Diastasis Recti Physiotherapy

Reviewed by the Circle Physiotherapy clinical team · 8 min read · Updated 7 August 2026

Almost every pregnancy produces some separation of the abdominal muscles, and almost every article about it puts the emphasis in the wrong place. Diastasis recti gets measured obsessively in finger-widths and blamed for everything from back pain to the shape of your stomach. The reality is calmer and far more useful: it is a normal adaptation, it improves substantially on its own for most people, and what predicts how well your abdomen works is not the width of the gap but whether you can generate tension across it under load.

What is diastasis recti, exactly?

Diastasis recti is the stretching and widening of the linea alba, the sheet of connective tissue running down the middle of your abdomen that joins the left and right halves of the rectus abdominis. The muscles themselves do not tear or split apart, which is what the word separation unhelpfully implies.

Because the linea alba is also where the oblique and transverse abdominal muscles anchor, a very lax midline can change how force transfers across the trunk. That is the mechanism worth caring about. It shows up as a ridge when you sit up, a soft midline, a stomach that still looks pregnant, or a sense that your middle is not connected when you lift.

Is a gap after birth normal, or a sign something went wrong?

It is normal — some degree of separation is present in the overwhelming majority of people in the days after giving birth, which makes it an expected consequence of pregnancy rather than an injury.

The gap also narrows spontaneously for most people over the first months, as swelling settles, the uterus returns towards its usual size and the tissue recoils. Some are left with a midline that stays wider or feels softer than before, and that group benefits most from structured loading. What none of this justifies is the fear-based advice circulating online: never lift your baby off the floor, never sit up, hold your stomach in permanently. Avoidance does not build tissue tolerance.

How do I check my own abdominal separation?

Lie on your back with knees bent and feet flat, place your fingertips along the midline just above the navel, and lift your head and shoulders slightly. Feel how many finger-widths across the space is, then repeat at the navel and a few centimetres below, since the gap is often a different size at each level.

Pay more attention to what happens under your fingers than to the number. Does the midline stay soft and let your fingers sink, or does it develop springy resistance as you lift? Self-checking is useful for tracking your own change over time, but it is not precise between people or examiners, so do not compare your number with anyone else's.

Why does width matter less than tension?

Because function tracks the stiffness of the midline far more closely than its width — two people with an identical measured gap can have completely different symptoms, and the one who can generate tension across the linea alba under load is usually the one lifting, running and moving without complaint.

So an assessment looks at what your abdominal wall does, not just how far apart things sit. Can you produce tension without gripping and holding your breath? Does the midline firm up when you exhale and load? What happens when you carry a toddler on one hip or press something overhead? Those answers change the plan; the width gets noted and then largely left alone.

Why is closing the gap the wrong goal?

Because it sets you chasing a number that may never change while ignoring what actually matters: whether your trunk can do its job. Some people keep a permanently wider midline and have no symptoms at all. Others narrow considerably and still feel weak, because the tissue stays soft.

Chasing the gap also has costs. It pushes people towards constant stomach-gripping, endless breath-holding drills and binders worn indefinitely, none of which build capacity. Better questions: can you lift what your life requires, does the midline stay loaded with tension under that lift, and are you getting stronger month to month? This sits inside the wider postpartum recovery picture.

What actually helps a diastasis?

Progressive loading helps, coordinated with breathing and applied to your real life. Early work is about coordination rather than effort: exhaling as you load, feeling the deep abdominal wall respond, and dropping the habit of bracing and holding air. From there the load climbs until you are doing genuine strength work.

The pelvic floor and abdominal wall work as one pressure system, so pelvic floor physiotherapy is often part of the plan — see bladder leakage and pelvic organ prolapse. And daily pressure management matters: straining on the toilet, a cough that never settles, and breath-holding on every lift all load the midline repeatedly.

Are crunches and planks banned forever, and what does coning mean?

No, they are not banned forever — they are simply too demanding for most abdominal walls in the early weeks, much as a marathon is too demanding for an ankle four weeks after a sprain. The blanket lifetime ban circulating online has no good basis, and plenty of people return to sit-ups, planks and rotational work once they have built the tolerance.

Coning or doming — the ridge that pushes up along the midline as you sit up or hold a plank — is information, not damage. It tells you the pressure inside your abdomen is outpacing your ability to tension the midline against it. Change one variable: reduce the range, exhale through the effort instead of holding your breath, drop the load, or choose a position with less leverage. If it persists through every regression, get it assessed.

When is surgery worth discussing, and what happens at an assessment?

A surgical opinion becomes reasonable when a consistent loading programme, run for six to twelve months, has not produced meaningful functional change, or when there are signs of a hernia at the navel or along the midline — a bulge that is tender, firm, or does not reduce when you lie down. Repair is elective, generally considered once your family is complete, and it works better on a trunk that has already been trained. Your family doctor is the route to that referral.

An assessment with Divya Sreejith, certified through all three pelvic health levels, covers your birth history, a tension test of the midline at several levels, and a look at how you breathe, brace, lift and load. We are at 10725 McLaughlin Rd, Unit #5, Brampton, open seven days a week with direct billing. Call (905) 495-5600, send us a message, or book online.

Frequently Asked Questions

Explore Women’s Health & Pelvic Care