Diastasis recti abdominis (DRA) is most common in pregnant women, which is caused by hormonal changes during pregnancy, increased uterine size, pelvic anterior tilt and increased abdominal pressure. In addition, the following factors may predispose to the occurrence of rectus abdominis muscle:

• caesarean section,
• multiple pregnancy,
• fetal macrosomia,
• genetically determined defects in collagen structure,
• significant weight loss occurring spontaneously or following bariatric or abdominal surgery,
• obesity,
• diabetes.

An increase in IRD distance decreases the strength of the rectus abdominis muscle and does not usually cause pain at rest. However, during physical activity, a characteristic bulging of the abdominal wall may occur due to an increase in abdominal pressure. For this reason, DRA may be associated with the occurrence of umbilical and supra-abdominal hernias. The occurrence of DRA can also cause:

• bad posture,
• restrictions during physical activity,
• back pain,
• lumbopelvic pain,
• dysfunction and weakness of the pelvic floor muscles, urinary incontinence,
• reduced quality of life.

Women with DRA may experience a fear of movement and therefore avoid movement. They may also be dissatisfied with their bodies. As a result, many women restrict their daily life and physical activity.

Some studies, however, contradict these findings and do not confirm differences regarding lumbopelvic area pain in women with and without DRA, associations of DRA severity with health-related quality of life impairment, impairment of abdominal muscle strength and do not find weaker pelvic floor muscles and pelvic floor dysfunction in women with DRA after childbirth.

The topic of the consequences of diastasis recti abdominis still requires further research.

Antonina Kaczorowska

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