Here's a subtle case of "Diastasis Recti" found in a male swimmer. He presented with ongoing low back pain, aggravated mostly in the morning upon waking. Aside from pain, he reports stiffness in the low back. Multisegmental Flexion as per SFMA was FP, Multisegmental Extension was DP, Multisegmental Rotation was FN bilaterally. All other top tier tests were FN aside from the Deep Squat which I did not assess. SFMA breakouts led me to SMCD findings (primarily with SLR) and DNS IAP tests led me to this subtle, but in my mind significant, finding. The summer swim season has now come to a close and OUR goal for the next six weeks is to normalize his SMCD. The significance of the above finding, especially in this population (male, young adult, athlete) is generally under appreciated as this finding is most commonly found in young babies and post-partum women. Although some will receive surgical intervention, the current thought process is that correction is largely cosmetic. In Prague and in the clinics of many practitioners who are DNS-trained, the prevalence of such findings are likely higher. This in my mind, is due to more astute and investigative clinical testing. While I have yet to see any published studies that show a correlative or causative relationship between diastasis recti and low back dysfunction, the Prague School seems correct in their observed relationships between such presentation and acquired spondylolistheses, especially in older, more overweight men. Their rationale, inadequate cylindrical intra-abdominal pressure.
Remember, this athlete is a swimmer and spends much of his time in a relative prone position. And while it may likely be inappropriate to rid him of (hyper)extension, achieving stability motor control in all positions, directions, and movements is a must. I will probably never see the end result 50 years from now, but my goal is for this swimmer to not become a statistic.
1 Comment
Paul Gallant
11/28/2022 03:58:52 am
Now that I know why I have what looks like a mountain range everytime my abs tighten, what can a a 60 year old male do about it and what should I avoid?
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