Diastasis Recti: Narrowing the Abdominal Gap

Diastasis Recti: Narrowing the Abdominal Gap Blog


Diastasis Rectus Abdominis, or DRA, is a common and natural condition experienced by women during pregnancy, although it can occur in anyone subjected to intra-abdominal pressure, including men. DRA is a separation of the two long muscle segments of the rectus abdominis that divide the “six-pack” down the middle. The separation takes place along the linea alba, the thin collagen sheath that runs the length of the RA, caused by pressure from the growing baby.

Complications Related to DRA

After pregnancy, the abdomens of about two-thirds of new mothers return to their pre-pregnancy gap. The remaining third retain a larger gap, accompanied by dysfunction of the linea alba and abdominal wall. Depending on the size and location of the diastais, it may be readily visible beneath the skin. Severe diastasis can be cosmetically disfiguring, but it can also cause other serious health problems.

Three common problems associated with DRA include:

  • Pelvic floor dysfunction: Urine leakage during physical activity, or when laughing, coughing or sneezing, is a common side effect of DRA, related to a dysfunctional pelvic floor. When the RA muscles are unable to properly contract, the pelvic floor is weakened, and the transverse abdominis is unable to effectively support the pelvic organs, causing prolapse, and placing pressure on the sphincters that control urine flow. Pelvic dysfunction related to DRA can lead to painful intercourse for women, and can cause inflammation of the male prostate.
  • Belly bulge: Most women retain a little tummy bulge after childbirth that gradually goes away after several weeks. However, with DRA, a postpartum tummy persists, even after weight loss and targeted exercise. A weakened abdominal wall with thin connective tissue is unable to support the abdominal organs, causing the abdomen to bulge. Traditional abdominal exercises may put additional pressure on connective tissues, increasing the bulge instead of diminishing it.
  • Low back pain: Your abdominal and pelvic floor muscles play an important role in stabilizing and protecting your spine. When those muscles are weakened, spinal stability is quickly compromised, causing misalignment and affecting other areas such as the sacroiliac (SI) joint. To maintain pelvic stability, you may compensate by overly contracting the gluteal muscles, which may in turn lead to sciatic nerve pain.

Hope for DRA Sufferers

Your ability to recover from DRA and tighten the abdominal gap has a great deal to do with the resiliency of your connective tissue, and your ability to control your abdominal center. Exercise may help, but in some cases it can do more harm than good.

In severe cases of DRA, surgery may provide a cosmetic improvement. However, surgery cannot resolve pelvic floor dysfunction. Conservative treatment by a trained physical therapist can help narrow the gap and restore function to your pelvic floor and abdomen.

The women’s health specialists at NYDNR are trained and experienced in treating DRA and its side effects. Contact us today, and take your first step toward resolving your DRA and restoring healthy pelvic function.

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)

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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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