Diastasis: urinary and pelvic floor disorders
rectus abdominis diastasis is a pathology of with multiple functional implications that go beyond the anterior abdominal wall and penalize various body districts anterior abdominal wall and go to penalize different body districts also apparently unrelated to the abdomen. The rectus abdominis muscles being abnormally distant and free to move no longer exercise their restraining function so well and their contraction, even if present, does not fully generate the normal physiological effects that should cause.
The intra-abdominal overpressure that should be generated during contraction is greatly reduced, and this concomitantly penalizes urinary bladder emptying.
It therefore happens that those who are affected by a clinically significant rectus abdominis diastasis often suffer, according to them, from "urinary incontinence".
If we analyze in depth the pathophysiology we realize instead that these phenomena are the result, not of a pure incontinence, but rather of a chronic and ineffective bladder emptying.
The subject is therefore inclined to have a full bladder, having to urinate more frequently than normal and classically under stress to "not being able to hold back".
The generation at the demand of a physiological abdominal overpressure is therefore very important and has repercussions also in various other functions such as for example that of the ponzamento (the act of "going to the toilet").
Since a large percentage of women already suffer from chronic constipation, independently of the rectus abdominis diastasis, this event can further slow down an already difficult situation.
There is a clear correlation between rectus abdominis diastasis and pelvic floor dysfunction. The physiopathology is very complex and there are several theoretical explanations, but in fact when there is a clinically significant diastasis also the pelvic floor is relaxed with a consequent decrease in tone at rectal and vaginal level up to various forms of prolapse.
If it was primarily rectus abdominis diastasis that favored some classic post-pregnancy pelvic floor dysfunctions post-pregnancy pelvic floor dysfunction, this would explain, at least in part, why so many patients patients, report improved pelvic function after reconstructive surgery of the diastasis.
It is common in recent years among physiotherapists and personal trainers to propose specific training programs to improve the pelvic floor, which include in a predominant form the activation of the low abdominal muscles and transverse.
As already explained in detail in the , those suffering from rectus abdominis diastasis abdominal pain cannot achieve healing of the damaged linea alba with muscle training alone, however, if the exercises are well calibrated in some cases a partial compensation of the tone of the abdominal wall and pelvic floor can be achieved with the related benefits.