Understanding Abdominal Separation: Key Insights You Need to Know
Pregnancy is an exciting time, but it also brings many changes to your body as it adapts to accommodate your growing baby. One such change is abdominal separation, clinically referred to as Diastasis Recti (DRAM), a normal part of pregnancy. The great news is there are several proactive steps you can take to manage it effectively, both during and after pregnancy, to support your core and overall recovery.
In this blog, we’ll talk about what abdominal separation is, the symptoms to look out for, and ways to support your recovery. We’ll also explain how our physiotherapists assess and treat DRAM, providing the care and guidance you need to feel strong and confident on your journey through motherhood.
Understanding Abdominal Separation
What is it?
DRAM occurs when the abdominal muscles “six-pack” separate along the linea alba, the connective tissue that holds them together. Normally, the linea alba is thick and strong, keeping the "six-pack" muscles close together with a small natural gap. However, during pregnancy, higher oestrogen levels make the tissue thinner and more flexible, increasing the space between these muscles. This separation is a normal part of pregnancy to allow space for bub to grow. It has been reported during the 2nd trimester of pregnancy 33% of women have abdominal separation, increasing to 100% of women by the 3rd trimester. Healing typically begins within 8 weeks postpartum and at 6 months postpartum this figure reduced to 35-39%, with recovery continuing for up to a year.
Recent evidence suggests that improving abdominal muscle function and appearance isn’t necessarily about closing the gap like we once thought! Now, physiotherapy focuses on enhancing posture, muscle activation and empowering women through targeted exercises!
What Causes Abdominal Separation?
Pregnancy is the most common cause of DRAM. During pregnancy, a woman’s body undergoes major changes due to the stretching of the uterus and a hormone called relaxin which helps pelvic ligaments stretch and relax for birth.
Other causes can include:
Injury
Abdominal surgery
Improper exercise technique
Males with abdominal aortic aneurysm can often present with DRAM
Common Symptoms Can Include:
A noticeable bulge in your abdomen, especially when engaging your core, also known as conning.
Weakness in the abdominal muscles
Low back pain
Pelvic floor dysfunction, such as incontinence
How do we measure DRAM in the Clinic?
We take three quick and easy measurements!
To assess DRAM, we gently press our fingers along the midline of your abdomen, with your consent while you perform an abdominal crunch. This technique helps us feel the width and depth of the separation between the rectus abdominis muscles. We take three measurements: above the belly button, at the belly button, and below the belly button, allowing us to develop a tailored plan just for you. A gap of more than two finger widths indicates DRAM.
We assess DRAM prenatally, typically in the second and third trimester, to establish a baseline before delivery. After birth, we measure DRAM during your physiotherapy consultation at around 6 to 8 weeks postpartum. This timing allows for initial healing to occur, giving us a clearer picture of the abdominal separation and guiding your personalised recovery plan.
Important Tips Post Birth To Minimise DRAM and Boost Recovery
Rest and Recovery
In the first six weeks post-birth, prioritise horizontal rest to minimise DRAM. Lying down reduces strain on the abdominal muscles, helping them heal and preventing further separation.
Compression Garments for Postpartum Recovery
In the first 8-10 weeks postpartum, your abdomen is healing and may feel weak or distended. During this time, your body is adjusting, and using abdominal support garments alongside core exercises can make a big difference!
Special garments like SRC Recovery Shorts provide gentle compression to support your stomach and reduce strain during everyday activities. We can measure you for these in the clinic from 36 weeks! Tubi grip is another great option, also available in clinic.
Research shows that wearing abdominal support for about 8 hours a day, combined with physio-led core exercises, results in:
✨ Reduced abdominal separation (DRAM)
✨ Improved core strength and endurance
Gentle Exercise
During this phase, we recommend focusing on gentle, physio-guided movements targeting deep core muscles to gradually rebuild strength and support healing.
The Role Of Physio-Led Exercise
At Kaylana we empower you to reconnect with your body, feel strong, and regain your confidence.
How We Can Support You
We understand that both pregnancy and postnatal recovery are unique journeys, and we’re here to guide and support you every step of the way. Our tailored physiotherapy programs, including Clinical Exercise Rehabilitation and Pilates classes, are designed to keep you moving safely, effectively, and with confidence—whether you're preparing for childbirth or working to regain your strength afterward.
We also collaborate with local pelvic health physiotherapists to ensure you receive the best possible care, creating a holistic support system around you.
Here’s how our prenatal program supports you:
Core and Pelvic Floor Strengthening: We introduce physiotherapist-guided exercises to activate your deep core and pelvic floor muscles, helping to support your growing body and reduce pregnancy-related discomforts.
Postural Support: As your body changes during pregnancy, we focus on posture and strength to reduce aches and pains.
Breathing Techniques: Learning proper breathing techniques helps you manage stress, improves oxygen flow, and supports your core, enhancing your wellbeing.
Mobility and Flexibility: With safe, low-impact movements, we work on maintaining flexibility and joint mobility, so you can stay active and at ease as your body adapts.
After childbirth, our postnatal recovery program focuses on your healing and rebuilding strength at a pace that suits your body:
Gentle Core and Pelvic Floor Activation: We start with low-impact movements to gently reactivate your core and pelvic floor, promoting healing without putting added stress on your body.
Postural Support and Breathing Techniques: We help correct postural imbalances and teach proper breathing techniques to support your core and reduce the risk of back pain or injury.
Gradual Progression to Full-Body Exercises: As your core and pelvic floor regain strength, we guide you through a safe progression to more complex full-body exercises, always prioritising your safety and comfort.
Return to Fitness and Running Safely: We’ll create a personalised plan to help you safely return to the fitness activities you love—whether that’s running, Reformer Pilates, strength training, or anything in between. Current guidelines recommend waiting at least 3 months before resuming high-impact activities like running. To ensure a safe return, we perform a thorough assessment to evaluate your pelvic floor function, making sure your body is ready to handle these increased demands.
Throughout your recovery, we closely monitor your progress and ensure you’re performing exercises safely to avoid abdominal bulging or doming. We regularly check-in with you to ensure you’re on track with your goals and feel confident in your journey with us.
Interested In Learning More? Reach Out To Us In Hurstville
We’re here to empower you on your journey to feeling your best. For more information about exercise during pregnancy and postpartum recovery reach out to us today—we’re excited to support you!
Disclaimer: This blog is for educational purposes only and is not intended to replace professional medical advice, diagnosis, or treatment. Always consult with a qualified healthcare provider for advice specific to your women’s health needs.