Abdominal muscle separation (Diastasis of the Rectus Abdominal Muscle, DRAM) after having a baby can be very common in post-partum women.

Abdominal Muscle separation: Diastasis Rectus Abdominal Muscle (DRAM)

By Melissa Harris
Titled Women’s Health Physiotherapist

Abdominal muscle separation (Diastasis of the Rectus Abdominal Muscle, DRAM) after having a baby can be very common in post-partum women. Research indicates that approximately 50% of women will have separation of more than 2 cm in the immediate post-partum period. This is the ‘gap’ in the midline from one rectus abdominis muscle to the other. During pregnancy, all women experience some degree of abdominal separation, which is completely normal. This separation is from stretch to the connective tissue in between the rectus abdominis muscles, the body’s way to accommodate the growing baby.

The 6 first weeks after birth are critical to help mother’s body make the best of this healing time. A common misconception is that there is “something wrong” with the abdominal muscle, however this is a natural process of pregnancy whereby the connective tissue (linea alba) that joins your abdominal muscles together is stretched and thinned during pregnancy.

Once baby is born, the research states:

  • 50% of women immediately post-partum will have an abdominal wall separation more than 2 cm
  • At 5 – 12 weeks post-partum, 36 % of women may still have a separation more than 2 cm

Abdominal wall dysfunction as well as pelvic floor weakness post-partum have been implicated in multiple conditions associated with pregnancy and delivery

Abdominal wall dysfunction as well as pelvic floor weakness post-partum have been implicated in multiple conditions associated with pregnancy and delivery including:

  • Low back pain
  • Pelvic girdle pain
  • Urinary incontinence
  • Pelvic organ prolapse
  • Abdominal wall hernia

Physiotherapists should assess women before leaving hospital and at 6 week post-partum:

  • Education to reduce any anxiety they may have regarding abdominal separation.
  • Wear high-waisted underwear or support garments for the first 6 weeks to help support the abdominal wall and linea alba.
  • Limit heavy lifting for the first 6 weeks post-partum (no more than 10kg).
  • Cease any high impact exercise or heavy weighted gym programs for the first 6 weeks. Your Physiotherapist can guide you to a safe return to exercise.
  • Start a strength and stability home exercise program, directed by a Physiotherapist. However, this is not a proven to ‘heal’ your separation. It is used to regain strength and stability of the abdominal and surrounding muscles.
  • A pelvic floor muscle assessment.

If you would like further information on abdominal wall separation, link onto the following educational website by Physiotherapist Dianne Lee: Diastasis Rectus Abdominis

Melissa Harris - Brisbane Women's Health Physiotherapist

Melissa Harris is a titled Women’s Health Physiotherapist at Carina Central Physiotherapy with a particular interest in management of abdominal muscle separation. Call our clinic on 07 3395 2448 to make an appointment with Melissa Harris.

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