Diastasis recti - Separation of the rectus abdominis which
can occur with pregnancy and other medical conditions including obesity. This affects both men and women. The connective tissue is stretched as the belly expands, causing a weakness of the core muscles. If you feel that you are suffering from this injury, contact us
today for evaluation and treatment options.
Diastasis recti (also known as abdominal separation) is commonly defined as a gap of roughly 2.7 cm or greater between the two sides of the rectus abdominis muscle.
The distance between the right and left rectus abdominis muscles is created by the stretching of the linea
alba, a connective collagen sheath created by the aponeurosis
insertions of the transverse abdominis, internal oblique, and external oblique.
of this muscle occurs principally in two populations: newborns and pregnant women. It is also known to occur in men, and in women who are not pregnant due to obesity.
In the newborn, the rectus abdominis is not fully developed and may not be sealed together at midline. Diastasis recti is more common in premature and black newborns.
In pregnant or postpartum women, the condition is caused by the stretching of the rectus abdominis by the growing uterus. It is more common in multiparous women due to repeated episodes of stretching. When the defect occurs during pregnancy, the uterus can sometimes be seen bulging through the abdominal wall beneath the skin.
Women are more susceptible to develop diastasis recti when over the age of 35, high birth weight of child, multiple birth pregnancy, and multiple pregnancies. Additional causes can be attributed to excessive abdominal exercises after the first trimester of pregnancy.
A diastasis recti may appear as a ridge running down the midline of the abdomen, anywhere from the xiphoid process to the umbilicus. It becomes more prominent with straining and may disappear when the abdominal muscles are relaxed. The medial borders of the right and left halves of the muscle may be palpated during contraction of the rectus abdominis. The condition can be diagnosed by physical exam, and must be differentiated from an epigastric hernia or incisional hernia, if the patient has had abdominal surgery. Hernias may be ruled out using ultrasound.
In infants, they typically result from a minor defect of the linea alba between the rectus abdominis muscles. This allows tissue from inside the abdomen to herniate anteriorly. On infants, this may manifest as an apparent 'bubble' under the skin of the belly between the umbilicus and xiphisternum (bottom of the breastbone).
Examination is performed with the subject lying on their back, knees bent at 90° with feet flat, head slightly lifted placing chin on chest. With muscles tense, examiners then place fingers in the ridge that is presented. Measurement of the width of separation is determined by the number of fingertips that can fit within the space between the left and right rectus abdominis muscles. Separation consisting of a width of 2 fingertips (approximately 1 1/2 centimeters) or more is the determining factor for diagnosing diastasis recti.