Rectus diastasis

It has been several months since you delivered your baby, you have gone on a healthy diet and stuck diligently to a regular exercise regime. You cannot wait to lose the post-partum weight, regain your pre-pregnancy body and flat tummy. Yet, while other mums seem to trim down quickly, you have not seen the same results – instead, a sausage-like mid-abdominal bulge remains, despite your best efforts. That stubborn bulge is called rectus diastasis, which, if not surgically corrected, may lead to other medical conditions.

What is rectus diastasis?

Rectus diastasis is also known as abdominal separation, abdominal muscle gap or abdominal midline weakness. It simply means the belly sticks out because the space between the left and right stomach muscles has widened, hence the bulge or pooch. Although it can happen to anyone of any age, even men, rectus diastasis is more common among women who have given birth, face weight fluctuation, or those with genetic conditions.

Why are our abdominal muscles Important?

The anterior abdominal muscle or rectus abdominis, is part of the core muscle, a long vertical muscle that runs down from the body’s midline. It holds our inner organs like the bladder, intestines, pelvis and uterus in place, works with our lower back to shift our weight evenly when we move, and acts like a stabiliser. Our core muscles give us balance and flexibility and allow us to move.

What happens if rectus diastasis is not treated?

It can cause multiple problems. Without the dynamic stabilisation of our core, weak abdominal walls can jeopardise trunk stability and mobility, compromise posture and contribute to chronic and severe back pain. It can also lead to spinal instability, pelvic floor dysfunction, urinary incontinence, bowel issues, possible hernia(s), or even affect vaginal delivery. Back and pelvic pain are the most common manifestations of rectus diastasis.

What can be done?

Rehabilitation exercise can help to strengthen our core muscles, but if the gap between the muscles is more than 3cm, surgery is the only option. The open method surgery involves skin removal for those with an excess fold of skin (known as abdominal apron). This will leave a visible scar on the bikini line but it will fade over time. The abdomen will be flattened and the pubis area lifted. The other surgical option is to use the minimally-invasive endoscopic method, which leaves minimal scarring but does not remove any skin. Recovery takes about two weeks, during which you are not to lift or carry heavy items. You may resume exercise after six to eight weeks.