Ab Separation After Pregnancy (Diastasis Recti): Symptoms, Causes & PT Treatment
Updated October 20261 minute read
Diastasis recti is a widening of the gap between the two halves of the "six-pack" muscles along the midline of your belly, very common during and after pregnancy. It can cause a lower-belly bulge or "doming," a feeling of core weakness, and sometimes back or pelvic discomfort. It's not a tear or hernia, and most cases improve with progressive, well-chosen core and pelvic floor rehab rather than crunches. Surgery is rarely needed.
What is diastasis recti?
The connective tissue along the midline (the linea alba) stretches and the abdominal halves separate. It's a normal response to a growing belly that often improves with time and the right rehab.
Symptoms
Common features are a visible bulge or "doming" along the midline when you sit up or strain, a soft gap you can feel, a sense of core weakness, and sometimes back or pelvic discomfort.
What causes it / risk factors
Pregnancy is the main cause; multiple pregnancies, larger babies, and certain genetics increase the chance. It can also occur from chronic intra-abdominal pressure.
How it's diagnosed
A PT or physician assesses the gap and, importantly, how well you can generate tension across the midline — function matters more than the gap's width alone.
Physical therapy treatment
What a PT does. Your therapist builds deep core and pelvic floor coordination and progresses loading safely, avoiding exercises that worsen doming early on. Exercises & progression (overview). Breathing and deep-core (transversus abdominis) and pelvic floor coordination, then progressive loading; modify crunch-type exercises early. Recovery timeline. Many people improve function over several months with consistent, progressive work.
Treatment options compared
Progressive rehab is first-line. Surgery is reserved for select cases with significant symptoms or a related hernia that don't respond to conservative care.
Red flags
Seek medical care for a painful, firm bulge that won't reduce (possible hernia), severe pain, or signs of infection.
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Frequently asked questions
Function (the ability to generate tension) matters most; many people regain a strong, functional core even if a small gap remains.
Sources (7)
- MedlinePlus: Diastasis recti. — NIH/MedlinePlus
- Benjamin DR, van de Water ATM, Peiris CL. Effects of exercise on diastasis of the rectus abdominis muscle in the antenatal and postnatal periods: a systematic review. Physiotherapy. 2014. — PubMed
- Sperstad JB, et al. Diastasis recti abdominis during pregnancy and 12 months after childbirth: prevalence, risk factors and report of lumbopelvic pain. Br J Sports Med. 2016. — PubMed
- Capoccia Giovannini S, et al. Non operative management of postpartum Diastasis Recti: a systematic review and metanalysis of randomized controlled trials. Hernia. 2026. — Hernia
- Lyons G, et al. What is the evidence for abdominal and pelvic floor muscle training to treat diastasis recti abdominis postpartum? An updated systematic review and meta-analysis of randomized clinical trials and trial sequential analysis. Hernia. 2026. — Hernia
- Denizoglu Kulli H, et al. A New Progressive Motor-Control-Based Exercise Approach for Women with Diastasis Recti Abdominis: The Denizoglu Method. Hernia. 2025. — Hernia
- ChoosePT (APTA): Physical Therapy Guide to Diastasis Rectus Abdominis. — ChoosePT (APTA)
This article is for education only and isn't medical advice. Always talk to a licensed clinician about your specific situation.