The Abdominal Wall & Diastasis Rectus Abdominis, 2nd edition: A Clinical Guide for Those Who Are Stretched Down the Middle Kindle Edition

Includes access to over 150 online videos of both assessment and treatment release techniques and movement training including both motor control and strength and endurance training. The abdominal muscles play a key role in the function of the trunk as well as the upper and lower extremity. Pregnancy and delivery can have a significant, and often long lasting, impact on both the appearance of the abdomen (form) and function of the whole body. Women with stretched/widened recti and linea alba, collectively called a diastasis rectus abdominis, DRA or DRAM, often ask whether treatment/exercise will help them or should they consider a surgical repair. Currently there are no guidelines, other than dissatisfaction with the results of training of any type, to know which individuals with DRA are appropriate for surgery. In 2007, this question prompted further study. In 2007, we believed that closing the gap between the recti was a prerequisite for improving both form and function of the abdomen. By 2016, we felt that the gap was less important than distortion (Lee & Hodges 2016). In this study, women with a DRA had both a wider gap (inter-recti distance) and a more distorted linea alba (lack of tension) at rest and during a curl-up task. In some, this distortion could be reduced when transversus abdominis (TrA) co-activated with the other abdominals in the curl-up task. This study prompted a paradigm shift towards providing exercises limited to those that could generate midline tension. While this shift made sense for those who could generate midline tension with co-activation of TrA, what about those who could not? Were they all to be considered surgical candidates?We have learned more clinically about training an individual with a large or small gap and significant distortion since 2016. Tension of the gap can be achieved in many ways. Is one way ‘better’ than another? Should training be limited to exercises that can only be done without doming of the linea alba and bulging of the recti? We now know that expectations for training those with a small gap and small distortion are different from those with a large or small gap and large distortion. We think, but don’t know yet, that loading the connective tissue is more important than distortion in those with a large or small gap and large distortion. How much and how often to load is still a valid question since the mechanism that results in ‘closure’ of the gap in some and no change in others is still unknown. So, while we have learned a lot and the time has come to update this guide and your clinical practice, there is still much to learn!Please note: Access to online material/videos requires an internet connection and some countries may block access to videos from North America. If you are unsure please try to access one of the free lectures on https://learnwithdianelee.com/resources/ before purchasing. Read more