DRAM – tummy muscle separation in pregnancy

Separation of the tummy muscle, also known as DRAM, is a very common condition seen in pregnancy and can also persist after having a baby.  As with most changes in pregnancy, this is caused by a number of factors like:

  • Pregnancy hormonal changes,
  • Weight gain (particularly in the belly)
  • Change of posture as your baby grows
  • Pressure on the tummy muscles by the increasing size of the womb, causing them to stretch

Your 6-pack tummy muscles are separated down the middle by a band of connective tissue called the linea alba.  In pregnancy, the abdominal muscles stretch and pull sideways to accommodate the growth of your baby.  For some women, this will result in separation of the abdominal muscles that you can see and feel.  Commonly known as a diastasis of the rectus abdominus musculature or “DRAM” for short, it can be quite severe for some women. Its severity can increase with increasing number of pregnancies.

It is important to know that changes in these muscles are NORMAL – the body is designed to allow this stretch in such a way that it minimises damage to the tissues as your baby and belly grows.  After pregnancy however, we want to encourage these muscles to come back together to offer increased postural support to the lower back.  Some women will also be keen to close the gap as they don’t like the way it looks.

Whilst exercise for these muscles can be very helpful, doing the wrong kind of abdominal exercises can actually make your separation worse and further weaken the muscles in your back and pelvis.  It is important these muscles are well looked after in pregnancy and following delivery, as they will help you lift your newborn, prevent back pain, and overall, feel stronger after delivery.

There are lots of things that you can do to control the degree of separation that you experience, and to increase the amount of tummy muscle closure that occurs after baby is born.  Our focus is on:

  1. Maintaining good posture and back support,
  2. Encouraging safe lifting techniques
  3. Correct exercises to strengthen the tummy muscles, including techniques to improve your pelvic floor muscles.
  4. Using compressive garments that assist in offering further support and comfort.

At SheFit Health, our physiotherapists can determine what exercises are appropriate for you, and provide equipment and home based programs to aid in your recovery following pregnancy.