Abdominal Separation Associated With Pregnancy

Dr Peta Antonello-OSTEOPATH-B.Sc.(Clinical), M.H.Sc.(Osteo)

Abdominal separation, also known as diastasis recti, or DRAM (diastasis of rectus abdominis muscle) is a disunion/stretching of the connective tissue known as the linea alba situated between the two bellies of the rectus abdominis muscle that commonly occurs during pregnancy.

The prevalence of DRAM is reported to be approximately 66% in the third trimester and 30-60% post-partum. In the majority of cases, separation will resolve within 12 months, but it has been reported that 1 in 3 women will experience DRAM beyond this.

It is suggested that DRAM can occur with:

· Increased weight gain

· Multiple pregnancies

· Small statured individuals

· Age over 35 years

The most common method to assess for the presence of DRAM is the 2-finger width method. This is performed via palpation of the linea alba between the two bellies of rectus abdominus, coupled with completing a low crunch. A positive test is where a gap of 2 finger widths or more exists. As with all conditions, it is recommended that you seek professional assessment in order for adequate diagnosis and management of your condition.

Although occurring in a high proportion of pregnancies, it does not lead to symptoms in all cases. In fact, the majority of women will continue on post-partum pain free!

Symptoms to be aware of that are suggested to be associated with DRAM include:

· Pain and discomfort in the abdomen

· Pelvic pain/instability

· Low back pain

· Urinary incontinence

· Fecal incontinence

How can osteopathy help?

Depending on the distance of separation, conservative management with an osteopath or physiotherapist will be prescribed. In more severe cases, surgical intervention is recommended.

Here at Western Region Health, we have the ability to adequately diagnose and provide recommendations on further management of DRAM. This may include clinical pilates, prescription of deep core activation exercises, referral to relevant health professionals, pelvic support braces or compression wear, including the SRC products and manual therapy to address biomechanical and musculoskeletal compensations that have occurred during pregnancy, which may be contributing to your pain.

If you suspect you are suffering from pain associated with DRAM during or post pregnancy, please give one of our friendly osteopaths a call to discuss your situation.

References:

Treatment Options for Abdominal Rectus Diastasis (nih.gov)

Abdominal separation (diastasis recti) | Pregnancy Birth and Baby (pregnancybirthbaby.org.au)

Abdominal Separation: Treating Abdominal Separation After Pregnancy | Phyx. Physio + Pilates (phyxphysio.com.au)

Abdominal Muscle Separation | Sydney Pelvic Clinic