Impairment in the lower portion of the rectus abdominis was felt in 15% of the bipedicle
TRAM recipients. Fifty-five percent of patients in the pedicle group and 30% in the bipedicled group reported mild back pain at six months. Zenn (2001) cautioned that preexisting back pain may be exacerbated by the surgery. Back pain is a concern because it can affect all aspects of a person’s life, including psychological well-being, family, and the ability to return to work and recreational activities (Mayo Clinic, 2007).