From the Guidelines
Women with diastasis recti should avoid abdominal strengthening exercises, such as abdominal curls, and instead focus on aerobic exercises like walking, as this can help decrease the odds of developing the condition. Diastasis recti is a common condition where the abdominal muscles separate along the midline of the stomach, creating a gap between the right and left sides of the rectus abdominis muscle. This separation typically occurs during pregnancy as the growing uterus puts pressure on the abdominal wall. According to the 2019 Canadian guideline for physical activity throughout pregnancy 1, women with diastasis recti are counselled to seek physiotherapy advice to manage the condition.
Some key points to consider for managing diastasis recti include:
- Avoiding abdominal strengthening exercises that may worsen the condition, such as abdominal curls 1
- Continuing aerobic exercise, like walking, which is associated with decreased odds of developing diastasis recti 1
- Considering physiotherapy to provide personalized exercise programs and monitor progress
- Focusing on exercises that target the transverse abdominis, such as pelvic tilts, toe taps, and modified planks, while avoiding movements that create bulging in the midline like traditional crunches or sit-ups.
It is essential to prioritize aerobic exercises and avoid activities that may exacerbate the condition, as recommended by the guideline 1. By following these guidelines and seeking professional advice, women with diastasis recti can effectively manage their condition and reduce the risk of further complications.
From the Research
Definition and Diagnosis of Diastasis Recti
- Diastasis recti abdominis is a condition where the rectus abdominis muscles separate, causing a bulge in the abdominal wall 2.
- Diagnosis can be made through clinical examination using a caliper or ruler, and diagnostic imaging such as ultrasound may be used to rule out other causes of symptoms 3.
Treatment Options for Diastasis Recti
- Physiotherapy is recommended as the first line of treatment for diastasis recti abdominis 3.
- Exercise therapy, including abdominal binding and targeting trunk exercises, has shown positive effects on body image and trunk flexion strength in post-partum women with diastasis recti abdominis 4.
- Surgery may be considered for patients with functional impairment and a diastasis width of at least 5cm, but only after a standardized 6-month abdominal core training program has been completed 3.
- Plication of the linea alba is a common surgical technique used to treat diastasis recti, but other techniques such as the use of resorbable or nonresorbable mesh may also be used 5.
Effectiveness of Exercise Programs for Diastasis Recti
- There is very low-quality evidence to support the use of specific exercise programs, including transversus abdominis training and curl-up exercises, for the treatment of diastasis recti abdominis postpartum 6.
- Abdominal and pelvic floor muscle training programs have shown some positive effects, but the evidence is limited and of low quality 6.
- Further research is needed to determine the effectiveness of exercise programs for the treatment of diastasis recti abdominis 4, 6.