What diastasis recti is
Diastasis recti means that the two rectus abdominis muscles are pushed apart during pregnancy because the linea alba, the connective tissue in the midline, stretches and lengthens. This is common in pregnancy and is initially a normal adaptation.
After birth this tissue can tighten again, but it does not always fully return or recover at the same speed. Often the important factor is not the gap alone but how well the tissue transmits tension and how your abdomen responds to loading.
Why the abdomen bulges
Many notice a central bulge or a ridge, especially when getting up, coughing or when lifting the head. This happens when intra‑abdominal pressure moves forwards because the midline is not yet transmitting much tension.
Typical situations where this is noticeable
- Sitting up from lying down
- Coughing, sneezing, laughing
- Carrying and lifting, particularly when tired
- Exercises such as sit-ups, planks or heavy abdominal training performed too early
This is not proof that your body is permanently damaged. It is feedback that load, technique and breathing pressure are not yet working well together.
How common it is and when it becomes relevant
Diastasis recti is very common around pregnancy and after birth. Many have it without it ever causing problems. For others it is associated with feelings of instability, back pain or pelvic floor symptoms.
It is therefore important to put it into 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 to notice without getting anxious
You don’t need to measure it like an exam. For daily life it is often enough to ask whether your abdomen feels controlled under load or whether it clearly bulges forwards.
Practical observations
- Does the abdomen bulge significantly in the middle with small movements
- Do you feel that the midline has no support
- Does it improve when you breathe more slowly and deliberately sit up
- Do you also have a feeling of pressure downwards or incontinence
If you have severe symptoms or are unsure, a check with specialist physiotherapy is sensible because tissue, breathing, posture and loading can be assessed together there.
What you need first: breathing, pressure management and basic 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 not coordinated.
A sensible start often feels boring
- Calm breathing where the abdomen does not simply push forwards
- Gentle activation of the deep abdominal muscles without bearing down
- Everyday techniques that reduce bulging, for example when getting up
Many guidelines and specialist texts today emphasise a functional perspective: it is about control and pressure regulation, not a single number. A clear overview of the postnatal abdominal wall and diastasis recti is available from 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. The key is whether you can maintain tension during exercise without the abdomen bulging forwards or holding your breath.
Often useful
- Exercises in supine with calm exhalation and gentle tension
- Controlled leg movements while keeping the abdominal wall stable
- Progression in hands-and-knees or standing with a focus on posture and breathing
Frequently too early
- Many sit-ups and crunches if they create a ridge
- Long planks if you hold your breath or the abdomen bulges
- Heavy lifting and intense training without good pressure management
If you are unsure, physiotherapist‑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 cannot achieve control despite training.
Good reasons for a specialised assessment
- Pronounced bulging or a ridge during many daily movements
- Pain, back pain or a feeling of instability
- Additionally incontinence or a feeling of pressure downwards
- Uncertainty when returning to sport
- Suspected hernia, for example a local, focal bulge
An evidence‑based overview for assessment and management is discussed in medical reviews, for example on PubMed, though details vary between studies. PubMed: Diastasis recti postpartum management
Diastasis recti and the pelvic floor: why they can be linked
The abdominal wall and pelvic floor work together as a pressure system. If you lose pressure downwards or forwards under load, symptoms such as a feeling of pressure or urinary leakage can be worse. Conversely, a very tense pelvic floor can also change how the abdominal wall works.
This does not mean every diastasis automatically causes pelvic floor problems. It simply explains why it is often sensible to consider core and pelvic floor together.
Timing and expectations: what is realistic
In the first weeks after birth much happens through uterine involution, reduced swelling and tissue healing. Training at that time is more about a gentle start than a transformation.
Many see improvements over months when they build up regularly and sensibly. Sometimes a residual gap remains. That is not necessarily a failure if function, stability and symptoms are acceptable.
When you should get it checked promptly
Seek help if you are unsure whether it is just a diastasis or if something else is going on. This is especially important with focal bulging or severe pain.
- a local, hard or painful bulge that feels like a single point
- severe pain or a clear deterioration
- accompanying symptoms such as significant incontinence or suspected pelvic organ prolapse
- no improvement over a prolonged period despite sensible load management
For a general overview of postnatal warning signs that require medical assessment, ACOG is a useful reference. ACOG: Warning signs of postpartum health problems
Conclusion
Diastasis recti is common after pregnancy and initially a normal adaptation. What matters is not only the gap but whether your abdominal wall can hold tension and manage pressure well. A sensible start focuses on breathing, control and gradual progression. If you have symptoms, marked bulging or difficulty progressing in sport, specialised physiotherapy is often the quickest route to confidence and improvement.
