Preview

Russian Journal for Personalized Medicine

Advanced search

Possibilities and prospects of non-surgical treatment of diastasis recti and hernia of the white line (literature review)

https://doi.org/10.18705/2782-3806-2025-5-5-412-419

Abstract

Currently, the issue of diastasis recti is increasingly being addressed in Russian and international literature. Diastasis recti is most common in women of childbearing age and leads to a reduced quality of life, impaired aesthetic function, and is a factor in the development of linea alba hernias. Isolated diastasis is not an indication for surgical treatment, therefore, the relevance of research into non-surgical treatments is increasing. The study of non-surgical treatment for diastasis as a method for preventing the development of linea alba hernias is a priority in the development of herniology over the next twenty-five years. This review presents non-surgical treatment options and a new approach to the problem of conservative management of patients with diastasis recti.

About the Authors

B. V. Sigua
Federal State Budgetary Institution “Almazov National Medical Research Centrе” of the Ministry of Health of the Russian Federation
Россия

Badri V. Sigua, MD, PhD, DSc, Professor, Head of the Department of General Surgery

St. Petersburg



A. A. Shatalova
Federal State Budgetary Institution “Almazov National Medical Research Centrе” of the Ministry of Health of the Russian Federation
Россия

Anna A. Shatalova, MD, Surgeon

2 Akkuratova str., St. Petersburg, 197341



K. A. Khatsimov
Federal State Budgetary Institution “Almazov National Medical Research Centrе” of the Ministry of Health of the Russian Federation
Россия

Kantemir A. Khatsimov, MD, PhD, Assistant of the Department of General Surgery, Surgeon

St. Petersburg



References

1. Yurasov AV, Rakintsev VS, Matveev NL, et al. Diastasis of the rectus abdominis muscles in the surgical aspect: determination, epidemiology, etiopathogenesis, clinical picture, diagnosis. Endoscopic Surgery. 2019;25(6):41-48. (In Russ.) https://doi.org/10.17116/endoskop20192506141

2. Rekhachev VP. Postoperative ventral hernias. Diastasis of the rectus abdominis muscles. Arkhangelsk: Publishing Center of the Arkhangelsk State Medical Academy; 1999. P. 145-161. (In Russ.)

3. Mnoyan AK, Mudarisov RR, Vtorenko VI. Topical issues of treatment of diastasis rectus abdominal muscles in combination with hernias of the anterior abdominal wall. Moscow Surgical Journal. 2022;(1):90-98. (In Russ.) https://doi.org/10.17238/20723180-2022-1-90-98

4. Mota PGFD, Pascoal AGBA, Carita AIAD, Bo K. Prevalence and risk factors of diastasis recti abdominis from late pregnancy to 6 months postpartum, and relationship with lumbo-pelvic pain. Man Ther. 2015;20(1):200-205. https://doi.org/10.1016/j.math.2014.09.002

5. Keeler J, Albrecht M, Eberhardt L, et al. Diastasis Recti Abdominis. Journal of Women?s Health Physical Therapy. 2012.36(3):131-142. https://doi.org/10.1097/JWH.0b013e318276f35f

6. Turan V, Colluoglu C, Turkyilmaz E, Korucuoglu U. Prevalence of diastasis recti abdominis in the population of young multiparous adults in Turkey. Ginekol Pol. 2011;82(11):817-821.

7. Champion P. Mind the gap: diastasis of the rectus abdominis muscles in pregnant and postnatal women. Pract Midwife. 2015;18(5):16-20.

8. Clinical guidelines Multiple pregnancy [Internet]. Russian Society of Obstetricians and Gynecologists; 2024 [cited 2025 Aug 07]. Available from: https://base.garant.ru/409619665/

9. Kalashnikov SA, Sichinava LG. The course and outcomes of multiple pregnancies resulting from assisted reproductive technologies. Obstetrics and Gynecology. 2020;10:71-77. https://dx.doi.org/10.18565/aig.2020.10.71-77

10. Pobedinskii NM, Botvin MA, Kiryushchenkov AP. Polyhydramnios: diagnosis and treatment. Akusherstvo i ginekologiya. 2004;1:7-9. (In Russ.)

11. Gorbunov NS, Samotesov PA, Petrushko SI. Features of the structure of the linea alba. Siberian Medical Review. 2011;3:1-16.

12. Fedoseev AV, Muravyev SYu, Budarev VN, et al. Morphofunctional characteristics of the linea alba from a herniologist's perspective. Nauka molodykh - Eruditio Juvenium. 2015;4:1-9.

13. Toskin KD, Zhebrovsky VV. Hernias of the abdominal wall. 2nd ed, revised and enlarged. Moscow: Medicine; 1990. 272 p. (In Russ.).

14. Gireev GI, Zagirov UZ, Shakhnazarov AM. Treatment of hernia of the white line and diastasis of the rectus abdominis muscles. Khirurgiya. 1997;7:58-61. (In Russ.).

15. Erin SA, Galliamov EA, Gololobov GYu, et al. Minimally invasive methods of reconstruction of the anterior abdominal wall in the treatment of diastasis recti and hernias of the white line. Literature review. Moscow Surgical Journal. 2025;2:176-183. (In Russ.) https://doi.org/10.17238/2072-3180-2025-2-176-183

16. Nahas FX. An aesthetic classification of the abdomen based on the myoaponeurotic layer. Plast Reconstr Surg. 2001;108(6):1787-1795. https://doi.org/10.1097/00006534200111000-00057

17. Rath AM, Attali P, Dumas JL, et al. The abdominal linea alba: an anatomo-radiologic and biomechanical study. Surg Radiol Anat. 1996;18(4):281-288. https://doi.org/10.1007/BF01627606

18. Beer GM, Schuster A, Seifert B, et al. The normal width of the linea alba in nulliparous women. Clin Anat. 2009;22(6):706-711. https://doi.org/10.1002/ca.20836

19. Askerkhanov RP. On the pathogenesis and treatment of diastasis of the rectus abdominis muscles. Sovetskaya meditsina. 1962;11:68-75. (In Russ.)

20. Hernandez-Granados P, Henriksen NA, Berrevoet F, et al. European Hernia Society guidelines on management of rectus diastasis. Br J Surg. 2021;108(10):1189-1191. https://doi.org/10.1093/bjs/znab128

21. Carlstedt A, Bringman S, Egberth M, et al. Management of diastasis of the rectus abdominis muscles: recommendations for swedish national guidelines. Scand J Surg. 2021;110(3):452- 459. https://doi.org/10.1177/1457496920961000

22. Smietanski M, Smietanska IA, Zamkowski M. Post-partum abdominal wall insufficiency syndrome (PPAWIS): lessons learned from a single surgeon's experience based on 200 cases. BMC Surg. 20228;22(1):305. https://doi.org/10.1186/s12893-022-01757-y

23. Boldyreva YuA, Tskhay VB, Polstyanoy AM, Polstyanaya OYu. Modern possibilities for the prevention of pelvic organ prolapse. Medical Herald of the South of Russia. 2022;13(2):7-17. (In Russ.) https://doi.org/10.21886/2219-8075-2022-13-2-7-17

24. Chiarello CM, Falzone LA, McCaslin KE, et al. The effects of an exercise program on diastasis recti abdominis in pregnant women. Journal of Women's Health Physical Therapy. 2005;29:11- 16. http://dx.doi.org/10.1097/01274882-200529010-00003

25. Awad MA, Morsy M, Mohamed MA, Gabr AA. Efficacy of tupler technique on reducing post natal diastasis recti: a controlled study. British Journal of Applied Science and Technology. 2016;12:1-8. http://dx.doi.org/10.9734/BJAST/2016/17876

26. Awad E, Mobark A, Zidan AA, Hamada HA, Shousha T. Effect of progressive prone plank exercise program on diastasis of rectus abdominis muscle in postpartum women: A randomized controlled trial. Journal of Human Sport and Exercise. 2021;16(2):395-403. https://doi.org/10.14198/jhse.2021.16.Proc2.24

27. Laframboise FC, Schlaff RA, Baruth M. Postpartum exercise intervention targeting diastasis recti abdominis. Int J Exerc Sci. 2021;14(3):400-409. https://doi.org/10.70252/GARZ3559

28. Thabet AA, Alshehri MA. Efficacy of deep core stability exercise program in postpartum women with diastasis recti abdominis: a randomised controlled trial. J Musculoskelet Neuronal Interact. 2019;19(1):62-68.

29. Vaishnavi G, Mohan Kumar G, Jayson C, et al. Effectiveness of exercise in treating rectus abdominis diastasis. Biomed. 2018;38(4):147-151.

30. Gluppe SL, Hilde G, Tennfjord MK, , et al. Effect of a postpartum training program on the prevalence of diastasis recti abdominis in postpartum primiparous women: a randomized controlled trial. Phys Ther. 2018;98(4):260-268. https://doi.org/10.1093/ptj/pzy008

31. Bobowik PZ, Dabek A. Physiotherapy in women with diastasis of the rectus abdominis muscles. Adv Rehabil. 2018;32:11-17. https://doi.org/10.5114/areh.2018.80964

32. Saleem Z, Khan AA, Farooqui SI, et al. Effect of exercise on inter-recti distance and associated low back pain among post-partum females: a randomized controlled trial. J Family Reprod Health. 2021;15(3):202-209. https://doi.org/10.18502/jfrh.v15i3.7139

33. Ptaszkowska L, Gorecka J, Paprocka-Borowicz M, et al. Immediate effects of kinesio taping on rectus abdominis diastasis in postpartum women-preliminary report. J Clin Med. 202128;10(21):5043. https://doi.org/10.3390/jcm10215043

34. Kamel DM, Yousif AM. Neuromuscular electrical stimulation and strength recovery of postnatal diastasis recti abdominis muscles. Ann Rehabil Med. 2017;41(3):465-474. https://doi.org/10.5535/arm.2017.41.3.465

35. Wei R, Yu F, et al. Effect of electrical stimulation followed by exercises in postnatal diastasis recti abdominis via mmp2 gene expression. Cell Mol Biol. 2022;67(6):82-88. https://doi.org/10.14715/cmb/2021.67.5.12. (In Russ.)

36. Khandale SR, Hande D. Effects of abdominal exercises on reduction of diastasis recti in postnatal women. IJHSR. 2016;6(6):182-191.

37. Kim S, Yi D, Yim J. The effect of core exercise using online videoconferencing platform and offline-based intervention in postpartum woman with diastasis recti abdominis. Int J Environ Res Public Health. 2022;19(12):7031. https://doi.org/10.3390/ijerph19127031

38. Mota P, Pascoal AG, et al. The immediate effects on inter-rectus distance of abdominal crunch and drawing-in exercises during pregnancy and the postpartum period. J Orthop Sports Phys Ther. 2015;45(10):781-788. https://doi.org/10.2519/jospt.2015.5459

39. Rabago D, Slattengren A, Zgierska A. Prolotherapy in primary care practice. Prim Care. 2010;37(1):65-80. https://doi.org/10.1016/j.pop.2009.09.013

40. Banks A. A rationale for prolotherapy. J Orthop Med. 1991;13(3):54-59.

41. Hoksrud A, Ohberg L, Alfredson H, Bahr R. Ultrasoundguided sclerosis of neovessels in painful chronic patellar tendinopathy: a randomized controlled trial. Am J Sports Med. 2006; 34(11):1738-1746. https://doi.org/10.1177/0363546506289168

42. Zeisig E, Fahlstrom M, Ohberg L, Alfredson H. A twoyear sonographic follow-up after intratendinous injection therapy in patients with tennis elbow. Br J Sports Med. 2010;44(8):584- 587. https://doi.org/10.1136

43. Kim SR, Stitik TP, Foye PM, et al. Critical review of prolotherapy for osteoarthritis, low back pain, and other musculoskeletal conditions: a physiatric perspective. Am J Phys Med Rehabil. 2004;83(5):379-389. https://doi.org/10.1097/01

44. Reeves KD, Hassanein K. Randomized prospective double-blind placebo-controlled study of dextrose prolotherapy for knee osteoarthritis with or without ACL laxity. Altern Ther Health Med. 2000;6(2):68-74.

45. Strauchman M, Morningstar M. Prolotherapy injections for diastasis recti: a case report. Case Reports in Clinical Medicine. 2016;5:342-346. https://doi.org/10.4236/crcm.2016.59052

46. Feins NR, Dzakovic A, Papadakis K. Minimally invasive closure of pediatric umbilical hernias. J Pediatr Surg. 2008;43(1):127-130. https://doi.org/10.1016/j.jpedsurg.2007.09.034

47. Sigua BV. Revolution in herniology: Forecast for the next 25 years. Russian Surgical Journal. 2025;2(2):42-47. (In Russ.). https://doi.org/10.18705/3034-7270-2025-1-2-42-47

48. Zulkifli D, Manan HA, Yahya N, Hamid HA. The applications of high-intensity focused ultrasound (HIFU) ablative therapy in the treatment of primary breast cancer: a systematic review. Diagnostics. 2023;13(15):2595. https://doi.org/10.3390/diagnostics13152595

49. Bachu VS, Kedda J, Suk I, et al. High-intensity focused ultrasound: a review of mechanisms and clinical applications. Ann Biomed Eng. 2021;49(9):1975-1991. https://doi.org/10.1007/s10439-021-02833-9


Review

For citations:


Sigua B.V., Shatalova A.A., Khatsimov K.A. Possibilities and prospects of non-surgical treatment of diastasis recti and hernia of the white line (literature review). Russian Journal for Personalized Medicine. 2025;5(5):412-419. (In Russ.) https://doi.org/10.18705/2782-3806-2025-5-5-412-419

Views: 30

JATS XML


Creative Commons License
This work is licensed under a Creative Commons Attribution 4.0 License.


ISSN 2782-3806 (Print)
ISSN 2782-3814 (Online)