Diastasis recti — the widening of the linea alba between the two halves of the rectus abdominis — happens in essentially every pregnancy. It is a normal adaptation to a growing uterus, not an injury. In most women it narrows substantially over the first eight weeks after birth without any intervention.
What brings people to a physiotherapist is the version that does not resolve: a persistent gap, a doming or coning of the abdomen on effort, a feeling that the middle of the body is not connected, and often back pain or bladder symptoms alongside it.
There is a great deal of poor information about this condition online, much of it selling something. What follows is what the evidence actually supports.
The gap is not the point
The single most useful thing to understand is that the width of the separation correlates poorly with symptoms and function. Women with wide gaps often have no symptoms and excellent function. Women with narrow gaps sometimes have significant problems.
What matters far more is the tension you can generate across the linea alba — whether the connective tissue between the muscles can transmit force, so the abdominal wall behaves like a functioning unit under load.
This reframes treatment entirely. The aim is not to close a gap by a measured number of centimetres. It is to restore the abdominal wall's ability to manage pressure and transfer load, which is what actually resolves the doming, the back pain and the feeling of disconnection.
This is why "closing the gap" programmes that focus solely on narrowing measurements often disappoint: patients follow them faithfully, the measurement barely changes, and they conclude they have failed — when function may have improved substantially.
How to check yourself at home
A rough self-assessment is straightforward. It is not a substitute for proper assessment, but it tells you whether to seek one.
- Lie on your back with knees bent and feet flat on the floor.
- Place your fingertips just above your belly button, pointing down towards your feet.
- Lift your head and shoulders slightly off the floor, as if starting a small curl-up.
- Feel for the edges of the muscle either side of your fingers, and note roughly how many finger-widths fit in the gap.
- Repeat just below the belly button, and a few centimetres higher up.
- Now the part most guides omit: as you lift, notice what the midline does. Does it feel springy and firm under your fingers, or soft and sinking? Does the abdomen dome or cone upwards along the midline?
Doming, coning, or a midline that sinks softly under your fingers is more clinically meaningful than the number of finger-widths. If you see or feel either, it is worth being assessed.
Symptoms that often accompany it
Doming or coning
A ridge or bulge along the midline when you sit up, lift, or exert yourself — the clearest functional sign.
Low back pain
The abdominal wall contributes to trunk load transfer. When it is not doing its share, the back frequently takes up the slack.
Bladder symptoms
Diastasis and pelvic floor dysfunction commonly co-exist because both relate to pressure management. See incontinence physiotherapy.
A persistent "pooch"
A lower abdominal bulge that does not change with weight loss, because it reflects tissue tension rather than fat.
Feeling disconnected
A sense of not being able to engage the middle of the body — very common, and a reasonable description of reduced load transfer.
Hernia symptoms
A distinct, palpable lump at the navel or midline, particularly if tender, needs medical assessment to exclude a hernia.
How it is treated
Assessment of tension, not just width
Measurement at several points along the midline, plus assessment of the tension generated across it during a controlled contraction, and of how your abdomen behaves under real load.
Pressure management retraining
How you breathe and brace during effort determines where pressure goes. Learning to exhale on exertion and to coordinate the diaphragm, abdominal wall and pelvic floor usually reduces doming immediately — often within the first session.
Progressive abdominal loading
The abdominal wall is muscle and connective tissue, and it adapts to progressive load like any other tissue. Programmes start where you can maintain tension without doming and progress systematically. Avoiding all abdominal work indefinitely is not treatment.
Pelvic floor integration
The abdominal wall and pelvic floor work as one pressure system. Treating either alone tends to plateau, which is why isolated "diastasis exercises" often stop producing results.
Return to full activity
The goal is running, lifting, carrying and training without symptoms — not permanent avoidance of a list of forbidden exercises.
What about crunches, planks and surgery?
Crunches and planks are not universally forbidden. The blanket prohibition circulating online is an oversimplification. The question is whether you, today, can perform a given movement while maintaining tension across the midline without doming. For many people early on, a full plank fails that test — and so it is regressed, not banned forever. The endpoint of a good programme is being able to do them again.
Surgery is a last resort, not a first line. Abdominoplasty with rectus plication is effective for selected patients, but conservative rehabilitation should come first, and surgeons generally want you to have completed it. Surgery also does not by itself restore the motor control that produced the symptoms.
Splints and binders can be useful short-term for comfort and support, particularly in the early weeks. Used as a long-term substitute for rehabilitation they encourage dependence rather than adaptation.
Frequently Asked Questions
How do I know if I have diastasis recti?
Lie on your back with knees bent, place your fingertips above and below your belly button, and lift your head and shoulders slightly. Feel for the gap between the muscle edges — but pay more attention to whether the midline feels firm and springy or soft and sinking, and whether your abdomen domes or cones along the midline. Doming and a soft midline are more clinically significant than the number of finger-widths.
How many finger-widths is too many?
Width alone is a poor guide, because it correlates weakly with symptoms and function. Separations of around two finger-widths or more are commonly described as a diastasis, but a woman with a three-finger gap and good tension across the midline may be entirely symptom-free, while someone with a smaller gap and poor tension has doming, back pain and bladder symptoms. Assessment looks at both.
Will my diastasis recti close completely?
Most separations narrow substantially in the first eight weeks after birth without intervention. Beyond that, rehabilitation reliably improves function, symptoms and the tension generated across the midline, and often narrows the gap — but the aim is a well-functioning abdominal wall rather than a specific measurement. Many women become entirely symptom-free while retaining a measurable gap.
Can I fix diastasis recti years after having children?
Yes. Muscle and connective tissue respond to progressive load at any age, and improvements in function, symptoms and midline tension are achievable years or decades after pregnancy. Programmes may take longer to establish, but the physiology does not have a deadline.
Are crunches and planks really banned?
Not permanently, and not for everyone. The relevant question is whether you can currently perform the movement while maintaining tension across the midline without doming or coning. If you cannot, it is regressed to a version you can control and progressed as you improve. Being able to plank and curl without symptoms is a normal goal of rehabilitation, not a permanent prohibition.
Do I need surgery?
Rarely, and not as a first step. Conservative rehabilitation should be completed first, and most surgeons expect that before considering abdominoplasty with rectus plication. Surgery may be appropriate for selected patients with a very large separation and persistent functional problems after a proper rehabilitation programme, or where a hernia is present.
Clinically reviewed by Jency Sudha, Consultant Pelvic Health Physiotherapist & Biofeedback Specialist — last updated 26 July 2026
The information on this page is for general guidance and does not replace individual clinical assessment. If your symptoms are new, worsening, or accompanied by bleeding, fever or severe pain, contact your GP or NHS 111.
Get an Accurate Assessment
Measurement plus function, and a loading programme that progresses rather than a list of things to avoid forever.
Book Your ConsultationOr contact us directly: 07999 996926 | info@zylohphysio.com