incontinence, leakage, constipation, etc)
A visible gap between the rectus abdominis muscles (some people can even feel the separation when in certain positions, and can measure the separation in finger widths)
The good news is that for about half the women who suffer from diastasis recti, the condition will correct itself within a year post-partum. But for the other 50%, there are treatment options! And whether for physical reasons or aesthetic reasons, women are justified in their concerns about their changing body.
What does treatment look like?
Exercise is the first treatment option to try. A pelvic floor physical therapist will guide you through a safe and effective plan of care, teaching you what exercises to do and which to avoid (at least early on; your plan of care should change as you heal!).
Sometimes taping or bracing will be recommended for external support of the muscles. It is not recommended for every patient to get a back brace as braces can actually lead to weakened muscles, since they don't have to work by themselves.
To support strong muscles, postural training imperative. This will involve activating core muscles and pelvic floor without overusing the rectus abdominus muscle. As well, stretching plays a big role in postural control. Balance of muscles is also incredibly important: where some muscles become weak during pregnancy or with disuse, other muscles may become tight and overactive. A physical therapist will help restore balance.
Whether on your own or with a physical therapist, give the condition time to heal. Unfortunately, diastasis recti does not have a quick fix. The body can only heal so quickly, and results are gradual.
However, if the condition is severe, or does not seem to be improving to your satisfaction, surgery can be an option. The surgery is called an abdominoplasty, or 'tummy tuck'. This isn't a one-size-fits-all operation, though. Depending on the severity of the diastasis recti, the surgery could be done with a small incision along the bikini line, or could involve the muscle tightening, the removal of some skin, and relocation of the belly button. Ultimately, it depends on the individual anatomy. Recovery can take up to a year, with restricted movement for the first week, then lifting and core exercises restricted for another five to six weeks. It takes longer for the swelling to subside and the scars to fade, about six months to a year.
If you or a loved one is in pain, we'd love to help. Call us at FlexPlus Physical Therapy & Balance Centers at 508-650-0060 to set up an initial evaluation. Not sure if physical therapy is right for you? Ask us for a FREE consultation! At FlexPlus, we're With You Every Step of the Way.