DRAM - Diastasis recti
When we are pregnant our body accommodates the growing baby in several different ways. One of these is by the gap between our rectus abdominus (the 6 pack muscles) stretching and becoming wider. The connective tissue in between the two muscle bellies is known as the linea alba and the thinning and stretching of this tissue is common in pregnancy – in fact it will stretch in 100% of pregnancies by 36 week and can continue into the post-natal period. This increase distance is called diastisis recti, also known as DRAM or DRA.
It is also associated with repeated heavy lifting, being older and is more common when you do not regularly exercise before or during pregnancy.
What are the symptoms of a DRAM?
A 2cm gap between the muscles is considered to be normal. The most important thing to know is that the muscles are activating and working well. Your muscles need to be strong enough to control abdominal movement and support your pelvis and pelvic organs through movement. They also contribute to posture and breathing.
If you are experiencing a DRAM you may notice some bulging/doming or sagging of the abdominal muscles or midline when you are doing effortful movements especially such as sitting up from lying, getting out of bed or lifting your baby.
If you are experiencing a DRAM you may notice some bulging/doming or sagging of the abdominal muscles or midline when you are doing effortful movements especially such as sitting up from lying, getting out of bed or lifting your baby.
Treatments for DRAM
Regular exercise before and during pregnancy can be helpful to reduce your risk of developing an ongoing DRAM. In an uncomplicated pregnancy aim for 150 minutes of moderate exercise per week – check out the “exercise during pregnancy” tabs.
If your DRAM is particularly large or bothersome you will be referred through to see a physiotherapist who can assess your abdominal muscles and will give you specific exercises based on your assessment. They will also advise you around pelvic floor strengthening as this can have an effect on abdominal muscle function.
There is some natural improvement that happens in the first 8 weeks following your delivery. In this time the focus on strengthening should be primarily on abdominal activation, pelvic floor exercises and a gradual return to gentle exercises. More guidance on this can be found in the “exercising after pregnancy” tab.
In the first instance it is advisable to avoid exercises and movements that significantly increase your abdominal pressure, such as sit ups, planks, high intensity exercise and repeated heavy lifting however this is not forever – as your strength returns you will be able to return to these activities as desired.
Sometimes a compression garment such as abdominal support can be helpful in the early stages – your physiotherapy will help you with guidance on this.
If your DRAM is particularly large or bothersome you will be referred through to see a physiotherapist who can assess your abdominal muscles and will give you specific exercises based on your assessment. They will also advise you around pelvic floor strengthening as this can have an effect on abdominal muscle function.
There is some natural improvement that happens in the first 8 weeks following your delivery. In this time the focus on strengthening should be primarily on abdominal activation, pelvic floor exercises and a gradual return to gentle exercises. More guidance on this can be found in the “exercising after pregnancy” tab.
In the first instance it is advisable to avoid exercises and movements that significantly increase your abdominal pressure, such as sit ups, planks, high intensity exercise and repeated heavy lifting however this is not forever – as your strength returns you will be able to return to these activities as desired.
Sometimes a compression garment such as abdominal support can be helpful in the early stages – your physiotherapy will help you with guidance on this.