January 16, 2019

009 - Grainne Donnelly - Is Diastasis A Disaster?

1 hour 28 minutes

Show Notes by Elaine Stevenson from Myotherapy Reading Room

Gráinne Donnelly is an NHS Specialist Physiotherapist, in Pelvic, Obstetric and Gynaecological Physiotherapy. She has a particular interest in the assessment and treatment of diastasis recti.

The word diastasis has an unfortunate tendency to strike fear into pregnant and post-natal women, and their clinicians alike, much of it unjustified.

Themes covered in the discussion included:

why diastasis is such a feared condition

relationship between fear and misinformation

a review of the anatomy of the affected tissues

common referral pathways, including self-referral

when treatment is required

differentiating between functional vs problematic

physical strategies used in treatment: breathing, abdominal wall control, pelvic floor function and exercises

the importance of seeing a pelvic health physio before returning to high intensity exercise, eg running, for all women

the role social media plays in driving unrealistic expectations

training of the rectus abdominus and address atrophy

navigating the confusion created by conflicting opinions and perspectives of the health and fitness professions

the importance of language and lessons from our understandings about pain

appearance (‘mummy tummy’), strength and function

need for education of health professionals re role of women’s health physiotherapists in the management of this condition

links to low back pain, urinary incontinence, pelvic floor function and pelvic organ prolapse

measurement issues: size of gap vs strength

importance of setting meaningful goals and getting back into sport and activities (ie moving away from ‘can’t do’ cultures)

pathways, physio rehab, referral into surgery, rehab post surgery (where surgery required)

strategies that affected women use to cope with diastasis

the importance of seeking help between pregnancies, as opposed to waiting until you’ve finished your family

Related Reading and Resources:

Video: Lisa and Erin - https://www.instagram.com/p/BrBJqyOB7ok/

Benjamin DR, Frawley HC, Shields N et al. Relationship between diastasis of the rectus abdominis muscle (DRAM) and musculoskeletal dysfunctions, pain and quality of life: a systematic review. Physiotherapy 2018. doi: 10.1016/j.physio.2018.07.002. [abstract]

Bø K, Hilde G, Tennfjord MK et al. Pelvic floor muscle function, pelvic floor dysfunction and diastasis recti abdominis: Prospective cohort study. Neurourol Urodyn 2017; 36(3): 716-721. [abstract]

Davenport MH, Ruchat SM, Sobierajski F et al. Impact of prenatal exercise on maternal harms, labour and delivery outcomes: a systematic review and meta-analysis. Br J Sports Med 2019; 53(2): 99-107. [abstract]

Gillard S, Ryan CG, Stokes M, Warner M, Dixon J. Effects of posture and anatomical location on inter-recti distance measured using ultrasound imaging in parous women. Musculoskelet Sci Pract 2018; 34: 1-7.

Dianne Lee & Associates Physiotherapy. Diastasis rectus abdominis & postpartum health. https://dianelee.ca/article-diastasis-rectus-abdominis.php

Mommers EHH, Ponten JEH, Al Omar AK et al. The general surgeon's perspective of rectus diastasis. A systematic review of treatment options. Surg Endosc 2017;31(12):4934-4949

van de Water AT, Benjamin DR. Measurement methods to assess diastasis of the rectus abdominis muscle (DRAM): A systematic review of their measurement properties and meta-analytic reliability generalisation. Man Ther 2016; 21: 41-53. [abstract]

Links:

Biography:https://www.absolute.physio/aboutus

Practice: Absolute Physioat Maguiresbridge, County Fermanagh in Northern Ireland.

Twitter:https://twitter.com/ABSPhysio

Twitter:https://twitter.com/diastasisphysio

Instagram:https://www.instagram.com/absolute.physio/

Instagram: https://www.instagram.com/diastasis.physio

Facebook:https://www.facebook.com/Absolute.PhysioNI/

Email: [email protected]

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