Diastasis recti occurs when there is separation of abdominal muscles such that they are no longer located close to each other. This condition may be caused by pregnancy. The separation occurs when rectus abdominis muscles becomes separated by more than 2.7 cm. While it is common to pregnant women, it may also occur in new babies and in men too.
A doctor may discover this problem by having a patient lie flat with their back and then bending their knees upward while the feet remain flat. The patient lifts the head so that it touches the chin to chest. This way, the doctor is able to feel the ridge.
Sometimes, there may be an issue to do with hernia, which may be detected in such a case. A hernia will occur when there is an organ, which has pushed through tissue or muscle opening where it is held in place. A good example is where the intestines break through a weak area within the abdominal wall.
In case a hernia is thought to occur, a doctor may order ultrasound imaging to examine the part of body. With diastasis recti, it is not an actual hernia. It is also not life threatening though surgery may be needed. When diastasis recti is caused by pregnancy, it may result in considerable alteration in shape of abdominal walling. This may be seen even in patients who are extremely thin. It may leave the abdomen looking swollen.
Diastasis recti is a common condition and studies indicate that it occurs in about 35 to 62 percent of women. While exercise and physical therapy may help, at times they are not able to reserve this condition. The only way it can be resolved is by having a surgical re-approximation of muscles involved.
Who gets diastasis recti?
In women, diastasis recti occurs because of stretching of muscle. It is most noticeable following delivery of a body in time of postpartum period. It may be detected that diastasis recti is happening in time pregnancy when bulges begin to appear. There may also occur a ridge right at the middle of abdomen.
Diastasis recti is common among pregnant women who are over the age of 35 or who have twin pregnancy. It may also occur when the size of the baby is too large. In infants, the condition occurs due to some defect occurring in the middle of rectus abdominis muscle. This causes the abdominal tissue to herniate forward. In babies, it may appear as a lump or bubble forming in between the belly button and the breastbone.
Diastasis recti surgery—when it is needed?
While diastasis recti may not be life threatening because it is not a hernia as such, it may not need surgical intervention. At first, doctors may try to correct it using techniques such as exercise. Exercising may help bring the muscles to the initial position where they are close together.
The exercises may include pelvic tilts, leg stretches, and heel slides. The exercises need not push the core muscles outward but keep them tight. Some exercises can push the core muscles outward such as crunches and planks; therefore, they need to be avoided.
When the abdominal muscles push outward or form a dome, it may worsen the condition. Patients may be referred to specialized exercise regimes by qualified trainers or they can do the physical therapy at home. The exercises can take time and should be done as recommended. This condition takes time to heal.
Where exercises may fail to improve the condition, as it happen in most of the cases, surgery is likely to be the next option. When the diastasis recti has occurred in infants, it will continue to heal and correct itself in its own. The abdominis rectus muscles will develop and close on without needing any kind of intervention. However, where the condition seems to be severe, a doctor may refer the baby to physical therapy.
A surgery is considered when the separation is thought to be 2 cm and above. This is the distance in which the muscles have separated. However, patients need to understand that any surgery procedure for diastasis recti is considered to be a cosmetic procedure and therefore, most health insurance policies will not pay for such treatment. At times, babies may be covered where the diastasis recti must be corrected surgically.
The surgery is often referred to as tummy tuck or abdominoplasty where doctors try to tighten the muscles and remove any extra skin while bringing the muscles together. It may also involve moving the position of the belly button to place it in a location where it appears more natural.
Depending on the needs of a patient, the surgery may be done laparoscopically meaning no major incision is required. However, in more serious cases, it may need open abdominal surgery. A laparoscopy may recover in a few weeks but with open abdominal surgery, it could take up to eight weeks to recover.
The cost of the surgery may average somewhere around $5,500 though there may be additional fees for things like medication, anesthesiologist, and hospitalization. The amount could stretch to about $10,000 and patients need to know that it is not covered by insurance.
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