This week the pelvic health group @pelvicroar has headed a social media campaign to put diastasis rectus abdominis (DRA) in the spotlight. This week long campaign has seen the hashtag #pelvicroar used extensively to raise awareness of this condition & hopefully shed some light on the wealth of information & support available to everyone.

So in the spirit of this campaign, we have decided to begin our blog with a Q&A post that (hopefully) helps to answer any questions you may have on the topic, as well as offer some advice on treatment & prevention.

1. What is Diastasis Rectus Abdominis?

Diastasis rectus abdominis (DRA) is defined as a separation of the abdominal muscles which results in a “bulging” along the abdominal midline on exertion. This may also be understood as a thinning & widening of the connective tissue between the “six pack” muscles.

Approx 1/3 women have DRA, but it very commonly occurs during pregnancy due to the size of growing belly. It is though that 100% of women experience some degree of DRA in their advancing pregnancy.

This separation generally resolves within 6-8 weeks post-partum and may not require further rehabilitation. In some cases, this laxity remains and varying levels of separation can result.

The separation itself is not a medical emergency, however, the impaired abdominal wall function can result in back pain, pelvic pain, constipation, pelvic organ prolapse and in rare cases a hernia. In addition, this condition can be associated feelings of negative body image & reduced self-confidence.

2. How do I know if I have DRA?
DRA is characterised by a visible “bulging” of the abdominal midline on effort or exertion, but also widely referred to as “mummy tummy” at rest which can appear to be loosened skin around the midsection of the abdomen.

The extent of the diastasis recti can be measured using your fingers; anything over 2 fingers is indicative of further investigation and/or rehabilitation. Your Women’s Health specialist or Physiotherapist can easily help you with a proper diagnosis & guided treatment.

3. Am I at risk?
Research is only just developing on DRA, but campaign’s such as the #pelvicroar allow health care professionals a platform to share their clinical knowledge on the condition.

Those women that may be at greater risk of persistent post-natal separation:
– Aged > 35years
– Increase in weight or size of baby/babies
– Previous pregnancies (>3 especially)
– Pre-existing separation

Further risk factors for DRA include:​
– Heavy or poor lifting techniques
– Chronic straining (constipation, cough etc)
– Excessive abdominal loading (i.e. exercise)

4. How can it be treated?
The first step to treating DRA is during the antenatal period, where we focus on prevention! Pre-natal strengthening and pelvic floor “PREhab” are the best tools to equip your body for the changes that occur during & after pregnancy.

In the post-natal period, it is recommended that you first see a Physiotherapist to assess your readiness to return to exercise & prescribe a home-based program to build the foundations for later strengthening. This guidance is essential, particularly in the case of DRA, as certain movements & exercises can exacerbate the condition.

5. What are the DO’s & DON’T’s?
The most important information I give patients is on the “DON’T” list. DRA can be easily exacerbated by doing the wrong things & this can result in longer-term implications:

  • DON’T Engage in excessive straining (i.e. lifting, carrying, coughing, constipation etc)
  • DON’T Perform exercise of trunk flexion or rotation (i.e. leaning forward, sitting up from
    lying, twisting)
  • DON’T Do crunches!!
  • DON’T be afraid to ask for help from a Physio

DO:

  • Consult your Physio for diagnosis & treatment guidance
  • Wear an abdominal support brace if necessary
  • Focus on pelvic floor exercises & gentle home-based rehab as prescribed by your Physio

Both pelvic floor trauma and DRA can be quite simple to treat in mild cases, however, it is important to find a Physio that is trained in this specific area. Move clinics offers Women’s Health specific appointments & Physio-led Clinical Pilates to assist in treating DRA & getting you back to exercising safely.

Our Women’s Health Physio, Sarah Henderson, is also able to answer any additional questions you may have regarding diagnosis & treatment. Feel free to email her on sarah@movesportsmed.com or call the clinic on 0208 994 8328.

For more information on DRA & the #pelvicroar campaign visit:
https://www.csp.org.uk/news/2019-05-10-pelvic-roar-campaign-raises-awareness-diastasis-rectus-abdominis

http://www.pelvicroar.org/