Diastasis Recti – What It Is, When to Be Concerned, and How to Fix It
5-min read
Diastasis recti (DRA) is a common but often misunderstood condition where the two sides of your rectus abdominis (“six-pack”) muscles separate along the midline, creating a gap. It’s most often seen during and after pregnancy, but can also occur in men and women unrelated to pregnancy due to abdominal pressure changes, certain exercises, or surgery.
At Atomic Physical Therapy, we work with many patients navigating DRA from new moms eager to return to activity, to athletes who notice abdominal changes affecting performance. Whether you are 6 weeks, 6 months, or even 6 years postpartum, there are always steps you can take to improve your core function and strength.
When to Be Concerned
A small gap between the abdominal muscles is normal and can often resolve over time.
It may be a concern if:
The separation is wider than two finger-widths and persists beyond 6–12 months postpartum
You experience core weakness, back pain, or pelvic floor symptoms (leakage, heaviness)
A visible bulge appears with certain movements (especially during lifting or sit-ups)
You notice signs of a hernia, such as a firm, tender bulge that does not go away when lying down
In these cases, an assessment with a physical therapist or healthcare provider is important.
Evidence-Based Rehab Approaches
Research supports several targeted strategies for improving DRA:
1. Deep Core and Transverse Abdominis (TrA) Activation
Gentle, controlled activation of the deep abdominal muscles helps restore tension in the linea alba (connective tissue between the rectus muscles).
Emphasis is placed on breathing control, ribcage positioning, and pelvic floor coordination.
This is often the first step before progressing to more challenging exercises.
(Benjamin et al., 2019)
2. Functional Strengthening
Integrating TrA activation into everyday movements (lifting, getting out of bed, standing from a chair) builds carryover into daily life.
Planks, modified sit-ups, and standing resistance work may be added as symptoms improve.
(Keeler et al., 2012)
3. Isotonic Abdominal Exercises
A meta-analysis found that specific abdominal exercises (e.g., heel slides, single-leg lifts, modified crunches) can reduce the inter-rectus distance, especially when combined with other core and pelvic floor strategies.
(Gluppe et al., 2018)
4. Electrical Muscle Stimulation (EMS) as an Adjunct
Some studies suggest EMS may further improve muscle activation and reduce separation when used alongside exercise, though it should not replace active rehab.
(Chiarello et al., 2021)
How Physical Therapy Helps
At Atomic PT, your rehab plan for diastasis recti is individualized to your symptoms, goals, and lifestyle. This may include:
Assessment of abdominal gap size and function
Teaching safe core activation and breathing strategies
Progressing to functional and sport-specific movements
Coordinating with pelvic floor therapy if needed
Tracking progress over time to ensure you can safely return to higher-level activities like running, lifting, or climbing
If PT Alone Isn’t Enough
In some cases, a persistent large gap or associated hernia may not fully resolve with conservative care. Other options may include:
Abdominal bracing or taping for symptom management
Surgical repair (such as plication) for severe, function-limiting cases usually considered after completing a dedicated rehab program
Referral to a specialist if pain, hernia, or other complications are present
Bottom line: With early and targeted intervention, most people with diastasis recti can significantly improve core strength, reduce symptoms, and return to the activities they love. The key is a plan that addresses both deep core function and your individual movement goals.
If you or someone you know is struggling with diastasis recti, partnering with a physical therapist is an excellent first step toward recovery. Schedule a discovery visit with our team to learn how personalized physical therapy can help you rebuild strength, function, and confidence.
