—– DR. RILEY OOTTON, PT, DPT, MS
What is Diastasis Recti Abdominus (DRA)?
DRA is defined as increased laxity and widening of the Linea Alba. This leads to a separation between the two halves of the Rectus Abdominus muscle. This widening can occur anywhere along the length of the Linea Alba.
What is the Rectus Abdominus (RA)?
The RA is a muscle that originates on the pubic symphysis and inserts onto the xiphoid process and rib cage. This muscle performs trunk flexion (crunching) and assists in controlling trunk extension (leaning back). This muscle is split into two halves which attach through a tendinous structure called the Linea Alba.
Risk Factors of DRA?
Pregnancy, increased number of pregnancies, Cesarean section birth, obesity, smoking, diabetes, and poor intra-abdominal pressure (IAP) management.
Why is it crucial to have DRA screened?
Research shows correlations between DRA and the development of midline hernias, Abdominal Aortic Aneurysms (AAA), and Low back pain (LBP).
What to expect from your Physical Therapist:
Measurement of the DRA depth, width and length, abdominal wall observation at rest and with core activation, muscle strength testing and a functional assessment.
Preventing worsening of the DRA:
Avoid any exercise that increases the doming of the DRA. Common exercises to avoid; crunches, oblique twists, sit-ups, leg lifts, planks, and backbends. These exercises should be added back into your routine once the core is strong enough to maintain engagement throughout the entirety of the exercise and no doming is visible.
Does DRA only happen to women?
No! While there is limited research pertaining to the incidence of DRA in men, throughout my practice I have commonly seen DRA in men over the age of 50 years old with LBP and poor abdominal engagement.
What can Physical Therapy do for you?
Be able to generate tension through the Linea Alba. This does not always mean the widening will close 100%. However, this does allow forces to be transmitted through the Linea Alba, providing stability to the thoracolumbar spine and pelvis.
Strengthen the core musculature through therapeutic exercise.
Educating the patient on IAP and proper management. Establish deep core engagement with good breath control.
Proper core activation with daily activities.
Progression to proper core activation with advanced exercise and higher-intensity activity.