This course is offered in conjunction with Kathe Wallace Physical Therapy.
Diastasis rectus abdominis (DRA) is very common in the obstetric patient and postpartum women. While most women recover both form and function of the abdominal wall in the postnatal period, persistent separation of the rectus abdominis muscles occurs in some. Rehabilitation has traditionally focused on exercises to ‘close the gap’ and reduce this separation. New data, and a controversial new interpretation, (Lee, D & Hodges, PW 2016, Journal of Ortho and Sports Physical Therapy) support exercises that widen the separation (i.e. increase the inter-recti distance) to increase tension in the linea alba (LA) and control the abdominal contents while optimizing the transfer of force between sides of the abdominal wall.
In this course Diane will present the current evidence pertaining to the functional and postnatal abdominal wall. Using short case reports and a live model with DRA, there will be descriptions and demonstration of the assessment of the abdominal wall. This includes muscle recruitment strategies and behaviour of the linea alba in response to the chosen strategy. The relationship between the recruitment strategy and postural/osteokinematic ‘twists’ between the thorax and pelvis will be identified. You will observe a Real Time Ultrasound imaging evaluation of the live model with DRA. This evaluation strategy will identify the treatment and training for restoration of form and function of the abdominal wall. Current clinical theories as to when a surgical consultation should be considered for repair of the linea alba will be presented.
Upon the conclusion of this seminar the participants will be able to:
- Describe the anatomy of the abdominal wall including the fascial organization of the linea alba, rectus sheaths, abdominal aponeuroses, and their continuity/organization with the thoracolumbar fascia
- Identify the recruitment strategy (optimal or suboptimal) of the abdominal wall and the behaviour of the linea alba in response to verbal cueing for contraction, the active straight leg raise task (ASLR) and during a curl-up task
- Describe the relationship between the posture/position of the thorax (individual lower thoracic rings) and pelvis on the presented recruitment strategy for a three tasks (response to verbal cue, ASLR and curl-up)
- Develop individualized treatment/training programs for restoring form and function of the postnatal abdominal wall
This one day CEU offering has sign-in beginning at 8:00 am. Content teaching is from 8:30 am – 4:30 pm. Specifics of course information for your clinical sharing or continuing education records are provided on this brochure download on the Teaching page.
- 8:00 – Registration
- 8:30 ~ 10:30 – Anatomy and function of the abdominal wall – what we know from the evidence and what happens in pregnancy
- 10:30 ~ 10:45 – Morning break
- 10:45 ~ 12:15 – Assessment of the abdominal wall – how to assess the recruitment strategy of the abdominal wall and behaviour of the linea alba (short cases to introduce the topic and then assess a live model followed by discussion for treatment/training)
- 12:15 ~ 1:30 – Lunch
- 1:30 ~ 3:00 – Diastasis rectus abdominis – when to train, when to refer for surgical repair, next steps for more research for formal data to support current clinical training theories
- 3:00 ~ 3:15 – Afternoon break
- 3:15 ~ 4:30 – Abdominal wall movement training
- 4:30 – Adjourn