Diastasis Recti and the Pelvic Floor: Supporting Your Core After Pregnancy

Diastasis recti is a common condition that many people experience during and after pregnancy. It refers to a separation of the two sides of the rectus abdominis muscles — the “six-pack” muscles — along the midline of the abdomen. While it might look like a bump, ridge, or gap in the stomach, diastasis recti is more than just a cosmetic concern. From a pelvic floor physical therapy perspective, it’s a functional issue that can affect core stability, posture, pelvic floor health, and overall movement.

Understanding diastasis recti, addressing it safely, and learning how to restore function is key to long-term recovery and wellbeing.

What Is Diastasis Recti?

During pregnancy, the growing uterus stretches the abdominal wall to accommodate the baby. Hormonal changes, particularly the effects of relaxin and progesterone, make connective tissue more flexible. This combination of stretch and tissue laxity can cause the rectus abdominis muscles to separate along the linea alba, the connective tissue running down the center of the abdomen.

After delivery, the muscles may not automatically return to their pre-pregnancy position. For some, the gap closes on its own over weeks to months. For others, the separation persists and can affect strength, stability, and function.

Common signs of diastasis recti include:

• A visible ridge or bulge along the midline of the abdomen

• Difficulty engaging the core or “feeling weak” in the stomach

• Lower back, hip, or pelvic pain

• Poor posture or difficulty lifting and carrying the baby

• Pelvic floor dysfunction, including urinary incontinence or pressure
  
  

While diastasis recti can be alarming, it is extremely common and, in most cases, treatable with proper guidance.

How Diastasis Recti Affects the Pelvic Floor

The core is a system that includes the diaphragm, abdominal muscles, pelvic floor, and deep back muscles. These structures work together to stabilize the spine, support the organs, and manage intra-abdominal pressure.

When the rectus abdominis separates, the core loses some of its natural tension and support. This can place extra strain on the pelvic floor. Over time, this imbalance may contribute to:

• Urinary or fecal incontinence

• Pelvic organ prolapse

• Low back or hip pain

• Difficulty with lifting, bending, or other functional movements
  

Pelvic floor physical therapy addresses diastasis recti by focusing on coordination and integration between the abdominal muscles and pelvic floor, rather than just “closing the gap.”

Why Traditional Crunches Can Make Diastasis Worse

Many people assume that strengthening the abs with traditional sit-ups or crunches will fix diastasis recti. In reality, these exercises can worsen the separation by increasing intra-abdominal pressure and pushing the abdominal wall outward.

Pelvic floor physical therapy focuses on safe, functional core exercises that:

• Promote alignment of the rectus abdominis

• Reconnect the muscles with the linea alba

• Improve coordination with the pelvic floor and diaphragm

• Reduce intra-abdominal pressure and tension
  
  

Safe exercises often include deep core engagement, controlled movements, and progressive strengthening that emphasizes connection over intensity.

How Pelvic Floor Physical Therapy Helps

Pelvic floor physical therapy takes a whole-body approach to diastasis recti. Treatment is not just about appearance; it’s about restoring strength, function, and confidence in movement.

Treatment may include:

• Assessment of the separation and abdominal muscle function

• Pelvic floor evaluation to address tension, weakness, or coordination issues

• Education on posture, lifting, and body mechanics

• Breathing and core engagement strategies

• Safe, progressive abdominal strengthening

• Integration of core and pelvic floor for daily movements

• Guidance on returning to exercise or athletic activity
  
  

Internal assessment is optional and performed only if the patient is comfortable. The focus is always on building awareness, control, and function rather than “fixing” the muscles alone.

Supporting Recovery at Home

Consistency and mindful movement are key. Simple habits like engaging your deep core while lifting your baby, practicing good posture, and avoiding heavy straining can make a meaningful difference. Pelvic floor physical therapy also provides exercises and strategies tailored to your body’s needs, ensuring that recovery is safe and effective.

It’s important to understand that healing takes time. Every person’s body is different, and progress may be gradual. Patience and consistency are essential components of successful rehabilitation.

Beyond the Physical: Confidence and Body Awareness

Diastasis recti can affect self-image and confidence. Many people feel frustrated when their body doesn’t “bounce back” after pregnancy. Pelvic floor physical therapy addresses not only the physical aspects of diastasis but also encourages body awareness, self-care, and empowerment.

Restoring connection with your core and pelvic floor can improve comfort, reduce pain, and enhance function thus, making everyday activities like lifting, walking, or playing with your baby easier and safer.

When to Seek Help

If you notice a gap in your abdomen, experience low back or pelvic pain, urinary leakage, or difficulty with core engagement, pelvic floor physical therapy may be helpful. Early intervention can prevent long-term issues and set the foundation for a strong, coordinated core.

Even if your diastasis seems mild or asymptomatic, learning safe movement strategies and core engagement techniques can prevent future discomfort and support overall function.

Takeaway

Diastasis recti is a common and treatable condition that affects more than just the appearance of the abdomen. It impacts core stability, pelvic floor health, posture, and daily function. Pelvic floor physical therapy provides a safe, individualized approach that addresses the whole core system, restores coordination, and empowers patients to move confidently in their bodies.

If you’re struggling with diastasis recti, discomfort, or functional limitations postpartum, reach out to WildHer Physical Therapy in Columbia, Maryland. With guidance, education, and support, your body can recover strength, stability, and confidence — one step at a time.