What is Diastasis Recti?
Diastasis Recti Abdominis (DRA) is the widening and thinning of the connective tissue (linea alba) that runs down the middle of the abdomen, separating the left and right sides of the rectus abdominis ("six-pack") muscle. It is very common during and after pregnancy, as the expanding uterus stretches the abdominal wall.
While a mild separation is normal, a gap wider than two finger-widths postpartum can affect core stability and contribute to lower back pain, pelvic instability, and postural changes. Identifying the separation with a proper diastasis recti assessment is the first step toward recovery. Targeted physical therapy focuses on deep core strengthening and pressure management to support healing.
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Comparison: Exercise Guidance for Diastasis Recti
When healing diastasis recti, exercise selection is critical. The goal is to strengthen the core without increasing outward pressure on the midline:
| Safe Core Stabilization Exercises | High-Risk Exercises to Avoid |
|---|---|
| **Diaphragmatic Breathing**: Restores pressure balance between chest and abdomen. | **Traditional Crunches / Sit-ups**: Increase pressure and pull the muscles apart. |
| **Transverse Abdominis Activation**: Gently pulling the lower belly in. | **Standard Planks / Push-ups**: Can cause the abdominal wall to sag or dome against gravity. |
| **Glute Bridges**: Strengthens the glutes and core with minimal [abdominal strain](/conditions/abdominal-strain). | **Double Leg Lifts**: Put significant strain on the lower back and lower abdominals. |
| **Gentle Clamshells**: Build pelvic stability. | **Heavy Overhead Presses**: Increase pressure inside the abdomen. |
| **Heel Slides**: Safe lower abdominal activation. | **Deep Spinal Twists**: Can shear the connective tissue at the midline. |
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How to Perform a Diastasis Recti Self-Test
You can perform a simple check at home to evaluate your abdominal wall. For an accurate assessment, follow these steps:
- Position: Lie on your back on a firm surface with your knees bent and feet flat on the floor.
- Finger Placement: Place the index and middle fingers of one hand horizontally on your midline, just above your belly button.
- Active Lift: Slowly lift your head and neck slightly off the floor. Keep your shoulders relaxed. This minor movement activates the abdominal muscles.
- Feel the Gap: Press your fingers gently into the midline. Feel for the borders of the left and right muscles. Note:
- Width: How many fingers fit between the muscle borders (e.g., 1, 2, 3, or more fingers)?
- Depth / Tension: Does the space feel soft and deep, or is there a firm barrier resisting your fingers?
- Check Multiple Areas: Repeat the test in three spots along the midline: 2 inches above the belly button, directly at the belly button, and 2 inches below it.
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Physiotherapy for Diastasis Recti Healing
Physical therapy focuses on restoring function to the entire abdominal wall, rather than just closing the gap:
- Pressure Management: Learning to coordinate breathing with movement (exhaling during exertion) to prevent excess pressure in the abdomen.
- Deep Core Strengthening: Targeting the deep transverse abdominis (TA) muscle. The TA acts like a corset, pulling the sides of the abdomen together and supporting the midline.
- Pelvic Floor Integration: Straining from core weakness can affect the pelvic floor. Coordinated exercises help strengthen both muscle groups together.