Show Notes by Elaine Stevenson from Myotherapy Reading Room
Gráinne Donnelly is an NHS Specialist Physiotherapist, in Pelvic, Obstetric and Gynaecological Physiotherapy. She has a particular interest in the assessment and treatment of diastasis recti.
The word diastasis has an unfortunate tendency to strike fear into pregnant and post-natal women, and their clinicians alike, much of it unjustified.
Themes covered in the discussion included:
why diastasis is such a feared condition
relationship between fear and misinformation
a review of the anatomy of the affected tissues
common referral pathways, including self-referral
when treatment is required
differentiating between functional vs problematic
physical strategies used in treatment: breathing, abdominal wall control, pelvic floor function and exercises
the importance of seeing a pelvic health physio before returning to high intensity exercise, eg running, for all women
the role social media plays in driving unrealistic expectations
training of the rectus abdominus and address atrophy
navigating the confusion created by conflicting opinions and perspectives of the health and fitness professions
the importance of language and lessons from our understandings about pain
appearance (‘mummy tummy’), strength and function
need for education of health professionals re role of women’s health physiotherapists in the management of this condition
links to low back pain, urinary incontinence, pelvic floor function and pelvic organ prolapse
measurement issues: size of gap vs strength
importance of setting meaningful goals and getting back into sport and activities (ie moving away from ‘can’t do’ cultures)
pathways, physio rehab, referral into surgery, rehab post surgery (where surgery required)
strategies that affected women use to cope with diastasis
the importance of seeking help between pregnancies, as opposed to waiting until you’ve finished your family
Related Reading and Resources:
Video: Lisa and Erin - https://www.instagram.com/p/BrBJqyOB7ok/
Benjamin DR, Frawley HC, Shields N et al. Relationship between diastasis of the rectus abdominis muscle (DRAM) and musculoskeletal dysfunctions, pain and quality of life: a systematic review. Physiotherapy 2018. doi: 10.1016/j.physio.2018.07.002. [abstract]
Bø K, Hilde G, Tennfjord MK et al. Pelvic floor muscle function, pelvic floor dysfunction and diastasis recti abdominis: Prospective cohort study. Neurourol Urodyn 2017; 36(3): 716-721. [abstract]
Davenport MH, Ruchat SM, Sobierajski F et al. Impact of prenatal exercise on maternal harms, labour and delivery outcomes: a systematic review and meta-analysis. Br J Sports Med 2019; 53(2): 99-107. [abstract]
Gillard S, Ryan CG, Stokes M, Warner M, Dixon J. Effects of posture and anatomical location on inter-recti distance measured using ultrasound imaging in parous women. Musculoskelet Sci Pract 2018; 34: 1-7.
Dianne Lee & Associates Physiotherapy. Diastasis rectus abdominis & postpartum health. https://dianelee.ca/article-diastasis-rectus-abdominis.php
Mommers EHH, Ponten JEH, Al Omar AK et al. The general surgeon's perspective of rectus diastasis. A systematic review of treatment options. Surg Endosc 2017;31(12):4934-4949
van de Water AT, Benjamin DR. Measurement methods to assess diastasis of the rectus abdominis muscle (DRAM): A systematic review of their measurement properties and meta-analytic reliability generalisation. Man Ther 2016; 21: 41-53. [abstract]
Links:
Biography:https://www.absolute.physio/aboutusPractice: Absolute Physioat Maguiresbridge, County Fermanagh in Northern Ireland.Twitter:https://twitter.com/ABSPhysioTwitter:https://twitter.com/diastasisphysioInstagram:https://www.instagram.com/absolute.physio/Instagram: https://www.instagram.com/diastasis.physioFacebook:https://www.facebook.com/Absolute.PhysioNI/Email: [email protected]
