Diastasis Recti: What it is, How to Prevent it and False Myths

Diastasis Recti: What it is, How to Prevent it and False Myths

You’ve probably heard the term “Diastasis Recti” (abdominal separation) in recent years.

You’re also likely to identify this term, which refers to a pathology, as a problem that happens only to women who have gone through pregnancy.

And nothing could be further from the truth.

It is becoming increasingly common to find people, both men and women, who suffer from abdominal separation.

Many men who train with free weights suffer from this problem.

In this article, we’re going to talk about what DIASTASIS RECTI is, the main causes for it occurring, as well as false myths surrounding the subject that we need to debunk, as well as some basic recommendations for how to prevent this abdomen rectus dysfunction.

What is Diastasis Recti?

Diastasis Recti is a separation of the rectal muscles from the abdomen; an increase in the distance of the muscles from the rectus of the abdomen.

Abdomen separatiom

The rectus abdominis is composed mostly of type I muscle fibres ( tonics) – 65% – and 35% by phasic fibers.

This results in:

  • Interruption of the transmission mechanism of facial muscle tension.
  • A prevention of intersegmental and intrapelvic support through the fascial tension it generates.

Abdomen

Normal Abdomen vs Abdomen with Diastasis.

What are the functions of the Rectus Abdominis?

The main functions of the abdominal muscles include:

  • Core flexing
  • Rib descension
  • Visceral Protection

Together with the rest of the muscle and connective tissue of the core, it is also formed by the: transverse perineal, obliques, iliopsoas, pelvic floor, lumbar square, diaphragm.:

They form a complex network that acts synergistically and jointly in the respiratory system, in the execution of the movements, in stabilisation, and in protecting the vital organs, amongst other functions.

Abdominal line

It also forms the core of the functional kinetic chain.

They therefore act as a functional unit: any problem in any of its parts will directly and/or indirectly affect the operation of the unit.

What are the effects of Diastasis Recti?

The fact that there is a separation of the abdomen rectus, decreasing the tenseness of the linea alba, causes different dysfunctions that directly affect the health of the subject.

There are different types of Diastasis Recti: above the navel, infra-umbilical, complete or around the navel…

Female abdominal diastasis

This needs to be assessed by the specialist.

Likewise, depending on the degree of separation between rectus and the quality of the muscles, one way or another their recovery and the specific exercise program must be addressed.

Before continuing, in order to understand some of the possible causes of this problem, we must bear in mind that, in all this complex of muscles, fascias and organs, there must be a correct distribution of pressures to avoid not only an abdominal diastasis, but also other problems and dysfunctions related to the pelvic floor and postures.

Intra-Abdominal Pressure

Rest Pressure

This is caused by the visceral mass and the postural tension of the parietal muscles. The average pressure at rest in the lying down position is 10 mmHg.

Pressure During Exertion

It depends on:

  • Airway resistance;
  • Type of breathing;
  • The synergy between the diaphragm, abdomen, pelvic floor, and the type of exertion..
During the Valsalva maneuver, for example, pressure can increase up to 40 mmHg. Have a look at this link if you want to learn more about this training-focused breathing technique.

Intra abdominal pressure

That’s to say, before any increase of Intra-abdominal Pressure, there is a connection between all the deep musculature.

Causes of Diastasis Recti

In view of the above, it’s easy to see how poor pressure management can lead to separation of the rectus from the abdomen, as well as uncontrolled overexertion.

Consequently, we can deduce a lack of motor control

  • Loss of function of the pelvic floor muscles.
  • An incorrect breathing pattern.
  • Poor posture.
  • Certain hormonal changes that weaken the connective tissue can also cause this separation of rectus from the abdomen.
  • Surgery in the abdominal area.
  • Abdominal weight and volume (diastasis recti is common in men with the well-known “Beer Belly”).
  • High intensity training without good management of pressure control.

Pregnancy and Diastasis Recti

Pregnancy is among the most common causes, as during pregnancy the rectus abdominis muscle expands and stretches.

At the same time, the linea alba decreases in thickness and weakens.

With pregnancy and postpartum, there’s a prevalence of abdominal diastasis of 27% in the second trimester; and it increases to 66% in the third, persisting until almost 12 months after delivery.

Diastasis variation pregnancy

Diastasis variation during pregnancy.

Remember, this problem does not only affect women who’ve been through pregnancy.

How to correct Diastasis Recti?

The whole functional unit we were talking about earlier, must work optimally.

It does not depend exclusively on the anatomical integrity of each of its parts, but on the correct functional coordination between them.

Activation of the abdomen traverse and breathing pattern functions will help the base of the unit to function optimally and protect the rest of the structures.

How do you know if you have Diastasis Recti?

First of all, a professional physiotherapist should look into it, and, working together with a trainer, assess the existence of possible dysfunctions in breathing patterns.

Additionally, of course, the clinical history of the subject should be analysed (in the case of a woman, to know how many times she has been pregnant); to evaluate postural hygiene etc too.

Palpation

Often, if the distance between the rectus is large (> 3 cm), it’ll be perfectly visible.

In most cases, we can try the self-palpation from a supine position (lying on our backs). The specialist places a pair of fingers on the linea alba and lifts the head.

The following things will be looked at:

  • Distance between rectus.
  • Depth (distortion of the linea alba).

In terms of the distance between rectus:

  • A separation less than 2.5 cm (about the width of a finger), is considered normal.
  • Over 3.5- 5 cm is considered moderate to severe.

As for the depth, if there’s a sinking of the finger above the nail, it’s considered moderate to severe.

Exercises

In any case, a complete professional evaluation is recommended.

It can also be assessed with an ultrasound scan, with the pacemeter, and by assessing the management of pressure and swelling of the abdominal area. Complete assessment of the core, respiratory pattern, diaphragmatic-costal mobility, etc.

How to prevent Diastasis Recti

An assessment by both a specialised physiotherapist and a trainer, who can direct the training and exercise program to reinforce any weakness.

In the beginning

  • Isolated breathing pattern work.
  • Posture control.
  • Activation of the transverse both in the basal state and integrated with certain exercises

Transverse Activation

Improves the integrity of the linea alba by increasing its fascial tension, which translates into better load transfer.

  1. Searching for transverse activation: analytical, postural, stabilisation and hypopressive work, where appropriate.
  2. Searching and integrating the work of the rest of the abdominal belt with previous transverse activation: motor control.

Conclusions

For all the above reasons, and in view of many apparently healthy fitness bodies with a very marked abdomen but with rectus separation, it is important to work from the basics:

  • Posture;
  • Breathing and pressure control;
  • Pelvic floor.
In order to improve the functional unit of the whole abdominal-lumbar and pelvic complex, both in terms of health and sports performance.

Bibliographic References

  1. Caufriez M , Domínguez JF, Ballester SE, Schulmann C. Estudio del Tono de Base del tejido músculo-conjuntivo del suelo pélvico en el postparto tras reeducación abdominal clásica. Fisioterapia 2007;29 (3):133-138.
  2. Lee D, Hodges PW. Behaviour of the Linea Alba During a Curl up task inn Diastasis Retus Abdominins: An Observatory Study, 2016.
  3. Mens J, Van Dijke GH, Pool-Goudwaraard A, Van der Hulst V, Stam H. Possible Harmful effects of intra- abdominal pressure on the pelvic girdle. J Biomech 2006:39 (4): 627-35.

Related Entries

  • We tell you all you need to know about Kegel Exercises to Strengthen the Pelvic Floor. Here at this link.
  • Do you know the Abdominal Vacuum technique? Here you’ll find all you need to know.
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About Isabel del Barrio
Isabel del Barrio
Sport runs in the blood of Isabel, which she has proven since she was very little up until now. She wants to share that passion with all those who are passionate about sports.
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