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How Physiotherapy Helps Diastasis Recti

Men! Have you ever wondered what that bulge along your abdomen is called? While this can appear commonly alongside the presence of a larger belly this is not always just a lump of adipose tissue (fat). This presentation also tends to come along with weakening through the trunk muscles and your ability to sit up from lying or sitting leaned back. This could be labeled as diastasis recti.

Diastasis recti is a condition where the abdominal muscles separate along the midline (linea alba), causing a visible bulge in the stomach area. The linea alba is a complex connective tissue which connects our right and left abdominal muscles. Nienhuijs et al. 2021 states that following the postpartum females, the middle-aged males living with obesity are the second most common group of rectus diastasis patients.

However, physiotherapy can be an effective treatment for this condition, helping to strengthen the abdominal muscles and return to previous level or improve overall core stability.

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Without contraction, no bulge at resting.
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With abdominal contraction – the bulge increases.

The first step in physiotherapy for diastasis recti is to assess the severity of the condition and determine any other underlying issues that may be contributing to the separation of the abdominal muscles. This can be measured hands on by a physiotherapist for and via exercises which load the abdominal muscles.

Once the assessment is complete, your physiotherapist will develop a personalized treatment plan to help you regain strength and stability in your abdominal muscles. Balancing specific exercises for the muscles affected by diastasis recti, as well as exercises to improve overall core strength and stability.

One of the key exercises that may be recommended by your physiotherapist is the “transverse abdominal contraction”, which is designed to target the deep abdominal muscles that are most affected by diastasis recti. This muscle is the deepest layer of abdominal muscle and acts as a corset wrapping around your entire torso between your lowest ribs and your hips. 

To perform this exercise, lie on your back with your knees bent and your feet flat on the floor. Place one hand on your stomach, and exhale as you pull your belly button in towards your spine, contracting your deep abdominal muscles. Hold this contraction at ~25-30% effort for 10-30s seconds, then release. Repeat this exercise several times a day, gradually increasing the number of repetitions as your muscles become stronger.

It’s important to work with a physiotherapist to ensure that you are performing these exercises correctly and to monitor your progress. It has been demonstrated in a small scale that physiotherapy interventions can lead to about 50% decrease in abdominal bulging, improved muscle activation, and improved functional movement patterns in 2-6 months (Reed, 2019). With proper physiotherapy, you can regain strength and stability in your abdominal muscles and improve your overall core stability, which can help to reduce the appearance of diastasis recti and provide an improvement in day to day function. 

References:

  1. Nienhuijs, S.W., Berkvens, E.H.M., de Vries Reilingh, T.S. et al. The male rectus diastasis: a different concept?. Hernia 25, 951–956 (2021). https://doi.org/10.1007/s10029-021-02467-9
  2. Reed, P. (2019). The Outcomes Of Therapeutic Exercise Interventions For A Male With Diastasis Recti: A Retrospective Case Report.

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