Diastasis Recti: Abdominal Separation Recovery Guide

Published by Lizzie Thornton

Diastasis recti is common after pregnancy but can be effectively treated. This comprehensive guide explains what it is, how to check for it, safe exercises for recovery, and when to seek professional help.

What is diastasis recti?

Definition

  • Separation of abdominal muscles
  • Gap in linea alba (connective tissue)
  • Normal during pregnancy
  • Usually improves postnatally
  • Can persist without treatment
  • Very treatable

How common?

  • 60% of women during pregnancy
  • 35% at 6 months postnatal
  • Can occur in men (rare)
  • More common with multiple pregnancies
  • Larger babies increase risk

Symptoms

  • Visible bulge when sitting up
  • Dome shape down midline
  • Lower back pain
  • Poor posture
  • Pelvic floor problems
  • Core weakness
  • "Mummy tummy"

Causes and risk factors

During pregnancy

  • Growing uterus
  • Hormonal changes
  • Stretching of connective tissue
  • Normal adaptation
  • Multiple pregnancies
  • Large babies
  • Twins or multiples

Other causes

  • Obesity
  • Incorrect exercise
  • Heavy lifting
  • Chronic coughing
  • Genetics

Self-checking for diastasis recti

How to check

  1. Lie on back, knees bent
  2. Place fingers above belly button
  3. Lift head and shoulders slightly
  4. Feel for gap
  5. Measure width in finger widths
  6. Check above, at, and below belly button
  7. Note depth and tension

What's normal?

  • Less than 2 finger widths: normal
  • 2-3 finger widths: mild separation
  • 3-4 finger widths: moderate
  • More than 4: significant
  • Depth and tension also important
  • Function matters more than gap size

Safe exercises for recovery

Core reconnection exercises

Diaphragmatic breathing

  1. Lie on back, knees bent
  2. Hands on belly
  3. Breathe in, belly rises
  4. Breathe out, belly falls
  5. 10 breaths, several times daily
  6. Connects to deep core

Pelvic floor connection

  1. Gentle pelvic floor squeeze
  2. Feel lower abs engage
  3. Hold 5 seconds
  4. 10 reps, 3 times daily
  5. Foundation exercise

Heel slides

  1. Lie on back, knees bent
  2. Engage core gently
  3. Slide one heel away
  4. Keep core stable
  5. 10 each leg, 2-3 sets

Pelvic tilts

  1. Lie on back, knees bent
  2. Gently tilt pelvis
  3. Flatten lower back
  4. Engage deep abs
  5. 10 reps, 2-3 sets

Progression exercises

Dead bug (modified)

  1. Lie on back
  2. Knees bent, feet up
  3. Lower one leg slowly
  4. Keep core engaged
  5. 10 each side, 2-3 sets

Bird dog

  1. On hands and knees
  2. Extend opposite arm and leg
  3. Keep core stable
  4. Hold 5 seconds
  5. 10 each side, 2-3 sets

Plank (when ready)

  1. On forearms and knees initially
  2. Body straight
  3. Hold 10-30 seconds
  4. Progress to toes
  5. No doming

Exercises to avoid

Don't do these

  • Traditional crunches
  • Sit-ups
  • Front planks (initially)
  • Heavy lifting
  • Intense twisting
  • Double leg raises
  • Any exercise causing doming

Signs to stop

  • Visible doming or bulging
  • Pain
  • Feeling of weakness
  • Pelvic floor symptoms
  • Back pain

Functional exercises

Daily activities

Getting up from lying

  1. Roll to side first
  2. Push up with arms
  3. Don't sit straight up
  4. Protects abs

Lifting

  1. Engage core first
  2. Bend knees
  3. Keep load close
  4. Don't hold breath

Carrying baby

  1. Core engaged
  2. Good posture
  3. Alternate sides
  4. Use sling if helpful

Posture and positioning

Good posture

  • Stand tall
  • Shoulders back
  • Ribs over pelvis
  • Core gently engaged
  • Avoid arching back
  • Weight evenly distributed

Feeding positions

  • Good back support
  • Bring baby to breast
  • Don't hunch forward
  • Use pillows
  • Vary positions

Using support

Abdominal binders

  • Can provide support
  • Not long-term solution
  • Use during activities
  • Still do exercises
  • Wean off gradually

Tubigrip or support wear

  • Gentle compression
  • Provides awareness
  • Not substitute for exercises
  • Can help initially

Recovery timeline

What to expect

  • 0-6 weeks: Natural healing begins
  • 6 weeks - 3 months: Active rehabilitation
  • 3-6 months: Significant improvement
  • 6-12 months: Continued progress
  • 12+ months: Maximum recovery
  • Varies individually
  • Consistency crucial

Realistic goals

  • Gap may not close completely
  • Function more important than size
  • Tension improves
  • Core strength returns
  • Symptoms resolve
  • Appearance improves

When to seek help

See physiotherapist if

  • Gap more than 3 finger widths
  • No improvement after 3 months
  • Back pain
  • Pelvic floor problems
  • Want to return to sport
  • Unsure about exercises
  • Visible bulging

Specialist assessment

  • Accurate measurement
  • Tension assessment
  • Functional testing
  • Personalized programme
  • Correct technique
  • Progression guidance

Surgery considerations

When considered

  • Very large gap (>5cm)
  • Failed conservative treatment
  • Significant functional problems
  • Hernia present
  • Completed family
  • Last resort

Before surgery

  • Try conservative treatment first
  • Minimum 12 months
  • Optimize function
  • Realistic expectations
  • Understand risks

Prevention in future pregnancies

During pregnancy

  • Continue safe core exercises
  • Good posture
  • Avoid excessive weight gain
  • Pelvic floor exercises
  • Modify activities

After delivery

  • Start exercises early
  • Proper technique
  • Gradual progression
  • Professional guidance
  • Patience

Returning to exercise

When ready

  • Good core control
  • No doming with exercises
  • Pelvic floor strong
  • No pain
  • Professional clearance

Gradual return

  • Start with low-impact
  • Build up slowly
  • Monitor symptoms
  • Modify as needed
  • Don't rush

The role of physiotherapy

Elderly Rehabilitation & Exercise provides specialist women's health physiotherapy including:

  • Comprehensive diastasis assessment
  • Accurate measurement
  • Personalized exercise programme
  • Correct technique instruction
  • Progression guidance
  • Return to sport planning
  • Ongoing support
  • High success rate

The bottom line

Recovering from diastasis recti requires:

  • Correct exercises
  • Avoiding harmful movements
  • Daily practice
  • Good posture
  • Patience (6-12 months)
  • Consistency
  • Professional guidance
  • Realistic expectations
  • Focus on function

Diastasis recti is very treatable with the right approach. Most women can significantly improve their core function and appearance with appropriate exercises and guidance. Don't accept it as permanent—help is available and effective.

Concerned about diastasis recti?

Our specialist physiotherapy service provides expert assessment and treatment for diastasis recti. We create personalized programmes to help you recover core strength and function safely and effectively.

Get in touch Learn about Elderly Rehabilitation & Exercise

Lizzie Thornton, Specialist Community Physiotherapist

About the author

Lizzie Thornton is a specialist community physiotherapist with over 15 years of experience in women's health and postnatal rehabilitation. She is HCPC registered and a member of the Chartered Society of Physiotherapy. Lizzie provides physiotherapy across Staffordshire Moorlands and Cheshire East.

View Lizzie's profile