Abdominal Diastasis: Symptoms, Consequences, and Intervention

Abdominal Diastasis: What is it?

Abdominal diastasis occurs when the rectus abdominis muscles separate due to the weakening of the midline tendons. This issue, far more than a mere aesthetic concern, can significantly impact physical and mental health by affecting the support function of the tendinous sheath surrounding these muscles. Well-known among pregnant women, abdominal diastasis generally occurs after pregnancy. It's caused by stretching of the rectus abdominis muscle under the increasing pressure of the uterus and fetus. The combined action of hormones also contributes to thinning connective tissues. If abdominal diastasis occurs during one pregnancy, it is more likely to recur in subsequent pregnancies. Unfortunately, the development of this separation during pregnancy is unpredictable.

How to Recognize Abdominal Diastasis?

Separation of the rectus abdominis usually heals on its own within 8 to 12 weeks postpartum. Diastasis occurs when the distance between the right and left sides of the rectus abdominis exceeds 2.5 centimeters, but this usually resolves naturally within 12 months after birth. If not, the first sign is visual. The abdomen takes on an abnormal and strange shape and tends to swell throughout the day, almost resuming its pregnant form. There are also physical symptoms. For example, there may be digestive and respiratory difficulties, a feeling of heaviness in the pelvic floor, and incontinence. Weakening of the abdominal muscles can also lead to back pain. Diastasis manifests as an increased lumbar curve and the emergence of pain in the lower back, pelvis, and hips.

How is Abdominal Diastasis Treated?

Treating Abdominal Diastasis with Simple Exercises

Technically, it's important to note that abdominal diastasis is considered normal as long as the separation between the right and left muscles does not exceed 2.5 cm. However, if you experience specific symptoms or notice worrisome signs, it is strongly recommended to consult a doctor for an accurate diagnosis of abdominal diastasis. In the presence of mild to moderate diastasis, passive or active exercises of the abdominal muscles can be performed. If the diastasis is significant, that is, it measures more than 5.5 to 6.0 cm, it is advisable to seek the opinion of a specialist before trying techniques that could worsen the fragility of the abdominal wall. It's important to avoid exercises that put stress on the rectus abdominis, especially stretches. Lying on your back on a fitball and carrying heavy objects is discouraged. Exercises to avoid also include abdominal exercises that put tension on the superficial muscles, obliques, and crunches, as well as upper body rotations. In the case of a mild to moderate degree, there are many exercises that can reduce diastasis postpartum. The problem is understanding whether these 2.5 cm are physiological or pathological. If in doubt, if the mother is unable to self-assess and is unsure of their appearance after pregnancy, surgery is necessary, as is the case with more serious conditions.

Treating Abdominal Diastasis with Cosmetic Surgery: The Role of Abdominoplasty

The abdominoplasty procedure aims to correct the separation of the abdominal muscles and resolve diastasis. During this procedure, a qualified surgeon can use less invasive techniques such as laparoscopy and endoscopy, while for complete or partial operations, the use of a plastic surgeon is recommended. It is important to note that laparoscopy has a higher recurrence rate than other procedures such as endoscopy, robotic laparoscopy, and classic and mini-abdominoplasty. Although these operations resolve aesthetic and functional problems, the scar left by laparoscopy may be similar to that of a cesarean section. However, back pain disappears immediately after the operation because the rectus muscles regain their role in supporting the trunk and containing the internal organs, even in the most invasive cases. Posture becomes correct again. Incontinence often regresses, nausea disappears, and bowel movements become regular. The restoration of a satisfactory aesthetic state also restores psychological well-being. However, since this is a surgical operation, it is essential to rest for several weeks and limit activities involving lifting heavy objects and exertion. Many women report numbness in the abdominal area, but rest assured, this fades over time. Any assessment of the advantages and disadvantages should be carefully weighed with the surgeon.

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Can Abdominal Diastasis Be Prevented?

To avoid abdominal diastasis, it is recommended to adopt good posture, such as a straight back and feet firmly planted on the ground when walking or sitting. In addition to this, exercises can be performed under the guidance of a physiotherapist to strengthen the abdominal wall without overworking the transverse muscle, while working the pelvic floor muscles. Although there is no precise data on the subject, these postural precautions and exercises may be beneficial in preventing abdominal diastasis. Physical exercise during pregnancy aims to ensure good posture and strengthen the pelvic floor muscles. Correct breathing to coordinate the diaphragm and pelvic floor helps reduce the possibility of the linea alba being damaged. There is no established and documented predisposition that can indicate which mothers might be "candidates" for this condition. Studies are underway to obtain guidelines to offer mothers in order to reduce incidence.

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