Rectus Abdominis Diastases

Just when you thought there was enough to screen for during pregnancy, the health of you’re rectus abdominis muscle (your ‘six pack muscle’) is one other important issue. If this can be monitored, a long list of secondary problems can be avoided, after all the rectus abdominis diastases can affect more than just the appearance and general tone of a post natal mom’s tummy.

What is it?

The abdominal muscles naturally are separated by a thin line of connective tissue called the ‘linea alba’. Superficially, the connective tissue is made up of the inner borders of the recti muscle. The deeper portions are formed by the tendinous fibres of the internal and external obliques and transverse abdominis. In short, the linea alba connects to all the important abdominal muscles. A Rectus Abdominis Diastases or RAD, is a lateral separation of the abdominal muscles from a split in the linea alba.

Why does it happen?

During pregnancy, the abdominal muscles and connective tissue stretch and widen to accommodate for the growing foetus.

This stretch causes the linea alba to thin, resulting in the rectus abdominis and other abdominal muscles to move further apart. The stretching of the linea alba most commonly occurs around the belly button, but can occur anywhere between the xiphoid process and pubic bone. This phenomenon is more common in multi-parous (more than one child) mothers, as the linea alba is repeatedly stretched.

Symptoms of RAD

This separation of the rectus abdominis muscle can cause an array of problems. Without the dynamic stabilisation that the abdominal muscles normally provide, reduced back support can lead to poor posture and can contribute to pelvic floor dysfunction. Back and /or pelvic pain as well as a feeling of reduced strength are the most common manifestation of a RAD. Over 6 weeks post partum, the RAD should close gradually and naturally. Further intervention is required if this does not occur, a physiotherapist can help.

Diagnosing RAD

RAD is difficult to find on a relaxed abdomen. A slight head lift in crook lying will require a rectus abdominis contraction, and will allow for assessment of the RAD. A RAD is present if you can fit two or more fingers (width wise) into the space above the umbilicus. On further abdominal contraction, the gap should close, however if there is still a gap larger than 1 finger wide, the RAD may need to be strengthened.

Management

• Exercise:

Clinical Pilates is great for this, as well as a specific strengthening program your physio can prescribe.

• Posture:

Maintaining correct pelvic positioning is crucial, your physio can help you with this.

• Braces/Binders/Corsets:

These can help temporarily, especially if back pain is an issue.

• Surgical Intervention:

This should only be an option once conservative treatment has been used.

Feel free to shoot us an email if you have any questions about this,

All the best,

Jess