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Rectus Abdominus Diastasis. What is it all about?

By Kate Fosdike
Women’s Health Physiotherapist at Life Ready Physio Yokine

What is a RAD?

You may have heard of Rectus Abdominus Diastasis (RAD, diastasis rectii or abdominal separation) and might be wondering, ‘what does this actually mean?!’
RAD is a common condition affecting many women during and after pregnancy. It refers to a separation between the two halves of the outer-most layer of the abdominal muscles. To fully understand RAD, you first have to understand a little bit about the anatomy of the abdominal wall.
The abdominal wall is made of up of four different muscles which sit in layers. The deepest layer runs horizontally across the abdomen, below the belly button and is called the Transverse Abdominus (TA). Next come the Internal and External Obliques which run diagonally across the abdomen in different directions. Finally, the Rectus Abdominus (RA) runs vertically between the ribs and the hips.

The RA is made up of two identical halves (left and right) which are joined in the middle by a connective tissue sheath called the linea alba. During pregnancy, your body produces a hormone called relaxin, which, as the name suggests, helps relax the connective tissues, allowing them to stretch. Relaxin effects all the connective tissues throughout the body, including the linea alba. This hormone is amazing as it allows your body to grow and birth your baby!

As your baby grows, the linea alba can stretch, making room for your baby and causing the two halves of the rectus abdominus to move further apart. This effect can be more pronounced in women who have a very tight or a very loose RA muscle, and in women who are small framed.

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So, why is this significant?

Although RAD during pregnancy is not abnormal, it is important to know whether you have one, so that you can take positive steps to manage it appropriately. If you routinely perform activities which place too much load on the muscles and connective tissues, RAD may persist after you have your baby and have consequences for your abdominal muscle function in the future.
After you give birth, the linea alba should return to its usual width and the rectus muscles should move back together towards your midline. If significant RAD persists postnatally, you will likely notice both functional and cosmetic issues.

Cosmetically, RAD gives the appearance of a ‘bulgy belly’ or ‘mummy tummy’ – your lower abdomen will protrude. In terms of function, significant RAD often results in lower back pain or pelvic girdle pain due to a reduction in the support function of the abdominal muscles. Studies also suggest a link between significant RAD and pelvic floor muscle dysfunction. These women may suffer from urinary leakage or prolapse.

Women’s health physiotherapists routinely screen for RAD both during and after pregnancy and can advise you on the management and rehabilitation of RAD.
If you are concerned about RAD during or after your pregnancy, make an appointment to see our women’s health team at Life Ready today! We have post-graduate trained women’s health physiotherapists treating at our Baldivis, Midland, Mobile and Yokine clinics.

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