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Abdominal Muscle Dysfunction
Diastasis Recti
32
Other
Graduate
11/25/2013

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Cards

Term
What is diastasis Recti
Definition
Separation of rectus abdominis muscles at the linea alba
Term
Can valsalva maneuver during pushing cause diastasis recti? Y/N
Definition
Yes
Term
What causes connective tissue softening while pregnant?
Definition
Hormone changes - Estrogen/Relaxen
Term
What causes diastasis recti in pregnancy?
Definition
1. Abs stretched to elastic limit = stretch weakness
2. Hormonal connective tissue softening
3. Excessive strain in late pregnancy when muscles are in lengthened state
4. Valsava maueuver during pushing
Term
Name a few risk factors for diastasis recti.
Definition
-Expecting more than one baby
-petite stature
-excessive lordosis and/or poor ab muscle tone
Term
Name a few more risk factors for diastasis recti.
Definition
-Not exercising while pregnant
-Genetics
-Aggressive exercises after 1st trimester
Term
Name a third set of risk factors for diastasis recti.
Definition
-Older than 35
-Obesity
-large baby, more weight during pregnancy
Term
Name the last set of risk factors for diastasis recti.
Definition
-Separation during a past pregnancy
-Parity (higher risk w/each preg)
-Previous c-section
Term
Consequences of diastasis recti
Definition
-reduces the integrity /functional strength of abdominal wall
-Can aggrevate lower back pain and pelvic instability
-Poor posture
Term
diastasis recti relationships w/pelvic floor
Definition
-Weaker floor
-Floor dysfunctions
Term
What percent of urogynecological population has DRA (diastasis recti abdominis)
Definition
52%
Term
Women with DRA tend to be...
Definition
-Older
-Higher gravity (# pregnant)
-Higher parity (births past 20 weeks)
-Weaker pelvic floor
Term
Name three support-related pelvic floor dysfunction....and what % of those with DRA have this issue?
Definition
1. Stress urinary incontinence
2. Fecal incontinence
3. Pelvic organ prolapse
66%
Term
measuring diastasis recti during third trimester
Definition
Palpate soft region > 1"
Measure finger widths at widest point above the umbilicus
Term
Is there a link between diastasis recti and low back/pelvic/abdominal pain?
Definition
Maybe. Case reports show a correlation.
Term
What recent study in 2009 compared DRA w/ lumbo-pelvic pain and bowel/bladder issues?
Definition
Parker.
Test (seeking treatment)- 75% had DRA
Control(not seeking treatment) - 51% had DRA
Term
Intervention for diastasis recti:
Position
Definition
Supine, knees bent, arms crossed over abdomen, neutral pelvis
Term
Intervention for diastasis recti:
Action
Definition
1. Breathe in deeply & set pelvic floor
2. Exhale while raising head until just before gap or bulge appear
Term
Intervention for diastasis recti:
Frequency - pregnant/postpartum
Definition
Pregnant - 5 reps - 2 per day
Post partum - 10 reps - 5 per day
Term
diastasis recti intervention progression
Definition
from hands to no hands
Term
Do not progress in diastasis recti intervention if...
Definition
1. Can't keep a neutral pelvis
2. gap/bulge appears
-continue in previous position
-move slowly
Term
What is critical with diastasis recti intervention
Definition
BREATHING
Term
How long after birth should you wait before testing for diastasis recti?
Definition
48 hours
Term
Gap vs bulge
Definition
Pregnant - gap or bulge
Postpartum - gap only
Term
Progression in posisitoning: supine
Definition
Supine: head lift only vs head lift with posterior pelvic tilt
Term
Progression in positioning: knees bent
Definition
knees bent: Single leg sliding w/pelvic tilt
-stop when tilt posture lost
Term
Progression in positioning: chin tuck
Definition
chin tuck:
1. lift head and clear scapulae
2. lift head/clear scapulae & rotate
Term
Positions in diastasis recti correction
Definition
Most common: supine
Can do: quadruped or semi-reclined
Term
w/isometric, eccentric, concentric avoid which range of positions
Definition
Outer positions
Term
If buldge appears w/lifts
Definition
Contract and pull
Term
Does exercise prevent diastasis recti?
Definition
Study: Chiarello (2005)
90% non-exercisers have DRA
12% exercisers have DRA
Term
DRA excercise precautions
Definition
1. while gap still open - avoid rotation or lateral bend
b/c obliques pull apart rectus abd.
1. If can't maintain form throughout entire exercise - don't do exercise
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