Dr. Atul Prakash
Orthopedician and Traumatology
The following is an actual conversation between an iCliniq user and a doctor that has been reviewed and published as a Premium Q&A.
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Patient's Query
Hello doctor,
My question is in regards to my very active nine year-old-son. He is very sporty and fit. Recently, we had him examined by a very young physiotherapist for his posture, who pointed out a mild bulging or ridge forming in our son's abdomen when doing leg lifts or getting into a laying position. This ridge is quite narrow and not always there. He was diagnosed with a diastasis recti. I have only seen it on myself after pregnancy and was surprised. When I tested my son, he had a narrow gap of about a finger. But not more. My question is, should this gap be closed, or is it something that will resolve spontaneously? Should he avoid the things he loves like fitness and monkey bars, etc.?
Thank you in advance.
Hello,
Welcome to icliniq.com.
Yes, your son's divarication of recti is evident from the pictures attached (attachment removed to protect the patient's identity).
It is thought that this condition will resolve in infants and toddlers with improvement in the strength of the midline linea alba. But in a 9-year-old active child that is difficult to say that it will resolve spontaneously.
You should have an ultrasound to rule out an epigastric hernia, and then it will only be a cosmetic issue at this age, though again, some think that it can lead to coordination disorders and back pain.
Per se, it may not be on the indication for repair as you will be replacing a bulge with a scar. Still, it may not be cosmetically acceptable or may, in some cases, worsen and lead to an epigastric hernia.
Appropriate core strengthening exercises and avoiding activities that cause divarication is needed, though not easy to adopt in children.
Tupler techniques are one way.
Patient's Query
Hi doctor,
Thank you for your reply.
From your response, I gather, that it is an abnormal finding in a 9-year-old.
Do you believe core strengthening will not work on my 9-year-old as it is too late, or could something have reopened it? The physiotherapist is working on strengthening his transverse abdominis muscle. Will this be redundant?
When doing a finger width test, I can barely fit a single finger in, which I am told is normal in most people. Should this gap be tighter in a child with this age?
Hello,
Welcome back to icliniq.com.
Yes, it is not a normal finding in a 9-year-old child. The core strengthening will only help reduce the way the muscles bulge out. I will not do anything to shrink the linea alba but only avoid further opening of the gap. So core strengthening has a role. Ideally, there should be no gap and certainly no bulging, whatever the finger gap be.
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Orthopedician and Traumatology
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