Diastasis is a divergence of the inner edges of the rectus abdominis muscles after childbirth: what is it, how to treat it? Diastasis after childbirth - how to return to previous forms
The divergence of the rectus abdominis muscles in medicine is called diastasis. This pathology occurs in 1% of the population. Most often it is diagnosed in women, although it is also not uncommon in men.
The disorder is an extension of the white line of the abdomen and has several stages. The rectus muscles diverge, moving away from one another at various distances. Moreover, the upper part of the white line is most often affected.
The deflection width can reach 10 cm, while normal condition- up to 2 cm. In newborns, it is diagnosed immediately.
The severity of the pathology is determined in the middle of the line connecting the navel and the xiphoid process of the sternum.
Three stages of violation are classified:
- The first is an extension of 5-7 cm;
- The second is more than 7 cm;
- The third is a pronounced diastasis with a sagging belly.
It is very important to determine the degree of the course of the disease, since it can be used to make a forecast for the future, as well as to choose an adequate therapy.
It is worth noting that despite the strong divergence of the muscles, the integrity of the white line is never violated. It stretches and becomes thinner, under the influence of abdominal pressure, a thin, but dense and elastic tendon bulges out.
Why does the divergence of the abdominal muscles occur?
Roll-shaped protrusion different sizes It is formed when straining, raising the head and torso, coughing, tension of the peritoneum. Difficulty in making a diagnosis often occurs in obese patients.
Often this pathology occurs as a result of congenital weakness of the connective tissues, which, in turn, is due to a hereditary predisposition. Often diastasis is combined with hernias of the anterior abdominal wall, flat feet, hemorrhoids, varicose veins veins.
Pathology is diagnosed more often in women, since the divergence of the abdominal muscles necessarily occurs during pregnancy. From the middle of the second trimester, the muscles diverge, because the stomach is enlarged due to the growing fetus.
The white line tightens and stretches along with the uterus. The degree of stretching depends on the course of pregnancy, the size of the fetus, the process of childbirth, and individual characteristics.
Provoking factors are also conditions accompanied by an increase in intra-abdominal pressure - impaired and difficult urination, constipation, physical stress, rapid weight gain, strong and prolonged cough, intensive training, obesity, fast weight loss, heavy lifting work. Such situations lead to the fact that the white line is stretched, thinned and expanded.
Divergence of the abdominal muscles baby, as a rule, arises due to their underdevelopment. Very often this deviation is diagnosed in premature babies.
At the same time, the relief of the anterior abdominal wall is preserved, so the organs are not injured by the hernial ring. In addition, diastasis is not accompanied by a hernial sac with contents. Accordingly, complications in the form of infringement, trauma, inflammation, adhesions, irreducibility, etc. are excluded.
The divergence of the abdominal muscles found in newborns is eliminated with the help of massage and a number of other procedures. In each individual case, the doctor selects the tactics of treatment, based on the degree of the disease, the cause of the onset and a number of concomitant factors.
However, this can be said about more mature patients. You should never do exercises without consulting a doctor, otherwise you can only harm the body.
Signs of violation
The clinical picture can be very diverse. For example, some people are not even aware of the presence of pathology, they are engaged in physical labor, physical education and sports. In such situations, the disease develops very slowly, there is no pain. But many young women who pay attention to their figure immediately notice a slight cosmetic defect in the form of a protrusion.
Also, the patient may complain of discomfort, a feeling of heaviness, constipation, belching, difficulty walking. Painful sensations can occur not only during physical labor, but also at rest.
The pain syndrome can also differ in strength, duration and nature of the attack. It mainly occurs after intense physical exertion, for example, due to work or sports, when lifting weights. In some patients, discomfort appears after a long walk.
The last stage of the disease is characterized by pronounced disorders: prolapse of organs, atrophy of the muscles of the peritoneum, thinning and stretching of the aponeuroses.
Treatment of pathology
Diastasis never disappears on its own. Although the divergence of the abdominal muscles becomes less noticeable after childbirth, it does not disappear anywhere and can progress with the appearance of adverse factors. However, he has the ability to progress. Many people use elastic bandages, but they will not help in this situation.
The optimal method of treatment is surgery. However, the operation is not carried out by everyone. It is noted that in the early stages of the disease good effect observed when performing a special set of exercises.
If surgical intervention cannot be avoided, then tension plasty with local tissues or tension-free plasty with a synthetic mesh endoprosthesis is performed.
Exercises to recover from the divergence of the abdominal muscles
You can get rid of pathology using several methods. Before starting classes, it is necessary to consult a doctor so that he excludes the presence of contraindications.
Usually, training starts a month after giving birth or immediately after diagnosing a deviation.
Breastfeeding mothers should engage in an hour before feeding or immediately after it:
- Starting position - lie on your back, bend your legs at the knees, place your arms along the body. The pelvis slowly begins to lift up, starting from the coccyx. Movements should be smooth, haste is not allowed. In this case, you need to pull the crown forward, and the tailbone up. Breathe only chest. They stop only when the knees, pelvis and shoulder are on the same diagonal line. Having reached this position, take a breath and begin to lower the spine down. These exercises effectively strengthen the muscles of the thighs and abs, stretch the spinal column. You need to repeat them 4 times;
- Starting position - as in the previous one. While exhaling, the right leg is bent at an angle of 90 °. While inhaling, they raise their hands, which are directed with their palms to the floor, and make movements with them (5 times), imitating hits on the water. As you exhale, turn your hands palms up and repeat the “blows”. Repeat 10 times with each leg. Such training has a warming effect, tones the arms and abdomen, and strengthens the peritoneum. In the future, the exercise can be made more difficult by lifting both limbs at once. Then they are kept straight, you can squeeze an ordinary ball with them;
- IP - as in the previous versions. The lower back should be firmly pressed to the floor. If you feel discomfort, a towel folded several times or a small pillow is placed under it. First, raise the leg bent at the knee. On exhalation, it is straightened, strongly drawing in the stomach. The pelvis should be straight, and the top of the head should stretch up. With a breath take IP. Perform movements for each limb 10 times. We remind you that everything should happen smoothly and slowly. It is necessary to constantly monitor the work of muscles and breathing. This exercise most effectively affects the deep transverse abdominal muscle. You can complicate it by raising both limbs at once. On the exhale, straighten one, and then bring the other with your knee to yourself to balance the pelvis;
- In a standing position on all fours, the palms are under the shoulders, the stomach is pulled up and not relaxed, the torso is kept straight. The left leg is straightened as you exhale until it rises parallel to the floor. With a breath they return to the IP. It is worth paying attention to the lower back - it cannot be bent. The crown, as usual, is pulled forward, the toe of the working leg is pulled back. Do 10 repetitions for each limb. To complicate this exercise, you can simultaneously raise the leg and the opposite arm.
Usually, after the birth of a child, the muscles fall into place. This does not occur with strong stretching, weakening of tissues, repeated and difficult births. To a certain extent, the development of diastasis depends on the number of pregnancies and childbirth.
Every woman after the birth of a child dreams of returning to her former forms. Some young mothers manage to do this with ease and without exhausting physical exercise.
Others have to make every effort to recover, and even so, it is not always possible to achieve the desired effect.
The fact is that many women experience changes in the musculoskeletal system during pregnancy, which should be corrected, otherwise the wasp waist will not return.
Diastasis after childbirth - what is it
Diastasis after childbirth is a divergence of the rectus abdominis muscles relative to the central white line, where the connective tissue ligaments are located. Normally, in humans, the distance between the abdominal muscles is no more than 0.5-2 cm.
During pregnancy, the load on the anterior abdominal wall increases, it presses on it, which increases tenfold as the fetus grows.
Also, the muscles of the abdomen of a pregnant woman relax under the influence of the hormone relaxin. As a result, the rectus muscles diverge - diastasis occurs.
The degree of diastasis of the abdominal muscles after childbirth is different: in some, the gap between the muscles does not exceed the upper limit of the norm (about 2 cm or a little more), in others a wide strip is formed up to 10 cm in width or more.
In this case, it is more difficult for a woman to return beautiful shapes after childbirth - the abdominal wall sags, it is difficult to tighten it.
Over time, the abdominal muscles lose their tone and slowly atrophy, the tendons become thinner. Other serious problems are possible: the appearance of hernias, displacement internal organs abdominal cavity.
Causes of strong muscle divergence
More often, severe diastasis appears in young mothers who have had multiple pregnancies, and those who have had (read about it on our website). A more noticeable divergence of the abdominal muscles is observed after repeated births.
The appearance of abdominal diastasis after childbirth is influenced by hereditary characteristics of muscle and connective tissue, the girl's lifestyle before pregnancy, and her weight. If you regularly engage in physical education before conception, prevent the accumulation of excess body weight and keep your abs taut, you can reduce the risk of developing a disorder many times over.
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How to determine diastasis after childbirth
A doctor can accurately determine the presence of diastasis. But you can do it yourself with this test:
1 You need to lie on a flat hard surface (on the floor), bend your legs, feet pressed to the floor. We raise the head and shoulders so that the muscles of the abdominal wall tense.
2 Right hand feel for the midline of the abdomen and the muscles that diverge from it (they are felt under the fingers like rollers that protrude around a flat protrusion).
3 Determine the width of the strip between the muscles near the navel by the number of fingers that fit in the gaps between the muscles (then translate into centimeters).
If the size of the gap does not exceed 2 cm, then there is no diastasis. The divergence of the abdominal muscles by less than 5-7 cm is the first degree of diastasis, more than 7 cm is the second degree, more than 10 cm is the third degree.
How to remove diastasis after childbirth
The following methods of treatment of diastasis of the rectus abdominis muscles after childbirth are possible:
1 Exercises for diastasis after childbirth - effective method, which can help to cope with the violation without surgery, but only when proper organization classes.
2 A more radical way to treat diastasis after childbirth is surgery. It is performed if the correction with the help of physical education is ineffective or the divergence of the muscles is too large.
There are two types of operations. In the first case, a special mesh is used, which is implanted into the anterior wall of the abdominal cavity, maintains the muscles and internal organs in a normal position. In the second case, the muscles and connective tissue of the white line of the abdomen are corrected without the use of an endoprosthesis.
The first degree of diastasis can pass over time without special treatment.
Diastasis of the rectus abdominis muscles after childbirth: exercises
Correctly organize the process of restoring the shape of the abdomen is possible only with the help of experienced professionals. A woman needs to consult with the attending gynecologist: when can you start exercising. In the first 6 weeks, the uterus is cleansed and lochia is released. If you overdo it with exercises, you can provoke bleeding.
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When the health of a young mother improves, and there are no more contraindications for physical education, you can start exercising.
First, a test is performed for the presence of diastasis. If there is a discrepancy, it all depends on its degree: in case of severe violation, you should definitely consult a doctor. If the degree is small, you need to choose a set of exercises.
It is better to first contact a specialist, for example, a fitness trainer - he will take into account all individual characteristics and advise the best method.
If you decide to practice at home, you can use the following exercises:
1 Lying on the floor, bend your knees, hands on the floor to the sides. Raise the pelvis so that a straight line is formed from the torso and legs to the fold in knee joint(3 sets of 10 times).
2 The same exercise can be performed by lifting the pelvis and alternately one leg vertically up, but the arms should lie along the body (10 times for each leg).
3 Lying on your back, put your hands behind your head. The legs are slightly raised, straight. We perform steps in the air, bringing straight legs to the body alternately (3 sets of 20 times).
4 Exercise "Planck": the body is straight, facing the floor, we rely only on the elbows and forearms of the hands and toes. In this position, you need to stay about 30 seconds (for beginners), 3 sets each.
To eliminate diastasis, you need to perform exercises regularly (3-4 times a week), and eat right, especially since after childbirth, most women breastfeed their baby (read the rules for nutrition during lactation on the website here).
With diastasis, it is harmful to overload the abdominal muscles, lift weights. You can not perform exercises lying on a fitball, apply the method "
“Normally, the rectus abdominis muscles are very tight to each other and are interconnected by a tendon (this is the so-called white line of the abdomen), says Natalya Kirillova, gynecologist at the Family Planning Center for the Eastern District of Moscow.- They speak of diastasis in cases where these muscles diverge along the midline. The gap between them can be from 2-3 cm to 10-15 cm.
Why does diastasis occur?
The main provocateurs of its development in women are pregnancy and childbirth. Moreover, the more often a woman gives birth, the higher the risk. The fact is that during pregnancy, the growing fetus presses on the anterior abdominal wall, causing overstretching and divergence of its muscles. Plus, while carrying a baby in the body future mother the hormone relaxin is produced, which softens the tendon of the abdomen, making it extremely elastic. After giving birth, everything “falls into place”. But, alas, not always. “If during pregnancy a woman had a very big belly(this happens when multiple pregnancy, polyhydramnios, or in the case when the fetus is large), the muscles and tendons are stretched much more than normal, - explains Natalya Kirillova. - Most often, diastasis is encountered by women who had before conception excess weight. If a woman followed her figure before and during pregnancy, regularly did exercises to strengthen her abdominal muscles, then diastasis after childbirth is unlikely to form in her.
Why is he dangerous
In most cases, this is only an aesthetic problem: the new mother cannot get rid of the “tummy” with the help of traditional diets and exercises. But in some cases, diastasis becomes a cause of discomfort, and sometimes serious problems with health. A woman may be disturbed by pain in the lower back, the abdominal region, which is aggravated after prolonged physical exertion or heavy lifting. “The most dangerous is diastasis of the third degree (muscle divergence of 10 or more cm), says Natalia Kirillova. “It leads to weakening of the abdominal muscles, increases the risk of hernias and prolapse of internal organs.”
Diastasis test
Lie on your back, knees bent, feet on the floor. Place your fingertips on the midline of the abdomen 3-5 cm above and below the navel. Keeping your abs relaxed, raise your head off the floor. If you feel the divergence of the rectus abdominis muscles, this is diastasis.
Diastasis: Precautions
If you have diastasis, first of all, avoid anything that increases intra-abdominal pressure. You need to learn how to properly lift weights, carry your baby, get up from a chair or bed, and even sleep and cough.
Do not take weights weighing more than 5-6 kg. Those that are easier, do not lift them with outstretched arms, bend them at the elbows.
If your baby calms down only in your arms, wear it with a postpartum bandage or, as they do in India and China.
When coughing, put your palm on the press and lightly press on it so that the stomach does not swell too much.
Lie down on the bed and get up from it only through the position of lying on your side. If you need to get up from a chair, transfer your weight to the right or left buttock, pull in your stomach and, having made a semicircle of the body to the right (or left) side, get up mainly due to the strength of your legs.
Save correct posture. Don't arch your back, but don't slouch either.
Sleep on your back or on your side. The posture on the stomach does not suit you! In this position of the body, pressure increases on the tendon (white line of the abdomen) and the anterior abdominal muscles, that is, you stretch them even more.
Exercises for diastasis
“Many classic press exercises for diastasis are contraindicated,” says Elena Korpanova, Ph.D. D., fitness instructor of the Happy Child family club. - In particular, you can not do full twists, lifting legs from a prone position (and their variants), push-ups, exercises with backbends. All these movements cause either a strong protrusion or a significant retraction of the abdominal wall.
Performing exercises against diastasis, Special attention should be given to breathing - during inhalation, you can not strongly inflate the stomach. If you have been diagnosed with a second degree of diastasis, and before pregnancy you did not train your abdominal muscles, it is better to do the exercises in a bandage.
Exercises against diastasis
Compression
Lie on the floor, bend your knees, feet on the floor. Stretch a towel under the lower back, take it by the ends and cross your arms slightly bent at the elbows in front of you. As you exhale, lift your head and shoulders while squeezing your waist tightly with a towel. Return to starting position. Repeat 10-15 times.
Exercise "Hundred"
Lie on the floor, bend your knees, feet on the floor, lower back pressed to the floor, arms along the body, palms down. As you exhale, lift your head, shoulders and arms off the floor. Hold this position for a few seconds. Return to starting position. Repeat 10-15 times.
Lying leg curl
Lie on the floor, arms along the body, lower back pressed to the floor. Alternately bend and straighten your legs, while the feet slide along the floor. Repeat 10-15 times for each leg.
shoulder bridge
Lie on your back, arms along the body with palms down, bend your knees, feet slightly wider than your hips. On the exhale lift the pelvis up, on the inhale lower it. Repeat 10-15 times.
"Cat"
Get on all fours, back straight, hands at shoulder level. As you exhale, pull in your belly and round your back. On an inhale, return to the starting position. Repeat 10-15 times.
If you regularly, at least three times a week, perform these exercises and follow the rules described above, in most cases, diastasis can be dealt with in 6-10 weeks. With third-degree diastasis, surgery may be necessary: following the endoscopic technique, the doctor will suture the anterior abdominal muscles through small incisions in the abdominal wall. In all other cases, it is wiser to start with the right exercises.
The rectus muscles are two vertically located muscular strands lying in the middle of the abdominal wall from its upper edge to the lower sections. Each of the two muscle formations is surrounded by a dense shell - an aponeurosis. The fibers of adjacent aponeuroses intertwine with each other, forming a “white line” between the rectus muscles, located vertically in the middle of the abdomen. It has a belly button. Normally, the width of the white line is up to 2 cm.
What is diastasis rectus abdominis?
Under the influence of certain factors, there is a weakening, stretching of the fibers that form the white line, and the muscle strands diverge to the sides. This discrepancy is what the medical term "diastasis" means. It is present in about 1 in 100 people.
Causes
The disease is more common in women. The predominant form is diastasis of the rectus abdominis muscles after childbirth. Most dangerous time for this - the first months. The likelihood of developing pathology increases after caesarean section, since the integrity of the muscle aponeurosis is violated, and its ability to contract decreases.
The connective tissue, which, in particular, consists of the aponeurosis of the abdominal muscles, becomes looser under the influence of hormones during pregnancy. This allows the ligaments of the pelvis to prepare for the passage of the baby through the birth canal. In addition, stretching the muscles is necessary for the normal growth of the baby in the uterus. After the birth of a baby, the connective tissue spontaneously strengthens, the shape of the abdomen is restored within a year. If you do not give the body time to rehabilitate and start intense training or do hard physical work, the connective tissue will not contract and will be fixed in a stretched position. There will be a divergence of the rectus abdominis muscles.
Obesity contributes to the occurrence of this disease, as well as rapid decline body weight, when the aponeurosis does not have time to contract behind the muscles that have lost volume, as a result of which its “surplus” is formed.
Muscle divergence can be facilitated by any factor that increases pressure in the abdominal cavity: persistent hacking cough, hard work, sports associated with weight lifting, chronic constipation.
Finally, in medicine there is such a thing as connective tissue dysplasia. This is a congenital condition characterized by an altered structure of the ligaments, tendons and other elements that make up the basis of the body. Dysplasia is manifested, in particular, by increased extensibility of the connective tissue. Therefore, hernias of different localization and muscle diastasis can occur.
The causes of diastasis of the abdominal muscles in men are all of the above factors, of course, except for pregnancy.
Classification and manifestations
Depending on the clinical signs, the following degrees of diastasis of the rectus abdominis muscles are sufficiently conventionally distinguished:
- The distance between the edges of the muscle cords, measured in the middle between the navel and the lower edge (xiphoid process) of the sternum, does not exceed 7 cm. The condition is observed in women after childbirth and usually does not change appearance belly. Symptoms accompanying this stage are dull pain in the epigastric region, weak strength, nausea, sometimes bloating and constipation, as well as discomfort and shortness of breath when walking.
- Diastasis is from 7 to 10 cm. At the same time, the lateral muscles begin to relax, the shape of the abdomen changes, it sags, a vertical protrusion is determined in the middle, and a deepening in the prone position.
- The pronounced discrepancy is more than 10 cm. There is a significant cosmetic defect. The muscles of the press weaken. Prolapse of organs develops, which is accompanied by various manifestations - constipation, abdominal pain, shortness of breath, disorders of the genitourinary system. At the same time, hernias of the white line or navel appear - protrusions of the aponeurosis through which intestinal loops or omentum sections penetrate. Incarcerated hernia requires urgent surgery and may be complicated by peritonitis.
Thus, the progression of the disease can lead to grave consequences. Therefore, when it appears, you need to consult a doctor.
How to determine the presence of diastasis of the rectus abdominis muscles at home?
To do this, lie on the floor and raise your head, looking at your stomach. In this case, the abdominal muscles should be slightly reduced. With the appearance of a vertical roller in the middle of the abdomen, one can assume the presence of diastasis. With severe obesity, the tension of the abdominal muscles, on the contrary, will manifest itself as a deepening of the depression between the rectus muscles.
Additional diagnostics is based on the data of ultrasound examination of the soft tissues of the abdominal wall. Data on diastasis can also be obtained during the study of the abdominal cavity for another reason, for example, using computed tomography.
Conservative therapy for diastasis
Elimination of diastasis is possible both conservatively and surgically, which depends on the severity of the pathology and the time of its existence.
Treatment of diastasis of the rectus abdominis muscles after childbirth is carried out conservatively for 12 months and only in the presence of stage 1 of the disease. It is based on exercise helping the muscles and connective tissue of the abdominal wall to restore their shape.
Within a year after childbirth, you do not need to strain your abdominal muscles. This will lead to an increase in intra-abdominal pressure and an even more pronounced stretching of the already weakened aponeurosis. The best option load is swimming, walking. It is better to choose a set of exercises together with a specialist in physiotherapy exercises. If a woman does this on her own, she must remember the ban on raising her legs, torso from her original prone position.
Exercises for diastasis of the rectus abdominis muscles
- The well-known "cat" will help the muscles of the abdominal wall contract better, while restoring the aponeurosis itself. Standing on all fours, arch your back in an arc, gently pulling in your stomach and taking a slow breath. Then straighten your back, but without arching, exhaling. Perform 10 times.
- Lie on your back and bend your legs. While inhaling, raise the buttocks, leaning on the feet, as you exhale, lower back. Perform 10 times.
- From the same starting position, raise your head and neck, trying to press your chin to your chest. At the same time, hands can be pulled forward, helping the shoulders to rise. Make sure that the press is not subjected to undue stress. Perform 10 times.
- In the same position, but the feet are raised up. We lower one leg until the heel touches the floor and slide it along the floor until it straightens out. The other leg at this time continues to remain in a bent position on weight. Perform 10 times. This exercise is quite difficult and creates a lot of stress, so it must be performed with caution; however, it helps strengthen the obliques.
- Lay a long enough towel or scarf on the floor and lie down on it. Take the ends of the fabric in fists, cross your arms. Raise your head and neck. Perform 10 times.
Gymnastics with diastasis is carried out several times a week. It should not cause soreness or erratic breathing. Otherwise, reduce the intensity of the load. Before starting the exercises, do a little warm-up - slow turns of the torso to the sides, breathing exercises. It is advisable to regularly consult with your doctor before starting training and during their process. It is important not to miss the moment when treatment without surgery will no longer be promising.
In addition to physiotherapy exercises, with diastasis of the rectus abdominis muscles, the doctor may advise a bandage. It is recommended to wear it immediately after childbirth for several hours a day, especially during physical activity and classes. physical therapy. This elastic corset helps the abdominal muscles not to stretch under the influence of loads. It is useful for the prevention of postpartum diastasis.
Massage
Massage will provide additional assistance with diastasis of the abdominal muscles. It is performed with light movements. use Massage Oil or cream with panthenol. The hands are placed on the center of the abdomen, warm it, then begin circular movements clockwise. First, light strokes are carried out in a circle of large diameter, gradually the massage area decreases, and the pressure intensity increases. At the end of the procedure, you should perform a few light strokes from the bottom up. You should not seriously rely on a significant effect from such a procedure, however, in combination with other measures, it will help to cope with mild muscle diastasis that occurs after childbirth.
Why is it necessary to take measures to treat pathology? In addition to the obvious aesthetic defect, pregnancy can be difficult with diastasis of the abdominal muscles. A weak abdominal wall will not be able to participate in the birth act, which will lead to complications in the next birth. Finally, with the progression of diastasis, there is a risk of developing hernias and their subsequent infringement.
Surgical treatment
The disease tends to progress. Often a late visit to the doctor leads to the need for surgical intervention.
Indications for surgery:
- the duration of the existence of diastasis for more than a year and the ineffectiveness of conservative methods;
- 2 and 3 stages of pathology.
Depending on how the intervention is performed, the operation for diastasis of the abdominal muscles implies either a wide incision of the tissues of the abdominal wall, or a low-traumatic procedure using laparoscopic techniques. In both cases, a mesh implant is often used, which is installed in the area of \u200b\u200bdamaged muscles and mechanically strengthens them. During such an operation, the surgeon can eliminate the patient's umbilical hernia, perform plastic elimination of the abdominal deformity ().
Methods of surgical treatment:
- traditional;
- minimally invasive.
Traditional interventions
They involve making a long incision in the abdominal wall. After the operation, the patient needs extended period rehabilitation. In the first three months, there are restrictions on lifting weights (no more than 10 kg) and playing sports. Longer and time of disability. In addition, with such interventions, there is a risk of recurrence of diastasis and complications; they do not provide the proper cosmetic effect. Therefore, in large clinics they are trying to abandon traditional interventions.
Nevertheless, these operations have the right to exist and can still be performed on patients with advanced cases of the disease or in the absence of trained personnel and the necessary medical equipment in the medical institution.
The Championer method involves suturing the diastasis of the rectus abdominis muscles with two rows of interrupted sutures placed on the sheaths (outer shells) of the muscles. As a result, muscle groups are attracted to the midline.
The Napalkov method is the removal of the excess part of the aponeurosis (the connective tissue sheath that covers the muscles) on both sides and the stitching of its edges. When using the Martynov method, the aponeurosis is dissected on one side only and sewn "overlap" onto the muscular membrane on the opposite side.
Cockerling's method - sewing in a polypropylene mesh that imitates aponeurosis and a white line.
The Voznesensky method includes opening the abdominal cavity, stitching the muscles directly and tightening them. Then the excess aponeurosis that covered the muscles is removed, and its edges are also sutured.
How to remove diastasis if there is a hernia of the white line at the same time?
There is a Troitsky operation, during which the surgeon not only restores the integrity of the aponeurosis, but also carefully removes the hernial sac and surrounding scar tissue.
Minimally invasive interventions
Elimination of muscle diastasis using endoscopic technique is modern method treatment of this disease. The operation requires a stay in the hospital for only 1-2 days, while patients note the practical absence of discomfort after the intervention. Exercise stress possible after 2 weeks, and after a month a person can return to normal life.
Endoscopic techniques very rarely lead to a recurrence of the disease (1%). There are no noticeable scars on the skin of the abdomen after them, which gives an excellent aesthetic effect. To make it even better, it is recommended not to expose the abdomen to direct action for a year after the operation. sun rays Simply put, do not sunbathe with an open belly.
With endoscopic correction of the pathology, it is possible to simultaneously carry out some additional interventions, in particular, to remove an ovarian cyst or stones from the gallbladder. In this case, the abdominal cavity is not opened widely, the instruments are inserted through small punctures in the abdominal wall. This helps to avoid the development of adhesions in the future and significantly reduces the risk of infectious complications and bleeding during surgery.
Endoscopic repair of the defect is performed either under general anesthesia or under epidural anesthesia. This allows such an operation to be performed in people with severe comorbidities or in elderly patients. Small skin incisions are made in the "bikini area" and in the navel, through which the surgeon inserts instruments and stitches the edges of the muscles. This operation can be combined with . Within a month after the intervention, it is recommended to use a bandage.
Laparoscopic surgery can be performed using blind plication. During it, gas is introduced into the abdominal cavity, as a result of which the peritoneum and aponeurosis "inflate". The doctor, using special tools, sews and tightens them along the entire length of the identified discrepancy. With a large diastasis, a mesh implant is additionally installed under the muscles.
There is an option to simultaneously get rid of diastasis and remove an umbilical hernia, followed by the imposition of a mesh prosthesis.
Abdominoplasty with elimination of diastasis of the rectus abdominis muscles
It is the removal of excess fat and skin, followed by suturing (tightening) of the aponeurosis. Getting rid of muscle divergence is the key to the formation flat stomach and beautiful waist. If diastasis is not eliminated, then the stomach will take on a rounded, protruding shape due to the parted abdominal muscles. This operation allows you to achieve the maximum aesthetic effect.
Speaking about the surgical treatment of diastasis, it should be mentioned that the sooner the patient sees a doctor, the better the result will be. Modern technologies allow you to perform surgery with minimal trauma and a very low likelihood of recurrence and complications.
In our article you will find comprehensive information about the stages of the development of the disease and methods of treating diastasis after childbirth. Learn how to get rid of the problem with the help of gymnastics. Also get acquainted with a set of special exercises to eliminate the divergence of the rectus abdominis muscles in the first stage of the disease.
For those who play sports, the risk of divergence of the abdominal muscles is minimal
The problem of diastasis after childbirth occurs in more than 20% of women. This problem is expressed not only as a cosmetic defect, but can also lead to various functional complications. Timely diagnosis and initiation of treatment are crucial in the fight against diastasis.
Diastasis is a divergence of the rectus abdominis muscles, the so-called expansion of the white line of the abdomen. This pathology is often found in women during pregnancy and after childbirth. To understand what diastasis is after childbirth and how to deal with it, one should turn to the structure of the internal organs of a person.
The rectus abdominis muscles are held together by connective tissue fibers. Initially, connective tissue is a weak muscle prone to stretching. During pregnancy, intra-abdominal pressure increases, connective tissue expands, and muscles move away from each other.
Changes in the hormonal background contribute to the appearance of diastasis after childbirth and during pregnancy. The level of the hormone relaxin rises, which has a relaxing effect on all muscle groups, including the connective tissue of the white line of the abdomen. The rectus abdominis, under the action of intra-abdominal pressure, easily diverge further and further apart. A depression forms in the middle of the abdomen.
Divergence of muscles can appear during pregnancy and 2-3 months after childbirth. Sometimes it is difficult to diagnose this pathology due to the implicit signs of the first stage of the disease.
Dangers of advanced forms of diastasis after childbirth
Postpartum diastasis does not lead to pinching of internal organs, such as a hernia. And yet, this problem should not be ignored. In the initial stages, the disease does not cause much discomfort, except for a cosmetic defect. Treatment should be started on time, otherwise the situation will worsen.
The consequences of running diastasis can be:
- Displacement of internal organs
- Bad posture
- Back pain
- Digestive problems
- Hernia Risk
- Ineffective attempts during childbirth
Stages of disease development
Normally, the distance between the rectus abdominis muscles is 0.5-2 cm. Muscle divergence above this indicator goes beyond the normal range and is divided into stages:
The stage of development of the disease determines the method of treatment
- Expansion of the white line within 5-7 cm. At this stage, there are such signs of the disease as: dull, infrequent pain in the navel, nausea, bloating.
- Expansion of the white line by 7-10 cm. Outwardly, a hollow becomes noticeable in the middle of the abdomen from the navel to the pubic bone.
- Muscle divergence by more than 10 cm. At this stage, diseases often occur. More serious consequences can be muscle atrophy and displacement of internal organs.
How to check if you have a discrepancy in the white line of the abdomen
Let's figure out how to determine diastasis.
A longitudinal depression larger than 2 cm is considered diastasis
To do this, you can conduct a simple test right at home. Lie on your back. Raise your head and shoulders off the floor as you lift up as in the photo above. If at the moment of tension in the middle of the abdomen a ridge or depression of more than 2 cm in size has formed, then this is a pathological expansion of the rectus abdominis muscles. A small depression between the rectus muscles should be, but not more than the indicated size. An accurate diagnosis can only be made by a doctor.
In any case, if you suspect an ailment, you should contact the surgeon. The sooner you start dealing with the problem, the easier it will be to deal with it.
Features treatment of diastasis of the first degree
At the first stage of the disease, special exercises will help fight diastasis. The second and third stages are corrected only by surgery. It is worth noting that doing therapeutic gymnastics only after consultation with the doctor. The specialist will diagnose and give necessary recommendations. After a natural birth, you can start exercising after 6 weeks, and after a cesarean, at least 12 weeks should pass.
Classic types of exercises for the press, raising legs from a prone position, twisting should be excluded. These types of loads can only aggravate the course of the disease.
“Particular attention should be paid to breathing exercises during classes. correct breathing exercises helps to strengthen the deep muscles of the abdominal cavity.
Swimming and running also give good results.
A set of exercises
The goal of gymnastics for diastasis is to strengthen the pelvic floor, work out the deep abdominal muscles, and the anterior abdominal wall.
Here are some exercises that will help remove diastasis at the initial stage of the disease:
Regular exercise helps beat diastasis
Remember that body twisting is prohibited in diastasis.
Exercises to strengthen the abdominal muscles will be effective only at the initial stage of the disease.
A separate type of exercise is breathing exercises. Inhale through the nose - inflate the stomach, as if in it balloon. Exhale - through the mouth, blow off the balloon. This exercise can be repeated many times throughout the day.
Watch a video clip in which a sports trainer clearly shows how to properly perform exercises to strengthen the abdominal muscles with diastasis.
What is prohibited with diastasis
In order not to aggravate the course of the disease, follow some recommendations:
- Getting out of bed should be from the “lying on your side” position.
- Carry the child using a bandage.
- Do not lift anything heavier than 6 kg.
- Don't slouch.
- When coughing, put your palm on your stomach, thereby reducing intra-abdominal pressure.
- You can't sleep on your stomach.
- Exercises based on twisting the body are prohibited.
Treatment of diastasis by surgery
Which doctor should I contact? The surgeon will be able to make an accurate diagnosis and prescribe treatment according to the stage of the disease. The second and third degree require surgical intervention. There are 2 main methods for eliminating diastasis surgically:
- Stretch plastic. The local tissues of the anterior abdominal wall are pulled together, thus removing the discrepancy. This type of surgery is now rarely used due to its inefficiency, long recovery period and risk of recurrence.
- Not stretchy plastic. The hole is covered with a special synthetic material, the fabrics do not tighten. Over time, the implant becomes overgrown with connective tissue and successfully performs the function of an endoprosthesis. Treatment of diastasis with an implant is considered the most effective. It takes on the load, does not allow weakened peritoneal tissues to stretch.
Surgical intervention may involve both an abdominal incision 16-18 cm long and an endoscopic method.
Minimally invasive intervention has several advantages:
- No major scars or stitches
- Short rehabilitation period
- The risk of re-divergence of muscles is minimal (about 1%)
3-4 punctures are made in the navel area. The implant is implanted under general anesthesia and endoscopic control, using special instruments. At the end of the operation, a cosmetic suture is applied. It is recommended to stay in the hospital for 1-2 days after the operation.
As we see, initial stages discrepancies in the muscles of the press can be cured with the help of regular classes in special gymnastics. In this matter, the main thing is to pay attention to the disease in time and begin active actions. Of course, classes should be regular. IN best case daily.
It is necessary to start treatment of diastasis as early as possible so as not to start the stages of the development of the disease.
In athletic women, diastasis after childbirth is less common than in those who are not friends with sports. Prepared abdominal muscles successfully cope with stress during pregnancy and childbirth and quickly return to normal.
If you have encountered the problem of diastasis after childbirth, tell us about your treatment experience in the comments to this article. Did you manage to get rid of the problem on your own or did you need surgery?
