Physiotherapy condition

Post-Pregnancy Abdominal Muscle Separation (DRAM)腹直肌分离

Diastasis recti, or diastasis of the rectus abdominis muscle (DRAM), is a separation of the abdominal muscles that leaves a gap of more than 2.8 cm down the middle of the tummy. It occurs most commonly after pregnancy.

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What Is Diastasis Recti?

Diastasis recti affects both men and women, but occurs more commonly in women because of the physical changes during pregnancy. Reported incidence ranges from 67% to 100% in post-partum women.

Why Does It Matter?

Diastasis Recti can lead to:

Post-delivery lower back and pelvic pains
Poor posture due to reduced core-muscle stabilisation of the spine and pelvis
Urinary incontinence, or uncontrolled leakage of urine
Gastrointestinal problems such as constipation and bloating
Abdominal hernias, where tissue or an organ such as the bowel protrudes through the wall of the cavity in which it normally sits

Who Does It Affect?

Diastasis can occur in both men and women.
For men, DRAM can be caused by improper exercise technique such as weightlifting without proper form, thus placing too much pressure on the abdominal wall.
Newborns can also be born with abdominal diastasis. Such diastasis usually resolves as the baby grows.
For pregnant women, diastasis in the third trimester is inevitable as the uterus stretches to allow for the baby’s rapid growth. This separates the rectus abdominis and linea alba (the connective tissue between the six-pack muscles) to accommodate the growing baby. The separation usually heals by itself within 8–12 weeks. For many new mothers, however, the gap persists because the connective tissues no longer provide enough tension and stability, compromising the abdominal muscles. This can affect the body both aesthetically and functionally, and may leave a post-baby tummy protrusion even after the baby weight has gone.

What Should You Look Out For?

Diastasis recti may appear as a protruding dome along the tummy, particularly around the belly button. You may notice it during everyday movements such as getting up or lying down in bed.

You can assess your tummy if you are at least 8 weeks post-delivery. A diastasis occurs when there is a gap of more than 2.8cm (around 3 fingers spacing) between the abdominal muscles.

Here are some simple steps to help you identify DRAM:

Lie on your back with your knees bent and feet flat on the floor.
Place your fingers on your belly button.
Lift your head and neck slightly off the floor as if doing a sit-up or crunch while tightening your abdominal muscles. Press your hand gently between your abdominal muscles, horizontal to your spine. A gap larger than two to three finger-spaces could indicate DRAM.
Repeat the test above and below your belly button and measure the gaps in these areas.

How Can Physiotherapy Help Diastasis Recti?

A proper assessment is required to determine the management plan. Treatment aims to restore the function of the rectus abdominis and surrounding core muscles to stabilise the pelvis during activity and under load. As core-muscle activation improves, symptoms such as lower-back strain or pelvic pain may reduce. Musculoskeletal physiotherapists trained in DRAM or physiotherapists specialising in pelvic-floor dysfunction can assess the condition and tailor a suitable programme.

Our women’s health physiotherapists at the Women & Children Centre can prescribe appropriate exercises and support your recovery. Send questions to our Ask A Physio WhatsApp service or contact the Women & Children Centre at 8481 3151.

For more insights on pregnancy-related pain, explore our page on Pelvic Girdle Pain.

Frequently Asked Questions on Diastasis Recti (DRAM)

What is diastasis recti (DRAM)?

Diastasis recti (DRAM) is a separation of the abdominal muscles (rectus abdominis) leaving a gap of more than 2.8 cm down the middle of the tummy. It is very common after pregnancy, with reported incidence of 67% to 100% in post-partum women.

Does diastasis recti heal on its own after pregnancy?

Diastasis recti usually heals on its own within 8–12 weeks after delivery, but for many mums the gap persists because the connective tissue no longer provides enough tension and stability.

How do you check for diastasis recti at home?

To check for diastasis recti at home from about 8 weeks post-delivery, lie on your back with knees bent, place your fingers on your belly button, and lift your head slightly as in a crunch while tightening your abs — feeling for a gap wider than 2–3 finger-spaces above and below the navel.

How can a physiotherapist help with diastasis recti?

A physiotherapist helps with diastasis recti by assessing the separation and tailoring a programme to restore the rectus abdominis and surrounding core muscles, stabilising the pelvis. Physio & Sole Clinic's women's health physiotherapists can guide this recovery.

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