DRAM

During pregnancy the abdominal muscles (Rectus abdominis) naturally stretch around your growing baby. The connective tissue, or linea alba, joining the two sides of the muscles stretches, forming a gap between them called a Diastasis of Rectus Abdominis (DRAM). This gap is usually two to four finger widths wide and it can gradually close after delivery but may require physiotherapy input.

Risk factors for developing DRA

There are several factors that we think may influence it, but we need further research in the area. Considerations:

• Pregnancy, specially multiples (twins, triplets)
• Genetics- some people may be more at risk due to their connective tissue composition
• IVF (due to potential prolonged hormonal influence)
• Exercise that excessively and repeatedly loads the abdominal wall
• Prolonged exposure to heavy lifting

How to check for DRAM:

1. Lie on your back with your knees bent and feet flat on floor.
2. Placing your four fingers east to west on your tummy, gently bring your chin to your chest. Feel down the midline from just below your sternum (chest bone) at the top, all the way down to the pubic bone.
3. How many fingers can you fit into the gap when you do a chin to chest movement?
4. There is no defined width of gap to indicate that you need physiotherapy input, it is a consideration of the width, the depth and whether you feel strong and functional at the abdomen or not.

Physiotherapy input may be required if:

• You measure a gap that has significant width and depth
• You sink in at the midline with abdominal effort
• You find it difficult to progress the strength in your “core”

Your mental health and self-confidence is impacted due to DRAM.