Recovery from Abdominal Separation after Birth

Recovery from Abdominal Separation after Birth

Abdominal separation is known by many different names: 

Diastasis Of Rectus Abdominis Muscle. 

DRAM  (short for Diastasis of Rectus Abdominal Muscle) 

DRA (Diastasis of Rectus Abdominis) 

Abdominal Diastasis (abdominal separation ) 

Diastasis Recti  (separation of rectus) 

In this blog when we refer to women/females we are referring to those presumed female at birth. 

Whatever term we use, diastasis is just a word  meaning separation.  The muscle which separates is called Rectus Abdominis.   Up to 2cms separation is considered normal.  It happens in 70% or so of women during and after pregnancy. You may be told to find advice on how to work pelvic floor with other deeper abdominal muscles (transversus abdominis) in order to pre-tension these muscles prior to sit ups, crunches and other more strenuous abdominal exercises. 

What is Rectus Abdominis? 

The Rectus Abdominis muscle is the one which gives people the “six pack” after a lot of hard work in the gym.  After a pregnancy, we are certainly not expecting to see anyone with a six pack…  But many women do want to return to flatter tummies and start to regain control over their abdominals.  Toned rectus, along with active transversus abdominis and oblique abdominal muscles, make for a flatter, more controlled tummy.   

So Why Does the Muscle Separate?  

The rectus abdominis is designed to be able to separate somewhat to accommodate the growing baby.  The muscle extends from the ribs at the top straight down, left and right of the belly button to the pubic bone in the middle of the front of your pelvis. The two halves of the muscle are joined with connective tissue which blends with  more connective tissue  called the “Linea Alba”.  This connective tissue is also designed to  widen to allow the belly to expand whilst keeping the abdominal contents behind supported.  

What Do We Do in a Consultation? 

  •  Assess the width and depth of the separation 
  • Use ultrasound to help us see how your muscles are recovering.   
  • Measure how much separation is present. 
  • Assess how well the linea alba is recovering 
  • Assess how the linea alba  (connective tissue behind the abdominals) responds to load (i.e. leg lifts, small weight lifts, crunches) 
  • Assess how well you can contract transversus abdominis 
  • Assess how well pelvic floor works with transversus abdominis 
  • Demonstrate how to tension these muscles whilst building up a  broader abdominal program.

What Might a Rehab Program Involve?  

  • Correct pelvic floor muscle contractions. 
  • Co-contraction of transversus abdominis with pelvic floor 
  • Addition of more strenuous exercises like crunches with transversus pre-contraction. 
  • If deep and wide,  an abdominal support may add comfort and support as you exercise. 

What About Surgery? 

We are often asked if surgery is needed.  Plastic surgeons can do surgery.  The main reason however is usually purely for aesthetic reasons.  In other words if someone thinks their tummy is unsightly, the surgeons will consider surgery to make the abdominals look better. 


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