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Strengthening from the inside out – Rethinking abdominal training in pre and postnatal women

Updated: Aug 12, 2019

We often spend time with our ladies discussing their concerns surrounding diastasis of rectus abdominis muscle (DRAM), more commonly known as abdominal muscle separation.

Did you know abdominal separation is one of the most common conditions that physiotherapists see in pregnant and postnatal patients? As many as two in three pregnant women have some degree of abdominal separation. As a result, it is essential that abdominal exercises in the childbearing years be carefully considered and modified.


Abdominal muscle separation refers to the widening of the space between the long muscles running along the centre of the abdomen (the 'six pack' muscle). This often involves stretching of the connective tissue which lies between these muscles known as the linea alba. Separation occurs as the abdominal wall adjusts to allow room for the growing baby during pregnancy, and this can occur any time from the first trimester. You may notice you have diastasis recti when you sit up or get up from the floor and notice a ‘doming’ or ‘tenting’ through the middle of the stomach.


As a result, DRAM can have a number of implications for pre and postnatal women. It can affect the stability of the trunk and may contribute to pelvic floor dysfunction (66% of patients with DRAM have reported to have pelvic floor dysfunction), back and pelvic girdle pain, and hernias. DRAM can create excessive intra-abdominal pressure leading to back pain, pelvic pain and incontinence as the stomach muscles have weakened and are not supporting the trunk adequately, resulting in a destabilized support system.

Unfortunately the research is quite varied in regards best practice for treatment. What we do know is that exercises that bring your tummy muscles together can help with recovery and exercises that pull our separation further apart should generally be avoided. But remember there is no one size fits all.

Our advice would be to manage your individual recovery by getting in touch with a Physiotherapist who has a special interest and experience in pre and postnatal exercise. This way they will be able to assist you with a thorough assessment and give appropriate INDIVIDUAL advice for management and exercise.


Feel free to give us a call on 44542309 if you would like to chat to one of our physiotherapist Amanda about your abdominal muscle recovery.


Abdominal muscle separation refers to the widening of the space between the long muscles running along the centre of the abdomen (the 'six pack' muscle). You may notice you have diastasis recti when you sit up or get up from the floor and notice a ‘doming’ or ‘tenting’ through the middle of the stomach. Picture: http://www.deliciouslyfitnhealthy.com/diastasis-recti-aka-the-mom-pooch/


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