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Divarication of Recti

Checked: 23-06-2023 by Sandi Littler Next Review: 23-06-2025

Overview

Divarication of the Rectus Abdominus Muscle (DRAM) is a normal occurrence of pregnancy. Often a small divarication improves within 6-8 weeks of delivery. Exercises can help the muscles to recover. A 2cm gap at the umbilicus is normal and does not need to be referred.

UHB have produced a patient information leaflet with advice on exercises

Patients can be directed to the BNSSG Pelvic Health website for further information.

https://myjointhealthhub.bnssg.nhs.uk/

Physiotherapy Referral

Patients can be referred to physio at UHBW or NBT by either GPs or midwives and this is normally done after the 6–8 week postpartum check. Patients cannot self-refer for DRAM.

Assessment, advice and exercises will be given.

Referrals should be made to the relevant physiotherapy department clearly stating what the referral is for. Referrals can be directly by e-mail, or attached as a GP letter or by using the ICB referral form.

UHBW

St Michael's: Email to be sent to ubh-tr.adulttherapies@nhs.net
WGH: Email to be sent to Physiotherapyoutpatientswestongeneral@uhbw.nhs.uk

NBT

Email to be sent to appointments@nbt.nhs.uk

Surgical Referral

Divarication of Recti is only commissioned by the ICB for extremely large, long-standing divarication which are causing herniation of abdominal contents and have failed conservative management or in conjunction with a routine midline hernia repair. See link to the Hernia Repair for patients 16 years and over CBA Policy, which includes Divarication of Recti.

Efforts are made to ensure the accuracy and agreement of these guidelines, including any content uploaded, referred to or linked to from the system. However, BNSSG ICB cannot guarantee this. This guidance does not override the individual responsibility of healthcare professionals to make decisions appropriate to the circumstances of the individual patient, in consultation with the patient and/or guardian or carer, in accordance with the mental capacity act, and informed by the summary of product characteristics of any drugs they are considering. Practitioners are required to perform their duties in accordance with the law and their regulators and nothing in this guidance should be interpreted in a way that would be inconsistent with compliance with those duties.

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