Low Back Pain and Motor Control Dysfunction After Pregnancy- The Possible Role of Abdominal Rectus Muscle Diastasis

Abstract PURPOSE Pregnancy-related low back pain is common. Persistent postpartum abdominal diastasis recti may cause back pain and motor control dysfunction. The role of diastasis in pregnancy-related back pain is under debate. The aim of this study was to compare participants with increased symptoms after index pregnancy with those reporting no change in back pain or subjective movement control and analyzed their inter rectus distance (IRD).METHODS: This study is a case-control study of a cohort of women who had delivered a year earlier. We recruited participants with increased symptoms (n=14) after index pregnancy and controls (n=41) and recorded their inter rectus distance with ultrasound. A questionnaire was filled, and an ultrasound was performed two times for the study groups.RESULTS: At the baseline there was no significant difference in IRD between cases and controls (mean 2.45±1.01 cm and 2.09±1.03 cm respectively). A year after index pregnancy cases had significantly wider IRD than controls (mean 3.45±0.90 cm and 2.40±0.79 cm respectively). Motor control dysfunction tests were not associated with core stability problems or back pain in this cohort. There was a difference in sit-up test between cases and controls (mean 4.7±4.2 and 8.2±3.9 respectively).CONCLUSION Women who reported increased back pain and core instability after index pregnancy had wider inter rectus diameter compared to controls. In case group with more symptom after pregnancy the classification of ARD changed from mild abdominal rectus diastasis (2-3cm) to moderate (>3-5cm). Abdominal rectus diastasis may have a role in persistent pregnancy related lumbopelvic pain.