Diastasis is a disorder defined by excessive stretching of the abdominal muscles (rectus abdominis). Normally, the two sides of the muscle are joined at the white line (Linea alba) of the abdomen on the midline of the body that runs from the rib cage to the pubis. This separation is called diastasis or abdominal diastasis, or diastasis of the rectus abdominis. This anomaly is benign and is easily corrected in most cases.
What causes diastasis ?
Diastasis of these muscles occurs mostly in pregnant women, but also in babies and in some cases in men and women with a significant weight change.
Pregnancy and postpartum
This excessive stretching of the abdominal muscles is often seen in women at the end of pregnancy and after childbirth. Indeed, at the end of pregnancy and after delivery, the woman’s belly undergoes significant changes. As the fetus develops, the rectus muscle at the front of the abdomen (rectus abdominis) and on either side of the midline may stretch until it splits in two. Maternal hormones act to relax the abdominal muscles and soften the connective tissue which helps the muscles stretch. Multiple and/or twin pregnancies are an additional risk as well as the absence of previous muscle tone in the pregnant woman (linked for example to a sedentary lifestyle). However, diastasis usually disappears spontaneously within 4 to 6 weeks after delivery.
Significant weight gain and loss
This muscular distension is also found in people who have gained a lot of weight quickly or conversely have lost a lot of weight.
Insufficient development
Newborns, especially premature babies can suffer from diastasis. This is due to insufficient development of the rectus muscles which does not allow them to fuse to their midline.
What are the symptoms and pain of diastasis ?
A diastasis appears as a linear bulge in the middle part of the belly (center of the belly). It can be visible continuously or only in case of muscular effort. This bulge diminishes when the abdominal muscles are sagging leaving a globally distended belly. In addition to the unattractive aspect of diastasis, it can be accompanied by various pains and health problems, such as :
-abdominal pain during effort (climbing stairs, physical activity or any other act of daily life)
-back pain
-pelvic pain
-transit problems (constipation)
-instability of the pelvis and lumbar region
-urinary incontinence
-umbilical hernia.
How is abdominal diastasis diagnosed ?
A diastasis is diagnosed during a clinical examination. This is accompanied by an interrogation to identify the risk factors of each patient. A radiological examination may be requested to validate the diagnosis.
For the health professional, it is important not to confuse diastasis with an epigastric hernia or incisional hernia if the individual has had abdominal surgery.
What are the treatments for diastasis ?
It depends on the extent of the disorder. If the diastasis is mild and not painful, no treatment is necessary.
Rehabilitation and strengthening exercises
Generally, abdominal diastasis that occurs during pregnancy resolves itself within 4 to 6 weeks after delivery. Perineal rehabilitation and hypopressive abdominal rehabilitation performed by a midwife or physical therapist can help resolve this condition. Hypopressive abdominal re-education, in particular, allows the deep abdominal muscles to be strengthened while taking care not to put pressure on the abdomen.
Cosmetic surgery
If the diastasis is important and does not resolve itself spontaneously, reconstructive surgery of the abdomen can be considered. This can be an abdominoplasty or a tummy tuck with diastasis. The surgeon closes the diastasis by tightening the distended muscles.
If it is a diastasis following childbirth, it will be necessary to wait a minimum of 6 months before proceeding with an operation. If the diastasis is due to a significant change in weight, it will be necessary to wait until the weight has stabilized completely.
Good practices
These few preventive measures limit the risk of developing diastasis during pregnancy :
-wearing an abdominal belt
-a healthy lifestyle (healthy diet and regular physical activities)
-practicing a gentle activity such as yoga and Pilates
-not carrying heavy loads.
