Abdominal Diastasis

Abdominal diastasis is the removal of the abdominal muscles and connective tissue that usually occurs during pregnancy and is the main cause of abdominal sagging and postpartum low back pain.</ span>

This distance can reach 10 cm and is due to the weakness of the abdominal muscle, which becomes very stretched due to the growth of the belly during pregnancy. However, diastasis can also happen outside of pregnancy, especially in people who lift very heavy objects in an incorrect posture.

The treatment to correct the abdominal diastasis can be done with exercises, physiotherapy or, as a last resort, surgery, especially when the distance is greater than 5 cm and the exercises were not effective to correct the situation.

  • Abdominal diastasis: what is it, how to identify and what to do

How do I know if I have abdominal diastasis?

It is possible to suspect that you are having a diastasis after giving birth when you feel the area below the navel is very soft and flaccid or notice a bulge in the abdomen when carrying some weight, squatting or cough, for example.

To make sure it’s an abdominal diastasis you should:

Lie on your back and press your index and middle fingers about 2 cm above and below your navel, then;

Contract the abdomen, as if you were doing an abdominal exercise.

The normal thing is that when contracting the abdomen, the fingers jump up a little, but in case of diastasis the fingers do not move, it is even possible to place 3 or 4 fingers side by side without them moving with the abdominal contraction.

Some situations that favor the development of abdominal diastasis are having more than one pregnancy, having a twin pregnancy, giving birth to a baby weighing more than 4 kg or being older than 35 years. When unrelated to pregnancy, diastasis usually occurs due to weakness of the abdominal muscles.

The treatment to correct the abdominal diastasis can be done with exercises, physiotherapy or, as a last resort, surgery, especially when the distance is greater than 5 cm and the exercises were not effective to correct the situation.

  • Abdominal diastasis: what is it, how to identify and what to do

How do I know if I have abdominal diastasis?

It is possible to suspect that you are having a diastasis after giving birth when you feel the area below the navel is very soft and flaccid or notice a bulge in the abdomen when carrying some weight, squatting or cough, for example.

To make sure it’s an abdominal diastasis you should:

Lie on your back and press your index and middle fingers about 2 cm above and below your navel, then;

Contract the abdomen, as if you were doing an abdominal exercise.

The normal thing is that when contracting the abdomen, the fingers jump up a little, but in case of diastasis the fingers do not move, it is even possible to place 3 or 4 fingers side by side without them moving with the abdominal contraction.

Some situations that favor the development of abdominal diastasis are having more than one pregnancy, having a twin pregnancy, giving birth to a baby weighing more than 4 kg or being older than 35 years. When unrelated to pregnancy, diastasis usually occurs due to weakness of the abdominal muscles.

Move in there

The change in internal structures triggers gastrointestinal changes, such as gas, discomfort, trapped bowel  and hernias. The bladder also suffers — it is not uncommon to develop urinary incontinence. Finally, the loss of one of the core walls, musculature that stabilizes the trunk, causes back pain.

Curiosity: Can men also have diastasis?

The incidence of cases of men who are diagnosed with abdominal diastasis is worrying and is directly related to weight gain. According to the Ministry of Health, more than half of the Brazilian population is overweight.

  • Accumulation of fat

When fat accumulates or the belly bulges out, the abdominal wall ends up deforming, and consequently causing abdominal diastasis.

  • Intra-abdominal pressure

This pressure is due to excessively intense abdominal exercises performed incorrectly. Hence the importance of activating the muscles in the abdomen.

  • How to end diastasis ?

The treatment options for curing abdominal diastasis and getting a tight belly again are: 

  1. Clinical Pilates Exercises

Exercises are of great help in treatment but should be performed under the supervision of a physiotherapist or personal trainer because poorly performed exercises can cause an increase in intra-abdominal pressure, and increase separation of the muscles. straight, worsening the diastasis or leading to the appearance of a hernia.

Some recommended exercises to correct diastasis I show in this video:

These exercises are the most suitable because they contract the transversus abdominis and the lower fibers of the rectus abdominis, strengthening them, without excessive pressure on the rectus abdominis.

  1. Physiotherapy

In physical therapy, equipment such as the FES can be used that promotes muscle contraction. This device can be done for 15 to 20 minutes and is very effective in strengthening the rectus abdominis.

  1. Surgery

Surgery is the last resort for diastasis correction, but it is very simple and involves sewing the muscles together. Although surgery can only be performed for this purpose, the doctor may also suggest liposuction or abdominoplasty to remove excess fat, sewing the muscle to finish.

To correct diastasis

There are two options:

During treatment to correct abdominal diastasis is also recommended:

  • Maintain good posture while standing and sitting;
  • Maintain the contraction of the transversus abdominis muscle throughout the day, this exercise being known as the hypopressive abdominal exercise, in which it is only necessary to try to bring the navel closer the back, shrinking the belly especially when sitting, but must maintain this contraction throughout the day. Learn better how to do hypopressive abs;
  • Whenever you need to bend down to pick something off the floor, bend your legs, squatting your body and not leaning forward;
  • Only change the baby’s diaper on a high surface such as a diaper changer, or if you need to change in bed, kneel on the floor to keep from tipping over the body forward;
  • Maintaining body weight close to ideal to reduce the amount of visceral fat

Treatment time:

The treatment time may vary depending on the size of the diastasis, as the greater the spacing, the more difficult it will be to promote the union of fibers only with exercise or physiotherapy. However, in diastasis with less than 5 cm, if the treatment is performed daily, in about 2 to 3 months it will be possible to observe a decrease in diastasis.

SURGERY

surgery is simple and just consists of sewing the muscles. The patient is under general anesthesia throughout the procedure and lasts an average of 1 hour.

In general, only the diastasis of the muscles is corrected by the general surgeon using a midline incision technique or by video laparoscopy!

The plastic surgeon will perform this correction within a broader context of abdominoplasty, which is the surgery that will remodel the entire abdominal wall, removing excess skin, from the stretch marks below of the umbilicus and the remodeling of the umbilical scar!

Can I have liposuction together?

If necessary and the patient wishes, liposuction can be performed together with the abdominoplasty.

But be aware that with this choice, you will spend more time in the OR and require even more post-operative care.

Does the health plan cover abdominal diastasis surgery?

If you have a medical indication, the health plan covers surgery of abdominal diastasis .

Be aware: the surgery does not include the removal of excess skin, nor the aesthetic part related to abdominoplasty!

I want to do a tummy tuck. Does the plan cover?

The health plan covers plastic surgery as long as they are considered repair , as ANS requires.

That way, with a abdominoplasty it’s no different: you need to a report that proves the need for this surgery, such as in patients after bariatric surgery, for example!

Remember: if it is for aesthetic purposes, the health insurance does not cover it.

Plastic surgery: repair vs. aesthetic. Understand the difference!

Did you know that plastic surgery is not just for aesthetic purposes?

  • Aesthetic plastic surgery

aesthetic plastic surgery, as the name suggests, is made for the purpose of improving appearance by correcting imperfections. The patient who seeks this type of surgery aims to raise their self-esteem by improving something they do not like in the body.

  • Repair plastic surgery

Unlike aesthetic plastic surgery, the repair machine has the function of correcting problems caused by trauma, malformations, tumors and diseases.

Health plans cover this type of surgery, but you need to be aware of the type of coverage in the hired plan and the regulations of the National Supplementary Health Agency (ANS).

Examples: breast reconstruction, post-bariatric surgery, hand surgery, cranio-maxillofacial surgery, ear reconstruction and others.</span >

Is Diastasis of the Rectus Abdominals a procedure with mandatory coverage in the ANS Procedure List?

Yes, Diastasis of the Rectus Abdominals is a procedure that has mandatory coverage in the SAN Procedures List.

However, in order to have the surgery performed by the health plan, it must be covered for surgeries and hospitalizations.

Complications of diastasis

The main complication of abdominal diastasis is the onset of back pain in the lower back. This pain occurs because the abdominal muscles act as a natural brace that protects the spine when walking, sitting, and exercising. When this muscle is too weak, the spine becomes overloaded and there is a greater risk of developing a herniated disc, for example. Therefore, it is important to carry out the treatment, promoting the union and strengthening of the abdominal fibers.

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Abdominoplasty
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