Diastasis Recti
Reviewed by Cheryl Long, AHPC-registered physiotherapist, Goji Physio
Diastasis recti is the widening of the two sides of the rectus abdominis (the "six-pack" muscle) at the linea alba — the connective tissue running down the centre of the abdomen. By the end of the third trimester, diastasis happens in virtually every pregnancy — it is a completely normal, natural adaptation to give your baby room to grow. However postnatally, the extent of natural recovery for each woman varies widely. The distance alone does not determine whether physiotherapy is needed. What matters more is the ability of the abdominal wall to generate and transfer load effectively.
What causes diastasis recti, and is it normal?
As the uterus grows during pregnancy, it pushes the abdominal muscles outward and stretches the linea alba. This is a normal adaptation. The linea alba thins and widens to accommodate the pregnancy, and may not always fully restore to its pre-pregnancy width after birth. Factors that influence the degree and persistence of diastasis include:
Multiple pregnancies or large babies
Carrying with significant anterior pelvic tilt
High intra-abdominal pressure during the third trimester
How the abdominal wall is loaded in the weeks and months after birth
Importantly, a small inter-recti distance does not necessarily mean a functional problem, and a larger gap does not automatically mean weakness or pain. This is why a clinical assessment — not just finger-width self-testing — is important.
What are the signs that diastasis recti is affecting function?
Many women with diastasis recti are asymptomatic. Others notice:
A visible cone, dome, or ridge down the midline when sitting up or performing abdominal exercises
Lower back pain or pelvic girdle pain that is not improving postnatally
Difficulty with tasks that load the abdominal wall — lifting, carrying, getting up from lying down
A feeling of "weakness" in the core or a sense that the abdomen is not supporting them
Bladder or bowel symptoms that have not resolved
If you are checking yourself at home: a gap wider than approximately 2 finger-widths at the umbilicus, combined with poor tension in the tissue when you lift your head, is worth having assessed. But the most important question is not "how big is the gap?" — it is "can the wall do its job?"
What does a session at Goji involve?
Our physiotherapists will take a history of your pregnancy, birth, and current symptoms. This is followed by a hands-on assessment of the abdominal wall. This includes:
Inter-recti distance: measured at multiple points along the linea alba using ultrasound or palpation
Tissue tension: assessing whether the linea alba can generate appropriate tension under load — this is distinct from gap size
Load testing: how the abdominal wall behaves during functional tasks (getting up, lifting, coughing, exercising)
Pelvic floor screen: diastasis recti and pelvic floor dysfunction frequently co-occur, and the two systems interact under load
You will leave with a clear picture of whether your diastasis is affecting function and, if so, a structured and progressive plan to address it — starting from where you are, not a generic postnatal programme.
What exercises should I avoid with diastasis recti?
The answer depends on your specific presentation. The older advice to avoid all sit-ups and crunches indefinitely has been largely superseded by a more nuanced approach: the goal is to progressively load the abdominal wall in a controlled way, not to avoid load permanently. There are situations where certain exercises are not appropriate at a given point in recovery, and a physiotherapist will advise specifically based on your assessment findings rather than applying blanket restrictions.
Frequently asked questions
Will my diastasis close on its own?
The gap often narrows in the first 8–12 weeks postpartum as the linea alba undergoes natural remodelling. However, this does not always happen, and gap closure does not guarantee restored function. If you are 3 or more months postpartum and still experiencing symptoms, an assessment is worthwhile.
Is surgery required for diastasis recti?
Surgical repair (abdominoplasty) is occasionally considered for severe cases where conservative management has not restored function over a prolonged period. However, the large majority of women do achieve functional improvement with physiotherapy. Surgery is not a first-line recommendation.
Can I exercise before seeing a physio?
Some activity is almost always safe and encouraged. Walking, gentle mobility, and pelvic floor exercises are appropriate from early in the postnatal period. The caution applies to high-load or high-impact exercise (heavy lifting, running, intense core work) before the abdominal wall has been assessed and progressively conditioned.
Does diastasis recti affect the pelvic floor?
The linea alba and the deep abdominal muscles (transversus abdominis) are structurally and functionally connected to the pelvic floor. Diastasis recti can affect how the system generates pressure and transfers load, which may contribute to pelvic floor symptoms. This is one reason why diastasis assessment at Goji includes a pelvic floor screening.
I am 18 months postpartum. Is it too late to address my diastasis?
No. There is no time limit on physiotherapy for diastasis recti. The tissue's tensile properties do change over time, but abdominal strength can always be trained. Women successfully address diastasis recti years after their last pregnancy with structured physiotherapy.
Can diastasis recti recur in a subsequent pregnancy?
Yes. If you plan to have more children, it is worth building good abdominal and pelvic floor function before and during subsequent pregnancies, and returning for a postnatal assessment after each birth.
Tell us about your symptoms and your postnatal stage — we'll help you understand what is happening and what to do next.
Reviewed by Cheryl Long, BSc (Hons) Physiotherapy, AHPC-registered
Clinical Director, Goji Physio — Women's and Family Physiotherapy, Lentor, Singapore
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C-Section Recovery & Scar Management | Urinary Incontinence | Pelvic Organ Prolapse
