Why do muscles diverge?
The rectus abdominis muscles run vertically on either side of the midline and are connected by the linea alba. During pregnancy, the uterus stretches the anterior abdominal wall, and hormonal changes make the connective tissue more pliable - this is a physiological process necessary for the growth of the fetus. After childbirth, the tissue gradually returns to its previous state, but not always completely. Outside of pregnancy, discrepancy is caused by rapid weight gain, heavy strength loads with straining, chronic cough and constipation, as well as congenital weakness of connective tissue.
- Pregnancy, especially repeated and multiple pregnancies
- Large fruit and polyhydramnios
- Rapid weight gain and obesity
- Incorrect strength training technique
- Chronic cough and constipation
- Hereditary weakness of connective tissue
How to test yourself at home
Lie on your back, bend your knees, place your feet on the floor and relax your stomach. Place your fingers across the midline just above the navel and lift your head and shoulders slightly, as at the beginning of the twist. If a gap wider than two fingers is felt between the muscles or you see a longitudinal ridge, diastasis is likely. Check also at and below the navel. This test is indicative: it does not replace an examination, because next to the diastasis there is often an umbilical hernia or a hernia of the white line that requires other treatment.
- Test lying on your back with your knees bent
- Assess above the navel, at its level and below
- Width of more than two fingers is a reason for inspection
- A longitudinal roll when raising the head is a characteristic feature
- The test does not replace a visit to the surgeon
What prevents diastasis
The main complaint is usually aesthetic: the abdomen looks bulging and does not shrink even with normal weight. But it's not just about appearance. A weakened abdominal wall supports the spine less well, resulting in lower back pain and rapid back fatigue. The coordinated work of the pelvic floor muscles is disrupted, which can be manifested by urine leakage when coughing and sneezing. There may be bloating, a feeling of heaviness after eating, and difficulty lifting heavy objects. In this case, diastasis by itself is not infringed - only the combination with a hernia is dangerous.
- A bulging belly that doesn't go away when you lose weight
- Lower back pain and fatigue
- Abdominal weakness
- Urine leakage during exercise
- Bloating and heaviness after eating
- The risk is associated with the accompanying hernia, and not with the diastasis itself
Conservative restoration
In the first months after childbirth, the main approach is time and proper work with the muscles. Breathing exercises with abdominal retraction, training of the transverse abdominis and pelvic floor muscles, and gradual strengthening of the back are useful. It is better to get out of bed on your side, lift something heavy with a straight back and exhale, watch your chair and weight. At the same time, classic crunches, straight leg raises, planks until the roller appears, and strong straining only increase the discrepancy. It makes sense to create a program with a specialist in physical therapy, and not based on videos from the Internet.
- Breathing exercises and work with the transverse muscle
- Pelvic floor muscle training
- Lifting weights with a straight back and exhaling
- Getting out of bed on your side
- Avoid twisting and straight leg lifts
- Normalization of weight and stool
- Classes under the supervision of a specialist
When is surgery needed?
Surgical treatment is discussed if the discrepancy is pronounced, persists approximately a year after birth despite exercise, interferes with everyday life, or is combined with an umbilical hernia and white line hernia. The essence of the operation is to bring the rectus muscles closer together and strengthen the abdominal wall, usually with a mesh implant; if there is excess skin and subcutaneous fat, this is combined with abdominoplasty. Access can be open or endoscopic. It is worth planning intervention after childbearing is completed and a stable weight is achieved, otherwise the likelihood of recurrent discrepancy is higher.
- Presence of diastasis one year after childbirth
- Combination with umbilical hernia or white line hernia
- Back pain and limitations in daily life
- Plastic surgery with mesh implant
- Combination with abdominoplasty for excess tissue
- The operation is planned after childbirth is completed
