Abdominal Muscle Function After Diastasis Rectus Abominis (DRA)

Abdominal Muscle Function After Diastasis Rectus Abominis (DRA) Blog

Diastasis rectus abominis (DRA) is a condition most commonly seen in post-partum females, although it occasionally occurs in obese individuals of both sexes. In a nutshell, DRA is a splitting of the linea alba, the thin but tough membrane that runs the length of the rectus abdominis (RA) muscle that defines the “six-pack.”

In some cases, DRA affects only a small section of the RA muscle, and there is little noticeable change in appearance or function. However, in severe cases, DRA can be both disfiguring and debilitating, compromising the function and performance of the RA and interfering with trunk and pelvic control.

RA Muscle Function

The RA muscle works together with the internal and external abdominal oblique muscles to form a canister that protects the internal organs, stabilizes the spine and pelvis, assists in breathing expiration, and increases intra-abdominal pressure when sneezing, coughing, urinating, defecating, lifting and during childbirth.

With DRA, the function of the RA is partially or completely inhibited, causing a variety of symptoms, including:

• weak flabby abdomen
• undesirable physical appearance
• pain in low back, hip or pelvis
• urinary and bowel problems
• poor posture
• feeling of weakness
• pain during intercourse

Effect of Surgery on DRA

Considering that severe cases of DRA cannot self-heal, many sufferers seek surgical intervention to rectify the condition. However, while surgery may be able to reunite the separated sections of the RA muscle, resulting in a positive cosmetic effect, surgery alone does little to restore function.

Conservative Treatment for DRA

Conservative treatment for DRA that focuses on retraining RA recruitment strategies has proven in many cases to successfully restore function, either partially or fully. Physical therapy for DRA may include the following:

Postural training: Because of the role the RA muscle plays in stabilizing your lower back and core, postural training focuses on learning to stabilize the core muscles without excessive use of the RA muscle. This may involve training other core muscles such as your transverse abdominus and pelvic floor muscles. Your therapy sessions may center on learning to perform daily activities like lifting your baby while maintaining proper posture.

Stretching: When muscles in one area of you body become weak, you may compensate by overusing other muscles, resulting in tightness that interferes with performance. Your therapist may prescribe stretching exercises to restore balanced muscle tension.

Bracing: Your therapist may recommend taping or bracing your low back and abdominal region to provide support during the early phases of rehab and to decreases pain.

Education: Your therapist will help you understand which movements to avoid with DRA, and teach you safe and effective ways to restore full function.

Specialized DRA Treatment Therapies at NYDNRehab

The physical therapy team at NYDNRehab uses the most innovative and effective therapies currently available for DRA:

Vojta Therapy works by reflex activation of the deep abdominal muscles, “reminding” your nervous system of how to effectively recruit them.

DNS (dynamic neuromuscular stabilization) and ISM (integrated system model) therapies take deep abdominal training to the next level, increasing strength and stability and promoting structural balance.

Failure to treat DRA can lead to postural decline, back and pelvic pain and progressive overall weakness. As a young mother, you want to be strong and healthy to keep up with your family and live life to its fullest. Call NYDNRehab today to schedule your DRA diagnosis, and set yourself on the road to recovery from DRA.

130 West 42 Street Suite 1055, New York NY 10036
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In this instance, an athlete was originally diagnosed with minor quadriceps muscle strain and was treated for four weeks, with unsatisfactory results. When he came to our clinic, the muscle was not healing, and the patients’ muscle tissue had already begun to atrophy.

Upon examination using MSUS, we discovered that he had a full muscle thickness tear that had been overlooked by his previous provider. To mitigate damage and promote healing, surgery should have been performed immediately after the injury occurred. Because of misdiagnosis and inappropriate treatment, the patient now has permanent damage that cannot be corrected.

The most important advantage of Ultrasound over MRI imaging is its ability to zero in on the symptomatic region and obtain imaging, with active participation and feedback from the patient. Using dynamic MSUS, we can see what happens when patients contract their muscles, something that cannot be done with MRI. From a diagnostic perspective, this interaction is invaluable.

Dynamic ultrasonography examination demonstrating
the full thickness tear and already occurring muscle atrophy
due to misdiagnosis and not referring the patient
to proper diagnostic workup

Demonstration of how very small muscle defect is made and revealed
to be a complete tear with muscle contraction
under diagnostic sonography (not possible with MRI)

image

Complete tear of rectus femoris
with large hematoma (blood)

image

Separation of muscle ends due to tear elicited
on dynamic sonography examination

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