Diastasis of the Rectus Abdominis – The Misunderstood Postnatal Condition

“Your abdominal muscles have separated.” While it's common to hear this from your nurse or physio after giving birth, what does it actually mean? And should you be worried? In this article, let's demystify the meaning of having separated abdominal muscles – and what it means for you.

“Your abdominal muscles have separated.”

“You have a 5cm DRAM.”

While it’s common to hear this from your nurse or physio after giving birth, what does it actually mean? And if you do have a separation, should you be worried? In this article, let’s demystify the meaning of having separated abdominal muscles – and what it means for you.

What is DRAM?

This condition has many names, but it essentially boils down to this:

Diastasis = separation of normally joined parts

Rectus Abdominis = the muscles that make up your abs (the part commonly called the “six-pack”!)

Between your abdominal muscles is a thin area of connective tissue called the linea alba. This tissue will be stretched during pregnancy by your growing baby, sometimes resulting in extra space between the two sections of your abdominal muscles. But this shouldn’t make you concerned – this is a normal part of the pregnancy process as your body makes room for your baby.

After giving birth, this distance in the abdominal muscles will often reduce and even disappear entirely for some women in the first six weeks. However, in 50% of cases, this separation can persist as a noticeable gap down the centre line of your abdominal region.

This can present in a number of ways. You might notice that when you tense your abdominal muscles, there’s a gap down the middle. Or even that your belly muscles can bulge out (also known as “tenting” or “coning”) or sink in through the centre when you sit up out of bed.

However, the most accurate way to get it assessed is to see a Women’s Health physiotherapist. They can measure where the separation is occurring, how wide it is, and most importantly, whether it’s a problem that needs to be addressed.

A Women’s Health physiotherapist can assess your DRAM size, location, and whether you need to be concerned

Should I be concerned?

Not necessarily! When it comes to DRAM, the most important thing to assess is, “is this separation affecting my core strength and daily life?” Smaller DRAMs less than 2cm don’t have an impact on your core strength or back function, which means that leaving it alone will have no long-term negative effects.

Larger DRAMs can mean your core is weaker and you will have more difficulty doing certain activities. If you are experiencing difficulty moving from lying to sitting up, lifting objects, or engaging your core muscles, then it is best to get yourself assessed. If a DRAM is found, it can often be easily addressed without invasive intervention.

What can be done to treat my DRAM?

Once your Women’s Health physiotherapist has assessed how your abdominal muscles are working, there are a range of treatment options.

Abdominal binding in combination with specific core strengthening have been shown to be effective in the recovery period after your baby’s birth, especially with caesarean deliveries.

Your Women’s Health physiotherapist can teach you are correct postures and lifting technique so your body remains protected and injury-free as you care for your newborn.

A physiotherapist prescribed regime of core stabilising exercises to regain strength and control in your abdominal muscles is the best solution. In particular, retraining your transversus abdominis (deep core) muscle has been shown to reduce bulging or tenting. The key is making sure the exercises are specific and set at the right level for you. If the exercises are too demanding, then it can lead to overloading and create pain in the back and elsewhere.

Work with a Women’s Health physiotherapist to ensure the exercises are right for you

Key Takeaways

You might experience a lot of fear and uncertainty after being told you have a DRAM. You might feel concerned about long-term injuries or how your belly might look. Having a DRAM of any size is not a cause for concern. Smaller DRAMs often require no treatment at all and larger DRAMs can be improved with the right advice and treatment.

The team at NWPG can help you get on the right track. Call us at the clinic or book in online for a thorough assessment with our Women’s Health Physiotherapist today.

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