What is diastasis rectus abdominis?
During pregnancy the linea alba, the seam of connective tissue that joins the two sides of the abdominal wall, stretches to make room. For many women it recoils in the months after birth; for others it stays wide and thin. The result is a soft midline that domes when you sit up, a belly that looks pregnant long after delivery, and a core that struggles to generate tension. Men, and women who have not been pregnant, can develop DRA too, usually from weight change or poor lifting mechanics.
DRA matters for how you function, not just how you look. It travels with back pain, pelvic floor problems and a sense of weakness in the middle. The width of the gap is only part of the story; what matters as much is whether the tissue can generate tension when you brace. That is what an assessment measures and what treatment restores.
Common signs and symptoms
- A visible gap, doming or “coning” down the middle of the abdomen when you sit up or lift
- A soft, bulging midline; the belly still looks pregnant months after birth
- A feeling of weakness or lack of support in the core
- Low back or pelvic pain, or poor posture
- Bloating or a belly that looks larger by the end of the day
- Pelvic floor symptoms such as leaks or heaviness alongside the abdominal changes
What causes it?
- Pregnancy, especially multiple pregnancies, twins or a large baby
- Heavy lifting or intense abdominal exercise with breath-holding and doming
- Rapid weight gain or loss, and abdominal surgery
- Connective tissue that is naturally more elastic
- Poor pressure management: bracing the abdomen outward instead of drawing it in
- In men, central weight gain and repeated heavy straining
How pelvic floor physiotherapy helps
Physiotherapy for diastasis recti aims to restore tension and function across the abdominal wall, not just to close a number on a tape measure. Because a general exercise class has not been shown to reduce DRA, the program is individual: your physiotherapist assesses the gap and the tissue, teaches you how to breathe and brace so the midline stays flat, and progresses your core work from there.
A treatment plan typically includes:
- Measurement of the gap and of how well the linea alba generates tension above, at and below the navel
- Breathing and pressure management so the abdomen draws in rather than domes under load
- Deep core (transversus abdominis) and pelvic floor activation, then progressive strengthening
- Correction of lifting, feeding and carrying habits that keep pushing the midline outward
- A graded return to full exercise, including guidance on which movements to modify and when to add them back
- Venus Ab Rehab (Emsculpt) in the same clinic when supramaximal muscle contractions are a useful addition to your program
What the research says
The studies below are peer-reviewed and linked to their permanent records so you can read them yourself.
In this study of 300 first-time mothers, diastasis recti was present in 33% at 21 weeks of pregnancy, 60% at six weeks postpartum, 45% at six months and 33% at 12 months after birth.
Sperstad JB, Tennfjord MK, Hilde G, Ellström-Engh M, Bø K. Diastasis recti abdominis during pregnancy and 12 months after childbirth: prevalence, risk factors and report of lumbopelvic pain. British Journal of Sports Medicine, 2016. View study
This systematic review found that exercise during and after pregnancy may reduce the presence and width of diastasis recti, while noting that the quality of the available studies was limited and individual programs need further research.
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. View study
A 16-week general postpartum exercise class did not reduce the prevalence of diastasis recti compared with no training in this randomized trial, which is why we assess and treat each abdominal wall individually rather than prescribing a generic routine.
Gluppe SL, Hilde G, Tennfjord MK, Engh ME, Bø K. Effect of a postpartum training program on the prevalence of diastasis recti abdominis in postpartum primiparous women: a randomized controlled trial. Physical Therapy, 2018. View study
Treatment at Corelife Wellness in Oakville
Corelife Wellness is a dedicated pelvic health clinic at 3075 Hospital Gate, Unit 312, Oakville, next to Oakville Trafalgar Memorial Hospital. Care starts with a free 15-minute consultation by phone, video or in person, followed by a full assessment with our Registered Physiotherapist. Every pelvis is unique, so your plan is built from that exam rather than a template. No referral is needed, and physiotherapy is often eligible under extended health benefits.
How assessment and treatment work, and how to book, are on our main page: Pelvic floor physiotherapy in Oakville. When a weak core or ab separation is part of the picture, Emsculpt in Oakville (Venus Ab Rehab) is available in the same clinic to complement your physiotherapy.
Helpful reading from our team
When to see a doctor first
Pelvic floor physiotherapy is safe and you do not need a referral, but some symptoms need a medical assessment before or alongside treatment:
- A bulge that is painful, hard, or cannot be pushed back in, which may be a hernia and needs medical assessment
- Sudden severe abdominal pain, vomiting or fever
- A midline bulge with skin changes, or that appeared after surgery and is enlarging
