What rectus diastasis is
Rectus diastasis means that the two rectus abdominis muscles separate during pregnancy because the linea alba, the connective tissue in the middle, stretches and lengthens. This is common in pregnancy and initially a normal adaptation.
After birth this tissue can tighten again, but that does not always happen completely or at the same speed. Often the important factor is less the gap alone than how well the tissue can transmit tension and how your belly responds under load.
Why the abdomen bulges
Many notice a central bulge or a ridge, especially when getting up, when coughing, or when lifting the head. This happens when intra-abdominal pressure is directed forward because the middle still transmits little tension.
Typical situations where this is noticeable
- Getting up from lying down
- Coughing, sneezing, laughing
- Carrying and lifting, especially when tired
- Exercises like sit-ups, planks or heavy abdominal training too early
That is not proof that your body is permanently damaged. It is feedback that load, technique and breathing/pressure control are not yet working well together.
How common it is and when it becomes an issue
Rectus diastasis is very common around pregnancy and after birth. Many have it without it ever causing symptoms. For others it is associated with a feeling of instability, back pain or pelvic floor problems.
It is therefore important to put it in context: not every diastasis needs to be closed. Many goals are functional: better tension, less bulging under load, fewer symptoms, more control in daily life and during sport.
Self-check: what you can observe without overthinking it
You don’t need to measure like it’s an exam. For daily life it is often enough to ask whether your belly feels controlled under load or whether it clearly bulges forward.
Practical observations
- Does the belly bulge noticeably in the middle with small movements
- Do you have the sense that the middle offers no support
- Does it improve when you breathe more slowly and deliberately sit/stand up
- Do you also have a feeling of pressure downward or incontinence
If you have severe symptoms or are unsure, a check with specialised physiotherapy is sensible because tissue, breathing, posture and loading can be assessed together there.
What you need first: breathing, pressure management and basic core tension
Many make the mistake of training too hard too early. The core is not just the abdominal muscles. It is a system of breathing, diaphragm, abdominal wall, back and pelvic floor. After pregnancy this system is often disconnected.
A sensible start often feels unexciting
- Calm breathing in which the abdomen does not simply push forward
- Gentle activation of the deep abdominal muscles, without straining
- Daily-life techniques that reduce bulging, for example when getting up
Many guidelines and specialist texts now emphasise a functional perspective: it’s about control and pressure regulation, not a single number. A clear, accessible overview of the postnatal abdominal wall and rectus diastasis can be found at Pelvic, Obstetric and Gynaecological Physiotherapy. POGP: Postnatal rectus diastasis
Exercises: what often helps and what is frequently too early
There is no single magic exercise. What matters is whether you can maintain tension during training without the belly pushing forward or holding your breath.
Often useful
- Exercises in supine with calm exhalation and gentle tension
- Controlled leg movements while the abdominal wall remains stable
- Progression in quadruped or standing with focus on posture and breathing
Often too early
- Many sit-ups and crunches if they produce a ridge
- Long planks if you hold your breath or the belly bulges
- Heavy lifting and intense training without good pressure control
If you are unsure, a physio-guided progression is often faster than months of trial and error.
Physiotherapy: when it is particularly useful
Physiotherapy is not only for severe cases. It is useful if you don’t know how to start, or if you don’t gain control despite training.
Good reasons for a specialised check
- Noticeable bulging or a ridge during many daily activities
- Pain, back pain or a feeling of instability
- Additionally incontinence or a feeling of pressure downward
- Uncertainty when returning to sport
- Suspected hernia, for example a local, focal bulge
An evidence-based overview for classification and management is also discussed in medical reviews, for example on PubMed, although details vary by study. PubMed: Diastasis recti postpartum management
Rectus diastasis and the pelvic floor: why they can be connected
The abdominal wall and pelvic floor work together as a pressure system. If you lose a lot of pressure downward or forward under load, this can worsen symptoms such as a feeling of pressure or urinary leakage. Conversely, an overly tense pelvic floor can also alter how the abdominal wall works.
This does not mean that every rectus diastasis automatically causes pelvic floor problems. It only explains why it is often sensible to consider core and pelvic floor together.
Timing and expectation management: what is realistic
In the first weeks after birth much happens through uterine involution, reduced swelling and tissue healing. Training at that stage is more of a gentle introduction than a transformation.
Many see improvements over months when they build up regularly and sensibly. Sometimes a residual gap remains. That is not automatically a failure if function, stability and symptoms are acceptable.
When you should have it checked promptly
Seek help if you are not sure whether it is just a diastasis or if something else is going on. This is especially true for focal bulging or severe pain.
- a local, firm or painful bulge that appears as a single point
- severe pain or a clear deterioration
- accompanying symptoms such as severe incontinence or a strong suspicion of prolapse
- no improvement over a long time despite sensible load management
For a general overview of postpartum warning signs that require medical assessment, ACOG is a solid reference. ACOG: Warning signs of postpartum health problems
Conclusion
Rectus diastasis is common after pregnancy and initially a normal adaptation. The important factor is not only the gap but whether your abdominal wall can hold tension and regulate pressure well. A sensible start focuses on breathing, control and gradual progression. If you have symptoms, marked bulging or cannot progress with sport, specialised physiotherapy is often the quickest route to confidence and improvement.
