Diastasis Rectus Abdominis Muscle (DRAM) commonly known as abdominal separation is a separation of the connective tissue (linea alba) between the abdominal muscles (rectus abdominis) through the centre of the abdomen.

This is most often seen during and after pregnancy, however it can be present in other populations.

Abdominal separation is generally not painful, however it can lead to back, hip and pelvic pain if the stomach muscles have weakened and are not supporting the trunk adequately.

It is completely normal and essential that your rectus abdominus muscle separates during pregnancy to allow for your growing baby.

It is estimated that 1 in 3 women (37%) will have abdominal separation after their first pregnancy, and 2 in 3 women (67%) who have had multiple pregnancies will have abdominal separation.

This separation can range from 2cm to 20cm wide.

You may have abdominal separation after pregnancy in the following patterns.

How Is Abdominal Separation Checked

The most traditionally used method used to check for abdominal separation is the finger-width method.

If on palpation, a gap exists which is greater than 2 finger widths (≈2cm) between the rectus abdominis muscles, this is considered separation.

We encourage that you see a qualified professional to check your abdominals, but here is a guide on how to check your abdominal separation at home:

 

1. Lie on your back, with your knees bent
2. Place your fingers in the centre of your tummy just below your breastbone
3. Raise your upper body off the floor as if doing a small sit up
4. Feel if there is a gap or divot between your abdominal muscles
5. Continue this, feeling all the way down the centre of your tummy to below your belly button

Exercise Precautions For Abdominal Separation

It is important that you do not attempt traditional abdominal strengthening exercises if you have separation, as many of these exercises increase the stress on both abdominals and pelvic floor and can further increase muscle separation.

There are specific exercises that you can do to help in a specific order.

These exercises start very basic and progress to the more traditional abdominal workouts as your technique and separation improves.

Your maternal health physiotherapist will check if you have abdominal separation after pregnancy and give you advice about how to start strengthening safely as well.

The following exercises should be avoided when your abdominal separation is larger than two fingers-width:

• Sit ups
• Crunches
• Curl ups
• 100s
• Double leg lifts
• V-sits
• Planks
• Push ups
• High impact exercise such as jumping, running, star jumps and skipping

 

While assessment from your health professional is necessary, the above exercises may be commenced once:

• Soft tissue healing is complete post-childbirth (minimum of 6 weeks)
• DRAM is less than 2cm, and no muscle peaking is experienced
• Control of pelvic floor and transversus abdominus

What You Can Do For Abdominal Separation

Sometimes abdominal compression garments can assist in recovery.

Compression garments such as SRC shorts are designed to aid in the recovery from pregnancy and can provide support with:

• C-section wounds
• Perineal trauma
• Episiotomy wounds
• Abdominal muscle separation
• Low back pain

2 Exercises You Can Do At Home

Here are 2 exercises you can get started with at home to wake up your abdominals:

These exercises are appropriate to do immediately post-partum BUT it should not be painful.

Stop if you experience any pain.

Tummy Vacuum Exercise to Help Abdominal Separation After Pregnancy

 

1. Start in 4 point kneeling on your hands and knees (with your hands under your shoulders, and knees under your hips)
2. Slowly and gently draw your tummy up toward your spine. Start by drawing in your lower tummy below your belly button, then around your belly button and all the way up toward your upper tummy (below your breastbone)
3. At the same time, gently round your spine up in to a cat stretch

 

Start with a 3/10 effort (don’t suck your tummy in too firmly to begin with) and over the coming weeks, you can slowly draw in firmer as you tolerate.

 

 

One Leg Stretch Level 1

1. Begin by laying on your back with your knees bent and feet on the floor
2. Gently lengthen one leg along the floor, sliding your heel away from you
3. Gently return your heel to the start
4. Repeat on the other leg
5. Repeat 10x each leg
6. Focus on keeping your pelvis and lower back still

This exercise will feel very easy, but the goal is to wake up the obliques (the muscles on the sides of your tummy). This will help to draw your waist in, helping the rectus abdominus to come closer together without placing any stress to the muscle or lower back.

Click for video – One Leg Stretch Level 1 (abdominal separation)

 Did You Know Abdominal Separation is Also Commonly Known As:

• Diastisis Recti
• Diastasis Rectus Abdominis (DRA)
• Rectus Abdominis Diastasis (RAD)
• Diastasis Rectus Abdominis Muscle (DRAM)
• Mummy tummy
• Tummy Separation
• Abdominal Separation

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