The straight abdominal muscles meet at the vertical midline of the abdomen. Rectus diastasis is the partial or complete drifting apart of these abdominal muscles. Rectus diastasis is also known as midline hernia. Pregnant women or women who have given birth are often affected. In men, a heavy weight is usually the cause of rectus diastasis.
Here you will find further information and selected rectus diastasis specialists and centers.
The rectus abdominis muscle is a straight abdominal muscle that starts at the rib cage and runs down to the pelvis. The linea alba runs between the two straight abdominal muscles. It consists of connective tissue. The rectus muscles are normally fused in the midline and are no more than one to two centimeters apart.
In rectus diastasis, however, there is a gap between the muscles without a fascial defect. The term rectus diastasis is used when the gap between the muscles is more than two centimetres wide.
The linea alba widens and the two tracks of the abdominal muscle diverge. This allows the abdominal contents to bulge out.
If the straight abdominal muscles diverge at the linea alba, this is known as rectus diastasis © bilderzwerg | AdobeStock
If women notice a visible bulge or ridge on their abdominal midline shortly after giving birth, they may be affected by rectus diastasis. When lying on the back, this area will recede between the muscles around the navel.
Those affected do not always suffer from painful symptoms. However, if the rectus diastasis is pronounced, unpleasant side effects occur. The signs and symptoms that may indicate rectus diastasis include
The condition occurs particularly frequently during pregnancy. This is when the abdominal muscles often move apart to make room for the growing baby. Up to 60 percent of women are affected by rectus diastasis during pregnancy or after giving birth.
The following factors most frequently play an important role in the development of rectus diastasis:
Men canalso be affected by rectus diastasis and its consequences, with a significant weight gain being the main cause . Conversely, significant weight loss within a short period of time can trigger rectus diastasis.
Other causes are
The midwife or attending doctor can diagnose rectus diastasis by palpating the abdominal wall. To do this, the patient lies on their back and tenses the abdominal wall. Above the navel, the doctor can feel the gap in the abdominal wall between the tense abdominal muscles.
In addition, an ultrasound examination should always be carried out in accordance with the current guidelines. This allows
can be determined. If the patient is very overweight, an ultrasound examination may not be sufficiently informative. Additional procedures such as computer tomography or magnetic resonance imaging are then necessary to confirm the diagnosis.
An untreated rectus diastasis weakens the body over time. It leads to chronic pain in the lower back and limited mobility. Weakness of the anterior abdominal wall can also weaken the pelvic floor. This in turn can lead to increasing urinary incontinence (bladder weakness) or rectal weakness with prolapse.
In addition, abdominal wall hernias can occur in the area of the weakened midline between the muscles. Umbilical hernias occur frequently. Surgery is always required for an abdominal wall hernia. It does not heal on its own and there is a risk of intestinal incarceration.
Depending on the severity of the condition, conservative and surgical treatment options can be considered.
In some people, the abdominal muscles have only partially drifted apart. In these mild cases, the abdominal muscles can strengthen and heal on their own after a few months. In women who have given birth, gentle postnatal training often helps.
In some cases, the doctor may recommend wearing a supportive bandage or abdominal tape. This provides additional support for the abdominal muscles during the healing process.
A physiotherapy program also strengthens the surrounding muscles. Exercises to strengthen the inner abdominal muscles and those that specifically train the pelvic floor are suitable.
Patients must not lift heavy objects during the healing process.
In most cases, doctors initially recommend non-surgical treatment options. If
a minimally invasive procedure should be considered.
The aim of the procedure is to restore the separated muscles. There are various access methods:
The aim is to
Minimally invasive procedures offer several advantages over conventional open surgery, including
Under certain circumstances, it may be advisable to perform open surgery on a rectus diastasis through a larger incision. This is used for
is considered.
The incision is then made
The muscles are also approximated during this procedure. They then lie directly next to each other in the midline.
Abdominal wall hernias are treated stably. As a rule, a plastic mesh is used. This may also be dissolvable under certain circumstances.
A tummy tuck may also be advisable if there is massive excess skin and too much subcutaneous tissue and fatty tissue. This enables a good cosmetic result after the operation.
Hernia surgeons and plastic surgeons often operate together.
If a rectus diastasis is suspected, patients consult a general practitioner or a gynecologist. Specialized hernia surgeons are also among the medical professionals who can make a diagnosis and plan appropriate treatment.
If the rectus diastasis can be attributed to severe obesity, it makes sense to consult a dietician. The aim is to reduce the weight by changing the diet. Targeted exercises should train the upper body and abdominal muscles.
In many cases, rectus diastasis is a cosmetic problem that does not cause any symptoms. Nevertheless, it is advisable to consult a doctor if you suspect it.
If it is less pronounced, regular exercises that strengthen the abdominal muscles can help after prior consultation with a doctor. In this way, the rectus diastasis can be closed again.
Increasing discomfort or severe symptoms, especially in grade III (over 5 cm), can no longer be treated conservatively. In the long term, this usually leads to complications such as abdominal wall hernias or increasing back pain.
Seek advice from a specialist and have hernias in particular ruled out. Isolated surgery of an abdominal wall hernia locally within a diastasis is not recommended!
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