Do you have Diastasis Recti Abdominis?

Diastasis Recti Abdominis (DRA) is the separation of your rectus abdominis. If you are pregnant or overweight, you may be at risk for this dysfunction which causes a small bulge either above or below your naval. This separation can increase the risk for hernias, urinary tract infections, and an increase in back pain due to decreased structural support. It usually occurs with inadequate muscle activation of the deep lumbar stabilizers. Pregnancy in women causes stretching of the rectus abdominis and laxity in the joints.  These changes weaken the muscle, and if improper lifting mechanics are attempted, a separation may occur.

A study published in October 2015 in the Journal of Orthopaedic and Sports Physical Therapy evaluated two exercises and their effect on decreasing the risk of DRA. The study used the “draw-in maneuver” and “abdominal crunch” exercises in a search to find the best exercise to reduce DRA. The conclusion was that overall, the abdominal crunch had the highest values in reducing DRA, while the draw-in maneuver increased the abdominal separation postpartum. Testing between the two exercises however, only measured the immediate effect of DRA reduction; therefore, the data does not show the effectiveness of treatment over time as an intervention or as a regular exercise. There were no outcome measures for back pain relief either. Finding a balance seems to be the key.

The following is an exercise to reduce this bulge if it you experience it. Begin by lying on your back with knees bent and feet flat. Next, wrap a sheet around your trunk and cross over the bulge. With your hands, pull the sheet tight across abdomen as if to tie it. Flatten your back to the floor to engage the lumbar stabilizers, then raise your head slowly as you exhale. Make sure to hold the sheet tight to prevent bulging. Exhale slowly and hold for 5 seconds, then slowly lower head back down. Repeat 10-20 repetitions, twice per day. Progress to 10 second holds as you are able, but do not hold your breath! We recommend coming in for an evaluation to see what is contributing to your DRA. Here at John Goetze Physical Therapy, the therapists focus on improving and maximizing your movement potential. We can provide training to correctly engage your core and reduce your risk for DRA, while also realigning your pelvis, working on posture, and decreasing your back pain. Call now to set up an evaluation.

Reference: Mota et al. The Immediate Effects on Inter-Rectus Distance of Abdominal Crunch and Drawing-in
Exercises During Pregnancy and the Postpartum Period. JOSPT.2015;45:781-788.