What rectus diastasis is
Rectus diastasis 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 this does not always happen fully or at the same pace for everyone. Often the distance alone is less important than how well the tissue transmits tension and how your abdomen responds under load.
Why the abdomen bulges
Many notice a central bulge or a ridge, especially when rising up, when coughing or when lifting the head. This happens when intra‑abdominal pressure is displaced forward because the midline still has little tension.
Typical situations in which this is noticeable
- Rising from lying down
- Coughing, sneezing, laughing
- Carrying and lifting, especially when tired
- Exercises such as sit-ups, planks or heavy abdominal training done too early
This 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 childbirth. Many have it without it ever causing symptoms. For others it is associated with a feeling of instability, back pain or pelvic floor problems.
Assessment is therefore important: 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 in sport.
Self-check: what to observe without worrying
You do not need to measure like in an exam. For daily life it is often enough to ask whether your abdomen feels controlled under load or whether it clearly bulges forward.
Practical observations
- Does the abdomen bulge noticeably in the middle with small movements
- Do you feel that the midline gives no support
- Does it improve when you breathe more slowly and intentionally sit or stand up
- Do you also have a feeling of downward pressure or incontinence
If you have severe symptoms or are unsure, a check with specialised physiotherapy is sensible because there tissue, breathing, posture and loading can be assessed together.
What you need first: breathing, pressure management and basic core activation
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 well coordinated.
A sensible start often feels boring
- Calm breathing that does not simply push the abdomen forward
- Gentle activation of the deep abdominal muscles without straining or bearing down
- Everyday techniques that reduce bulging, for example when getting up
Many guidelines and professional texts today emphasise the functional perspective: it is about control and pressure regulation, not a single measurement. A clear 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 often too early
There is no single magical exercise. What matters is whether you can maintain tension during the exercise without the abdomen bulging forward or holding your breath.
Often helpful
- Exercises in supine with calm exhalation and gentle tension
- Controlled leg movements while the abdominal wall remains stable
- Progression in hands-and-knees or standing with focus on posture and breathing
Often too early
- Many sit-ups and crunches if they cause a ridge to appear
- Long planks if you hold your breath or the abdomen bulges
- Heavy lifting and intense training without good pressure management
If you are unsure, a 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 when you do not know how to start, or when you do not achieve control despite training.
Good reasons for a specialised assessment
- Pronounced bulging or a ridge with many daily movements
- Pain, back pain or a feeling of instability
- Additionally incontinence or a feeling of downward pressure
- Uncertainty when returning to sport
- Suspected hernia, for example a localised, focal protrusion
An evidence-based overview for assessment and management is also discussed in review articles indexed on PubMed, with details varying by study. PubMed: Diastasis recti postpartum management
Rectus diastasis and the pelvic floor: why they can be linked
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 change 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 managing expectations: what is realistic
In the first weeks after birth many changes occur due to uterine involution, reduction of swelling and tissue healing. Training at that stage is more about a gentle start than a transformation.
Many see improvements over months if they build up regularly and sensibly. Sometimes a residual gap remains. That is not automatically a failure if function, stability and symptoms are satisfactory.
When you should seek assessment soon
Seek help if you are unsure whether it is only a diastasis or if something else is causing the problem. This is particularly important with a focal bulge or severe pain.
- Local, hard or painful protrusion that feels like a single point
- Severe pain or marked worsening
- Accompanying symptoms such as severe incontinence or a clear suspicion of prolapse
- No improvement over a longer period despite sensible load management
For a general overview of postnatal warning signs that warrant medical review, ACOG is a reliable reference. ACOG: Warning signs of postpartum health problems
Conclusion
Rectus diastasis is common after pregnancy and is initially a normal adaptation. The key point is not only the separation but whether your abdominal wall can hold tension and manage pressure well. A sensible start focuses on breathing, control and steady progression. If you have symptoms, pronounced bulging or are not progressing with exercise, specialised physiotherapy is often the quickest route to confidence and improvement.
