Diastasis recti (DR) is a common physical change that occurs when the two long, parallel bands of the rectus abdominis muscles, often called the “six-pack” muscles, separate from each other. This separation happens along the midline connective tissue known as the linea alba. The condition is a natural adaptation, especially during pregnancy, as the uterus expands and stretches the abdominal wall. This stretching causes the linea alba to thin and widen, and while the tissue often recovers after childbirth, the separation can persist in a significant number of postpartum individuals.
Identifying Diastasis Recti
Before starting recovery, confirm the presence and extent of the separation using a simple self-assessment. Lie on your back with your knees bent and feet flat. Place one hand behind your head for support, and position the fingertips of the other hand directly on your abdomen at the belly button, pointing toward your pelvis.
Gently press down with your fingertips, then lift your head and shoulders slightly, as if starting a small crunch. As you lift, the two ridges of the rectus abdominis muscles will move closer. Measure the width of the gap between the muscle ridges using your fingers. A separation of two finger-widths or more is considered diastasis recti.
Also assess the depth of the separation, or the integrity of the connective tissue. If the tissue feels deep and soft with little resistance, it suggests a lack of tension in the linea alba, which indicates functional weakness. Repeat this check both above and below the navel, as the separation can vary along the midline.
Activities and Exercises to Avoid
Certain exercises and movements place excessive outward pressure on the weakened linea alba, potentially worsening the separation or delaying recovery. The goal is to prevent the abdominal wall from visibly bulging, coning, or doming during any physical effort, as this indicates unsafe intra-abdominal pressure. High-risk movements typically involve forceful torso flexion or extension without proper deep core engagement.
Traditional abdominal exercises should be avoided, especially in early rehabilitation, as they stress the rectus abdominis and drive contents outward through the gap. These include:
- Full crunches
- Sit-ups
- Bicycle crunches
- Reverse crunches
Similarly, static positions like full planks or push-ups, or Pilates moves such as double leg lifts or rollbacks, can generate unsafe pressure.
Approach any activity requiring forceful twisting or heavy lifting, particularly overhead lifting, with caution or stop temporarily. Avoid aggressively sitting straight up out of bed, which strains the abdominal wall. Instead, focus on rolling onto your side to get up and practice proper core bracing during all efforts, such as coughing or sneezing.
Guided Core Strengthening for Recovery
Healing diastasis recti requires a specific, progressive approach that focuses on restoring the function and tension of the deep core muscles. The foundation of recovery begins with mastering proper breathwork, which involves shifting away from shallow chest breathing toward diaphragmatic, or 360-degree, breathing.
To practice this, lie on your back with your knees bent and place your hands on your lower ribcage and abdomen. Inhale deeply through your nose, allowing the breath to expand your ribs outward and slightly into your sides and back. This focused inhalation encourages a full expansion of the diaphragm.
The next step is activating the transverse abdominis (TVA), the deepest layer of the core muscles which acts like a natural corset. As you exhale slowly through pursed lips, gently draw your belly button inward toward your spine, feeling the abdominal muscles flatten and tighten. Imagine zipping up a pair of tight jeans to cue this deep engagement. This exhale-based contraction stabilizes the torso and helps draw the separated muscles closer together.
Initial exercises should be non-load bearing, such as practicing TVA breathing while lying on your back or on all fours. Once you can maintain this deep core connection without bulging, progress to adding simple limb movements. A safe progression involves starting with small, controlled movements like heel taps or alternating leg slides while maintaining the TVA contraction on the exhale.
As your strength improves, you can advance the exercises by challenging your stability with movements like elevated bent-knee marches or seated core compressions. The goal is always to prioritize the quality of the contraction and avoid any sign of doming or coning in the midline. Consistent, slow, and controlled engagement of the TVA builds the foundational strength necessary to handle more functional movements and greater loads.
Daily posture modification is also an important part of the healing process outside of dedicated exercise time. Always roll onto your side before using your arms to push yourself up to a seated or standing position, preventing unnecessary strain on the healing linea alba. Maintaining an awareness of this deep core engagement throughout the day—when lifting objects or carrying children—reinforces the work done during formal exercise.
When to Seek Professional Medical Care
While self-guided exercise can be highly effective, professional medical assessment may be necessary for a safe and complete recovery. Seek consultation if you are not seeing noticeable results after six months of consistent, targeted core strengthening. A specialist can provide a personalized, comprehensive rehabilitation plan tailored to your specific condition and functional needs.
It is important to consult a pelvic floor physical therapist (PFPT) if the diastasis recti is accompanied by other functional issues. These symptoms can include lower back pain, pelvic girdle pain, urinary incontinence, or the sensation of pelvic organ prolapse. A PFPT is trained to assess the entire core unit, including the pelvic floor, which works closely with the TVA.
For severe or non-responsive cases causing significant pain or functional impairment, a medical professional may discuss surgical options. The most common surgical intervention is an abdominoplasty, which physically repairs the abdominal wall. Non-surgical core rehabilitation remains the recommended first line of treatment.