Diastasis recti (abominal separation)
Diastasis recti, commonly referred to as abdominal separation, is a condition characterized by a partial or complete separation of the rectus abdominis muscles, which run vertically along the front of the abdomen. It frequently occurs in women during or after pregnancy, as the growing uterus exerts pressure on the abdominal muscles, leading to stretching and separation. This condition can also affect newborns whose abdominal muscles are underdeveloped at birth and men, particularly those who perform exercises incorrectly, such as weightlifting or sit-ups.
Diagnosis can often be done at home by feeling for gaps between the muscles, but medical professionals may also use ultrasounds or calipers for confirmation. While diastasis recti typically resolves on its own, it can lead to complications like lower back pain, constipation, and difficulty breathing. In severe cases, it may result in a hernia, requiring surgical intervention. To aid recovery, individuals are encouraged to avoid heavy lifting and engage in specific exercises that strengthen core muscles. Maintaining core strength before and during early pregnancy can also be beneficial in preventing or mitigating this condition.
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Diastasis recti (abdominal separation)
Diastasis recti (abdominal separation) is a partial or complete separation of the two sides of the rectus abdominis, or abdominal, muscle. The condition commonly occurs in women during or after a pregnancy. In pregnant women, the uterus stretches as the fetus grows. This growth also stretches the abdominal muscles. With enough pressure, the abdominal muscles will stretch and split off to the sides of the uterus to accommodate its size. Abdominal separation can also occur in newborn babies whose abdominal region is not fully developed at birth. Men can also develop the condition by using incorrect form during weight lifting or abdominal exercises. Treatment is often unnecessary, as the condition normally corrects itself with time. In rare cases, surgery may be necessary.
Background
The abdominal muscles are located in the midsection of the abdomen. This section of muscle stretches from the pubic bone up to the sternum. It is surrounded by the external oblique muscles on either side. The rectus abdominis is separated into left and right sections. These sections are joined by connective tissues called the linea alba, or white line. The abdominal muscles play an important role in childbirth, coughing, and other bodily functions. Tightening of the muscles occurs during these processes so the body can expel what it needs to. During a bowel movement, the abdominal muscles contract so a person can push feces out of the rectum. Abdominal contraction also occurs with coughing, which is a bodily reflex used to expel fluid or irritants from the breathing passages. When in labor, a woman contracts her rectus abdominis muscles to help push the baby out of her vaginal canal.
The rectus abdominis can become separated when enough pressure is placed against the linea alba. Pressure causes this connective tissue to stretch as the abdominal muscles continue to distend. Abdominal separation most often presents in pregnant or postpartum women. The separation occurs as a result of fetal growth in the uterus. The uterus is located behind the abdominal muscle wall. As a fetus grows inside a mother’s womb, the mother’s stomach begins to expand to accommodate the size of the fetus. This growth can create pressure against the abdominal wall. If the pressure becomes too much for the abdominal muscles to handle, the linea alba will begin to stretch. Once the linea alba stretches far enough, abdominal separation begins to occur. Without the abdominal muscles to cover the uterus and other organs, they may protrude.
Abdominal separation is most common in women who have experienced multiple pregnancies. Repeated stretching of the abdominal region leads to a higher risk of separation. The closer together each pregnancy is, the more likely separation will occur. Abdominal separation is also more common in women aged thirty-five and older, as well as in women pregnant with multiples.
In newborns, abdominal separation is known to occur when the rectus abdominis muscles have not fully formed during fetal development in the womb. Premature newborns are most likely to develop the condition. Men have also been known to experience abdominal separation, usually as a result of improper exercise. Performing sit-ups or weight lifting exercises incorrectly can cause abdominal separation.
Overview
In pregnant women, diastasis recti can be diagnosed with a simple physical exam done by the woman at home. When lying on the back, a pregnant woman can check for gaps in between the abdominal muscles by moving her finger along the midline area above and below the belly button. If a gap that is between one and two fingers in length is present, abdominal separation has likely occurred. Doctors can also use devices such as an ultrasound machine or a measuring tool called a caliper to confirm abdominal separation.
When the abdominal muscles move to uncover the uterus and other organs, these areas are only covered by a thin layer of connective tissue and lose necessary muscle support. This can make vaginal delivery of a newborn difficult. Abdominal separation can also cause other problems, such as lower back pain, constipation, and bladder leakage. The condition has been known to affect a person’s ability to breathe properly. In rare cases, the stretched tissue covering the organs may tear and the organs may poke out of the hole. This condition is called a hernia.
Abdominal separation corrects itself over time in most cases. In newborns, abdominal separation heals itself as the child continues to develop normally. In pregnant women, the gap between the left and right abdominal muscles begins to narrow within a few weeks following birth. Some women continue to experience abdominal separation many weeks after birth, though. In some extreme cases, such as the development of a hernia, surgery may be required to fix the tear in the connective tissue. To promote recovery, pregnant women are cautioned against heavy lifting or placing any strain on the abdominal region after delivery.
Specific exercises can help with the symptoms of abdominal separation. These exercises can be performed at home or with the help of a physical therapist. If the condition is causing pain that inhibits a person’s ability to do everyday activities, surgery may be necessary. Maintaining core strength before pregnancy and into the first trimester is recommended to encourage postpartum abdominal strength. Exercises that strengthen the pelvic floor and oblique muscles are especially helpful, and it is important to use good form when performing these exercises to avoid injury. Exercises that involve stomach bulging or back strain should be avoided.
Bibliography
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