Diastasis rectus abdominis (DRA), the separation of the right and left sides of the long rectus abdominis (RA) muscle that forms the “six pack,” is most commonly seen in pregnancy, although it does occur to a much lesser extent in other population sectors, such as the obese. The condition results from over-stretching of the linea alba (LA), a tough vertical line of connective tissue that connects the two sides of the RA, and naturally expands with the growing fetus.
Because during DRA the two sides of the RA muscle are farther apart than normal, it has long been assumed that exercises like traditional crunches that draw the sections closer to one another were the logical choice for rehabilitation. However, new research is emerging that suggests that low pressure exercise may offer a more effective approach to resolving DRA than traditional abdominal exercises.
In a recent study by Lee and Hodges (2016), 26 women with DRA and 17 control participants performed abdominal curl-ups using two distinct techniques. The first technique was a traditional curl-up, or crunch, that draws the rib cage toward the hips. In the second technique, activation of the transverse abdominal muscle preceded the curl-up.
Ultrasound images recorded the actions of RA and LA during the two crunch techniques, and at rest. The LA was rated on a distortion index during the three tasks.
The study’s authors concluded:
It is thought that tension on the fascia during transverse contraction may stimulate tissue repair to the LA.
Hypopressive exercise is increasingly being used to treat post-partum pelvic issues like incontinence, pelvic pain and uterine prolapse. To activate the tranverse abdominal muscles, perform the following steps:
Practice tranverse abdominal muscle recruitment until you feel confident, then add an abdominal crunch in the vacuum phase.
Long-term benefits include:
If you are suffering from Diastasis Rectus Abdominis or other post-partem pelvic issues like incontinence, prolapse or pelvic pain, the sports medicine team at NYDNRehab can help. We use the latest technologies, therapies and treatments to accurately diagnose and treat your condition. Contact NYDNRehab today and restore your body’s form and function, so you can get back to your active life.
Lee, D., & Hodges, P. W. (2016). Behavior of the linea alba during a curl-up task in diastasis rectus abdominis: an observational study. journal of orthopaedic & sports physical therapy, 46(7), 580-589.