Abdominal Muscle Separation (Ab separation)

January 24, 2023
Avatar for Meredith PfohlMeredith Pfohl

Abdominal separation (also know as rectus diastasis – RAD, or diastasis of the rectus abdominal muscles – DRAM) is a normal part of pregnancy and occurs when the left and right rectus abdominus muscles spread apart to make space for the growing fetus. Almost 100% of women will have abdominal separation by the end of the third trimester. This separation causes a stretch on the connective tissue between the left and right rectus abdominus muscles, which is called the linea alba. This stretch, in conjunction with pregnancy hormones can cause the linea alba to become soft as well as wide. During pregnancy, this means that some modifications may need to be made to physical activities to ensure undue stretch is not placed on the linea alba which would result in excessive widening of the gap, or thinning of the linea alba, which can make post-partum recovery more difficult.

After bub is born, the body undergoes a process of natural healing over the first 12 weeks, during which we typically see a narrowing of the abdominal separation and a re-firming of the linea alba. This can be assisted with appropriate exercises, and the use of an abdominal support. For some women, no further treatment is required, and abdominal function returns to normal from this point. For others, abdominal separation may remain and they may require more extensive abdominal re-training to assist in reducing their abdominal separation and restoring their abdominal function. Our best window of opportunity for addressing abdominal separation is in the first year post-partum, and particularly in the first 12 weeks post-partum, so it is ideal to see your Women’s Health physiotherapist early in your recovery to ensure optimal results! If you are more than a year post-partum then don’t despair, we can still assist you with improving your abdominal function to help you achieve your goals!