Can Low Pressure Exercise Help Resolve Abdominal Diastasis?

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 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 resolving DRA than traditional abdominal exercises.

Effect of Crunches on DRA

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:

• During a traditional crunch the right and left RA sections drew closer, but the LA was distorted.
• During the transverse activation crunch, right and left sides of the RA were more separated, but the force transfer between the two sides was greater, and the LA was not distorted.
• Reduced IRD narrowing by transverse contraction may positively impact abdominal mechanics.

It is thought that tension on the fascia during transverse contraction may stimulate tissue repair to the LA.

Low Pressure Exercises to Resolve DRA

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:

1. Lie on your back, knees hip width at 90°, feet flexed in toes-up position, arms flat at sides at 45°.
2. Elongate your spine by tucking your chin and pulling your crown upward.
3. Inhale deeply through your nose and expand your ribcage (do not do diaphragmatic or “belly” breathing).
4. Exhale slowly through your mouth and allow your ribs to separate as you hollow out your midsection, creating a vacuum.
5. Hold for several seconds until you are forced to take a breath.
6. Perform two cycles of breathing-only, then create the vacuum on the third cycle.

Practice tranverse abdominal muscle recruitment until you feel confident, then add an abdominal crunch in the vacuum phase.

Long-term benefits include:

• Flatter abdomen
• Narrower waist
• Less pelvic pressure
• Improved posture
• Diminished RA gap
• Improved continence

DRA Treatment in NYC

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 your active life.

Source

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.