After the birth of a child, not all women quickly restore their former figure. Many of them face the problem beautiful belly, often without even assuming that the trouble that has arisen can be not only of an aesthetic nature.
Diastasis of the rectus abdominis muscles after childbirth or surgery caesarean section- one of the most common complications that requires qualified treatment. If appropriate measures are not taken in time, then a trifling, at first glance, problem can lead to serious medical consequences.
What is postpartum diastasis?
In Greek, diastasis means separation. In our case we are talking about postpartum period and we will talk about the divergence of the abdominal muscles, primarily due to a recent pregnancy.
Do you have diastasis?
Any woman can check this on her own.
To start, lie on your back. Now raise your head and slightly tighten your stomach. Take a look at it. If in the middle line you have an elongated bulge-like protrusion with even outlines, then the probability of having diastasis is very high.
How serious is this pathology?
IN this case you need to know that the divergence of the rectus abdominis muscles after childbirth or caesarean section can be expressed in varying degrees. This, in fact, determines the seriousness of your situation.
In surgery, there are three stages of the disease:
- I-I - when the white line is stretched by 5-7 cm;
- II-I - when the specified distance is exceeded;
- III-I - characterized by a large diastasis simultaneously with a sagging abdomen.
Depending on how large the discrepancy is (here - how outwardly noticeable the diastasis is), the method of treatment is chosen - whether it is a specially selected set of physical exercises, or surgical intervention.
As you may have noticed, in this article we call diastasis of the abdominal muscles a disease. Such a pathology never goes away on its own and the doctor must determine the method of its correction.
What are the predictions if the divergence of the muscles is severe enough and the stomach sags?
It is very likely that in this case you will be offered a surgical correction when the anterior wall of the abdominal wall is strengthened artificially. Muscle plastic surgery can be performed by stretching the patient's own tissues or by using a synthetic endoprosthesis, roughly speaking, the wall is reinforced with a special mesh.
In the absence of associated complications this operation cannot be classified as complex. As a rule, it lasts up to one and a half hours. As a result, the abdominal muscles come together at a normal distance and their functional activity is restored. Unpleasant-looking protrusion will disappear, and the stomach will regain its attractive appearance.
Some mothers are completely at a loss when, subject to the regimen balanced nutrition and regular exercise, the tummy after pregnancy and childbirth does not decrease, and, at times, even continues to grow. Perhaps the reason is diastasis of the abdominal muscles - it is he who does not allow women to come into a pre-pregnant form.
What is diastasis and the causes of its occurrence:
The rectus abdominis muscles are interconnected like a mesh of tendon fibers. This place, called the abdominal white line, is literally the lightest against the background of the muscles. The expansion of this ligament and the divergence to the sides of the muscles is called diastasis.
Diastasis occurs due to increasing intra-abdominal pressure, pressing on the anterior muscular wall of the abdomen due to the growing uterus. Also during pregnancy, the hormone relaxin is produced, which softens the muscle fibers and ligamentous apparatus of the muscles and pelvic joints, making them more elastic and mobile.
The risk group is women with:
large pregnancy;
- multiple pregnancy;
- second or more births;
- polyhydramnios.
In addition to pregnancy, stress in childbirth and other related factors, there are other causes of diastasis:
Improper physical activity during sports, prolonged and debilitating cough, unjustified straining;
- decrease muscle tone due to sudden weight loss or, conversely, excessive weight gain;
- congenital weakness of the abdominal ligament along the white line of the abdomen (often keeps pace with hernias).
How to determine diastasis and its degree:
To determine the presence of diastasis, you need to sit on a flat surface on your back, bend your knees and press your feet firmly to the floor. One hand winds up behind the head and the stomach slightly tenses. With the second hand, they probe a place in the middle of the abdomen along the midline. In the presence of diastasis, a muscle divergence will be felt along this line, like an oblong fossa. If you raise your head with your hand, then a protrusion in the form of a roller with a clear contour will be revealed in the place of diastasis. The location of the fossa can be under or above the navel and directly at the navel, which already leads to the risk of umbilical hernia.
Normally, the gap between the rectus abdominis muscles is up to 2 cm (minimum 0.5 cm). The nature of the pathology is assessed by the distance between the xiphoid thoracic process and the navel. In order to draw up the correct treatment tactics and give correct predictions for the development of the disease, it is necessary to determine the degree of diastasis (or stage).
In total, there are 3 degrees of diastasis muscle divergence:
At I degree diastasis, the divergence of muscles along the white line does not exceed 5-7 cm. This degree does not affect the condition of the abdomen, it is observed after the first normal birth. Occasionally, nausea, epigastric pain, constipation, discomfort while walking are possible.
- II degree observed with a discrepancy of more than 7 cm. At the same time, the lateral abdominal muscles begin to relax.
- III degree diastasis is noted if the fossa exceeds 10 cm. At this stage, umbilical or abdominal hernias are possible, sagging of the abdomen is observed, there is a risk of muscle atrophy and displacement internal organs with associated impairments in their functions. There may be a limitation in working capacity.
What can not be done with diastasis?:
If the fact of the presence of diastasis is fixed, then, first of all, everything that will increase pressure on the abdominal wall from the inside should be avoided. It will be necessary to learn how to lift heavy things correctly; pick up, hold and carry a child; getting out of bed correctly, sleeping properly and coughing.
1. Do not lift objects heavier than 5-6 kg. The lung should be raised at the bend in the elbows, if possible, without stretching the arms.
2. A child can be lifted and rocked in his arms only with a postpartum bandage on or simply with a belly tied with any tissue.
3. At the moment of coughing, it is necessary to slightly press the press with the palm of your hand to avoid excessive inflation of the abdomen.
5. You can not unnecessarily bend in the lower back and stoop, while maintaining the natural position of the posture.
6. It is best to sleep on your back or on either side, but not on your stomach! If you sleep on your stomach, the pressure on the rectus abdominis muscles will increase, due to which they are more stretched.
Treatment of diastasis:
It must be understood that muscle diastasis is not capable of self-elimination, and its increase is noted over time. Methods of dealing with the divergence of the abdominal muscles will directly depend on the degree of this divergence. With I and II degree good effect can be achieved through the complex special exercises aimed at strengthening the anterior abdominal wall and oblique abdominal muscles (the anterior wall will be reduced precisely due to the lateral ones). III degree, unfortunately, is eliminated only surgically.
It is useful to periodically retract the stomach at any convenient time. It is necessary to draw in the stomach, hold it in this position for up to 30 seconds, relax and repeat after a few seconds. Any frequency, but not to bring to pain.
Lying on your back, you need to slightly raise your head with your shoulders and fix this position for up to 30 seconds. Frequency - up to 30 times.
Also suitable are any exercises that help contract the deep transverse abdominal muscle, which, in fact, performs the function of a corset, encircling the back with the stomach. Training this muscle helps to reduce diastasis.
It is forbidden to pump the superficial muscles of the abdomen, as this process will only aggravate and increase the divergence of the muscles (the usual direct press). Also prohibited are exercises where the upper or lower body of the body is lifted separately, when inflation of the abdominal cavity is observed from the inside.
You can do Pilates by choosing a set of exercises shown for diastasis. Pilates will help strengthen and favorably stretch the abdominal muscles without sudden loads. Pilates will be especially useful for women who also have back problems after pregnancy. When performing the exercises, it is important that the stomach is kept drawn in, and the chest without the stomach is involved in the breathing process.
Operation for diastasis:
Surgical elimination of diastasis consists in the actual elimination of the diastasis orifice and strengthening of the abdominal wall. Effects are noted, both cosmetic and functional. However, surgical intervention should only be considered as a last resort III degree diastasis, when the risk of internal complications is high.
Surgically, diastasis is eliminated in two ways:
- stretch plastics of their tissues (when the muscles and ligaments are actually stitched together different ways, thereby tightening the edges of the diastasis);
- non-stretch plasty using mesh endoprostheses (the prosthesis is fixed at the edges of the diastasis, covering its entire surface and bringing its edges together), which, after 1.5-2 months, germinate with connective tissue, forming a dense anatomical vault between the rectus abdominis muscles.
Conclusion: despite the fact that, according to statistics, about 40% of women who have given birth face the problem of diastasis, not everyone needs prompt assistance. In most cases, diastasis can be eliminated with a special set of physical exercises, subject to simple rules in Everyday life. The main thing to remember is that diastasis will not go away on its own, it will progress, which will be fraught with serious complications for the whole organism.
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 are intertwined, 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 means medical term"diastasis". 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. The most dangerous time for this is 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 child through 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 engage in heavy 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 in sufficient conditionally distinguish such degrees of diastasis of the rectus abdominis muscles:
- 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, of 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 depression 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. Infringement of a hernia requires urgent surgical operation and may be complicated by peritonitis.
So, the progression of the disease can lead to serious 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 physical exercises that help the muscles and connective tissue of the abdominal wall to regain 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 torso turns 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 exercise 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 a long period of 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.
Championer's method involves suturing the diastasis of the rectus abdominis muscles with two rows of interrupted sutures placed on the vagina ( outer shells) 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 only on one side and sewn “overlapped” onto the muscle membrane from 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 discomfort after the intervention. Physical activity is 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 sunlight for a year after the operation, in other words, not to sunbathe with an open stomach.
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 wide, 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 zone" 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 her in abdominal cavity gas is injected, 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 umbilical hernia with the subsequent 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 of surgical treatment 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.
Everyone knows that during pregnancy, the abdominal muscles are greatly stretched, supporting the ever-increasing uterus. That it takes time and effort to put the body in order after childbirth. But often recovery naturally not happening. The reason for this is diastasis. What to do? Really, now stretched out forever? What is diastasis after childbirth? From a medical point of view, this is a divergence of the rectus abdominis muscles due to a weakening of the ligament connecting them.
To understand what happens to the body of a woman who is diagnosed with postpartum diastasis, you need to know anatomical structure and location of the abdominal muscles.
The press consists of 2 muscles connected by tendons. The junction is called the white line. The pressure of the fetus puts pressure on the rectus muscles and causes this connective tissue to stretch, forming diastasis of the abdominal muscles, which manifests itself after childbirth. Now that it has become clear what diastasis is, it remains to determine what to do if diastasis has already occurred or if there is a high probability of its occurrence.
First of all, you need to understand that diastasis after childbirth of varying degrees occurs in almost everyone. Health and diastasis are quite compatible. A slight sprain is corrected and is not considered a disease. In this case, the fabric is tightened without any effort on the part of the woman. Another thing is severe injuries, ligament sprain with a large muscle tear after childbirth. In this case, it can be difficult to cope with diastasis of the rectus abdominis muscles of a woman after childbirth.
The main means capable of leading to the restoration of a normal state is considered to be physical exercise. But they are also the main scourge of the recovery period. Physical exercise can both significantly improve and worsen the situation. But not all cases can be corrected through training. Sometimes the divergence of the rectus abdominis muscles after childbirth can only be corrected by contacting a plastic surgeon.
It is not difficult to detect pronounced diastasis. If there is a hole under the navel on the abdomen, then diastasis of one degree or another has already appeared. Sometimes a depression is present at the site of the navel itself.
Reasons for the development of diastasis after childbirth
The problem of female diastasis can occur due to several reasons:
- Congenital weakness of the ligament connecting paired muscles. It does not depend on childbirth, lifestyle, visits to gym. Therefore, women who do not understand the reasons why the problem arose often blame themselves in vain.
- Weak muscle tone. The reason may be insufficient physical activity or drastic weight loss.
- Violation of the technique of performing physical exercises.
- Weight lifting. The probability of complications is higher, the less the body is prepared for intense physical exertion. If your back hurts after lifting heavy, this does not necessarily mean a problem with your spine. Diastasis is common cause lower back pain.
- Excessive straining during coughing.
- Congenital predisposition to the emergence and development.
In addition, pregnancy itself is a significant burden on. Therefore, at least 40% of mothers of newborns face this problem. With mild forms of diastasis, it is possible to cope quite quickly. In some cases, only surgery is effective.
How to determine diastasis after childbirth
Many women, having heard and read scary stories about the problem of almost all pregnancies - diastasis, try to find signs of muscle divergence in themselves. In most cases this is possible. So, after childbirth, how to determine diastasis?
- Excessively convex or, conversely, located in the fossa of the navel.
- Big belly. Especially after a large number time after the baby is born. If a woman was plump before childbirth, then a bulging belly may not indicate diastasis.
- Frequent .
- Low back pain is also common symptom diastasis.
Test
Obviously, many symptoms do not allow self-diagnosis. Moreover, much depends on the stage of muscle divergence. From how much the connective tissue of the median (white) line is stretched. Therefore, for self-diagnosis, it is best to resort to a simple test.
For the test you need:
- Lie down on the floor or other flat surface. A sofa or bed with a soft, highly sagging mattress is not suitable for this purpose.
- Bend your legs, moving your heels towards your buttocks.
- Put 1 hand behind your head.
- Post right hand on the abdomen near the navel. Mentally dividing the stomach into 2 halves - right and left. Pass exactly in the middle. A hollow should be visible in the navel area. Even if nothing is clearly visible, feel the skin, you should feel a deepening. Ligament divergence usually occurs at the bottom. Those. the fossa should be visible at the location of the navel itself or slightly below it.
If the discrepancy is clearly expressed, the diagnosis can be carried out with both hands. Simply, lying on your back, lower your hands to your stomach and gradually begin to draw them along the center line of the abdomen in the navel area.
As you know, the white line of the abdomen has no muscles. It is made up of connective tissue. When it is stretched, places are formed through which, by pulling the skin, you can usually insert your fingers 1-2 cm deep. Those. you can feel the divergence of the middle fascia of the abdomen (white line).
Provoking factors
In itself, the bearing of the fetus, as mentioned above, is a factor provoking diastasis. Since the load on the press seriously increases during pregnancy. Large pregnancy carries more risk. Just like having twins. The greater the load on the muscles and the less they are ready for it, the higher the likelihood of unpleasant consequences.
Dysplasia (weak connective tissue) is often congenital. And usually this problem manifests itself not only in this place, but throughout the body. People with weak connective tissue often also suffer from varicose veins, hemorrhoids, and hernias.
How to treat diastasis
Before proceeding with enthusiasm for treatment, you need to postpartum. This period does not include exercises and other activities, but involves a number of prohibitions:
- Limit the lifting of any objects weighing more than 5 kg.
- Do not lift objects from 2-3 kg with outstretched arms.
- Use a bandage, especially when you need to pick up the baby.
- Limit any load on the abdominal muscles. Gently get out of bed, do not strain too much, coughing.
- Don't sleep on your stomach.
- Don't slouch. Follow your posture.
The main thing is not to self-medicate. The planned set of exercises should also be discussed with the doctor. Since even a small mistake during the exercise (violation of technique) can lead to deterioration.
Elimination Features
Treatment methods depend on the stage:
- At the 1st stage, the discrepancy does not exceed 7 cm. This is not much. Therefore, questions on the topic of elimination (how to fix, eliminate diastasis) should not arise at all. Physical training certainly won't hurt. But in general, such diastasis is considered the norm and passes without much effort.
- At the 2nd stage, the discrepancy can reach up to 10 cm. The tone of the press is noticeably weakened. Here it will be necessary to give increased attention recovery period.
- At the 3rd stage, the discrepancy exceeds 10 cm. It is difficult to work with such a problem. Complications are possible.
The motto “we get rid of diastasis” and queries “how to get rid of diastasis” in the search will not help much. In this case, each step must be coordinated with the attending physician.
Treatment of diastasis of the rectus abdominis muscles after childbirth
Facilities traditional medicine weak in the face of this disease. But that doesn't mean it can't be dealt with. Diastasis can be treated surgically if the disease has reached grade 3. In other cases, exercise therapy is indicated. Treatment of diastasis is limited to these two methods. Pills and injections, despite the danger of the disease, are powerless with this disease.
How to remove the stomach
There are several ways to remove diastasis. Which one to choose depends on the degree. If the discrepancy is insignificant, then you can cope with simple physical exercises. Additionally, it is desirable to wear a bandage. It usually takes months to fully resolve the problem.
If the diastasis is pronounced, and there is a risk of complications, an operation is performed to eliminate the muscle discrepancy.
Exercises for diastasis
When choosing a set of exercises, you need to be very careful, since activity can only increase muscle divergence. In addition, it is important to properly perform physical exercises that are recommended by experts. Not any gymnastics that strengthens muscles will benefit.
Exercises for diastasis after childbirth should be performed slowly, slowly. You should constantly monitor the technique. It is better if the complex is selected by a competent trainer. If you decide to exercise on your own, or there is no way to go to the gym, specialized exercises can be done at home. So, let's move on to the complex recommended by experts.
Attention: it is impossible to download the press after childbirth. Leg raise exercises are also undesirable. There are other positions, exercises that are unacceptable for diastasis. For example, push-ups. Any poses with an emphasis on the palms or elbows are unacceptable.
It's not uncommon to see advice to strengthen your abs, like this: lie down on the floor, bring your legs together, and start moving them. It is strongly not recommended to do such exercises without consulting a doctor.
Exercises against diastasis
- Stand with your back to the wall and sit down. It is important not to take your back off the wall.
- From a prone position, lift your leg vertically up, tearing off the body. Then, drop. Repeat 10 times for each leg.
- Lie down on the floor. Bend your knees. Slowly lift your pelvis up. Repeat 10 times.
Before starting gymnastics, do not forget to consult with your doctor.
Diastasis and fitness
There is an opinion that pregnant women should not do fitness. It is also unacceptable to load the muscles immediately after the birth of a child. This is not entirely true. During pregnancy, you can and should exercise. Properly selected exercises make the muscle more elastic, and therefore resistant to stress. The load is selected based on whether the woman was engaged before she decided to become a mother.
After giving birth, you really can’t train for some time. Recovery period everyone is different. Much depends on how the pregnancy proceeded, what the birth was like. Physically prepared girls usually have 1-2 months of pause, after which they gradually return to classes. But you can not do this without first consulting a doctor.
Is diastasis dangerous?
It depends on the degree of neglect of diastasis. In extreme cases, diastasis can lead to a hernia. This is the prolapse of organs into the gap between the muscles. In addition, life with diastasis will be accompanied by:
- frequent;
- shortness of breath
- possible urinary incontinence.
It should also be borne in mind that women with such a problem should not lift heavy, so as not to aggravate the discrepancy.
If the problem reached the surgeon
In surgery, there are several methods for eliminating diastasis of the abdominal muscles after childbirth. Which one is suitable for a particular patient depends on the indications and what techniques a particular specialist owns. Among the most common are laparoscopy and abdominoplasty.
By medical indications surgical elimination of diastasis is resorted to only in extreme cases - in the diagnosis of the 3rd degree of the disease. In this case, there is a risk that diastasis will negatively affect the functioning of internal organs. But sometimes women go for it for the sake of a cosmetic effect. Not everyone has the will, organization and patience.
Operation for diastasis
Diastasis correction methods are reduced to 2:
- Suturing, when the dispersed muscles are connected without the use of prostheses. Excess skin is excised.
- Correction using artificial materials - mesh, which over time becomes overgrown with connective tissue.
Complete educational program on diastasis
Having discovered diastasis in yourself, it is important not to be upset, not to give up. Everything is in our hands. Regular exercise will definitely help, it just doesn't happen quickly. Even if you train with a trainer in the gym, it will take more than one month. There is no need to rush the process. It is better, of course, to start exercising before the problem appears and even before pregnancy.
The main assistant of a woman after the birth of a child should be breathing exercise vacuum. It is safe and will definitely help. It is most convenient to perform breathing exercises from the “Cat” position (standing on all fours).
But you need to understand that it all depends on the degree of diastasis. If the discrepancy is from 10 cm, then only surgery is effective.
In half of the cases, diastasis is expressed only in late pregnancy, and after childbirth it almost completely disappears naturally. For some time, deviations from the norm may still be recorded, but they will also pass.
Myths about stretching and separation of the abdominal muscles after childbirth
- You will never be able to fully recover. It is not true.
- If there is no pain, there is no problem. Also incorrect.
- The only way to get rid of it completely is through surgery. Delusion.
As you can see, diastasis is not so terrible. Except in rare cases, it can be dealt with if you make an effort. The problem will completely disappear, leaving no trace.
Every woman wants to get rid of extra pounds and centimeters. Sometimes attempts to make the stomach fit are doomed to failure. healthy eating and physical activity only increase its volume. The reason for this phenomenon is the divergence of the abdominal muscles after childbirth.
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The essence of the discrepancy
The anatomy of the anterior abdominal wall in women is important for understanding what rectus diastasis is. The abdominal area consists of the external muscle group, which includes the external oblique and rectus muscles and forms the relief of the press, and the internal muscle group (contains the internal oblique and transverse muscles; forms a waist; supports organs).
After natural delivery or rectus muscles diverge in opposite directions. This causes the expansion of the white line. It is a connective tissue. Its task is to connect the tendons. When diagnosing pathology, the white line becomes thinner and stretched. This process does not provoke damage to the abdominal suture.
Diastasis of the rectus abdominis muscles manifests itself at the time of increased intra-abdominal pressure. There is a protrusion of areas along the white line. They can be palpated without difficulty. It is important to remember that the pressure increases with any load on the press.
Diastasis after childbirth does not belong to the category of hernia. Despite the divergence of the abdominal muscles after childbirth, there is no hernial sac. The relief of the anterior abdominal wall remains unchanged. The presence of diastasis after childbirth or caesarean section excludes adhesive development or inflammatory process with in the intestines.
The study of what and how diastasis of the rectus abdominis muscles looks like is inextricably linked with the identification of the degree of pathology. To assess the condition, the interval between the muscle groups of the press is measured. The gap between the navel and the xiphoid process is determined. Normally, it is equal to a 2-centimeter value or less.
Based on the results of the measurement, the divergence of the abdominal muscles after childbirth is divided into the following stages:
- distance - 5-7 cm range;
- appearance does not undergo drastic changes;
- condition considered natural after delivery;
- accompanied by constipation, discomfort when walking, painful sensations in the epigastric region, nausea;
- the gap is more than 7 cm;
- significantly affects the appearance;
- the stomach bulges forward, the elasticity of the skin in the middle decreases;
- noticeable lack of tone of the lateral muscle group;
- interval - over a 10-centimeter threshold;
- manifests itself in the form of a strongly sagging area;
- lack of skin elasticity;
- accompanied by a hernia of an abdominal or umbilical nature;
- causes muscle atrophy;
- leads to displacement of internal organs;
- causes temporary disability for women.
The divergence of the abdominal muscles after labor is also classified depending on the location, namely:
- above the navel;
- under the navel;
- throughout the region.
Signs and causes of pathology
Diastasis after childbirth is diagnosed based on characteristic features. The divergence of the abdominal muscles after childbirth includes the following symptoms:
- excessively protruding navel;
- significantly rounded abdomen (present after a considerable period of time after childbirth);
- difficulty with defecation;
- systematic pain in the back or lower back;
- discomfort in the protrusion zone;
- increased pain with prolonged walking, lifting heavy objects, intense physical activity;
- the occurrence of fat folds.
The above symptoms should be the reason for a visit to the doctor. If the signs are ignored, diastasis of the rectus abdominis muscles will progress.
Important! Diastasis of the rectus abdominis muscles after a previous gestation is most likely to appear during the next pregnancy.
The divergence of the abdominal muscles after childbirth is due to numerous factors. Causes of diastasis after a caesarean section or vaginal delivery include:
- weakness of the connective tissue of a congenital nature (connective tissue dysplasia). Leads to a strong tension of the white line. There is no return to the original state;
- active production of relaxin. noted softening and decrease in the tone of muscle fibers. Causes the mobility of ligaments and joints in the pelvic area;
- bearing a large fetus;
- multiple pregnancy;
- (after 30 years);
- next gestation of the fetus (second, third and subsequent pregnancies);
- elevated physical exercise;
- lack of correct technique during strength exercises;
- predisposition to the appearance of a hernia;
- lack of muscle tone in the background cardinal weight changes(rapid weight loss or rapid weight gain);
- prolonged cough with intense straining (has a chronic character);
- curvature of the upper spine (kyphosis);
- atrophied or atonic abdominal muscles;
- overweight.
Diagnostics
Diastasis after natural delivery or caesarean section develops asymptomatically. In view of this feature, it becomes necessary to study how to determine diastasis in the early stages.
It is important to remember that diastasis of the rectus muscles in the postpartum period is present in most women in labor. To obtain reliable results, it is recommended to wait a month and a half. During this period, there natural tissue repair. The divergence of the abdominal muscles after childbirth can disappear on its own.
Diagnostics
To determine how widely the abdominal muscles have dispersed after delivery, a special test is performed. It allows the detection of pathology early stage. Performed following algorithm actions:
- Take a horizontal position.
- The legs are bent at the knees.
- The feet are pressed to the floor.
- One hand winds up in the back of the head.
- The other hand is placed on the press. white line should be at a 90 degree angle. in relation to the fingers.
- The shoulders are slightly raised.
- The area from the bottom is examined chest to the navel with light pressure.
Remember, palpation requires tightening the press. true initial position guarantees reliable results. At a distance of more than 2 cm divergence of the abdominal muscles after childbirth is diagnosed.
If self-palpation is not successful, specialist advice is required. May need ultrasound procedure. It is relevant for overweight at the patient.
Treatment
It should be borne in mind that often the divergence of the abdominal muscles after childbirth does not spontaneously disappear. In order to eliminate the pathology, a woman should apply for medical care. Otherwise, the condition worsens.
Among possible ways how to treat the discrepancy, it is customary to distinguish:
- Specially designed gymnastics. Includes an exercise system. The goal is to strengthen the muscle group of the anterior abdominal wall and the lateral press. Actual in pathology of 1 and 2 degrees.
- Operational intervention. It is used for 3 degrees of pathology.
Held tension or tension Plastic surgery . Tension plastic - tightening diastasis by stitching. Tension-free plasty is a laparoscopy procedure with the introduction of a mesh endoprosthesis (leaves no traces, the probability of recurrence is low).
Plastic surgery
The therapeutic method is selected depending on the condition of the muscles and the degree of its divergence.
If the abdominal muscles disperse after childbirth, you should adhere to a sparing regimen. There is a list of what not to do:
- Lift particularly heavy objects and loads. Weight should not exceed 5-6 kg value. The arms are bent at the elbow joint. It is contraindicated to stretch your arms when lifting a load.
- Pump or carry children without a special bandage. Required fix the stomach with a postpartum bandage or wrap it with a cloth.
- Cough without stomach support. With any urge to cough, the stomach is held with the palm of your hand; you can press it down a little.
- Rise or fall from any position. It is recommended to lie down or get up exclusively from the state of lying on your side. At the moment of lifting from a chair, the stomach is drawn in, the weight of the body is transferred to the buttocks, a turn is made to the side with an emphasis on the legs.
- Stooping or excessive bending in the lumbar region.
- Sleep on your stomach. Sleeping on your back or side is allowed.
A set of exercises
Thinking about how to treat the initial diastasis after childbirth, it is necessary to give preference to the gymnastic complex.
Exercises
The following exercises are distinguished for diastasis after childbirth:
- Abdominal retraction for half a minute, followed by relaxation. The number of repetitions depends on the state of the body. Avoid pain while exercising.
- Raise your shoulders off the floor. Position - lying on the back. The head rises and lingers in this state for half a minute. The number of repetitions is at least 30 times.
- Raise the pelvis from the floor. The exercise is performed on the exhale. The knees bend, when the top point is reached, the buttocks and abs should be tightened, breathing from the chest. The number of repetitions is at least 10 times. 3 approaches are recommended.
- Straight leg up. Position - lying on the back, legs bent at the knees, the leg is lifted when the buttocks are lifted off the floor. When performed, an angle of 90 degrees is reached. The number of repetitions is at least 10 times on each leg.
- Squats near the wall with the ball. The back is pressed against the wall, the legs should be placed in relation to it at 45 degrees. The ball is clamped between the knees (it is recommended to choose a medium-sized fitball). The hips should be parallel to the floor at the time of the squat, at the bottom point you should linger for half a minute and slowly rise. The number of repetitions is at least 20 times.
The divergence of the abdominal muscles after childbirth is eliminated in the case of:
- regular classes;
- correct execution technique (assumes correct breathing and retraction);
- balanced nutrition;
- spending time outdoors.
Diastasis after childbirth requires an immediate response. However, you should think about how to eliminate it after a 2-4-week recovery period.
There is a list of things to do strongly not recommended for pathology, namely:
- lifting straight legs in the supine position;
- lifting the body from a prone position;
- exercises with the adoption of the knee-elbow position;
- pushups;
- side twists;
- plank;
- fitball training;
- breathing techniques: include fire breathing, vacuum; found in yoga;
- abdominal stretching exercises.
Prohibited loads fall into the category of traditional abs training.
Prevention
In order not to treat diastasis after delivery, you can do its prevention. You should think about this long before planning a pregnancy.
Setting the goal of how to avoid diastasis during pregnancy, you should:
- Minimize physical stress on the press: do not carry heavy objects; don't wear shoes high heels (due to a shift in the center of gravity and overstressing of the press); eliminate the muscle strength of the press when lifting the body.
- Exercise systematically: perform physical exercises on the back, pelvic floor muscles and abs; work out muscle groups; include a set of exercises from yoga therapy to relax the spine; work on strengthening the diaphragm.
