Do you know what abdominal diastasis (diastasis recti) is?

What it is

Abdominal diastasis, or diastasis recti, is the separation of the rectus abdominis muscles as a result of damage to the connective tissue.

Diastasis is a functional problem which, although more commonly associated with women — pregnancy increases the likelihood of developing it by up to 66% — can affect anyone, regardless of age, whether you are a man or a woman, whether you exercise regularly or lead a sedentary lifestyle. It could even affect someone who suddenly lifts a heavy load their abdomen is not prepared for, or someone who is overweight: abdominal pressure increases and causes the same stretching of the rectus abdominis muscles.

Risk factors for diastasis

Abdominal diastasis, due to the stretching of the abdominal wall and the lack of good control of the body's core, leads to postural changes and, as possible consequences, back pain and herniation of the abdominal organs. Functional digestive problems such as constipation, gas and poor digestion are also common. There is also an important relationship between diastasis and pelvic floor dysfunctions such as urinary incontinence, prolapse and pelvic pain.

There are several risk factors for diastasis:

• Weight gain: an excessive increase in pressure in the abdominal cavity causes the linea alba to be damaged, as it cannot withstand that tension
• Pregnancy or multiple pregnancies: during pregnancy, the abdomen gradually stretches to accommodate the baby. The connective tissue is also weakened by hormonal changes, as relaxin, progesterone, elastin and oestrogens are secreted, altering its collagen.
• Childbirth: complicated deliveries with many hours of pushing can also damage this tissue, and there are even patients with diastasis who have given birth by caesarean section.
• Size of the baby: the larger the baby, the greater the risk.
• Lack of, or excessive, exercise.
• Previous caesarean sections.

Treatment and advice if you have diastasis

It is important to treat diastasis not only for aesthetic reasons, but for the proper functioning of the abdomen, the pelvic floor and the person's posture.

The success of the treatment depends mainly on the distance, width and depth of the separation between the rectus abdominis muscles. However, be aware that while different techniques and treatments can bring improvement, a complete return to the original position and appearance is very difficult to achieve.

The best advice is to put yourself in the hands of a physiotherapist specialised in the pelvic floor, who can evaluate your diastasis and design a treatment plan specifically adapted to your needs and your case, and also follow these recommendations to avoid further widening the separation of your rectus abdominis muscles:

• Avoid activities that significantly increase intra-abdominal pressure, such as running or jumping. In the final recovery phase, hypopressive abdominal exercises, Pilates or yoga are recommended to build body awareness and postural re-education.
• Do not lift heavy objects.
• Do not do traditional sit-ups, which increase abdominal pressure and put strain on the linea alba.
• When coughing, hold your abdominal muscles with your hands so that the pressure of the organs cannot strain the linea alba.
• Do not get out of bed without first turning onto your side.
• Bend your knees, not your trunk, when crouching down.
• Do not use lumbar support belts, unless you are doing heavy lifting work and only for the duration of the activity.
• Avoid a second pregnancy before recovering as much as possible. Lumbopelvic stability is not yet good.
• Eliminate constipation for good: increasing intra-abdominal pressure to pass stools significantly widens the separation of the rectus abdominis muscles and can also harm the pelvic floor.

At Akro you can count on the guidance of our colleague Judith Olguín, a physiotherapist specialised in the Pelvic Floor, for specific treatments focused on the prevention and care of everything related to the pelvic floor. Don't hesitate to book your assessment appointment.