Diastasis Recti Abdominis Muscles (DRAM) is a common condition experienced by women during and after pregnancy. DRAM refers to the separation of the rectus abdominis muscles that run down the front of the abdomen. This separation can lead to weakness and instability in the core, causing pain, discomfort, and difficulty with daily activities.
Fortunately, there are a range of physiotherapy and Pilates interventions that can help to manage and alleviate DRAM. This essay will explore the evidence behind these interventions and how they are implemented at Sum Of Us studio.
Diagnosis of DRAM:
A diagnosis of DRAM is made by a qualified physiotherapist or health practitioner who is trained in assessing the condition. During the assessment, the physiotherapist will perform a series of tests to check for the presence and severity of DRAM.One common test used to diagnose DRAM is the finger-width test. The physiotherapist will ask the client to lie on their back with their knees bent and feet flat on the ground. The physiotherapist will then place their fingers along the midline of the abdomen and ask the client to lift their head and shoulders off the ground. If there is a gap between the two halves of the rectus abdominis muscle, the physiotherapist will be able to feel it.
Another test that may be used to diagnose DRAM is ultrasound imaging. This is a non-invasive test that uses sound waves to create images of the abdominal muscles. Ultrasound imaging can help determine the severity of DRAM and can be used to monitor progress during treatment.
Symptoms of DRAM:
The symptoms of DRAM include:
– A protruding belly
– A bulge that runs down the center of the abdomen
– Lower back painPoor posture
– Difficulty engaging the core muscles
– Weakness in the pelvic floor muscles
How DRAM Affects the Body During Pregnancy and Postnatal Periods:
DRAM can cause a number of issues during pregnancy and postnatal periods. One of the most common issues associated with DRAM is back pain. As the rectus abdominis muscle becomes weakened and stretched, it can put additional strain on the lower back muscles, leading to pain and discomfort.In addition to back pain, DRAM can also cause poor posture. When the rectus abdominis muscle becomes separated, it can cause the belly to protrude forward, leading to a slouched posture. This can put additional strain on the spine, leading to more back pain and discomfort.Another issue associated with DRAM is difficulty with core strength.
The rectus abdominis muscle is an important muscle in the core, and when it becomes weakened and stretched, it can be difficult to engage the core muscles effectively. This can lead to a lack of stability in the pelvis and lower back, which can further exacerbate the issues associated with DRAM.
Physiotherapy Interventions for DRAM:
Pelvic Floor Muscle Training (PFMT):Pelvic floor muscle training is a physiotherapy intervention that involves strengthening the muscles of the pelvic floor, which can help to improve core stability and reduce the severity of DRAM. PFMT has been shown to be effective in reducing the width of the DRAM and improving core function (1).
Abdominal Binder:An abdominal binder is a supportive garment that is worn around the abdomen to help reduce the separation of the rectus abdominis muscles. This can provide additional support to the abdominal muscles during daily activities and exercises, reducing the risk of exacerbating DRAM.
Manual Therapy:Manual therapy techniques, such as massage and myofascial release, can help to improve circulation and tissue mobility in the abdominal muscles. This can help to reduce pain and discomfort associated with DRAM, while also promoting healing and tissue repair.
Pilates Interventions for DRAM: Modified Pilates Exercises:Pilates is a form of exercise that emphasizes core strength and stability. However, traditional Pilates exercises may not be appropriate for women with DRAM, as they can exacerbate the separation of the rectus abdominis muscles. Modified Pilates exercises, which are designed specifically for women with DRAM, can be effective in reducing the severity of the condition (2). These will be discussed in detail below.
Core Strengthening Exercises:Core strengthening exercises are an essential component of Pilates practice and can be effective in improving core stability and reducing the severity of DRAM. These exercises can include pelvic tilts, bridging, and leg lifts, which can help to strengthen the transverse abdominis muscle, which is a key muscle involved in DRAM.
Breathing Exercises:Breathing exercises are an important part of Pilates practice, as they can help to improve diaphragmatic function and reduce tension in the abdominal muscles. By improving breathing patterns, women with DRAM can reduce the strain on their abdominal muscles during daily activities and exercises, reducing the risk of exacerbating DRAM.
Evidence for Physiotherapy and Pilates Interventions:
There is growing evidence to support the use of physiotherapy and Pilates interventions for DRAM. A systematic review of the literature found that PFMT was effective in reducing the width of the DRAM and improving core function (1). Another study found that a six-week Pilates program was effective in reducing the severity of DRAM and improving core strength and stability in postpartum women (3).Pilates is a highly effective exercise technique that can help to improve core strength and function, making it an excellent choice for women experiencing DRAM during pregnancy and postpartum.
At Sum Of Us studio, we offer a range of Pilates classes specifically designed to help women address DRAM and improve overall core strength and function.Here are some ways that Pilates at Sum Of Us can help with DRAM:
Focus on the deep core muscles:Pilates is known for its emphasis on the deep core muscles, including the transverse abdominis, which is one of the key muscles involved in DRAM. By focusing on these muscles, Pilates can help to improve their strength and function, reducing the severity of DRAM and improving core stability.
Targeted exercises:Our Pilates instructors at Sum Of Us are trained to provide targeted exercises that are specifically designed to help women address DRAM. These exercises may include modifications to traditional Pilates moves, as well as specific exercises that target the rectus abdominis muscle and other core muscles.
Safe and low-impact:Pilates is a low-impact exercise technique that is safe for pregnant and postpartum women. At Sum Of Us, we offer a range of classes that are specifically designed for women at different stages of pregnancy and postpartum, ensuring that each woman can safely and effectively participate in Pilates.
Individualized approach:At Sum Of Us, we take an individualized approach to Pilates, tailoring each session to the specific needs and goals of the woman. For women with DRAM, this may involve focusing on specific exercises and modifications that are most effective for addressing their particular case of DRAM.
Emphasis on proper technique:Proper technique is essential for effective Pilates practice, and it is particularly important for women with DRAM. Our Pilates instructors at Sum Of Us are trained to ensure that each woman is using proper technique during each exercise, reducing the risk of injury and ensuring that the exercises are as effective as possible.
Focus on mind-body connection:Pilates is known for its focus on the mind-body connection, with each exercise emphasizing the importance of being present and mindful in the moment. This can be particularly helpful for women with DRAM, as it can help to reduce stress and tension in the abdominal muscles, improving core function and reducing the severity of DRAM.
At Sum Of Us, we offer a range of Pilates classes that are specifically designed to help women address DRAM and improve core strength and function. These classes are led by highly trained and experienced Pilates instructors who are passionate about helping women achieve their health and wellness goals during pregnancy and postpartum.
Our Pilates classes are held in a welcoming and supportive environment, with each class emphasizing the importance of proper technique, mindfulness, and individualized attention. Whether you are looking to reduce the severity of DRAM, improve core strength and function, or simply stay active and healthy during pregnancy and postpartum, Pilates at Sum Of Us can help.