Have you heard of DRAM? DRAM is an acronym for “Divarication of rectus abdominis muscles” and, put simply, it’s the splitting of the fascia that runs between the abdominal muscles. It occurs in pregnant women as pregnancy hormones soften connective tissue and the abdominal muscles separate to make way for the growing baby. Separation can occur any time in the last trimester but is most problematic after pregnancy when the abdominal wall is weak. DRAM can remain for a few months after pregnancy, but in some people it can be a permanent change. If your abdominal muscles remain weak, you are more likely to suffer from back pain and have increased risk of a hernia. This is because the abdominals are important in supporting your back.
You can easily test your DRAM by doing a little head lift whilst lying down. You may either see a little dome forming between the muscles or you can feel it. It is often measured in centimetres or by the number of fingers you can fit in the gap. Some reports indicate that a 2-3cm DRAM is normal, but more than this needs treatment.
All women with concerns about their DRAM should seek advice from their physiotherapist about exercises and activities to try but especially the ones to avoid. Some people benefit from functional bracing, however doing pelvic floor exercises is very important, especially for those with ongoing lower back pain. At Burleigh Central Physiotherapy we encourage long-term Pilates for pelvic floor and core strengthening whilst avoiding exercises that may prevent a patient’s recovery.