Abdominal muscle separation after childbirth: what to do? Diastasis of the rectus abdominis muscles: Who is to blame and what to do

Everyone knows that during pregnancy, the abdominal muscles stretch greatly, supporting the ever-expanding uterus. That it takes time and effort to get your body in order after giving birth. But often recovery naturally not happening. The reason for this is diastasis. What to do? Is it really stretched out now forever? What is diastasis after childbirth? From a medical point of view, this is a divergence of the rectus abdominis muscles due to weakening of the ligament connecting them.

To understand what happens to the body of a woman diagnosed with postpartum diastasis, you need to know anatomical structure and the location of the abdominal muscles.

The abs consists of 2 muscles connected by tendons. The junction is usually called the white line. Fetal pressure puts pressure on the rectus muscles and causes this connective tissue to stretch, forming diastasis of the abdominal muscles, which appears after childbirth. Now that it has become clear what diastasis is, it remains to determine what to do if diastasis has already occurred or if there is a high probability of its occurrence.

First of all, you need to understand that diastasis after childbirth of varying degrees occurs in almost everyone. Health and diastasis are quite compatible. Mild sprains are corrected and are not considered an illness. In this case, the fabric is tightened without any effort on the part of the woman. Another thing is severe damage, a sprained ligament with a large muscle tear after childbirth. In this case, it can be difficult to cope with diastasis of the rectus abdominis muscles of a woman after childbirth.

The main means that can lead to recovery normal condition, is considered to be physical exercise. But they are also the main scourge of the recovery period. Physical activity can either significantly improve or worsen the situation. But not all cases can be corrected through training. Sometimes the discrepancy of the rectus abdominis muscles after childbirth can only be corrected by contacting plastic surgeon.

It is not difficult to detect pronounced diastasis. If there is a dimple in the abdomen under the navel, then diastasis of one degree or another has already appeared. Sometimes a depression is present at the site of the navel itself.

Reasons for the development of diastasis after childbirth

The problem of female diastasis can arise due to several reasons:

1. Congenital weakness of the ligament connecting paired muscles. This does not depend on childbirth, lifestyle, or visits to the gym. Therefore, women who do not understand the reasons why the problem arose often blame themselves in vain.
2. Weak muscle tone. The reason may be insufficient physical activity or sudden weight loss.
3. Violation of the technique of performing physical exercises.
4. Lifting weights. The less prepared the body is for intense physical activity, the higher the likelihood of complications. If your back hurts after lifting something heavy, this does not necessarily mean a spinal problem. Diastasis appears common cause lower back pain.
5. Excessive straining when coughing.
6. Congenital predisposition to the appearance and development.

In addition, pregnancy itself is a significant burden on. Therefore, at least 40% of mothers of newborns face this problem. Mild forms of diastasis can be dealt with quite quickly. In some cases, only surgery is effective.

How to determine diastasis after childbirth

Many women, having heard and read enough scary stories about the problem of almost all pregnancies - diastasis, try to find signs of muscle discrepancy on their own. In most cases this is possible. So, after childbirth, how to determine diastasis?

1. An excessively convex or, conversely, located in a fossa navel.
2. Big belly. Especially after large quantity time after the baby is born. If a woman was plump before giving birth, then a bulging belly may not indicate diastasis.
3. Frequent.
4. Lumbar pain is also a common symptom of diastasis.

Test

Obviously, many symptoms do not allow self-diagnosis. Moreover, much depends on the stage of muscle divergence. It depends on how much the connective tissue of the midline (white) line is stretched. Therefore, for self-diagnosis, it is best to resort to a simple test.

To carry out the test you need:

1. Lie on the floor or other flat surface. A sofa or bed with a soft, heavily sagging mattress is not suitable for this purpose.
2. Bend your legs, bringing your heels toward your buttocks.
3. Place 1 hand behind your head.
4. Place right hand on the stomach in the navel area. Mentally dividing the stomach into 2 halves - right and left. Draw exactly in the middle. A depression should be visible in the navel area. Even if nothing is clearly noticeable, feel the skin, you should feel a depression. Ligament dehiscence usually occurs in the lower part. Those. the fossa should be visible at the location of the navel itself or slightly below it.

If the discrepancy is clearly expressed, diagnosis can be carried out with both hands. Simply, lying on your back, lower your hands to your stomach and gradually begin to move them along the center line of your abdomen in the navel area.

As you know, the linea alba has no muscles. It consists of connective tissue. When it is stretched, places are formed through which, by stretching the skin, you can insert your fingers usually 1-2 cm deep. Those. you can feel the separation of the medial fascia of the abdomen (linea alba).

Provoking factors

Bearing a fetus itself, as mentioned above, is a factor that provokes diastasis. Since the load on the abs seriously increases during pregnancy. Large pregnancies carry more risks. The same goes for the birth of twins. The greater the load on the muscles and the less ready they are for it, the higher the likelihood of unpleasant consequences.

Dysplasia (weakness of connective tissue) is often congenital. And usually this problem manifests itself not only in this place, but throughout the body. People with weak connective tissue often also suffer from varicose veins, hemorrhoids, and hernias.

How to treat diastasis

It is necessary after childbirth before starting treatment with enthusiasm. This period does not include exercises or other activities, but involves a number of prohibitions:

1. Limit lifting of any objects weighing more than 5 kg.
2. Do not lift objects over 2-3 kg with outstretched arms.
3. Use a bandage, especially when you need to pick up a baby.
4. Limit any strain on the abdominal muscles. Carefully get out of bed, do not strain too much or cough.
5. Don't sleep on your stomach.
6. Don't slouch. Watch your posture.

The main thing is not to self-medicate. The planned set of exercises should also be discussed with your doctor. Since even a small mistake when performing an exercise (violation of technique) can lead to deterioration.

Elimination Features

Treatment methods depend on the stage:

1. At the 1st stage, the discrepancy does not exceed 7 cm. This is not much. Therefore, questions on the topic of elimination (how to correct, eliminate diastasis) should not arise at all. Physical training certainly won't hurt. But in general, such diastasis is considered normal and goes away without much effort.
2. At the 2nd stage, the discrepancy can reach up to 10 cm. The tone of the press is noticeably weakened. Here it will be necessary to pay increased attention to the recovery period.
3. At the 3rd stage, the discrepancy exceeds 10 cm. Working with such a problem is difficult. Complications are possible.

The motto “getting rid of diastasis” and queries “how to get rid of diastasis” will not help much in the search. In this case, each step must be coordinated with your doctor.

Treatment of diastasis of the rectus abdominis muscles after childbirth

Traditional medicine is weak against this disease. But this does not mean that it is impossible to cope with it. Diastasis can be treated surgically if the disease has reached stage 3. In other cases, physical therapy is indicated. Treatment of diastasis is limited to these two methods. Tablets and injections, despite the danger of the disease, are powerless for this disease.

How to remove belly fat

There are several ways to remove diastasis. Which one to choose depends on the degree. If the discrepancy is insignificant, then you can cope with simple physical exercises. Additionally, it is advisable to wear a bandage. It usually takes months to completely resolve the problem.

If the diastasis is severe and there is a risk of complications, surgery is performed to eliminate the muscle discrepancy.

Exercises for diastasis

When choosing a set of exercises, you need to be very careful, since activity can only increase the discrepancy of the muscles. In addition, it is important to properly perform physical exercises that are recommended by experts. Not every gymnastics that strengthens muscles will be beneficial.

Exercises for diastasis after childbirth should be performed slowly and leisurely. You should constantly monitor your equipment. It is better if the complex is selected by a competent trainer. If you decide to exercise on your own, or it is not possible to visit the gym, you can perform specialized exercises at home. So, let's move on to the complex recommended by experts.

Attention: you can’t pump up your abs after giving birth. Leg raising exercises are also not advisable. There are other positions and exercises that are unacceptable for diastasis. For example, push-ups. Any poses with emphasis on the palms or elbows are unacceptable.

You can often find advice to strengthen your abs, for example: lie on the floor, bring your legs together and start moving them. It is strictly not recommended to do such exercises without consulting a doctor.

Exercises against diastasis

1. Stand with your back to the wall and sit down. It is important not to lift your back from the wall.
2. From a lying position, lift your leg vertically up, lifting your body. Then, lower it. Repeat 10 times for each leg.
3. Lie down on the floor. Bend your knees. Slowly lift your pelvis up. Repeat 10 times.

Before you start exercising, be sure to consult your doctor.

Diastasis and fitness

There is an opinion that pregnant women should not exercise. It is also unacceptable to put stress on the muscles immediately after the birth of the child. This is not entirely true. You can and should exercise during pregnancy. Correctly selected exercises make the muscle more elastic, and therefore resistant to stress. The load is selected based on whether the woman was engaged before she decided to become a mother.

After giving birth, you really can’t exercise for a while. Recovery period everyone has a different one. Much depends on how the pregnancy proceeded and what the birth was like. For physically fit girls, a 1-2 month break is usually enough, after which they gradually return to classes. But this cannot be done without first consulting a doctor.

Is diastasis dangerous?

This depends on the degree of neglect of diastasis. In extreme cases, diastasis can lead to a hernia. This is the prolapse of organs into the space between the muscles. In addition, life with diastasis will be accompanied by:

• frequent;
• shortness of breath;
• Possible urinary incontinence.

It should also be taken into account that women with such a problem should not lift anything heavy, so as not to aggravate the discrepancy.

If the problem reaches the surgeon

In surgery, there are several methods for eliminating diastasis of the abdominal muscles after childbirth. Which one is suitable for a particular patient depends on the indications and what techniques the particular specialist knows. Among the most common: laparoscopy and abdominoplasty.

For medical reasons, surgical removal of diastasis is resorted to only in extreme cases - when diagnosing stage 3 of the disease. In this case, there is a risk that diastasis will negatively affect the functioning internal organs. But sometimes women do it for the sake of cosmetic effect. Not everyone has the will, organization and patience.

Surgery for diastasis

Methods for correcting diastasis come down to 2:

1. Suturing, when separated muscles are connected without the use of prostheses. Excess skin is excised.
2. Correction using artificial materials - mesh, which over time becomes overgrown with connective tissue.

Complete educational program on diastasis

Having discovered that you have diastasis, it is important not to get upset and not to give up. All in our hands. Regular training They will definitely help, it just doesn’t happen quickly. Even if you work out with a trainer in the gym, it will take more than one month. There is no need to rush the process. It’s better, of course, to start exercising before problems arise and even before pregnancy.

A woman’s main assistant after the birth of a child should be breathing exercise vacuum. It is safe and will definitely help. It is most convenient to perform breathing exercises from the “Cat” position (standing on all fours).

But you need to understand that everything depends on the degree of diastasis. If the discrepancy is more than 10 cm, then only surgery is effective.

In half of the cases, diastasis is expressed only on later pregnancy, and after childbirth almost completely goes away naturally. Deviations from the norm may still be recorded for some time, but they will pass.

Myths about stretching and separation of abdominal muscles after childbirth

1. It will never be possible to fully recover. It is not true.
2. If there is no pain, there is no problem. Also wrong.
3. The only way to fully cope is with surgery. Misconception.

As you can see, diastasis is not so scary. Except in rare cases, it can be dealt with with effort. The problem will completely disappear without leaving a trace.

Many women diligently get their physical shape in order after childbirth and do not suspect that the problem of a round belly that is not going to go anywhere can be diastasis. In fact, we're talking about about such a problem as diastasis of the rectus abdominis muscles. It is completely solvable, so you don’t have to worry that you will remain in this form forever.

What it is

Diastasis is a physiological modification of the rectus abdominis muscles, the divergence of the white line of the muscles located very close to the skin. The single line of abdominal muscle is divided into two halves, for a couple of reasons:

• Diastasis occurs due to pressure on the connective tissue that binds the muscles - this happens during pregnancy.
• Another reason is a hereditary factor.
• Obesity and weakened abdominal muscles are also risk factors for this disease.

This pathology occurs in many women who have given birth, but both men and children fall into this category, so diastasis of the recti muscles is now not uncommon. The effect of diastasis is inevitably familiar to women who have had a caesarean section. In the case of diastasis of the rectus muscles, they are weakened and ineffective. Due to improperly distributed load on other muscles, prolapse or displacement of internal organs occurs, the occurrence of an umbilical hernia, digestive disorders, and pain in the spine.

Signs of diastasis of the rectus abdominis muscles

The clinical course of diastasis recti can vary. Some patients are not bothered by anything, they continue to live their lives ordinary life, even engage in physical labor or physical education, fitness. In such cases, diastasis develops unnoticed, gradually, and completely without pain. But women, especially young women, in most cases (regardless of the size of the protruding abdomen) note a cosmetic defect associated with diastasis.

In other cases, a slightly different situation is observed, since patients complain of:

• feeling of discomfort, heaviness in the stomach;
• difficulty walking;
• constipation;
• burping;
• pain in the area of ​​protrusion at rest and during physical activity.

Painful sensations vary in nature, strength, and duration of a painful attack. Pain often occurs after intense sports, heavy lifting, and long walking. The presented symptoms can also be observed in men and children. Large diastasis can lead to pronounced functional changes:

• organ prolapse abdominal cavity,
• the formation of atrophy of the abdominal wall muscles, as well as a decrease in their contractility,
• stretching and thinning of the aponeuroses, resulting in decreased abdominal function.

Diagnostics

To make an accurate diagnosis, you need to seek help from a doctor who, based on the examination and existing signs of the disease, will be able to accurately establish the diagnosis. The severity of diastasis of the rectus muscles on the abdomen is determined in the middle of the distance between the xiphoid process of the sternum and the navel, because this is the widest and weakest point of the white line of the abdomen. It is possible to determine the degree of discrepancy of the abdominal muscles using the following test:

1. Take the starting position lying on your back and bend your knees and press your feet to the floor.
2. One hand should be under the head, and the other on the stomach so that the location of all the fingertips is perpendicular to the white line somewhere at the level of the navel.
3. Relax your stomach completely and then gently place your fingers into your stomach.
4. Then lift your chest and shoulders off the floor, as when doing an abdominal exercise.
5. Moving your fingertips along the linea alba of the abdomen, find the medial edges of the rectus muscles by touch, and also determine the degree of their divergence and measure its width.

Non-surgical treatment methods

Diastasis of the rectus abdominis muscles does not disappear on its own, but only increases in size over time. How to remove a round belly? An excellent effect is achieved when performing special physical exercise, the purpose of which is to strengthen the abdominal muscles. If there is 1st degree of diastasis, then you can really only get by with exercises; if 3rd degree, treatment occurs only with the help of surgery.

Diastasis of the rectus abdominis muscles is eliminated by retracting the abdomen. You need to pull in your stomach and hold this position for 30 seconds. To perform the second exercise, you should lie on your back and raise your head and shoulders, holding yourself in this position for 25-30 seconds. Number of repetitions – 25 times. Other exercises involve strengthening the deep transverse abdominis muscle. By strengthening it, you will be able to keep the abdominal wall from protruding. The effectiveness of the exercises is evidenced by the reviews of the girls who performed them and the following photo.

It is possible to reduce diastasis of the rectus abdominis muscles with the help of an effective and simple complex based on Pilates. ? It is a special system of exercises, the action of which is aimed at stretching and strengthening the muscles of the body without the use of shock loads. Pilates is especially necessary for women with back problems. While performing the exercise, you need to keep your stomach pulled in and breathe through your chest without the participation of your stomach.

Surgery for diastasis recti

1. Elimination of diastasis using an endoprosthesis. Obstructive hernioplasty is considered the most effective surgical method for eliminating diastasis. During the operation, the defect is closed and the stretched white line of the abdomen is strengthened using a special multilayer mesh. The use of a mesh endoprosthesis protects the suture area from tension and provides 3 main advantages compared to traditional surgical techniques:

• Very mild pain syndrome.
• Short rehabilitation period. The next day after the operation, the patient can go home independently, and a month after the operation he can play sports and lift weights.
• Minimal risk of relapse.

Within a month after the operation, the mesh begins to grow with connective tissue and complete engraftment of the endoprosthesis occurs. As a result, an anatomically unified complex is formed that reliably covers the defect of the anterior abdominal wall and protects the tissue from repeated stretching. Installation of the endoprosthesis is carried out using the open method through a small incision at the navel or endoscopically through small punctures.

2. Endoscopic hernioplasty. This method is modern and not dangerous. The endoscopic method of eliminating diastasis has a number of undeniable advantages:

• no visible scars,
• no pain,
• short period of time for recovery (start doing physical exercise a few days later)
• short period of rehabilitation (100% return to active life after 10 days)
• minimal number of relapses (less than 1%).

Unlike the classic open surgery method, surgical intervention occurs not through one incision, but through 3 small punctures in the navel area and above the pubis. Special endoscopic manipulators with a small video camera are inserted there, which sends an image to the monitor. Thanks to her, the doctor monitors the progress of the operation. This operation allows you to:

• restore normal position and function of the abdominal muscles;
• eliminate protrusion in the midline;
• improve appearance tummy, shape the waist line;
• Diastasis of the rectus abdominis muscles can be effectively eliminated together with plastic surgery of the hernia of the linea alba.

3. Abdominoplasty. When there are stretch marks, excess skin and subcutaneous fat on the abdomen, then elimination of diastasis should be combined with abdominoplasty. Thanks to this, it is possible, simultaneously with the correction of diastasis, to eliminate the skin-fat “apron”, remove sagging skin and stretch marks and make slim stomach and a thin waist. After surgery, patients must wear a bandage.

A set of exercises for tummy tuck

1. Take position: lying on your back, bend your knees, place your arms along your body. Slowly lift the pelvis off the floor, starting from the tailbone. All movements must be smooth, literally “vertebra by vertebra.” The tailbone needs to be pulled up, the crown forward. We must not forget that you need to breathe only through the chest. When the pelvis, knee and shoulder are located in the same line, you need to stop and take a breath. You begin to lower your spine to the floor. This exercise perfectly stretches the spine, strengthens the thigh muscles and abs. Number of repetitions – 4 times.
2. Take the same starting position. As you exhale, bend your right leg at a right angle, and as you inhale, raise your arms (palms facing the floor) and perform 5 active movements, reminiscent of hitting water. As you exhale, perform 5 active movements with your palms up. Repeat the exercise for each leg 10 times. As a result, the abdominal and arm muscles are warmed up, and the transverse abdominal muscle is strengthened. To complicate the exercise, you should lift 2 legs at once, bent at a right angle. Then you are allowed to keep your legs straight and squeeze a small ball between them.
3. Take the starting position. You should press your lower back to the floor as tightly as possible. Raise up to right angle right shin (knee bent), as you exhale, straighten your entire leg, but draw in your stomach as much as possible. Pull the top of your head up, and your pelvis is level. As you inhale, return to the starting position and change legs. Number of repetitions: 10 times for each leg. All exercises are performed slowly and smoothly, as if in slow motion filming. Constantly exercise control over your breathing and muscle function.
4. Take a different starting position - on all fours, place your palms strictly under your shoulders. The stomach should be tucked in and the body should be straight. Slowly straighten your left leg as you exit until it reaches a position parallel to the floor. While inhaling, you should return to the starting position. Do not bend your lower back, but stretch the top of your head forward, with the toe of your raised leg in the opposite side. Do 10 repetitions for each leg. You can make the exercise more difficult if you simultaneously raise your leg on the opposite side.

Video

The occurrence of diastasis of the rectus abdominis muscles occurs in almost 25% of women who give birth. Usually, after giving birth, women notice that a small depression has formed in the center of their abdomen in a horizontal position, and when the abdominal tension occurs, a protrusion appears.

The rectus abdominis muscles are connected to each other by a narrow plate, which is formed by the interweaving of light-colored tendon fibers - hence the name “white” line of the abdomen. Diastasis is its expansion as a result of pressure, with the divergence of the rectus abdominis muscles occurring. The disease manifests itself as a protrusion along the midline of the abdomen, shaped like a roller that appears when tense. This pathology is quite common and is diagnosed in 0.5-1% of patients.

Who gets diastasis?

More often, this disease is diagnosed in women; as a rule, expansion - diastasis of the rectus abdominis muscles - develops during pregnancy, 2-3 months after childbirth. During pregnancy, under the influence of a changed normal background, connective tissue becomes looser - this occurs to ensure normal labor activity. The tissue structure is restored only after 8-12 months. But, if a woman started training early in gym To correct your stomach, diastasis of the rectus muscles appears. Thus, intense physical activity during the postpartum period can lead to the formation of diastasis. Men also suffer from this pathology, which occurs with heavy physical activity or obesity.

Causes

Thus, as a result of thinning and stretching of the linea alba, the muscles stretch and diverge. The cause of this condition may be:

• pregnancy and childbirth;
• unjustified physical stress, chronic constipation, prolonged and strained cough, etc. - conditions leading to increased intra-abdominal pressure;
• obesity or rapid loss of body weight, leading to decreased muscle tone;
• congenital weakness of connective tissue; Often this condition is accompanied by hernias of the anterior abdominal wall of various locations.

It should be noted that in most cases, in women after the birth of a child, the rectus abdominis muscles contract within 2 months and converge back to the center. However, the initial state is not always achieved, for example, with weakened abdominal muscles, with a large degree of stretching, with repeat pregnancies or congenital connective tissue dysplasia.

How to determine diastasis

To check for the presence of diastasis of the white line of the abdomen, you should perform a simple test. The patient, lying on his back, should bend his knees and place his feet on the floor. Next, bend your neck and slightly tense your abdominal muscles; To do this, just rise a little. Use your fingers to explore the navel and midline area. The appearance of a roller-like protrusion along the midline of the abdomen with smooth contours indicates pathology. It is a little more difficult to identify the disease in people who are obese. More accurate information can be obtained using ultrasound of the anterior abdominal wall.

To determine the stage of diastasis and indications for surgery, as well as select the correct tactics of surgical treatment, you must send it to my personal email address [email protected] [email protected] copy photo of the abdomen in frontal and lateral projection in an inflated and calm state (can be taken with a phone). Optimally, a complete description of the ultrasound of the abdominal cavity and anterior abdominal wall, preferably an examination by a surgeon, indicate age and main complaints. Then I will be able to give a more accurate answer to your situation.

Stage I- expansion of the white line in the navel area up to 3 cm.

Stage II- the discrepancy reaches 3-6 cm.

Stage III- characterized by a diastasis of more than 6 cm.

Stages of the disease

The distance between the rectus muscles is normally only 0.5-2 cm. The severity of the disease (its stage) is indicated by the size of the divergence of the rectus muscles, measured in the middle between the navel and the xiphoid process of the sternum. There are three stages of the disease:

• Stage I - expansion of the white line in the navel area up to 3 cm. This defect does not affect the shape of the abdomen. As a rule, it occurs in women after their first birth. Signs of diastasis of the rectus abdominis muscles at this stage are dull, low-intensity pain in the epigastrium, nausea, constipation, and bloating. Often the patient experiences difficulty walking.
• Stage II - the discrepancy reaches 3-6 cm. At this stage, relaxation of the lateral muscle groups and the formation of an umbilical hernia are noted.
• Stage III - this stage of the disease is characterized by a diastasis of more than 6 cm. At this stage, hernias (umbilical and linea alba) are not uncommon. In addition to a saggy belly, the patient is concerned about more serious disorders. Muscle atrophy and splanchnoptosis develop - displacement of the abdominal organs, accompanied by various disorders. The working capacity of such patients is limited.

Is it necessary to treat diastasis?

The clinical picture depends on the stage of the disease. At the initial stage, there are often no complaints other than a cosmetic defect. However, various symptoms may gradually appear, which intensify after physical activity. If left untreated, the disease will progress, and respiratory, digestive, circulatory, etc. disorders will gradually develop. The appearance of hernias poses a serious danger.

When will exercise help?

However, at the initial stage in women after childbirth (in the first months), significant improvement can be achieved without surgical treatment. It should be taken into account that you should not prescribe physical activity on the abs for diastasis; optimally - swimming pool, walking, running. There is also a set of special exercises, which includes simple movements, which a specialist will help you choose. physical therapy. It should be noted that lifting the legs and body in a lying position should be avoided. In advanced cases, as well as a year after childbirth, exercises for diastasis of the rectus abdominis muscles will no longer bring the expected result. In such a situation, correction of the stretched abdominal line is necessary.

When to see a surgeon

It should be understood that diastasis will not disappear on its own; moreover, the course of the disease is progressive. In advanced forms of the disease, quite dangerous disorders often develop. For example, a hernia can form at any time, the infringement of which can lead to the development of hazardous health consequences. In addition, with diastasis of II-III degree, the area of ​​​​disturbances is quite impressive, which affects the scope of surgical intervention.

Often, diastasis of the rectus muscles is accompanied by ptosis of the anterior abdominal wall and the presence of ventral hernias of different localization. There may be additional cosmetic problems: post-operative scars or postpartum stretch marks. The surgeon is obliged to take into account all anatomical changes in this area and the cosmetic wishes of the patient. In such a situation, the effect of the operation will be maximum.

Patent. Method of Lipoabdominoplasty with navel relocation

Main types of operations

The goal of surgical treatment is to eliminate diastasis and strengthen this area of ​​the abdominal wall. The result is a good functional and cosmetic effect.

Currently there are:

• tension plastic with local tissues- during the operation, structures are created from tissue of the anterior abdominal wall, which we currently do not use in our practice, due to big amount relapses and lack of cosmetic effect (incision on the abdominal wall 16-18 cm);
• non-tension plastic surgery using a mesh endoprosthesis. A mesh made of synthetic material completely covers the diastasis area, being fixed along the edge. The downside is that the lack of alignment of the rectus muscles does not lead to a good cosmetic effect during abdominal wall reconstruction.
• tension plasty with suturing of diastasis and additional use of a mesh endoprosthesis. The diastasis is sutured and the plastic site is additionally strengthened with a mesh implant. A mesh made of synthetic material completely covers the area of ​​the sutured diastasis, additionally secured along the edge with suture material. After 2 months, the prosthesis grows into connective tissue, forming a single anatomical complex. Subsequently, it turns into a durable connective tissue structure up to 2 mm thick, which can withstand quite heavy loads. This plastic surgery allows to reduce relapses to 1%, instead of 20% during plastic surgery using tension approaches without an implant.
• tension plasty with suturing of diastasis using a mesh endoprosthesis and abdominoplasty. This operation is performed for diastasis, which is accompanied by ptosis of the anterior abdominal wall, the presence of ventral hernias of different locations, cosmetic problems - postoperative scars or postpartum stretch marks.

Today different kinds Plastic surgery with a mesh implant for diastasis of the rectus abdominis muscles can be performed either by the open method or using endoscopic equipment through a small incision in the umbilical area or punctures of the abdominal wall - laparoscopically.

Endoscopic hernioplasty for diastasis of the rectus muscles has a number of advantages:

• absence of pain syndrome;
• minimal risk of disease relapse (less than 1%);
• no visible scars;
• shorter rehabilitation period.

There isn't one the only way correction of abdominal wall diastasis. In each specific case, everything is decided individually, based on the stage of the disease, associated cosmetic problems and the woman’s wishes.
I have extensive experience (more than 400 operations) in various methods of correcting diastasis in difficult situations, so I can solve the problems of every woman with this disease. copy

“When you write a letter, know that it goes to me on my personal email. I always answer all your letters myself. I remember that you trust me with the most valuable things - your health, your destiny, your family, your loved ones, and I do everything possible to justify your trust.

Every day I spend several hours answering your letters.

By sending me a letter with a question, you can be sure that I will carefully study your situation and, if necessary, request additional medical documents.

Vast clinical experience and tens of thousands of successful operations will help me understand your problem even from a distance. Many patients do not require surgical treatment, but rather properly selected conservative treatment, while others require urgent surgery. In both cases, I outline a course of action and, if necessary, recommend additional examinations or emergency hospitalization. It is important to remember that some patients successful operation preliminary treatment of concomitant diseases and proper preoperative preparation are required.

In the letter, be sure (!) to indicate age, main complaints, place of residence, contact number and address Email for direct communication.

So that I can answer all your questions in detail, please send along with your request scanned reports of ultrasound, CT, MRI and consultations of other specialists. After reviewing your case, I will send you either a detailed response or a letter with additional questions. In any case, I will try to help you and justify your trust, which is the highest value for me.

Yours sincerely,

surgeon Konstantin Puchkov"

My respect, gentlemen and especially ladies! And today we have a note on one of the most popular women's topics - diastasis after childbirth. Therefore, men, if you stopped by to see us, you can calmly return to your business, because such trouble does not threaten you due to the lack of opportunity to be in an interesting situation :).

Ladies, you will learn everything about diastasis - what it is, why it occurs especially often in pregnant women, what myths exist around it and what body movements, or rather exercises, will help improve your situation with it.

So, please sit down, let's begin.

Diastasis after childbirth: what, why and why?

Lately, I often receive letters from young mothers in the mail, in which they share their problems, in particular about diastasis after childbirth. Many people complain that there is no truth on the Internet. (not contradictory) clear information regarding this phenomenon. Due to the fact that the number of requests has exceeded the impossibility of responding to everyone, I decided to devote a full-fledged note to this issue, which is in front of you. Well, let's start with this...

Giving birth to a child is one of the main missions of a woman on this planet, and perhaps you would not be reading these lines if such a mission had not been completed by my most beloved woman. However, the birth of a child (and even more so the second) does not go unnoticed for the woman in labor and often brings a whole bunch of additional goodies, in particular, the following:

• weight gain;
• appearance of riding breeches - ears/sides;
• cellulite;
• breast enlargement/swelling;
• flattening of the buttocks;
• abdominal muscle diastasis;
• other.

Thus, it turns out that by giving life to a new little man, a woman sacrifices herself, her beauty. Therefore, after childbirth, curvy changes make themselves felt for a long time. However, there is enough information about losing weight and creating streamlined shapes, but too little attention is paid to diastasis of the abdominal muscles, although the problem is very common. Therefore, in this article let us try to understand this phenomenon.

Note:

For better assimilation of the material, all further narration will be divided into subchapters.

Diastasis after childbirth: the theoretical side of the issue

Diastasis is the separation/divergence of the rectus abdominis muscles. As a result of this separation, the right and left halves of the rectus abdominis muscle (Rectus Abdominis) are moved apart relative to the middle fascia of the abdomen, the linea alba. In the picture version, the muscle divergence looks like this.

Note:

Diastasis most common (in two cases out of three) occurs in women who have given birth to a second and subsequent child.

The expansion and thinning of midline tissue occurs in response to the force of the uterus pressing against the abdominal wall, and hormones also contribute to the “softening” of connective tissue. The middle line is more 2-2,5 fingers wide (approx. 2 cm) is considered problematic. Diastasis most often appears precisely after pregnancy, when the abdominal wall is quite soft and the thin tissues of the midline of the abdomen no longer provide adequate support for the torso and internal organs. Young ladies should understand that a slight expansion of the midline occurs during all pregnancies, and this is a normal phenomenon. In some women after childbirth, the discrepancy does not exceed 1,5-2 - fingers, however, for the most part, the meanings go beyond 2,5 .

Diastasis often disrupts the slender figure of a flat prenatal tummy and is a serious problem that causes aesthetic discomfort in a woman. In particular, as surveys show, ladies are embarrassed to undress and bare their tops even in front of their betrothed. Therefore, the problem definitely requires a solution. In addition to aesthetic inferiority, diastasis recti reduces the integrity and functional strength of the abdominal wall, and can also cause low back pain and pelvic instability. Genetics plays a big role in getting diastasis during childbirth; in particular, miniature and small-sized young ladies are at increased risk. For thicker women and those who are no strangers to physical activity and fitness, pregnancy can proceed without diastasis at all.

In the modern information flow, you may encounter many conflicting opinions and advice on how to restore the abdominal wall and midline after childbirth. Most of these recommendations can worsen the abdominal separation, and in fact you will get even more diastasis.

Therefore, you need to know about...

Myths about diastasis after childbirth

So, there are the following myths regarding the divergence of the rectus muscles, and in particular the following:

• causes irreversible damage to the abdomen;
• requires only surgical intervention;
• causes constant bloating a.k.a. “mummy-tummy”;
• causes pain;
• the abdominal muscles will never recover after childbirth and will always be weak;
• all women should wait at least 8-10 weeks after giving birth before starting any exercise or postpartum recovery program.

Remember, none of these statements are true.

How to determine if I have diastasis after childbirth

The following simple test will allow you to determine whether you have a discrepancy in your abdominal muscles or if your abdominal muscles are raised prematurely :). To identify diastasis, do the following:

• lie on your back, bend your knees, place the soles of your feet on the floor;
• place one hand behind your head and the other hand on your stomach, touching your entire midline with your fingertips at the level of your navel;
• relax your abdominal wall and lightly press your abdominal cavity with your fingertips;
• lightly twist/tear your top part off the floor using crunches, making sure to keep your chest close to your pelvis. As soon as the muscles begin to move, immediately record how many fingers fit inside them and how deep the fingers go inside;
• also record how many fingers can be placed between the tense muscles slightly above and below the navel (3-5 cm in both directions).

This home test will allow you to determine the size of the “hole” in your stomach - the area around the navel that is not covered by muscles. If such a “gap” is not palpable, then you do not have diastasis, otherwise it does exist, and the degree of muscle divergence depends on how many fingers the “hole” has swallowed. Accordingly, the larger/deeper, the stronger the diastasis.

Note:

Don't panic if you feel "big holes" in your belly in the first few weeks postpartum. The midline connective tissue after childbirth is quite soft, but over time and with appropriate exercise, it will slowly but surely regain its former density and elasticity, reducing the size of the holes.

So, you have done the test and suspect you have diastasis. Now let's decide what degree it is, and the following classification will help us with this.

• 1 type - a slight expansion of the white lines in the umbilical region, the most harmless, i.e. virtually no effect on the shape of the abdomen. Formed after the first pregnancy;
• 2 type – divergence in the lower sections with relaxation of the lateral muscles. It is reflected in the shape of the abdomen, making it slightly protruding from below;
• 3 type - divergence of the abdominal muscles along all seams, both upper and lower sections. Accompanied by the presence of umbilical hernias and an unaesthetic appearance of the abdomen.

As you might guess, all work to restore the former flat shape of the tummy depends on the stage of muscle separation. The smaller it is (1 And 2 type), t We are more likely to achieve our prenatal curves naturally (non-surgical) way. The third stage usually involves abdominoplasty. It is also important to understand that when the abdominal muscles diverge and the midline bulges, it is extremely difficult to achieve a reverse complete “tightening” (especially when 3 type) due to the fact that the linea alba does not have muscles, it is connective tissue. Therefore, realistically assess your prospects and the degree to which the efforts expended are necessary.

Why pregnant women may get diastasis after childbirth

In fact, abdominal muscle discrepancy is not just for pregnant women, it can be:

• a consequence of incorrect exercise technique;
• a consequence of performing certain exercises and sports;
• a consequence of excessive weight gain.

In pregnant women, diastasis forms when the growing uterus presses on the abdominal wall - a.k.a. 6 abs cubes. If the lower/transverse abdominal muscles are weak and unable to support a growing uterus (its increasing pressure on the rectus muscles), That 6 cubes become 2 By 3 . As a result of fetal enlargement, the linea alba (its connective tissue) stretches to the sides. Your organs will now “press” on this connective tissue, and you will look with a protruding tummy and, through weak point– abdominal muscles, feel and feel their divergence.

So, we laid down some theory and realized that diastasis is a protrusion of the inner abdomen from under the muscles. Now let's move on to practical measures to improve this “interesting” situation.

First, let's figure out what movements/exercises should be categorically avoided so as not to worsen the situation. These include:

• exercises that involve lying on your back on a fitball;
• yoga poses that involve stretching the abdominal muscles (dog, cow) and breathing with the stomach (vacuum);
• Abdominal exercises that involve bending the upper spine/lifting it off the floor against gravity. For example: lying abdominal crunches, cross crunches, bicycle, roll-ups, cable crunches, push-ups, planks;
• lifting/carrying heavy objects (including children);
• most four-legged exercises.

In the picture version, the compilation atlas of prohibited exercises looks like this:

In general, it can be done next output- with diastasis, you should avoid “direct” press exercises, you need to focus your attention on certain isometric movements. In particular, the following exercises can be performed with a discrepancy in the abdominal muscles in order to improve the situation.

Exercise No. 1. Lying pelvic lifts (bridge).

Lie on the floor on your back, bend your knees. Start lifting your pelvis by lifting your hips up. Pause at the top, squeezing your buttocks and tensing your abs. Execute 3 approach to 10 repetitions.

Exercise No. 2. Wall squats with a Pilates ball between your legs.

Press your back against the wall and squat down to the corner 90 degrees, placing a small ball at your feet. Stay in the bottom position for 25-30 seconds, and then straighten your legs, standing up to your full height.

Exercise No. 3. Raising your leg up from a lying position.

Lie on your back, bend your knees and place your feet on the floor. Lift your left leg vertically up, lifting your body off the surface. Lower your leg, returning it to the starting position. Repeat the same for right leg by completing 10 repetitions of each.

Exercise No. 4. Slides with your feet.

Lie on your back and put your hands behind your head, stretch your legs. Raising your straight legs slightly, begin to bring them towards your body, taking steps in the air. Execute Execute 3 approach to 20 repetitions.

Exercise No. 5. Crunch with a towel.

Wrap a towel around your torso and lie on the floor. Cross its ends at your waist and cross it with your hands. Slightly lifting your head, neck and top of your shoulders, pull the ends of the towel, bringing your chest closer to your pelvis. Execute 3 approach to 10 repetitions.

Note:

On average, with regular exercise, at least 3 once a week, first visible result can be seen later 1,5-2 months of classes.

Actually, these are all exercises for diastasis of the rectus abdominis muscles, as you can see, simple, but extremely effective.

However, exercise is not a panacea, and the synergistic effect ( 2+2 =5 ) they will provide, working in conjunction with a tailored diet and aerobic activity. In particular, it should be remembered that when burning fat, there is a general change (reduction) in circumferences, including in the abdominal area, so burning excess weight will help reduce pressure on the rectus abdominis muscles, and therefore the process of “healing” of diastasis will go faster.

Thus, it turns out that an effective plan for combating abdominal muscle separation is as follows:

1. power adjustment/setting;
2. incorporating cardiovascular activity into your daily routine;
3. performing specialized exercises.

So, we figured out the action plan. Now let's answer the question: when can you start working to improve the situation with diastasis.

As for the start time of work, it all depends on the degree of “neglect” of the source material. Those. usually mild stages of diastasis ( 1 ) go away on their own over time - the fabric tightens itself, without unnecessary movements on your part. On average at proper diet and avoidance bad habits, the deadline is 1,5-3 month. All further stages ( 2 And 3 ) involve actions on your part, and the deadlines can range from 5 months to 1 of the year. Therefore, if you are the owner of diastasis 2-3 degrees, get ready for long-term work that you can start after 2-4 weeks after the baby is born.

Well, that’s basically all I would like to talk about, now you know how to behave and what steps to take. Let's take stock and say goodbye.

Afterword

With the birth of a child, our women face many curvy misfortunes. With one of them, diastasis of the rectus abdominis muscles, you, my dears, now know how to fight, so give him a hard time!

All this time has passed and he still looks like the birth happened yesterday. Getting your sagging belly in order is actually not that easy. And this is not at all surprising: after all, it is precisely this part female body“gets it” the most during pregnancy. If neither nutrition nor exercise helps get rid of unsightly folds at the waist, you may have diastasis.

What is diastasis?

Diastasis is a divergence of the rectus abdominis muscles, which statistically occurs in 25-30% of women who have given birth. Mothers who have had multiple pregnancies, polyhydramnios, or repeated births are most susceptible to diastasis.

The rectus abdominis muscles are the same abs that a young mother no longer hopes to see on her once slender waist. The left and right abdominal muscles are connected to each other by connective tissue, which is subject to enormous stress during pregnancy due to pressure from inside the growing baby and placenta. In most cases, the muscles return to normal some time after childbirth. However, this does not always happen.

How to determine if you have diastasis?

With diastasis, the skin looks flabby despite any anti-cellulite tricks, and the stomach itself visibly protrudes. You can make sure that diastasis is to blame in just a few minutes. To do this you need to go through a simple test at home:

1. Lie on your back, bend your knees, place your feet side by side.
2. Place one hand behind your head and lift your head and shoulders off the floor as if you were about to do an abdominal crunch.
3. Mentally divide your stomach into two parts along the navel, this is where the connective tissue is located. Place three fingers of your free hand on the navel and first feel the lower zone from the navel to the pubis, and then go up - from the navel to the chest. The fingers should be across the stomach.
4. If, when palpating in any place, your fingers sink to a depth of more than 3 cm, then with a high degree of probability you have diastasis. To confirm the diagnosis, you should consult a surgeon.

Attention!

• If, when palpating, you feel a slight discrepancy (no more than 3 cm), you do not have diastasis, it is just a strip of connective tissue.
• If the width of the depression is 5-7 cm, you have a mild degree of diastasis.
• We felt a discrepancy of 7-10 cm - this is the average degree of diastasis.
• If during the test the fingers sink 10 cm or more deep, this is a reason to seek advice from a plastic surgeon. Unfortunately, neither diet nor exercise will return the stomach to its former shape: such deformation can only be corrected Plastic surgery on the stomach – abdominoplasty.

How to get rid of diastasis?

If you discover that you have diastasis, you should not panic. Of course, this is an unpleasant thing, but in most cases it is fixable. It is important to remember that in the fight for a flat tummy, correct balanced diet . It is this that helps start the metabolism of a young mother, which means that the extra centimeters will go away faster. The second component of success is special exercises . With diastasis, all classic abdominal exercises are prohibited: crunches, planks, push-ups, squats and deadlifts, especially with weights. The fact is that they increase intra-abdominal pressure, aggravating the situation.

You can get rid of diastasis only with the help of special exercises aimed at strengthening the transverse abdominal muscle, located deep under the abdominal muscles. Here most effective of them.

Exercise 1

Lie on your back and tighten your transverse abdominis muscle. You can do this correctly by imagining that your navel is retracting, as if reaching towards the spine. Don't hold your breath. Raise your legs at a 90 degree angle. As you exhale, slowly touch the floor with the heel of one foot, and as you inhale, return your leg to the starting position.

Exercise 2

Lying on your back, bend your knees and tighten your transverse abdominis muscle. As you exhale, slowly move your bent leg along the floor until fully straightened. Return the leg to the starting position and repeat the same with the other leg.

Repeat 10 times on each leg.

Important!

Your shoulders and lower back should be pressed firmly to the floor while performing this exercise.

Exercise 3

Lying on your back, place the resistance band just above your knees and bend your knees. Spread your legs slightly to shoulder width. Your back and shoulders should be pressed tightly to the floor. Exhale and slowly spread your legs, overcoming the resistance of the elastic band; inhale and return to the starting position. When performing this exercise, you should feel the tension in the transverse abdominis muscle.

To make it more challenging, you can perform a resistance exercise from bridge pose.

Exercise 4

Lying on your back, bend your knees and hold a gymnastic ball between them - a fitball (you can replace it with a regular children's ball).

As you exhale, lightly squeeze the ball with your knees, using the transverse abdominal muscles, and release as you inhale.

Repeat the exercise 10-15 times, gradually increasing the number of repetitions to 20.

Exercise 5

Lying on your back, bend your knees and place small dumbbells on your hips, holding them with your hands. As you exhale, assume a bridge pose, only with dumbbells at your sides. As you lift your buttocks off the floor, you should feel the transverse abdominis muscle tighten. Exhale and gently return your pelvis to the floor.