Understanding Divarication of Recti: Symptoms, Causes, and Treatment

Divarication of Recti, also known as Diastasis Recti, is a condition characterized by the separation of the midline abdominal wall muscles called Recti Abdominis, which are two in number and lie parallel in the midline one on each side. It commonly occurs during or after pregnancy but can also affect men and women who are not pregnant. This blog aims to provide a comprehensive understanding of Divarication of Recti, including its symptoms, causes, and available treatment options.

Symptoms:

The primary symptom of Divarication of Recti is the visible separation of the abdominal muscles. Other common symptoms include:

1.  Bulging or protrusion of the abdomen: A noticeable bulge or ridge running vertically along the midline of the abdomen, particularly when straining or engaging the abdominal muscles.
2.  Weakness in the core muscles: Difficulty with activities that require core strength, such as sitting up from a lying position or carrying heavy objects.
3.  Lower back pain: Many individuals with Divarication of Recti experience discomfort or pain in the lower back due to inadequate core muscle support.
4.  Digestive issues: Some people may develop digestive problems like bloating or constipation, as the separated abdominal muscles are less efficient in supporting proper digestion.
5.  Urinary incontinence: In severe cases, Divarication of Recti may contribute to urinary leakage or stress incontinence, especially when coughing, sneezing, or lifting heavy objects.
6.  At times divarication is associated with with ventral or umbilical hernia.

Causes:

Divarication of Recti typically occurs due to excessive pressure on the abdominal muscles. The most common causes include:

1. Pregnancy: The growing uterus during pregnancy puts significant strain on the abdominal muscles, leading to their separation.
2. Rapid weight gain: Sudden and substantial weight gain can stretch the abdominal muscles, resulting in diastasis.
3. Incorrect exercise techniques: Performing exercises that excessively strain the abdominal muscles, such as improper crunches or sit-ups, can contribute to the development of Divarication of Recti.
4. Multiple pregnancies: Women who have had multiple pregnancies are more susceptible to developing this condition due to repeated stretching and straining of the abdominal muscles.

Treatment Options:

Fortunately, there are various treatment options available for Divarication of Recti, depending on the severity of the condition. Patients with small divarications are offered no surgical treatment listed below:

1.  Physical therapy: A specialized physical therapist can provide exercises and techniques to strengthen the abdominal muscles and promote proper alignment of the core. Physical therapy can be highly effective, especially for mild cases.
2.  Core-strengthening exercises: Specific exercises, such as pelvic tilts, transverse abdominis activations, and kegel exercises, can help strengthen the abdominal muscles and improve core stability. However, it’s crucial to perform these exercises correctly to avoid further exacerbating the condition. These are not very effective in curing the problem.
3.  Supportive garments: Wearing abdominal binders or support belts can provide temporary relief by offering additional support to the weakened abdominal muscles.

Surgical intervention: In most of the symptomatic cases or when conservative treatments fail, surgical repair is almost always recommended. This procedure is called repair of divarication of Recti and may also need repair of the hernia associated if any. This procedure is routinely performed laparoscopically. Mesh is invariably used to reinforce the repairs. If the patient also has extra abdominal skin, then the above are associated with some form of abdominoplasty or tummy tuck.

See Also: Understanding Diastasis Recti: Unveiling the Causes 

Conclusion:

Divarication of Recti is a common condition, particularly among pregnant women, but it can affect anyone. Recognizing the symptoms and understanding the causes can help individuals seek appropriate treatment options. Physical therapy, core-strengthening exercises, and supportive garments are non-surgical approaches offered but not very effective. 

Surgery remains the main treatment option. Almost always the repair can be done by the minimal access method, especially if abdominoplasty is not required. It’s important to consult with surgeons, to develop a personalized treatment plan that addresses individual needs. With the right approach, individuals with Divarication of Recti can regain abdominal strength and improve their overall quality of life.