What is DRA?

Diastasis Recti Abdominis (DRA) is a common condition that occurs during and after pregnancy.  An incidence of 66% in the third trimester of pregnancy and 58% in post-natal women has been reported (Boissonnault & Blaschak,1988).

It can be defined as an excessive widening or separation between the two bellies of the rectus abdominis muscles (Boissonnault & Blaschak,1988).  During pregnancy, hormonal changes caused by relaxin, progesterone and estrogen combined with uterine growth cause stretching of the abdominal wall, affecting mainly the rectus abdominis and the linea alba (El Makawy, Eldeeb, El-Lythy & El-Begawy 2013).

The procedure that is most commonly utilised as a diagnostic tool in clinical practice is the finger width measure (Mota et al 2013). Other methods used are dial calipers and realtime ultrasound.  The horizontal distance between the Rectus Abdominis borders is measured 4.5cm above and below the umbilicus, and at the umbilicus. An Inter-rectal distance (IRD) at the level of the umbilicus of more than 2.7cm has been suggested to be pathological of DRA (Rath et al 1996) and in clinical practice, an IRD of 2 or more fingers on partial sit-up at the umbilicus is used as diagnostic of DRA (Keeler et al 2012). Severity of DRA ranges from mild, 2.5 to 3.4 cm wide and up to 12cm long with or without bulging, to severe greater than 5 cm wide and up to the entire length of the rectus muscles (Polden and Mantle 1990).

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