Abdominal Separation Blog
Laura Justin
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Posted Oct 21, 2023
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What you need to know about Diastasis Recti
What is Diastasis Recti?
Diastasis Recti is commonly known as abdominal separation or DRAM (Diastasis Rectus Abdominus Muscles). It is the separation of the connective tissue that runs down the middle of the abdomen and connects the two bellies of the rectus abdominus muscle.
Why does Diastasis Recti occur?
During pregnancy, the abdomen has to make room for growing baby, which means that the abdominal muscles have to stretch.
The pressure of the growing uterus as well as hormonal effects on the tissue can cause the linea alba (connective tissue) between the muscles to separate.
Is it normal?
A small abdominal separation (2 finger width) is considered a normal
change during pregnancy, with 100% of women having some degree of separation
during or immediately after pregnancy.
However, a separation means that the
muscles of the tummy may be weaker, and can lead to bulging or doming and even
pain or discomfort.
Signs associated with DRA:
• Belly bulge or doming appearance in the middle of tummy
• Feeling of “core” weakness
• Low back or pelvic pain
• Pelvic floor weakness or
incontinence
Multiple pregnancies without recovery of abdominal muscles in between increases the risk for developing diastasis due to repeated and prolonged stretch on the abdominal wall.
How do I know if I have DRAM?
An assessment by a trained Physiotherapist, obstetrician or midwife can usually determine the presence of abdominal separation after having a baby.
What do I do if I have DRAM?
After having a baby, reducing excessive pressure on the abdominal wall can help to reduce the look and feel of DRAM.
Generally, through pregnancy and early
postpartum is is best to avoid:
• Sit up type motions ie. when getting out of bed. Try rolling to the side and then pushing up as a safer alternative
• Constipation and straining on the toilet
• Heavy lifting
• Crunches or sit ups
Gentle abdominal exercises that don’t involve ‘crunching’ can increase the strength and function of the abdomen, and reduce the visual concerns of the abdomen as well as risk of developing other back or pelvic pains.
Some women with a severe DRAM may have concerns about the cosmetic change to their abdomen, and surgical repair may be an option in these cases.
Other tips for DRAM in the early period after having a baby include:
• Wearing compression garments over the abdomen. A Women’s Health Physiotherapist can prescribe and provide abdominal supports or compression garments.
• Practice good standing position. You should be upright and tall, with a small curve in your lower back. Try to reduce excessive sway in the lower back and try not to push your hips forward.
• Pelvic floor and specific abdominal exercises – such as light pilates or exercises prescribed by your Physiotherapist.