Abdominal diastasis

Abdominal diastasis occurs from damage to connective tissue as the rectus abdominis muscles in the front of the abdomen separate. They are joined by the linea alba, made of collagen and fibrous connective tissue.

Diastasis is often thought of as only a cosmetic problem because of possible laxity, but there are also functional symptoms, including:

• The abdomen also works together with the pelvic floor, so other symptoms may include urinary or faecal incontinence, pelvic pain or organ prolapse.

Factors that can lead to abdominal diastasis include:

• Pregnancy: the body and tissues stretch the abdominal wall to make space for the baby’s growth; hormonal changes in pregnancy can also affect connective tissue.
• Excessive loads in exercise, lifting very heavy objects or sustained effort can mean connective tissue cannot withstand abdominal tension and pressure, producing diastasis.

Assessment

Assessment should be done by a physiotherapist specialised in pelvic floor. You can also do a simple check: lie on your back, palpate between the rectus muscles above the navel with your fingertips and do a classic sit-up; if the gap is more than two fingers, it may be abdominal diastasis.

We also use functional ultrasound and manual assessment. We look at the width of the tissue gap to see if it is physiological (2 cm or less) or pathological (more than 2 cm), and we assess the length of the connective tissue and whether there was a rupture. When diastasis exceeds 4 cm of separation, surgical consideration applies.

We also assess activation and strength of the abdominal corset muscles: rectus abdominis, transversus abdominis, internal and external obliques, as well as blood flow and oxygenation.

Treatment

Specific physical therapy for abdomen and pelvic floor uses several techniques, which we can also use during pregnancy to help prevent diastasis:

• Breathing exercises: during pregnancy it is vital to use breathing for proper activation and to strengthen both abdominal and pelvic muscles, which matter for birth.

Postpartum

After birth, equipment can be added to diastasis rehabilitation, including:

• Tecar therapy (CAPENERGY), high-frequency energy that enters the body as heat, increasing blood flow and muscle oxygenation, and helping regenerate existing collagen in connective tissue.
• Electromagnetic fields: electromagnetic waves stimulate the abdominal musculature, generating activation and strengthening.
• Exercise: it is important to continue the exercises taught in pregnancy and progress loads after birth.

If this is your case, at Clínica Traña we can definitely help.