How to Fix Diastasis Recti: Exercises & Treatment Options

Diastasis recti, the separation of the left and right halves of the abdominal muscles along the midline, can improve significantly with targeted exercise, and most people do not need surgery. The gap often narrows on its own in the early months after pregnancy, but for many it persists, with research showing that roughly a third of women still have a separation wider than two centimeters years after giving birth. The right combination of core exercises, breathing strategies, and, in stubborn cases, professional guidance or surgical repair can meaningfully close that gap and restore function.

What Is Actually Happening in Your Abdomen

Your abdominal muscles are joined at the center by a strip of connective tissue called the linea alba. Diastasis recti occurs when this tissue stretches and thins, allowing the two sides of the rectus abdominis (the “six-pack” muscle) to drift apart. Pregnancy is the most common cause: a study tracking 171 pregnant women with ultrasound found that by 37 weeks of gestation the gap between the muscles was significantly wider than at 12 weeks, and the muscle tissue itself was thinner and less stiff. By six weeks postpartum, the gap had partially closed and the muscle had begun to recover, but both measures were still worse than early pregnancy values.¹

Hormones play a role in this softening. Estrogen and relaxin, which surge during pregnancy, cause a loss of collagen in connective tissues throughout the body, weakening ligaments, fascia, and the structures that hold the abdominal wall together.² That hormonal environment means the tissue is at its most vulnerable right around delivery and in the weeks that follow.

Whether the gap closes fully depends on several factors. Higher body weight, carrying twins, having had multiple pregnancies, and diabetes all independently raise the odds of a persistent separation.³ This is not a condition that only matters in the first year after childbirth. When researchers measured women at 3, 5, 10, 20, and 30 years postpartum using a two-centimeter threshold, they found prevalence rates of 36%, 31%, 22%, 26%, and 30%, respectively.³ The takeaway is that for a meaningful number of women, diastasis recti does not simply resolve on its own, even decades later.

How to Check Whether You Have It

The simplest self-check is the finger-width test: lie on your back with knees bent, lift your head slightly to engage the abs, and press your fingers into the midline above and below your navel. If you can fit two or more finger-widths into the gap, you likely have some degree of separation. Research comparing different measurement tools to ultrasound found that the finger-width method correlates reasonably well with imaging, though it is less precise than calipers or ultrasound itself.⁴ For a more accurate measurement, a physiotherapist can use calipers, which had a strong correlation with ultrasound and narrow limits of agreement.

The width of the gap matters, but so does the quality of the tissue. A narrow gap with very soft, unsupportive connective tissue can be more functionally problematic than a wider gap with firm tissue that still generates tension. This is why many physiotherapists assess not just the distance but how much tension you can create along the midline when you contract your core.

Exercises That Actually Help

Exercise is the first-line treatment for diastasis recti, and the evidence supports a range of approaches rather than one single magic move. A scoping review of postpartum rehabilitation found that programs targeting both the deep core muscles (like the transversus abdominis and pelvic floor) and the superficial muscles (like the rectus abdominis itself), along with breathing exercises and functional movements, showed promising results in reducing the gap and improving related symptoms.⁵ A systematic review similarly found that improvements came from traditional abdominal exercises combined with deep core work, pelvic floor exercises, crunch-type movements, drawing-in exercises alongside other abdominal work, and even neuromuscular electrical stimulation paired with exercise.⁶

The most important practical takeaway from the research is that you do not need to avoid all traditional abdominal exercises. For years, many postpartum fitness guides warned against crunches, sit-ups, or any exercise that visibly “domes” the belly. The evidence tells a more nuanced story.

The Crunch Versus Drawing-In Debate

One study measured what happened to the gap immediately during two different exercises in pregnant and postpartum women. Abdominal crunches consistently narrowed the distance between the muscles, while drawing-in exercises (pulling the navel toward the spine without moving the trunk) tended to slightly widen it.⁷ That does not mean drawing-in is useless. It activates the deep stabilizers, which contribute to long-term support. But the finding challenges the common advice that crunches are always harmful for diastasis recti.

A pilot trial comparing early postpartum exercise programs also found that women assigned to rectus abdominis exercises (movements that work the outer “six-pack” muscles) achieved a greater reduction in the gap at both 6 and 12 weeks compared to women assigned to transversus abdominis (deep core) exercises alone.⁸ The key caveat is that this was a small pilot study, but it adds to a growing picture: strengthening the rectus abdominis directly appears to help close the gap, not worsen it.

Deep Core Stability Programs

A randomized trial of a deep core stability exercise program (targeting the transversus abdominis, pelvic floor, diaphragm, and multifidus as a coordinated unit) found a highly significant decrease in the separation along with meaningful improvement in quality of life.⁹ A separate study tested a program that combined core strengthening with stability-oriented breathing training and found that while both the exercise group and control group improved, the group that added coordinated breathing exercises to their core work saw a significantly greater reduction in the gap at every measurement point.¹⁰

Putting this together, the best approach is probably not to choose between deep core and superficial abdominal exercises but to do both, with an emphasis on coordinated breathing and gradual progression. A physiotherapist who specializes in postpartum recovery can tailor the program to where you are starting from.

Do Belly Wraps and Binders Help

Abdominal binders and compression garments are widely marketed to postpartum women, and many people find them comfortable in the early weeks after delivery. But the evidence for their effect on the gap itself is underwhelming. A randomized trial comparing a rigid belt, a Tubigrip compression bandage, and no support at all found that the separation reduced by about 46% over eight weeks across all three groups, with no significant difference between them.¹¹ The researchers questioned whether either support improved outcomes beyond what natural healing would accomplish on its own.

That said, a separate pilot trial found that women who combined exercise therapy with abdominal binding showed a moderate positive effect on trunk strength, while binding alone had a positive effect on body image.¹² So a binder may help you feel more supported and confident while you exercise, even if it is not directly fixing the tissue. Think of it as a comfort tool rather than a treatment.

Device-Based Options

High-intensity focused electromagnetic (HIFEM) devices, marketed under brand names you have probably seen advertised for body contouring, work by forcing rapid, powerful muscle contractions that are far beyond what you could achieve voluntarily. A pilot study using MRI to track changes in nine postpartum women found that after a course of treatments, the distance between the rectus muscles decreased by about 17% at one month and nearly 23% at three months, alongside increases in muscle thickness and reductions in abdominal fat.¹³

A systematic review pooling results from multiple HIFEM studies reported more modest average improvements for abdominal contouring: a mean reduction in fat thickness of about 5.5 millimeters, muscle thickness increase of 2 millimeters, and diastasis improvement of 3.0 millimeters.¹⁴ A 3-millimeter improvement is real but modest, and these devices are expensive and not typically covered by insurance. They are worth knowing about, but for most people, a disciplined exercise program will accomplish more at lower cost. The technology may be a reasonable add-on for someone who has plateaued with exercise, not a replacement for it.

When Surgery Makes Sense

For people with a large, symptomatic separation that has not responded to months of consistent exercise, surgical repair becomes a real conversation. Surgery is also strongly worth considering when diastasis recti coexists with an abdominal hernia, because the combination makes hernia recurrence much more likely if only the hernia is fixed. One study of patients who had small umbilical or epigastric hernias repaired with sutures found that those who also had diastasis recti had a significantly higher rate of hernia recurrence compared to those without diastasis.¹⁵ In other words, ignoring the diastasis during a hernia repair can set you up for another operation down the road.

Surgical approaches broadly fall into two categories: open and minimally invasive. Open repair is often combined with abdominoplasty (a tummy tuck), which simultaneously removes excess skin and tightens the muscle wall. One series of 32 patients who had mesh-reinforced midline repair with abdominoplasty reported no infections and no recurrence of a bulge or hernia after an average follow-up of about 15 months.¹⁶

Minimally invasive techniques are gaining ground. Laparoscopic and endoscopic repairs use small incisions and involve stitching the separated muscles back together, sometimes reinforced with mesh. A pilot study of a minimally invasive technique in 74 patients (mostly women) reported no major complications, no infections, and only two recurrences after six months, with a significant reduction in symptoms.¹⁷ A systematic review comparing open and laparoscopic methods concluded that both approaches are safe and effective.¹⁸ The laparoscopic approach typically offers a shorter hospital stay and less visible scarring, while open repair gives the surgeon more room to address larger defects and remove skin.

When an umbilical hernia and diastasis are repaired together, recovery tends to be straightforward. A study of 100 patients who had combined hernia and diastasis repair reported an average hospital stay of about two days, with drain removal within two days and only one complication (a wound hematoma that healed without further intervention).¹⁹

Does Diastasis Recti Cause Back Pain and Pelvic Floor Problems

One of the most common things you will read online is that diastasis recti causes low back pain, pelvic floor dysfunction, and urinary incontinence. The actual evidence is surprisingly thin on this. A systematic review examining the relationship between diastasis recti and musculoskeletal problems found no significant association between the presence of a separation and either low back/pelvic pain or incontinence.²⁰ A retrospective study of women with varying severities of diastasis recti found no difference in rates of urinary incontinence, pelvic organ prolapse, or back pain between those with and without the condition, even when the researchers tried different threshold widths.²¹

This does not mean your back pain is not real, or that your pelvic floor is fine. It means the gap itself may not be the direct cause. Many postpartum women experience back pain, pelvic floor weakness, and incontinence for reasons that overlap with but are distinct from diastasis recti: general deconditioning, changes in posture, hormonal effects on connective tissue, and the physical demands of carrying and feeding a baby. Treating these issues alongside diastasis recti, rather than assuming the gap is the single culprit, tends to lead to better outcomes.

Diastasis Recti in Men

Though pregnancy is the most common cause, diastasis recti is not exclusively a postpartum condition. Middle-aged men with obesity are the second most common group affected.²² The causes in men are different: visceral fat pressing outward against the abdominal wall, age-related changes in connective tissue, heavy lifting, and possibly genetic differences in collagen composition. Smoking also appears to degrade the quality of the linea alba, and men with diastasis recti have notably high rates of concurrent abdominal wall hernias and, in some cases, aortic aneurysms.²³

The condition tends to be most common in men over 60 who are overweight and physically inactive.²⁴ In most cases it is asymptomatic, though it can cause functional problems when a hernia is also present. The treatment principles are broadly the same: core strengthening, weight management, and surgical repair for significant cases. One interesting difference is that body image distress, a major concern for postpartum women with diastasis recti, appears to be less commonly reported in men, while low back pain connected to core instability may be more of a driver for seeking treatment.²²

The Emotional Side

The research on the lived experience of diastasis recti is clear that this condition affects far more than the abdominal wall. Qualitative studies of women living with diastasis recti consistently identify themes of frustration, poor body image, difficulty with self-esteem and intimacy, and a feeling that the condition is not taken seriously by healthcare providers.²⁵ Women describe the impact extending into social functioning, child-rearing, and their ability to return to work. Another study found that body image dissatisfaction and emotional difficulty in accepting appearance changes are core parts of the symptom picture, not just add-ons.²⁶

A recurring theme in interviews is that women struggle to get clear information about their condition. Many describe not being told about diastasis recti by their midwife or obstetrician, discovering it on their own months or years later, and then encountering conflicting advice online.²⁷ If this describes your experience, you are far from alone. The condition is extremely common, and the gap in professional awareness is slowly closing as more research accumulates.

A Practical Starting Framework

Given the range of options, a reasonable approach looks something like this:

• First few weeks postpartum: Gentle breathing exercises coordinated with pelvic floor activation. Allow early natural recovery to happen. Binders are fine for comfort but are not treatment.
• From about six weeks on: Begin a structured program that includes both deep core activation and progressive rectus abdominis strengthening. Crunches are not inherently off-limits, but start slow and watch for excessive doming of the midline during any exercise.
• Three to six months: If consistent exercise has not produced noticeable improvement, seek assessment from a physiotherapist who can use calipers or ultrasound to measure the gap precisely and adjust your program.
• Beyond six months to a year: If the gap remains functionally problematic after dedicated rehab, consider a surgical consultation, particularly if you also have a hernia or plan another pregnancy (some surgeons recommend waiting until you are done having children).

This timeline is a guide, not a prescription. Some women see rapid improvement, others plateau. Men with the condition follow a similar trajectory: core strengthening first, weight management where applicable, surgery if conservative measures fall short.

Exercises to Approach With Caution

While the blanket ban on crunches is not well supported, certain high-pressure movements deserve genuine caution, particularly early in recovery. Exercises that create large spikes in intra-abdominal pressure without adequate core control can push the abdominal contents outward and stress the already-weakened linea alba. Heavy deadlifts, uncontrolled sit-ups performed rapidly, and double-leg lifts from a flat-lying position are common offenders. The issue is not the specific exercise so much as whether your core can maintain tension along the midline throughout the movement. If you see a visible ridge or dome running down the center of your belly during any exercise, that is a signal to regress the difficulty. As your core strengthens and the tissue firms up, movements that once caused doming often become safe to perform.

Yoga and Pilates-inspired movements show up frequently in the rehabilitation literature, and both can be helpful when modified appropriately. Suspension training and what are called “hypopressive” exercises (a breathing technique that creates negative pressure in the abdomen) have also shown promise, though the evidence base is still small.⁵ The common thread across all effective programs is progressive loading: you start easy, monitor how your midline responds, and gradually increase demand on the muscles over weeks and months.