Medical Question #46

MEDICAL ADVICE FROM

DR. ANN BEAUMONT


Q#1: I have a condition called Diastasis Recti, where the abdominus recti muscle down the centre of my stomach has not knitted back together after pregnancy, leaving a rather unsightly bulge of the stomach.  Is it advisable or not to wear a corset?   I want a corset primarily for special occasions when I want to keep my stomach under control, but wondered if it would actually benefit me to wear it more and help encourage the muscle to knit back together?  --  Jan (11/13/03)

A#1: Your condition can be helped first by strengthening the transverse abdominal muscle, with targeted exercises. This muscle is the inner most abdominal layer and forms the internal corset of the body.  By strengthening this, the stress on
the abdominus recti muscles is reduced, hence its condition should improve over time as you increase the tone of the transverse muscle group. A corset with a long abdominal apron, covering most of the lower abdomen, will provide valuable support by containing and supporting the abdomen. However, any kind of lacing should be combined with a long term exercise program to ensure strengthening of the innermost (transverse) muscle layer. Do not overtighten, but build it up very gradually and your condition should improve.


(11/15/03)-46

Q#2: Approximately 15% of women after pregnancy experience a problem called 'diastasis recti.'  (Separation of the frontal abdominal muscles from the ribcage down to the hips.  Actually, I gain very little weight during my pregnancy, which I took off immediately after, but even today, after a year, I look like a 6-month pregnant woman. I found on the Internet a lot of similar stories. The women are frustrated with it, nobody warns you about that, and even in 1950s, they used to wrap a woman's torso after pregnancy, but today, nothing is done. The problem is that many exercises can strengthen the muscles, but only surgery can put them back together, closing the gap between them. In many countries, although it can produce many problems (hernia, etc.), it is considered to be only a cosmetic problem not covered by insurance. So, I read that women all round the world plan to approach even the Oprah Show about it, since everyone is frustrated when people all the time ask if they are pregnant, since the figure is slim and elegant, but the stomach protrudes grotesquely  because of the separated muscles. Do you think that corseting could be of some help with this? Maybe it could keep the muscles together until the fiber connects them back? -  Lorena (12/25/07)

A#2:

This maternity-related condition of abdominal muscle separation comes in varying degrees. From slight tearing, to a full separation, which can give rise to herniation. Aside from the standard retraining of the muscles, some scar tissue may remain, and this cannot be retrained, as no muscle fibers are contained in it. In a number of Asian cultures, post partum abdominal binding is still in practice for three to six months post partum to prevent this and also to restore the shape. It is similar to wearing a corset as you suggest. Indeed, the binding or corset will take the strain of the abdominal layers and allow them to heal without stress. Wearing a maternity support during a heavy pregnancy also helps to at least reduce the risk of this condition.

During the 70's and 80's prescription of abdominal binders had essentially disappeared in part because of the belief that the body can and should maintain it's own muscle corset. In the ideal case this is true, but in reality for many women, it is not. There are a number of very good postpartum girdles available, and I would recommend their use.

In the more dramatic case such as diastasis recti, corseting is likely to bring relief, provided the corset has sufficient length below the waist. A lower inward curve of the bottom of the busk is recommended, to avoid placing displacement stress on the abdominal wall below the corset.

(1/1/08)-46


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