Understanding Diastasis Recti Abdominis (DRAM): Causes, Prevention, and Treatment

Understanding Diastasis Recti Abdominis (DRAM): Causes, Prevention, and Treatment

Diastasis Recti Abdominis (DRAM) is a common condition affecting many women during pregnancy and the postpartum period. It involves the separation of the rectus abdominis muscles along the midline of the abdomen, leading to a noticeable bulge and, in some cases, discomfort or functional issues. It occurs when the connective tissue (linea alba) between the left and right sides of the rectus abdominis muscle stretches or thins, or if the length-tension of the rectus abdominal muscles become lax, causing a gap. This separation can result from the increased pressure on the abdominal wall during weight gain, breath holding and “baring down” movements or pregnancy.
Persistent DRAM postpartum is largely due to a lack of the normal Type III Collagen fibres that are responsible for elastic recoil postpartum.

Prevention and Treatment Strategies

New literature has found strong benefits of conservative interventions for managing DRAM:

• Abdominal Strengthening Exercises: Despite common misconceptions where abdominal exercise in pregnancy is often avoided, new evidence (Theodorsen et al. 2024) has confirmed that engaging in targeted rectus abdominis exercises during pregnancy can lead to a reduction in DRAM and may even decrease second stage of labour and assist in better postpartum recovery. 
• Abdominal Support such as compression garments or braces: Wearing an abdominal binder such as a compression garment in anyone early postpartum who can’t reduce their DRAM to 3cm by contracting their abdominals could help to safeguard newly generated collagen as the linea alba undergoes healing (Kaya, 2023), however anyone wearing an abdominal binder should use it in conjunction with another solution such as targeted strengthening exercises. 

Recommendations for Expectant and New Mothers

If you’re concerned about DRAM, consider the following steps:

• Consult a Healthcare Professional: Seek advice from a physiotherapist or healthcare provider experienced in managing DRAM.
• Engage in Safe Exercises: Participate in exercises designed to strengthen the core muscles without lying on your back if you are pregnant.
• Practice Good Posture: Maintain proper posture to reduce strain on the abdominal area ie. avoid excessive anterior pelvic sway. 
• Use Supportive Garments: Consider using abdominal support garments as recommended by your healthcare provider.

At All for One, we’re dedicated to supporting you through every stage of your journey. Our expert team provides evidence-based, holistic care tailored to your needs. Remember, you’re not alone—together, we’ll create a path that’s right for you.

For more information on managing DRAM and other pregnancy-related concerns, explore our range of services designed to empower and support you.