# Association Between Diastasis of the Rectus Abdominis Muscles and Musculoskeletal Conditions in the First 2 Years Postpartum: A Cross‐Sectional Study

**Authors:** Eloise Simpson, Madeline Hannington, Kari BØ, Andrew Hahne

PMC · DOI: 10.1002/msc.70209 · Musculoskeletal Care · 2026-03-23

## TL;DR

This study found that diastasis of the rectus abdominis muscles is weakly linked to abdominal discomfort and urinary urgency in the first two years after childbirth.

## Contribution

The study provides new evidence on the relationship between DRAM and specific postpartum musculoskeletal symptoms.

## Key findings

- DRAM presence was significantly associated with current and early postpartum abdominal discomfort.
- DRAM was linked to early postpartum urinary urgency symptoms.
- No significant associations were found between DRAM and low back pain or pelvic girdle pain.

## Abstract

To explore associations between the presence and severity of diastasis of the rectus abdominis muscles (DRAM) and common postpartum musculoskeletal complaints in the first 2 years postpartum.

Cross‐sectional survey among women within 2 years of childbirth.

DRAM commonly affects women during pregnancy and postpartum, but its relationship with musculoskeletal complaints remains unclear. This study investigates the association between DRAM and postpartum musculoskeletal complaints, including low back pain, pelvic girdle pain, abdominal pain, and pelvic floor dysfunction.

Participants were identified from medical records of women who had delivered a baby in the previous 2 years at Southwest Healthcare, Warrnambool, Victoria, Australia. An electronic questionnaire collected data on DRAM presence and severity (self‐reported based on self‐assessment or prior healthcare professional screening), musculoskeletal complaints, and pelvic floor dysfunction both currently (within the past week) and early postpartum (within the first 3 months). Statistical univariate and multivariate regression analyses explored associations between DRAM presence or severity and reported symptoms adjusted for age, parity, delivery method and time since last delivery.

Of 177 respondents (from 785 survey invitations), 38% (n = 70) reported DRAM. In multivariate analysis, DRAM presence was significantly associated with current (p = 0.034) and early postpartum (p = 0.037) abdominal discomfort, and urinary urgency symptoms early postpartum (p = 0.033). No significant associations were found between DRAM and low back pain, pelvic girdle pain, or stress urinary incontinence.

DRAM was weakly associated with abdominal discomfort and urinary urgency symptoms but not with other musculoskeletal complaints. These findings align with limited previous research on this topic. More data are needed to explore the association between DRAM severity and musculoskeletal disorders.

## Full-text entities

- **Genes:** DRAM1 (DNA damage regulated autophagy modulator 1) [NCBI Gene 55332] {aka DRAM}
- **Diseases:** Pelvic Girdle Pain (MESH:D059388), urgency urinary symptoms (MESH:D059411), Pelvic Floor Dysfunction (MESH:D059952), stillbirth (MESH:D050497), infant death (MESH:D066088), girdle pain (MESH:D010146), stress urinary incontinence (MESH:D014550), sequelae (MESH:D000094024), abdominal discomfort (MESH:D000007), Low Back Pain (MESH:D017116), Diastasis of the Rectus Abdominis Muscles (MESH:D000070630), incontinence of the bowel (MESH:D005242), Musculoskeletal Complaints (MESH:D009140), pelvic pain (MESH:D017699), musculoskeletal pain (MESH:D059352), pelvic organ prolapse (MESH:D056887), Abdominal Pain (MESH:D015746)
- **Species:** Homo sapiens (human, species) [taxon 9606]

## Full text

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## Figures

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## References

40 references — full list in the complete paper: https://tomesphere.com/paper/PMC13008823/full.md

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Source: https://tomesphere.com/paper/PMC13008823