The abdominal diastasis It is a distention of the abdominal girdle: the separation of the rectus abdominis from the linea alba of the abdomen. From 2.5 centimeters it can be considered that there is a diastasis, below it would be physiological, and above 4 or 5 centimeters, abdominal surgery should be evaluated. What factors predispose or trigger an abdominal diastasis?
Palpation is the most common method to assess the separation of the rectus abdominis, if we had an ultrasound or a caliper we could be more precise, but for its diagnosis it is not essential, since there is a good correlation between the three tests.
To assess the degree of abdominal diastasis by palpation, we place the index and middle fingers at the umbilical level and ask the patient to perform an anterior flexion of the head and neck: the test will be positive when the separation between the two muscular bellies of the rectus abdominis greater than 2.5 cm; then we will do it at the supra and infraumbilical levels.
The abdominal diastasis is common during and after pregnancy, with a prevalence between 30% and 70% during pregnancy and postpartum. The hormonal changes caused by relaxin, progesterone and estrogens cause the overstretching of the rectus abdominis, in addition to the fact that the pregnancy itself entails an alteration of the biomechanics of the posture, reducing the support of the visceral organs.
A hypotonia of the abdominal girdle, lumbo-pelvic instability and weakness of the pelvic floor muscles usually go hand in hand with a diastasis, but There are also cases of very athletic people, that due to excessive recruitment of the rectus abdominis they see them shortened, which can also be a negative factor.
He overweight, Whether due to pregnancy or not, it causes an increase in pressure in the abdominal area that indirectly causes abdominal distention. Constipation or coughing can also negatively affect.
But at this point the most important thing, in addition to explaining what we can do to improve our diastasis, is to know and become aware of what we should avoid:
- Do not do sit-ups
If the origin of your diastasis has been pregnancy, do not be in a hurry to return to your normal state! It is normal that you want to see yourself as before and that you take care of your diet and exercise, but substitute the classic abs for walks with your baby. Your body will thank you (and your baby too)!
- Control the weight you take
It is clear that there will be things that you cannot avoid doing, such as holding your little one in your arms, but perhaps you should not go to the supermarket by yourself to buy milk or jugs of water. With abdominal diastasis, it is not the most advisable!
- Avoid impact exercises
You know what I mean right? Zumba, fitness, jump rope ... The most important thing now is that your abdomen is corrected and then there will be time to jump.
- Be consistent with the exercises that your physiotherapist prescribes you
At this time it is necessary to be very applied and responsible and not skip the exercises to correct diastasis recti that your physiotherapist or your midwife have recommended for anything in the world.
- Be careful when coughing or sneezing
A gesture as innocent as this can aggravate this diastasis. To try and stop it from going too far, here is a trick: place your hands on the abdomen area the next time you feel like coughing or sneezing.
- Moderate the use of abdominal girdles
They will probably recommend you to wear an abdominal girdle, but first of all you have to take into account certain measures: do not wear it all day and look for one that supports us but without causing more pressure in the area.
As you progress in your recovery, you will see how each time you can do more things without discomfort and without aggravating your separation of rectums.
The first thing I would recommend would be to go to your trusted midwife and / or physiotherapist specialized in pelvic floor, to see to what degree you are and what you can start to do, on the one hand to improve and reduce the diastasis you have, and, on the other, side, to become very aware of what is not convenient for you to do.
There is no perfect solution, you have to practice different exercises and we can start with the ones that give us the best and recruit the most fibers from our transverse and perineum; in this way you will gain strength and coordination. We can start with a few and, little by little, evolve and change exercises:
- Hypopressive abdominal gymnastics.
- Work the transverse of the abdomen in depth (Tupler Technique).
- Postural reeducation method perineal proprioceptive (5P ChantalFabre).
- Core strengthening.
- Pelvic floor exercises, in reference to Kegel exercises.
There are some women who recover spontaneously from a diastasisOthers that improve so much that the mark of the alba line is barely noticeable. There are also those people who, although they have a very marked 'groove' between the abdominals (1 or 2 centimeters) have good control, and others who improve with the exercises, but when they leave it the diastasis is widened again.
These women are candidates for surgery, which can be a mesh or partial rectus suture. Choosing one option or another is at the discretion of the surgeon and will depend on whether there is an umbilical hernia, which usually accompanies large diastasis that require surgery.
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