Abdominal Muscle Separation

Rectus Abdominis Diastasis (RAD) commonly known as abdominal separation is when the outer layer of the abdominal muscles separate through the center of the abdominal wall. This is most commonly seen during and after pregnancy, however it can be present in other populations including men and athletes.

RAD is generally not painful, however it can lead to back pain if the stomach muscles have weakened and are not supporting the trunk adequately. Usually people become aware of having an RAD when they sit up or get up from the floor and notice a doming through the middle of their tummy. Sometimes however, people are not aware of it and it can go undiagnosed for a long time.

There are several important measures when checking for RAD. These include:

1. Width of the RAD

• • The measurement of separation between the left and right rectus abdominis muscles
  • This is also known as the inter-recti distance (IRD)

2. Length of the RAD

• • The distance along the midline above and below the belly button

3. Depth of the RAD

• • This indicates the quality of the connective tissue (linea alba) you have available to transmit force across the abdomen

4. Linea alba Integrity & Tension

• • The linea alba is the connective tissue which connects the rectus muscles in the midline. It is a very important structure which transmits force across the abdomen while maintaining optimal intra-abdominal pressure
  • The linea alba widens and softens during pregnancy to allow for the growing size of the pregnant belly however sometimes after birth, the linea alba remains widened which reveals the “gap” or separation between the abdominal muscles.

5. Transverse Abdominis Activation

• • The transverse abdominis is the deepest layer of the abdominal wall and represents the front of your “core” canister. Learn more with this PDF: Your Inner Core
  • The transverse abdominis creates tension across the linea alba allowing for optimal loading through the tummy muscles
  • This is checked on real time ultrasound to ensure correct activation patterning
  • The pelvic floor is closely linked with transverse abdominis and can be checked on ultrasound at the same time as we assess your abdominal muscles. It is not unusual to have incontinence and RAD occur together and therefore it is important to investigate both the pelvic floor and abdominals in the postpartum period. Learn more here: Post-Natal Assessment

Following a thorough examination, an exercise program can be devised which will help to strengthen the abdominal wall safely and effectively. Sometimes an abdominal binder or compression shorts can assist in recovery and will be prescribed.