Diastasis recti abdominis, pelvic floor and the abdominals.
The postpartum period is often defined as six to eight weeks from delivery, but many physical changes are identified up to 12 months and years after delivery. Many changes occur during the post-partum period, expansion of the abdominal wall to accommodate the growing foetus during pregnancy commonly leaves prominent persistent physiological changes.
So, what is diastasis recti abdominis?
DRAMS is measured by touching 4.5cm above and below the umbilicus using an abdominal crunch in supine; women are classified into four categories dependant on number of finger breadths.
How common is it?
The prevalence of DRAMS in 12 months post-partum population is 32.6%. Despite this prevalence, the exact aetiology and risk factors are still under high debate.
Risk factors can include high age of mother, multi-parity, caesarean section particularly in those who have had multiple children and weight gain or obesity; as these elevate intra abdominal pressure or from abdominal surgery. It can occur in both men and women, although pregnancy is the most common cause, thought to be due to the increase in intra abdominal pressure from the growing foetus and hormonal changes. There is a higher likelihood of DRAMS among post-natal women who are exposed to heavy lifting 20 times a week or more.
What can you do if you think you may have DRAMS?
Firstly, all women should see a pelvic floor specialist or pelvic floor physio post childbirth for a proper pelvic floor assessment, as some women will have an overactive pelvic floor while others will have weakened muscle in need of more support. Multidisciplinary care can really help women move forward, here at Myothrive we work with women health physios regularly and communicate for the best outcome for our patients!
From here you will be given a unique program to start working your pelvic floor, any muscle weakness you may have through your abdominal area and hips, it may also include a balance activity. Everyone is unique with the timing and exercises they require, it’s not a cookie cutter plan.
Here some things we would look at implementing.
- Diaphragmatic breathing exercises should first involve focused belly breathing contracting the abdominals on exhale as a foundation, progressing to more specific mindful focus on the area of diastasis, breathing through isometric abdominal contractions then integrating the pelvic floor muscles.
- Exercises targeting transverse abdominis in conjunction with all the abdominal muscles, and pelvic floor muscles to help decrease intra-abdominal pressure and laxity of the linea alba to assist in more effective load transfer across the midline.
- Restoring strength and function. Strength exercises can include glute bridges progressing to marches, dead bugs variations, bird dog then modified plank variations.
What is the link between DRAMS and the pelvic floor?
Here at MyoThrive we have an interest in women’s health and will work your women’s health physio or pelvic floor physio for the best outcome 😊
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