Repair the Rectus Diastasis

When Dr Marco talks about one having a rectus diastasis problem, what does it mean?

The rectus refers to the rectus abdominal or core muscles, and diastasis means separation gap.

So rectus diastasis, in simple terms, is the separation of the left and right abdominal muscles, also known as the linea alba. It is a separation of the rectus abdominal (abdominis) in the midline of the core muscles. The separation gap can be larger than 2 cm.

The Look

A physical manifestation is the “abdominal bulge”. The bulge will make one look like they are pregnant or still having a “mummy tummy”.  It is a possible condition for anyone who has tried to exercise or has been constantly exercising and is always careful about their diet but still has an abdominal bulge that does not go away.

Self-Physical Check

Here’s how to do a self-check at home:

• Lie down your back on the floor, bend your knees, and keep your feet flat on the floor.
• Hold your head in your hands and lift your shoulders and head off the floor.
• Place two fingers in the midline of your abdomen.
• If you feel a gap in the midline, you might have a rectus diastasis gap.
• Try to do a sit-up, and if you have a sausage-like bulge projecting on your abdomen, it may also indicate rectus diastasis.

The Complaints

• Constant or frequent backaches and pain (even if you have gone for professional advice and help)
• Signs of urinary incontinence
• Early signs of pelvic floor dysfunction
• Spine instability – such as poor posture or lordosis, commonly known as swaying of the spine
• Limited functional movements

Failure to seek treatment for rectus diastasis can lead to chronic medical problems, such as:

• Back pain
• Hip pain
• Bad postures from lordosis & swaying of the spine
• Pelvic floor dysfunction and weakness
• Pelvic organ prolapse
• Urinary incontinence
• Onset of hernias
• Chronic constipation

How is the surgery done?

Surgery can be via:

• Open method
• Close method

What is an open method?

Open-method surgery is for those who present with excess skin. The incision is made along the bikini line, and the excess skin is removed simultaneously. This technique has a tightening effect on the abdomen and also the groin area.

What is a close method?

Close-method surgery is for those without excess skin but only a prominent abdomen bulge. It can be done through the endoscopic method or the latest high-tech way of using the  Da Vinci© Robotic Surgical System. These methods leave minimal keyhole scars.

The rectus diastasis plication surgery is done by stitching the left and right abdominal muscles to make an inner-like corset in the midline from the xiphoid to the umbilicus and down to the pubis area. Depending on the severity of the gap and the condition of the rectus tissues, the repair can be done in two layers.