DRAM (DIASTASIS RECTI) – WHAT YOU NEED TO KNOW

Abdominal Separation is known as DRAM, or Diastasis Recti. It refers to the stretching of the line of tissue (the linea alba) that runs down the centre of the rectus abdominis muscles  (the ‘6 pack’ part of our stomachs).

It’s fairly common as the belly grows during pregnancy for this to happen, as the muscles need to ‘slacken off’ in order to make room for the baby.  It doesn’t always create a problem – but the severity of the gap can vary - and this is the main difference.  Like anything it can be made worse or better by the things that we do in our daily life – so it’s important to know what those things are.

What to do (and avoid) if you have DRAM –

• An overly strong rectus abdominis (the one that does all the crunches) can cause a larger separation due to it being excessively tight.  This means it’s counterproductive to exercise this muscle on it’s own while you are pregnant, so it's a great idea to avoid the sit ups, crunches and ab cycles.

• Avoid exercises that produce a ‘coning effect’ – which is a long and raised lump that runs down the centre of your stomach where the linea alba is – it can make separation worse. The coning is actually abdominal contents pushing up through the gap. Avoid anything that forces long, isometric holds (such as planks)  or lifting really heavy loads, which can raise intra abdominal pressure and have a pushing out effect in the stomach.  The best thing to do is have a look at your belly – if it’s coning – pick a different exercise.

• Do continue to work on your ‘core’ as a whole entity during your pregnancy – and aim for deep stabilisation rather than strength or power – that comes later.

Can Abdominal Separation be rehabilitated?

The answer is absolutely YES.  The key is to measure the separation, along with feeling the integrity along that linea alba (does it feel jelly like, or have some tone?).

Figure out where along the linea alba the gap is most prominent, and then do segmental rehabilitation exercises that progress in difficulty as the gap decreases.

If you rehab it properly before you launch into the  hard core exercise (no pun intended) you will build enough intergrity to be withstand the pressure of harder exercises. 

When we don’t do that, either from a lack of patience or a lack of proper support in knowing how to,  it leaves an unstable section.   The body will always ‘break’ at the weakest link in the chain, which is when women get recurring pain, or injuries that keep coming back.

For a full program that rehabilitates the core from the deepest layer out, check out The Core and Pelvic Floor Program.  

Kristy Ahale is an Exercise Scientist who specialises in injury, rehabilitation and postpartum conditions.