DRAM

DRAM (Abdominal seperation) – an update from Ali Harding

Abdominal Separation: What is it? Can we prevent it? And what to do about it!

 

Ali recently headed to Sydney to update her skills and knowledge on DRAM management and the function  of the abdominal wall.

Abdominal separation or DRAM (Diastasis Rectus Abdominal Muscle separation), happens commonly during pregnancy, and, to a degree is a normal change in a woman’s body.  As your baby grows, the increase in abdominal pressure has to be transferred somewhere.  The fascia or Linea Alba (strong tissue holding our six pack abs together) softens and widens and the abdominal muscles elongate and stretch, resulting in these muscles pulling away from the midline and the characteristic ‘separation’.  Research states that up to 66% of women will have a diastasis in the third trimester of pregnancy, and other literature found 100% of women included in their study had a diastasis at 35 weeks!  So – it is certainly common, and to some degree we would expect it.

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Why do we care?

Our abdominal muscles are important in maintaining the function and support of our abdominal wall and are involved in all movement of the trunk.  They help to maintain and contribute to intra-abdominal pressure which can affect the pelvic floor and lower back.  This is particularly important during the post-natal recovery phase as our bodies are recovering.

Furthermore, women are often concerned about the appearance of their belly post-natally and we know that treating and undergoing rehab for an seperation can help improve this.  DRAM has been linked to low self body image due to this fact.

Recovery:

We do know that there is a period of natural self recovery in abdominal separation, usually until 12 weeks post-partum.  If your separation remains wide following this time it is a good sign that you should seek an opinion from your women’s health physiotherapist, in order to ensure full functional recovery.

How do we assess it?

Your treating physiotherapist will use the real time ultrasound to visualise and measure the separation, assess superficial and deep abdominal muscle function, strength and endurance, and provide appropriate exercises based on this information.

How do we treat it?

Commonly used and researched treatment methods include, abdominal binding (Such as compression garments or tubigrip, load management, postural education and retraining, and appropriate exercise rehab.  The key to successful management of these conditions is to retrain and improve the function of the abdominal muscles and strengthen the fascia.  This is achieved by exercising the abdominal muscles in the right way and allowing your body time to retrain this function in a safe and load appropriate manner for your recovery.

And finally, can we prevent it?

Maybe, in some cases.  As we mentioned earlier it is most often a normal change that occurs during pregnancy!  However, if we can identify it early, teach postural awareness, load modification and the appropriate type of abdominal exercises, we can often reduce the degree to which a separation will occur!

Ali and all of our female physios are able to help provide assessment and management of these conditions in post-natal women.  If you have any further questions, don’t hesitate to give us a call to discuss further!  

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