Does surgery only close the gap or does it improve muscular function too?

Diastasis Recti, Improved Muscle Function and Back Pain. I'm 42, 5'4", 125 lbs. Had 2nd child in 2007. After 2 yrs questioning cause of back pain, it seems it is due to my lower abs being "asleep." They do not contract even when I try. The PT suspects my diast. as the cause- about 2-2.5 fingers in width. I worked out my entire pregnancy but slacked off ~3 yrs after & back muscles couldn't compensate any longer. Also had numbness along midline for a ~yr. after birth. Question: does surgery only close the gap or does it improve muscular function too?

Doctor Answers 8

Does #surgery only close the gap or does it improve #muscularfunction too?

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I think in theory it could help in function by changing the orientation of the muscle to a more "anatomic" position...and I too have had stories related to me about better function and support....
But then I have had the experience of doing a TT on a belly dancer, only to have her end up so tight that she couldn't move like before!!
So I depends....

Muscle tightening and abdominal wall function

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To my knowledge, there are no good studies out there confirm that muscle tightening in a tummy tuck (plication) helps to improve abdominal wall/core strength.  The muscle tightening is really cosmetic technique to help "close the gap".   Having said that, I can tell you that many of my patients who are fitness enthusiasts or trainers have come back after their tummy tucks and told me that their core strength significantly improved.  This of course is my observation and has not been corroborated by any randomized blinded studies.  Hope this helps.

Dr. Basu

Houston, TX

Muscle function

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Muscle function could be improved with thightening of the fascia around it but it is not a guarantee that the patient will be able to feel the difference. There have been studies documenting the improvement of the back pain and discomfort after abdominoplasty

M. Vincent Makhlouf, MD, FACS
Chicago Plastic Surgeon

Muscle repair closes the gap, but seems to improve function as well.

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I agree with the others posted here.  Although there is no way to guarantee that the muscle repair will lessen back pain or improve muscle function, a significant number of my patients report it without prompting.  Many report that they are better able to do sit-ups and crunches after surgery.  I don't know if it is only psychological, but it is not uncommon.


Hope this helps.

Michael S. Hopkins, MD (retired)
Albuquerque Plastic Surgeon

Does surgery only close the gap or does it improve muscular function too?

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Repairing a diastasis rectus is usually considered an aesthetic rather than a functional operation. Most of these procedures were done by plastic surgeons and there done for reasons of improving appearance.

Of the many patients I have seen over the years and stasis very few of them complained of back pain so it seems unlikely that it is a common cause of back problems.

I think most surgeon's have an occasional patient who will say the his or her back pain improved after a tummy tuck and diastasis repair, those cases are rather unusual. The operation changes, slightly, the arc of the rectus abdominis muscles, while their origins and insertions remain the same. The causes of back pain are often poorly understood so to absolutely exclude diastasis as a possible cause cannot be done.

I am a bit puzzled by the inability to  contract the lower part of the rectus muscle, and it may be well for your physician to initiate some testing. To lose function of the lower half of these paired muscles seems quite mysterious to me.

Best wishes.

Jourdan Gottlieb, MD
Seattle Plastic Surgeon

Diastasis and back pain

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Generally speaking, closing a Diastasis is more of an aesthetic issue than a functional issues as it is not truly a hernia. However, I have had a few patients inform me after an abdominoplasty ( the Diastasis was repaired) that their back pain was markedly improved.

I would not recommend to patients to have an abdominoplasty solely to improve chronic back pain; if it it incidentally helps, then that is an added benefit.

William Loutfy, MD
Albuquerque Plastic Surgeon

Rectus Diastasis Repair and Back Pain

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I know of one study with a small group of patients that suggested a rectus diastasis repair may offer some relief for low back pain. In my practice, I have treated a handful of patients whose low back pain improved after an abdominoplasty with a rectus diastasis repair. Unfortunately, there is no way of predicting who will benefit from the procedure or how long the improvement in back pain will last. Some insurance companies did cover this in the past but it is unlikely to get covered now.

Surgery "closes the gap" in a diastasis but does not change muscle function directly. Indirectly however, the rectus muscle is more centralized and perhaps this may improve function and may result in better abdominal wall - back muscle dynamics.

You should work with your physical therapist to maximize your muscle strength and function before considering surgery. Good Luck.

Repairing rectus diastasis

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Repairing the diastasis is primarily to flatten the abdomen but in my experience, those patients who have had this done have better muscle function and are able to work out better and some even have improved back pain issues.  All this cannot be guaranteed but it is a general observation.

These answers are for educational purposes and should not be relied upon as a substitute for medical advice you may receive from your physician. If you have a medical emergency, please call 911. These answers do not constitute or initiate a patient/doctor relationship.