Table of contents:
- Symptoms of abdominal diastasis
- How to confirm the diagnosis
- Possible causes
- How the treatment is done
- Care during treatment
- Possible complications
Abdominal diastasis is the separation of the rectus abdominis muscles and connective tissue, in the region of the linea nigra or alba, caused by a weakness of the abdominal muscle, and leading to the appearance of symptoms such as a bulge above or below the navel or belly flaccidity.
Diastasis of the abdomen, also called diastasis recti abdominis muscles (DMRA), usually occurs during or after pregnancy, being the main cause of postpartum abdominal sagging and low back pain, but it can also arise in babies or due to abdominal obesity, for example.
Treatment of abdominal diastasis can be done with exercises, physical therapy or, in some cases, surgery, especially when the distance is greater than 5 cm and the exercises were not effective to correct the distance.
Symptoms of abdominal diastasis
The main symptoms of abdominal diastasis are:
- Length in the abdomen, above or below the navel, especially when lifting weights, squatting or coughing;
- Excessive sagging in the belly;
- Abdominal weakness;
- Difficulty lifting objects or performing everyday activities, such as walking;
- Pain during intimate contact;
- Lumbar, pelvis or hip pain;
- Urinary incontinence during exertion, such as when coughing or sneezing;
Furthermore, you may experience poor posture, a bloated belly sensation, or a jelly-like skin sensation.
The separation of the abdominal muscles can reach a distance of 10 cm, and it is important to be evaluated by the doctor, who can indicate the most appropriate treatment.
How to know if I have abdominal diastasis
To make sure it is an abdominal diastasis, you must:
- Lie on your back;
- Press the index and middle fingers about 2 cm above and below the navel;
- Squeeze the abdomen, as if performing an abdominal exercise.
The normal thing is that when contracting the abdomen, the fingers jump up a little, but in case of diastasis the fingers do not move, it is even possible to place 3 or 4 fingers side by side without them moving with abdominal contraction.
How to confirm the diagnosis
The diagnosis of abdominal diastasis is made by the gynecologist or general surgeon, through physical examination, by evaluating the characteristics of the abdominal muscles, in addition to the presence of symptoms.
In some cases, the doctor may order imaging tests, such as ultrasound or computed tomography, to analyze the abdominal muscles in more detail and confirm the diagnosis of abdominal diastasis.
Diastasis abdominis is caused by weakness of the rectus abdominis muscles, or thinning or widening of the linea alba or nigra, leading to withdrawal of the abdominal muscles.
Some factors can contribute to the appearance of abdominal diastasis, such as:
- More than one pregnancy, in short time intervals;
- Twin pregnancy;
- Pregnancy after 35 years;
- Giving birth to a baby weighing more than 4 kg, especially in small women;
- Abdominal obesity, in men and women;
- Multiple abdominal surgeries.
In addition, although it is rarer, abdominal diastasis can also be present from birth, being called congenital abdominal diastasis, usually caused by premature birth, as the abdominal muscles may not be fully developed and closed yet.
How the treatment is done
Treatment of abdominal diastasis must be guided by the doctor and varies according to the degree of separation of the abdominal muscles, and the treatment time may vary according to the size of the diastasis, since the greater the spacing, the greater the spacing. more difficult it will be to promote the union of the fibers with only exercises or physiotherapy. However, in diastasis with less than 5 cm, if the treatment is performed daily, in about 2 to 3 months it will be possible to observe a decrease in diastasis.
The main treatment options for abdominal diastasis that may be indicated by the doctor are:
Exercises for abdominal diastasis are indicated to reduce the withdrawal of the abdominal muscles and strengthen the muscles that give stability to the abdominal region, and must be performed under the supervision of a physical therapist or personal trainer because if not performed correctly, they can cause an increase in intra-abdominal pressure, and increase the separation of the rectum, worsening diastasis or lead to the appearance of a hernia.
Generally, these exercises can be started about 6 to 8 weeks postpartum, but only after medical evaluation and approval, and clinical pilates exercises or hypopressive exercises, for example.
These exercises are the most suitable because they contract the transversus abdominis and the lower fibers of the rectus abdominis, strengthening them without excessive pressure on the rectus abdominis.
Furthermore, it is important to point out that exercises such as sit-ups, planks or push-ups, for example, should be avoided, as they can worsen the withdrawal of the abdominal muscles.
Watch the following video with some hypopressive gymnastics exercises to help correct abdominal diastasis:
Physiotherapy for abdominal diastasis may be indicated by the doctor and should be performed with the guidance of the physical therapist, with stretching and strengthening exercises for the rectus abdominis, pelvic floor and lumbar muscles.
Physical therapy should be chosen by the physical therapist individually, and the use of equipment such as functional electrical stimulation (FES) that promotes muscle contraction may also be indicated. This device can be done for 15 to 20 minutes and is very efficient in strengthening the rectus abdominis. Find out how FES is made.
Surgery for abdominal diastasis is usually indicated by the doctor when:
- The rectus abdominis muscles are more than 5 cm apart;
- Exercise or physical therapy were not effective in decreasing muscle separation;
- Presence of symptoms such as low back pain or stress urinary incontinence;
- Aesthetic reasons.
The abdominal diastasis surgery consists of bringing together and sewing the rectus abdominis muscles, which can be done conventionally or by laparoscopy.In addition, the doctor may also suggest a liposuction or tummy tuck to remove excess fat or skin, stitching the muscle together to finish. See how the surgery for abdominal diastasis is performed and the postoperative care.
Care during treatment
During treatment to correct abdominal diastasis is also recommended:
- Maintain good posture standing and sitting;
- Maintain the contraction of the transversus abdominis muscle throughout the day, this exercise being known as hypopressive abdominal, in which it is only necessary to try to bring the navel closer to the back, pulling in the belly especially when sitting, but you should maintain this contraction throughout the day. Learn more about how to do hypopressive sit-ups;
- Avoid bending your body forward as much as possible, as if doing a traditional sit-up because it worsens diastasis;
- Whenever you need to bend down to pick something up from the floor, bend your legs, crouching down and not leaning your body forward;
- Changing the baby's diaper on a high surface such as a changing table, or if you need to change in bed, keep your knees on the floor so you don't lean forward;
- Wear the postpartum girdle, if directed by your doctor, for most of the day and even when sleeping, but be sure to keep your belly tucked in to strengthen the transversus abdominis during the day;
Furthermore, it is important not to perform the traditional abdominal exercises, nor the oblique abdominal exercises so as not to worsen the diastasis.
The main complication of abdominal diastasis is the onset of back pain in the lumbar region. This pain occurs because the abdominal muscles act as a natural brace that protects the spine when walking, sitting, and exercising.When this muscle is very weak, the spine is overloaded and there is a greater risk of developing a herniated disc, for example.
Therefore, it is important to carry out the treatment, promoting the union and strengthening of the abdominal fibers.