Diastasis Recti (Abdominal Separation)

Diastasis recti occurs when the abdominal muscles move apart along the midline and the connective tissue between them widens. After birth, you may notice it as doming along the middle of your belly, a feeling of weakness in your core, or difficulty with certain movements. However, it isn't right to judge how well someone functions just by looking at the belly or measuring the width of the gap between the muscles. A physiotherapy assessment considers the tension and function of the abdominal wall together with breathing, trunk control and everyday movement. The exercise plan aims to gradually strengthen the abdominal muscles according to your needs and to manage pressure during movement. Because the same exercise program may not suit everyone, a personalized roadmap is created after the assessment.

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Diastasis Recti After Birth (Abdominal Separation): Assessment and Physiotherapy

Changes in the Abdominal Wall After Pregnancy

As the belly grows during pregnancy, the connective tissue in the middle of the abdominal muscles stretches and the distance between the muscles increases. This change may persist for a while after birth. Noticing a bulge along the midline of your belly does not by itself mean you have diastasis recti; an assessment is always needed.

How Can Midline Doming Affect Everyday Movement?

You may see doming along the middle of your belly when getting out of bed, bending forward or lifting your baby. Some people feel weakness in the abdominal area or have trouble with control during movement; others have no noticeable symptoms. The type of symptoms and their effect on daily life vary from person to person.

Physiotherapy Assessment for Diastasis Recti

A physiotherapy assessment considers the strength and movement of the abdominal wall together with breathing, trunk control and daily activities. Exercises are planned gradually based on your symptoms and goals. The aim is not only to reduce the distance between the muscles but to improve the function of the abdominal wall and your control during movement. Physiotherapy is one of the approaches that can be considered before surgical options.

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Common and Treatable

In a study following 300 first-time pregnant women, a gap between the abdominal muscles was found in about 60 of every 100 women at 6 weeks after birth and in 33 at 1 year.

"When I get out of bed, a ridge appears in the middle of my belly."

"I find it hard to control my belly when I lift my baby."

"I noticed a gap between my abdominal muscles; I don't know which movements I can do."

Sperstad JB, Tennfjord MK, Hilde G, Ellström-Engh M, Bø K. Diastasis recti abdominis during pregnancy and 12 months after childbirth: prevalence, risk factors and report of lumbopelvic pain. British Journal of Sports Medicine. 2016;50(17):1092–1096.

Diastasis Recti (Abdominal Separation) FAQ

How can I tell if I have diastasis recti?

You may notice a bulge or doming along the midline when getting out of bed or using your abdominal muscles. This appearance alone is not a diagnosis; a physiotherapist or doctor assesses your abdominal wall and how it functions. If there is a noticeable swelling or pain, a doctor's examination may also be needed.

Can diastasis recti be fixed with exercise?

Exercise helps improve the strength and movement control of the abdominal wall. How much the distance between the muscles changes differs from person to person. That's why the exercise program is based on the assessment findings. The European Hernia Society states that physiotherapy can be considered before surgical options are explored.

Should I stop doing ab exercises completely?

You don't need to stop every abdominal exercise. If you notice obvious doming along the midline, pain or difficulty with control during an exercise, the way you do the movement, its difficulty or your breathing can be adjusted. The right exercises for you are chosen based on your assessment and goals.

Can diastasis recti also occur after a C-section?

Yes. Diastasis recti is related to the stretching of the abdominal wall during pregnancy and can occur after any type of birth. Along with how you gave birth, the assessment also takes into account your recovery and your symptoms.

Does the assessment only measure the gap between the muscles?

No. Measuring the gap is only one part of the assessment; the tension of the abdominal wall, how the muscles work, and breathing and movement control are also important. The European Hernia Society's 2 cm criterion helps with the definition, but on its own it does not determine your exercise needs or treatment plan.