Mom & expert talk with Dr. Susanne Fasler, senior physician in the women’s clinic (Cantonal Hospital Aarau) and mother
I am very pleased, Dr. We would like to welcome Susanne Fasler (gynecologist) to the expert talk. We will delve intensively into the topic of diastasis recti. A few years ago almost no one knew what this term meant. Now it seems that most women are confronted with the term after giving birth.
Diastasis recti involves the abdominal muscles. These are stretched a lot during pregnancy and have to return to a good shape after the birth so that the woman feels strong, centered and good in her body. You can find the medical background and tips in the following interview. Have fun while reading!
What is diastasis recti in your words?
The Latin word Diastasis Recti consists of the two words “Musculus Rectus Abdmominis”, which means the rectus abdominal muscle, and “Diastasis”, which means to slide apart.
Is there a medical condition called diastasis recti, or is another term used when this diastasis represents a medical problem?
Diastasis recti is simply a description and the term does not mean that there is a pathological case. When diastasis recti is problematic is always discussed and reassessed. In medicine, 2 cm is used as a guideline. This means that if the abdominal muscles are more than 2 cm apart, the gap is still too big.
How is the exam done to determine if diastasis is problematic?
The doctor can tell simply by palpation whether there is a diastasis and how severe it is. If you want to examine it at home, you can lie down, put your feet up and lift your head a little. Then use your fingers to feel the midline of the abdomen above the belly button up to the breastbone, and below the belly button to the pubic bone. If the distance between the two rectus abdominal muscles is greater than two fingers, this indicates that the opening is too large and needs more time, recovery training or treatment.
However, the distance between the rectus abdominis muscles is only an indicator indicating a pathological situation. Equally important is the strength of the tissue between the muscles that holds them together. This can still be very soft for hormonal reasons. When the woman breastfeeds her baby, the tissue remains soft for longer.
35-40% of menopausal women have diastasis recti.
How many women do you estimate have diastasis recti that is problematic?
During pregnancy, 90% of women have diastasis recti at 35 weeks of pregnancy. Sixty percent of women still have a gap between their abdominal muscles six weeks after giving birth. About half of these 60% of women still have stretched abdominal muscles after 12 months.
Diastasis recti is particularly a problem if the woman suffers from pain in the back, pelvic or abdominal areas.
What kind of measures will the medical side take in this case?
As a first step, the doctors send the affected women to physiotherapy. If there is no improvement, diastasis recti can be treated surgically. A kind of net is then placed over the entire length of the rectus abdominal muscles, which holds them together.
In your opinion, does abdominal muscle training make sense during pregnancy? If so, why. If not, why not?
There used to be an absolute ban on training your abdominal muscles during pregnancy. There is currently more and more core training for pregnant women, which can also be useful when it comes to strengthening the back and strengthening the deep abdominal muscles. The woman should feel well how she feels after training and whether it is right for her.
In your opinion, how long does it take until the abdominal muscles are intact again?
I would estimate an average of 6 months, although it can of course vary up and down. In certain women, diastasis recti becomes barely visible shortly after birth and in some it persists throughout their life.
It is important to note here that the degree of diastasis recti also changes with hormonal changes. When a woman breastfeeds, the tissue remains even softer, compromising the strength and cohesion of the muscles.
There is too little data to determine whether diastasis recti has negative long-term consequences.
When treating a problematic diastasis recti, do you also consider the pelvic floor?
In medicine, the areas are generally treated separately, so no. However, I think it may have a connection. Individual areas of the body are interconnected, which means that they can condition or influence each other.
What problems could arise if diastasis recti were not treated?
Interestingly, there are few studies that provide data on this. That’s why it’s difficult to say from a medical point of view. For some women it is more of an aesthetic problem. In some women, the stomach feels very unstable, the intestines can be pushed forward and this is uncomfortable. But more research definitely needs to be done in order to have better data in this regard.
Diastasis recti is particularly a problem if the woman suffers from pain in the back, pelvic or abdominal areas.
Is diastasis recti present longer after a cesarean birth?
As a result of the surgical procedure, the abdominal muscles in the lower area are separated and must also heal again. That’s why it can take longer for the abdominal muscles to close again. However, wound healing is very individual and depending on the woman’s body, it takes different amounts of time until the abdominal muscles are intact again.
