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Abdominal Muscle Separation- DRAM

Posted by Eqphysio on 15 June 2018


Did you know it is estimated that two thirds of pregnant women will experience DRAM?

Women especially at risk are those who have large babies,

twins or have had multiple pregnancies.



What is DRAM?

Abdominal muscle separation, also known as Diastasis of the Rectus Abdominus Muscle (DRAM) is the separation of the rectus abdominis muscle. This is the body's normal safety mechanism which occurs most often in the second and third trimester of pregnancy as the body changes to make room for the growing baby. DRAM can become a problem if the muscles stay separated postnatally. Other factors that might influence this separation include: hormonal changes, weight gain or abdominal muscle weakness.

Signs and symptoms:

  • A visible or palpable gap down the midline of your abdominal muscles

  • A bulge in your stomach especially when straining or contracting the abdominal muscles

  • Weakness in your abdominal muscles or abdominals feeling "loose"

  • Back Pain

  • Poor Posture


How can you tell if you have DRAM?

You can perform this simple test to see if you are experiencing DRAM

  1. Lie on your back with your knees bent. Place your index and middle finger over your navel.

  2. Lift your head and shoulders off the floor as if you a performing an abdominal crunch.

  3. Hold the lift and press your fingers down into your stomach. Feel for a gap between the left and right side of the abdominal muscles. If you have a gap of more than two finger widths, that is a sign of DRAM.


Dos and Don'ts

  • Don't strain. This puts extra pressure on the connective tissue and can make the separation worse. It is recommended you avoid constipation and heavy lifting.

  • Do start gentle deep abdominal muscle exercises such as drawing your belly button down towards your spine when lying on your back. Your physiotherapist can ensure you perform these correctly.

  • Do maintain good posture at all times. Try to avoid standing or walking with your belly pushed forward.

  • Don't perform vigorous abdominal exercises such as sit-ups, crunches or planks until you are deemed safe to do so by your physiotherapist. Performing these exercises too early can worsen the separation.

  • Do use a compression garment if you feel unsupported Abdominal supports such as tubigrip, elastic abdominal binders or pregnancy compression shorts such as SRC Recovery Shorts.

  • Do roll in and out of bed rather than "sit up".


How can physiotherapy help?

It is recommended that all women should be assessed after giving birth. Physiotherapists are able to provide guidance to ensure safe return to exercise and teach appropriate abdominal strengthening exercises. Physiotherapists can also prescribe suitable compression garments for DRAM. Without the correct advice, women may risk worsening of symptoms or herniation.

Research has shown that 66% of women who experience DRAM also experience pelvic floor dysfunction such as urinary incontinence, faecal incontinence or vaginal prolapse[1]. Our pelvic floor physiotherapists are trained to assess and manage other pregnancy related conditions such as incontinence, pelvic girdle pain, pubic symphysis pain, back pain and prolapse.

Equilibrium Physiotherapy is a recommended stockist of SRC Pregnancy and Recovery Shorts.















1. Spitznagle et al (2007) Prevalence of diastasis recti abdominis in a urogynecological patient population. Int Urogynecol J Pelvic Floor Dysfunct 2007 Mar; 18(3):321-8

If we can help you with any of your pregnancy related issues, please feel free to contact us: 

Phone: 9553 8145

Or if you're in the area, drop on by and have a chat with us to see if we can help in any way.

We're located at 1/45 Montgomery St, Kogarah NSW 2217

Author: Eqphysio
Tags: Pregnancy Women's Health

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