Archive for DIASTASIS

DIASTASIS


What is DIASTASIS RECTI ABDOMINIS (DRA)?

⦁ Separation of the rectus abdominis muscle bellies

⦁ Diastasis rectus abdominis is present when the inter-rectus distance (IRD) exceeds normal values

⦁ Pathological diastasis occurs with .2.0-2.7cm width between muscle bellies

Prevalence: 33% at 21 weeks gestation, 60% at 6 weeks post-partum, 46% 6 months post-partum, 33% 12 months post-partum

RISK FACTORS: Age, multiparity, C-section, weight gain, high birth weight, multiple pregnancy, ethnicity, and childbearing.

*Information provided by -Kristina Kehoe PT, DPT

DIASTASIS

What is DIASTASIS RECTI ABDOMINIS (DRA)?

Exercises for DRA

Supine Hook-Lying Curl Up
• Using a hand on either side of your abdomen for support
• Inhale and then as you exhale, draw your lower tummy into your spine and lift your head and neck off the bed
• Breathe again, then slowly lower and relax
• Repeat 5 times
• Using a towel or a scarf to gently pull the two sides of your abdomen together, repeat the exercise.

*Information provided by -Kristina Kehoe PT, DPT

DIASTASIS

What is DIASTASIS RECTI ABDOMINIS (DRA)?

Exercise Alignment 

  • Pelvic position should be untucked to optimize glute activation

    • Rib cage position over the pelvis to help balance the forces, pressures, and appropriate recruitment of the front (abdominals), back (glutes), top (diaphragm), and bottom(pelvic floor)

    *Information provided by -Kristina Kehoe PT, DPT

DIASTASIS

What is DIASTASIS RECTI ABDOMINIS (DRA)?

Precaution Exercises during pregnancy

 

 

Valsalva maneuver breath holding during activities

Coughing, sneezing, lifting, bending, transitional movements WITHOUT abdominal bracing

Full sit-ups, jack-knifes, bilateral leg raises

Hyperextension of lumbar spine or exercises that overstretch the abdominal wall

Bouncing exercises

Aggressive stretching

Rotational trunk exercises

Relative precaution using quadruped exercises without proper support (may increase abdominal pressure on linea alba)

*Information provided by -Kristina Kehoe PT, DPT

DIASTASIS

What is DIASTASIS RECTI ABDOMINIS (DRA)?

Exercise Considerations

• Best treated post-partum but could begin abdominal exercises during pregnancy
• Focusing only on narrowing the inter-rectus distance (IRD) may not achieve the best cosmetic or functional outcomes for abdominal wall due to distortion of the linea alba
• If person has good control of Transverse Abdominus function and is not breath holding (Valsalva) there is no reason to avoid plank exercises
• Perform exertion portion of the exercise on the exhale to avoid increasing intra-abdominal pressure
• Be sure to include functional movements as well as postural strengthening and hip exercises.

*Information provided by -Kristina Kehoe PT, DPT

DIASTASIS

What is DIASTASIS RECTI ABDOMINIS (DRA)?

Symptoms of DRA

• Visible and palpable separation of rectus abdominis muscle bellies (You can test yourself to feel for any separation or be assessed by physician or physical therapist)
• Feeling of “flabbiness” in abdominal muscles
• Pelvic floor muscle dysfunction that causes urinary or bowel problems
• Poor posture
• Feeling weak through the midsection
• Painful intercourse

*Information provided by -Kristina Kehoe PT, DPT

DIASTASIS

What is Diastasis Recti Abdominis (DRA)?

Implications of DRA

• Abdominal wall functions; posture, trunk and pelvic stability, respiration, trunk movement, and support of abdominal viscera (stomach, intestine, liver and biliary system, pancreas, spleen, kidneys, ureters, and suprarenal glands).
• DRA can weaken abdominal muscles resulting in altered trunk mechanics, impaired pelvic stability and changed posture

*Information provided by -Kristina Kehoe PT, DPT

DIASTASIS

What is DIASTASIS RECTI ABDOMINIS (DRA)?

Anatomical Considerations

 

  • DRA occurs due to hormonal elastic changes of the connective tissue and the mechanical stresses placed on the abdominal wall and displacement of abdominal organs

  • Widening of this distance can modify capability to transfer force across the midline of the abdomen

    *Information provided by -Kristina Kehoe PT, DPT