WORKSHOP 2

Diastasis Rectus Abdominis- Implications for Assessment and Treatment of Thoraco-Lumbar-Pelvic Pain & Disability 
Presenter: Diane Lee PT  (full day)

Maximum number of participants: 40
 

Impairments of abdominal wall anatomy and function have been implicated in multiple conditions associated with pregnancy and delivery including low back and pelvic girdle pain, urinary incontinence, pelvic organ prolapse and diastasis rectus abdominis (DRA). DRA is a common occurrence in pregnancy and postpartum, it does not completely recover in some, and the current evidence has not clarified the risk factors for this condition, nor provided direction for treatment. This lecture and workshop will:

  1.  present the current research evidence on the prevalence, risk factors known/not known and the course of recovery of DRA,
  2. discuss the anatomical variations of the upper, middle and lower abdominal wall, particularly the aponeurotic extensions of the lateral muscles in all three regions and how they form the linea alba,
  3. discuss the role of the abdominal wall in function of the thorax, lumbar spine and pelvic girdle,
  4. define and suggest a classification model for subgrouping women with DRA both for research and clinical practice,
  5. demonstrate and practice clinical tests for determining if the individual’s strategy for transferring loads through the thorax, lumbar spine and pelvic girdle is optimal (i.e. is their motor control strategies and force closure mechanisms optimal for function),
  6. clinically reason the load transfer test findings to determine which level/region of the abdomen (upper, middle lower) requires further assessment,
  7. demonstrate the clinical and ultrasound evaluation of the lateral and midline abdominal muscles as well as their connective tissue connections to determine if the myofascial system can transfer loads. These tests consider the following parameters for function:
    1. anatomical integrity
    2. motor control
    3. strength and endurance capacity,
  8. discuss current clinical thoughts on who should be referred for surgical repair and who should respond to treatment/training
  9. present the 3 stages of motor learning training (cognitive, associative, and automatic) for the abdominal wall and how to progress this training for strength, endurance and function.


About the presenter: Diane Lee is an orthopaedic musculoskeletal physiotherapist (FCAMT) and designated as a Clinical Specialist in Women’s Health by the Canadian Physiotherapy Association.  She follows the research evidence closely and draws from her clinical experience to combine the two in teaching and lecturing internationally.