How to recognize the symptoms of diastasis and how to treat it:
White line
The abdominal wall is a muscular structure. It has important roles in holding the body, stability of the torso and pelvis, breathing, movement, and support of the abdominal internal organs. Adequate abdominal muscle position ensures these functions. The abdominal wall consists of five paired muscles. These are, in the anterior midline, the rectus or rectus muscles with fibers running vertically, and the lateral muscles: the external obliques, the internal obliques and the transverse, with oblique and vertical fibers attached to the rectus muscles. The right and left sides of the abdominal wall are connected via white line. The white line (linea alba) is formed as a fusion of the abdominal muscle sheath and consists of a three-dimensional network of collagen fibers. The white line plays an important role in maintaining the stability of the abdominal wall. The width of the normal white line ranges from 11 to 21 mm.
When does diastasis occur
Diastasis occurs in both sexes, but most commonly it occurs in women after childbirth. During pregnancy, progressive changes occur that result in multidirectional stretching of the abdominal muscles and white line. Diastasis occurs due to increased levels of hormones, which cause softening of connective tissue and weakening of the white line; as well as mechanical stresses that the growing fetus exerts on the abdominal wall, and moves the abdominal organs. Diastasis usually appears at the end of the second trimester of pregnancy and continues to increase until delivery. The natural recovery of diastasis lasts usually up to 8 weeks after birth.
Risk factors
Risk factors include age, i.e. women older than 35 years, multiple pregnancies, high birth weight, consecutive pregnancies, obesity, excessive abdominal muscle effort in the last trimester of pregnancy ...
Diastasis types
Diastasis is classified according to the maximum measured distance between the rectus muscles: (1) mild diastasis, 2-3 finger widths, (2) moderate diastasis, 3-4 finger widths, and (3) large diastasis, 4 or more fingers width. Diastasis is a common and significant clinical problem. Many of these patients seek help because the symptoms affect their quality of life. These include cosmetic defects (stretched skin, bulging in the abdominal wall), psychological discomfort (altered image of the abdomen and body), physical discomfort such as lower back pain, weakness of the abdominal wall, and decreased abdominal muscle strength, as well as limitations during physical activity.
Diagnosis
After pregnancy, diastasis looks like a ridge or loaf of bread that is bulging in the area of the middle abdominal line. The bulge becomes more prominent during physical activity, sitting or walking. Over time, the diastase increases and the woman gets a bulging and flabby belly and looks like she is "still pregnant". Diastasis is diagnosed by a simple physical examination by a surgeon as well as an ultrasound examination of the abdominal wall.
Treatment
Diastasis treatment first uses a conservative approach, i.e. specific exercises for the abdominal muscles. They help maintain tone, strength and control of the abdominal muscles, which in turn reduces diastase. All corrective exercises are mainly in the form of pulling the abdominal muscles instead of pushing them out. The most commonly used exercizes are: a program to strengthen the transverse muscles of the abdomen or rectus muscles, postural training as well as education on appropriate techniques for getting up, walking and lifting weights. Exercises are individualized, and therefore it is of great importance that any exercise program is supervised by a healthcare professional. Surgical treatment is mainly performed for aesthetic reasons (flabby abdomen, excess skin ...). It is basically reserved for large diastases, or when there is a joint hernia of the abdominal wall (umbilical, epigastric ...). There are several methods of surgical diastasis correction: conventional surgery using a mesh, abdominoplasty or laparoscopic method of approaching the rectus muscles.