Diastasis Recti Abdominis (DRAM) is often surrounded by myths and misconceptions that can make it difficult to understand and manage. From the belief that it's only a concern for post-pregnancy women to the idea that it can’t be fixed with exercise, these myths can lead to confusion and unnecessary worry.
In this post, we’ll address some of the most common misconceptions about DRAM and set the record straight.
Myth 1: Crunches will worsen DRAM
There is an OUTDATED common belief that crunches aren’t universally safe, and you should not do them post-partum. This is not true. The latest research encourages low level crunches done with the correct technique and education. And with a baseline abdominal core strength. This should be determined by your physiotherapist.
The key is to avoid increasing intra-abdominal pressure, focus on deep core engagement, and ensure movements are slow and controlled. Proper breathing techniques and pelvic floor muscle activation are essential to prevent excessive strain on the abdominal muscles.
Crunches may be appropriate if they are introduced progressively and tailored to your body’s needs. Starting with foundational exercises helps build stability before attempting more advanced movements.
Myth 2: I should avoid activities that cause me to “cone” or “dome”
A common misconception about DRAM is that any sign of coning or doming means you must stop all activity.
Coning or doming refers to a visible bulge or ridge along the midline of your abdomen, often appearing when your core isn’t managing intra-abdominal pressure effectively during certain movements, but they don’t automatically mean the movement itself is harmful.
Often, the issue lies in how an exercise is performed rather than the exercise itself. With proper core engagement, breathing techniques, and modifications, many activities can still be safe and beneficial. Instead of avoiding exercise entirely, use coning and doming as feedback.
Pause, reassess your form, and focus on engaging your deep core muscles. Simple adjustments—such as slowing down movements, reducing the range of motion, or modifying the exercise—can often resolve the issue.
If you're unsure, please consult our team at PhysioMatters as we specialising in DRAM can provide tailored guidance to ensure your recovery is both safe and effective.
Myth 3: Diastasis Recti may cause me to have other aches and pains
Many people believe that DRAM inevitably leads to chronic aches and pains, such as lower back pain, pelvic discomfort, or hip instability. While DRAM can contribute to these issues, it doesn’t guarantee they will occur. The key factor is how well your core muscles are functioning and whether they provide adequate support during daily movements and activities.
In fact, many individuals with DRAM experience no symptoms at all. For some, abdominal separation doesn’t interfere with their core strength, posture, or overall stability, allowing them to carry on with daily tasks and physical activities without any pain or discomfort. In these cases, their body has adapted well to the separation, and the surrounding muscles are effectively compensating to provide stability and support. Whether or not DRAM becomes symptomatic often depends on factors such as posture, movement habits, and overall muscle strength.
When the abdominal muscles are weakened or not working together properly due to DRAM, your body may compensate by placing extra strain on other muscle groups, such as those in your lower back, hips, or pelvic floor. This imbalance can contribute to discomfort or pain over time. However, aches and pains are not an unavoidable consequence of DRAM—they are often the result of poor movement patterns, lack of core engagement, or incorrect posture.
With proper rehabilitation, many people with DRAM can prevent or alleviate these aches and pains. As physiotherapists we assess YOUR movement patterns, identify areas of weakness or compensation, and guide you through a tailored program to restore core strength and overall stability.
In short, DRAM doesn’t guarantee pain—it’s how your body adapts to the condition that makes the difference.
Myth 4: The size of my gap matters
A common myth surrounding DRAM is that the size of the gap between the abdominal muscles directly correlates to the severity of the condition or the impact on overall health. While it’s true that a larger gap may indicate a more significant separation, the size of the gap alone doesn’t necessarily determine the severity or functional limitations of DRAM.
In fact, many people with a relatively wide separation experience minimal symptoms or functional issues, while others with a smaller gap may face significant challenges. What truly matters is how well your core muscles are functioning, how much pressure is placed on your abdominal wall, and how effectively your body compensates for the separation.
The function of the connective tissue (Linea Alba) and the ability of the deeper core muscles, such as the transverse abdominis, to engage and provide stability is far more important than the width of the gap itself. Moreover, research has shown that DRAM can be improved over time with the right rehabilitation strategies, even if the gap remains present.
A well-designed exercise program focusing on core strength, proper breathing techniques, and pelvic floor engagement can help close the gap and restore abdominal function, regardless of its initial size. Therefore, it's essential not to focus solely on the gap measurement but to consider overall core strength and muscle function when assessing and treating DRAM.
Myth 5: Only surgery will fix it
Many people believe that surgery is the only way to treat DRAM. However, this is not the case. While surgery can be an option for severe cases, especially when there are complications, many individuals can effectively manage and improve DRAM through non-surgical methods, such as core strengthening exercises, pelvic floor muscle training, and postural correction, often with the guidance of physiotherapy.
Conservative treatments that focus on restoring core strength and improving stability can significantly reduce the gap and help alleviate any associated symptoms. Surgery is generally considered as a last resort, only when other approaches do not provide relief or if DRAM causes persistent pain or dysfunction. For most, non-invasive methods offer a safe and effective solution.
What’s Next?
There are many misconceptions surrounding the management of DRAM, leading to confusion about what treatments and exercises are truly effective.
If you're unsure about whether crunches are appropriate for your situation, or if you're just starting out on your recovery journey, we suggest YOU come into PhysioMatters for a consultation. We will provide personalised advice and guide you through a tailored program that strengthens your core safely.
We look forwards to assessing You and providing you with an evidence based and functional core strengthening program 😊
Claire
Physiotherapist specialising in Women’s and Men’s Health – PhysioMatters
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