Diastasis Recti Abdominis
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Diastasis recti is a widening/separation of the rectus abdominis along the linea alba (common in/after pregnancy) — managed with progressive deep-core and load-management work, not by avoiding all abdominal training.
Detail
Diastasis recti abdominis (DRA) is an increased inter-recti distance — the two halves of the Rectus Abdominis separate along the midline connective tissue (linea alba). It is very common in late pregnancy and early postpartum (the abdominal wall stretches to accommodate the growing uterus) and often narrows on its own in the months after birth. It can also occur in others with high intraabdominal pressure.
Management (evidence-informed, exercise-based):
- Focus on deep-core control: coordinated breathing, transversus abdominis and pelvic-floor activation, and managing intraabdominal pressure during effort — rather than chasing complete closure of the gap, since function (load transfer, no doming/bulging) matters more than absolute width.
- Progressive loading: start with low-pressure exercises (e.g., Dead Bug, heel slides, controlled breathing), then progress as the wall tolerates load without doming/bulging along the midline.
- Abdominal training is part of the fix, not off-limits. ACOG Committee Opinion 804 (2020, reaffirmed 2023) notes that abdominal strengthening exercises — including crunches and the drawing-in manoeuvre — have been shown to reduce the incidence of diastasis and the inter-rectus distance after vaginal or caesarean birth. Scale the pressure of a movement (heavy Valsalva lifts, full sit-ups, long hard planks) to how well the midline is controlled, rather than banning it.
- Refer to a pelvic-health/physiotherapist for assessment, especially if there is doming, pain, or pelvic-floor symptoms.
What to monitor: visible bulging or "coning/doming" along the midline during effort signals the load exceeds current control — regress.
Non-medical-advice disclaimer
Educational only; not a diagnosis or treatment plan. Assessment by a clinician or pelvic-health physiotherapist is recommended for symptomatic or persistent cases.
Key facts
- DRA = widened inter-recti distance along the linea alba; common in/after pregnancy, often improves spontaneously.
- Manage with deep-core control (TA + pelvic floor + breathing) and progressive loading.
- Function/no doming matters more than fully closing the gap.
- Regress when midline doming/coning appears under load.
- Refer to pelvic-health PT for symptoms, pain, or persistence.
Connections
- Postpartum Return to Exercise — DRA assessment is part of postpartum return.
- Pelvic-Floor Considerations in Exercise — co-managed with pelvic-floor function.
- Rectus Abdominis — the muscle that separates.
- Dead Bug — a low-pressure starting exercise.
Sources
- GuidelineACOG Committee Opinion No. 804: Physical Activity and Exercise During Pregnancy and the Postpartum Period. Obstet Gynecol 2020;135(4):e178–e188 (reaffirmed 2023) Published 2020 · DOI 10.1097/AOG.0000000000003772 · Accessed 2026-10-13
Corrections (1)
- 2026-10-13 — Added what ACOG Committee Opinion 804 (2020, reaffirmed 2023) actually says about diastasis: abdominal strengthening exercises, including crunches and the drawing-in manoeuvre, have been shown to reduce the incidence of diastasis recti and the inter-rectus distance postpartum. The advice to 'modify or delay crunches' is therefore reframed as load management guided by midline control, not avoidance, and is no longer implied to be ACOG's position.
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Educational content only — not medical advice. Always consult a qualified professional for individualized guidance, especially around injury, pregnancy, or medical conditions.