Rectus Diastasis DRA- Tummy Muscle Separation

The clinical name for the separation of the stomach muscles is Diastasis Recti Abdominis (DRA). The stretching and thinning of the recti abdominis muscles is a natural occurrence during pregnancy due to abdominal growth and up to 66% of women have a significant separation by the end of their third trimester.
The good news is that for the majority of women this condition resolves during the early postpartum period. Unfortunately for some however, a weakened abdominal wall persists well into the postpartum period, impairing activities of daily living.
Anatomicaly, diastasis recti abdominis (DRA) is defined as a separation and thinning of the recti abdominis muscles and stretching of the Linea alba, a fibrous connective tissue structure. This fascial structure plays an integral role in maintaining the integrity of the anterior abdominal wall. These structures are important to maintain stability with load transfer activities such as standing, walking, lifting, bending and squatting.
Can only pregnant people get DRA?
Whilst pregnancy is the most frequent cause of a DRA due to the enlarged abdomen from gestational weight gain and hormonal influences there are other causes that affect a variety of people including men. These include: improper weightlifting or abdominal strength training, advanced maternal age (>34), history of midline or cesarian surgery, multiple pregnancies, having twins or triplets, a lack of regular exercise, obesity or conditions that increase intra-abdominal pressure such as chronic obstructive pulmonary disease.
When is it a problem?
A DRA is considered pathologic when the interrecti distance (IRD) measurement exceeds 2.5 to 2.7cm width and severity ranges from mild (2.5-3.4cm) to severe (5-20cm or greater)
How is it measured?
The gold standard for diastasis recti measurement is computed tomography, however it is rarely used because of expense and impracticality for clinical settings. The most common clinical measurement of DRA used by Physiotherapists is finger width measurement, where the measurement is considered significant if more than 2 fingers can horizontally be placed in the interrecti space (with each finger approximating 1.5cm). This method however has poor interrater reliability and validity due to differences in finger size.

What if I do nothing about it?
A DRA has been suggested as a precursor to problems later in life. A retrospective chart review established a correlation between the presence of a DRA and one or more supportive pelvic floor dysfunctions that included stress urinary incontinence (SUI), fecal incontinence and pelvic organ prolapse (POP). A large DRA with impaired muscle strength and poor recruitment of the abdominal muscles can result in posture dysfunction, impaired biomechanics, decreased stability during load transfer activities, and poor tolerance and/or pain for activities of daily living.
What can I do about it?
If you are assessed on the ward after having your baby by a Physiotherapist and found to have a significant DRA, you may be given an abdominal support garment to wear in the initial post-natal period. This consists of a thick layer of elastic fabric that binds tightly around the abdomen, approximating the recti muscles. This is important to wear when walking around, lifting prams, toddlers or your baby. You can take this off at night. You also do not want to become reliant on the garment and need to wean off it whilst retraining your deep abdominal muscles to help support the anterior abdominal wall.
What do I need to avoid?
• It is important to avoid abdominal exercises that may further separate the interrecti muscles such as sit-ups and crunches. Also avoid aggressive stretching of the abdominals.
• Keep symmetrical in standing and sitting positions to prevent excessive load transfer.
• Activate the abdominals and pelvic floor muscles during functional transfers such as rolling over, lying to sitting, sitting to standing and lifting.
• You can also do self-bracing of your abdomen using hands or a pillow to approximate the recti muscles to reduce abdominal pressure during laughing, coughing or sneezing.

What exercises can I do?
Initial intervention will focus on exercises isolating, retraining and strengthening the deep local postural muscle stabilizers such as the transversus abdominis and the pelvic floor in a neutral spine position. Once local stabilization has improved, exercises to strengthen global hip and trunk musculature are added to assist with restoring abdominal wall integrity. Exercises are progressed from being stable to dynamic under the guidance of your Physiotherapist. Attending Pilates classes run and monitored by a Physiotherapist are paramount to recovery.

Pelvic Floor Q Pilates Jindalee

Why do I need to to Pelvic Floor Exercises

These days most people are aware that pregnancy and childbirth are risk factors for weakening and injury to the perineum and pelvic floor. This may result in urinary and faecal incontinence, pelvic organ prolapse, defecation dysfunction, sexual dysfunction, sensory and emptying abnormalities of the lower urinary tract, and chronic pain syndromes. Read more

Barre Pilates Q Pilates

Barre Pilates

Barre Pilates at Q Pilates. 

We offer Barre classes at our Indooroopilly and Jindalee studios. Many people do not know what Barre is all about. So here are some common questions answered for you. Come along, give it a try and see if it’s something for you!  Read more

5 Reasons Why Matwork Pilates is seriously underrated.

5 Reasons why Matwork Pilates is seriously underrated

With so many new and fascinating forms of Pilates emerging into our ever evolving health and wellness arena (case in point; barre, reformer, aerobatic, cardiolates, interval pilates wunda chair and the list goes on) it’s only fair we think spending an hour sprawled on the mat without all the fancy equipment is a waste of our time, right? We couldn’t be more wrong. In fact, Matwork Pilates can be just as challenging (if not more) as the equipment versions and should not be overlooked in our weekly exercise regime. Here are five great reasons why you should pencil in a Pilates Mat workout 1-2 times per week.

Read more

Exercise & Cancer: Is Exercise The New Best Medicine?

Exercise & Cancer: Is Exercise The New Best Medicine?

Last year Professor Robert Thomas (oncologist from Cambridge University Hospital NHS foundation trust) stated in the news article “Exercise best help for cancer patients” that “ We know that 3 hours exercise per week after most cancers will reduce the chance of relapse by up to 30%.” Read more

Pilates and Shoulder Pain

The shoulder girdle and upper quadrant of our bodies is a very complex and intricate system of muscles, joints, nerves and ligaments that allow humans to produce gross and fine motor movements for full dexterity and upright posture. If you have pain around the neck, shoulder or in your arm, chances are that there may be more than one of the above anatomical structures not working to its fullest capacity and creating a situation of overload on your body and resultant pain. The shoulder (and shoulder blade) sacrifice stability for mobility, meaning that due to our need to be able to move our arms in many different directions, the joint itself is inherently less stable to allow for more range of movement. In turn, this means that our shoulder requires much more coordinated muscle activation to remain “stable” and account for the greater flexibility.

Read more

Osteoporosis & Pilates


Osteoporosis
is a condition affecting bone density. Bones are mostly made up of collagen, a protein that provides the flexible framework of bone, and minerals such as calcium phosphate and calcium carbonate that provide rigidity and strength to the framework.
Read more

Improve Hamstring Flexibility through Pilates

One of the biggest benefits of Pilates and a goal my clients often come in with, is to increase their flexibility. The most measurable of which, seems to be the ability to touch one’s toes, aka hamstring flexibility. Although possible, it is not always as straight forward as performing daily static stretches. It is important to address all of the contributing factors to “hamstring tightness” to achieve increased range of motion and henceforth “flexibility” within these muscles.  Read more

All Womens Health

So, I’ve just had my baby. Now what?!

 

For many of us as first time mums, having a baby is an absolutely life changing event! No amount of preparation, reading, classes, courses, old wives tales, advice (both welcomed or unwelcomed!) can prepare you for being a mum! Read more