What diastasis recti is
Diastasis recti means 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 initially a normal adaptation.
After birth this tissue can tighten again, but that does not always happen completely or at the same speed for everyone. Often the gap alone is less important than how well the tissue can transmit tension and how your abdomen responds under load.
Why the belly bulges
Many notice a central bulge or a ridge, especially when sitting up, coughing, or lifting the head. This happens when intra-abdominal pressure is displaced forward because the midline still has little tension.
Typical situations where this is noticeable
- Rising from lying down
- Coughing, sneezing, laughing
- Carrying and lifting, especially when fatigued
- Exercises like sit-ups, planks, or heavy abdominal training too early
This is not proof that your body is permanently damaged. It is feedback that load, technique, and breathing pressure are not yet well coordinated.
How common it is and when it becomes an issue
Diastasis recti 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.
Context 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 during exercise.
Self-check: what to observe without stressing yourself out
You don’t need to measure like it’s an exam. For everyday life it is often enough to ask whether your abdomen feels controlled under load or whether it clearly moves forward.
Practical observations
- Does the belly noticeably bulge in the midline with small movements
- Do you feel the midline has little support
- Does it improve when you breathe more slowly and consciously sit up
- Do you also have a feeling of downward pressure or incontinence
If you have strong symptoms or are unsure, a check with a specialized physical therapist is sensible because tissue, breathing, posture, and load can be assessed together there.
What you need first: breathing, pressure management, and core engagement
Many make the mistake of training too hard too soon. 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 decoupled.
A sensible start often feels unexciting
- Calm breathing that does not just push the abdomen forward
- 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 now emphasize the functional perspective: it’s about control and pressure regulation, not a single number. A clear, patient-oriented overview of the postnatal abdominal wall and diastasis recti 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 magic exercise. The key is whether you can maintain tension during the exercise without the belly pushing forward or you holding your breath.
Often helpful
- Exercises in supine position with steady exhalation and gentle tension
- Controlled leg movements when the abdominal wall stays 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 form
- 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 therapist-led progression is often faster than months of trial and error.
Physical therapy: when it is especially useful
Physical therapy is not only for severe cases. It is useful if you don’t know how to start, or if you don’t achieve control despite training.
Good reasons for a specialized assessment
- Noticeable bulging or a ridge with many daily movements
- Pain, back pain, or a feeling of instability
- Also incontinence or a sense of downward pressure
- Uncertainty about returning to sport
- Suspected hernia, for example a local, focal bulge
An evidence-based overview for classification and management is also discussed in review articles, for example on PubMed, though details vary by study. PubMed: Diastasis recti postpartum management
Diastasis recti 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, symptoms like pressure or urine leakage can worsen. Conversely, a very tight pelvic floor can also change how the abdominal wall works.
That does not mean every 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's realistic
In the first weeks after birth a lot changes through uterine involution, reduced swelling, and tissue healing. Training is then more of a gentle introduction 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 acceptable.
When you should seek prompt evaluation
Get help if you are unsure whether it is just a diastasis or something else. This is especially true for focal bulges or severe pain.
- Local, firm, or painful protrusion that feels like a single point
- Severe pain or noticeable deterioration
- Accompanying symptoms like significant incontinence or suspected prolapse
- No improvement over an extended time despite sensible load management
For a general overview of postpartum warning signs that need medical evaluation, ACOG is a reliable 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 a gradual build-up. If you have symptoms, a marked bulge, or problems returning to exercise, specialized physical therapy is often the quickest route to confidence and progress.
