If you’ve ever looked down postpartum and noticed a “pooch” in your abdomen, a ridge or doming through your midline during movement, or felt like your core just doesn’t feel strong anymore — you are not alone.
As a pelvic floor physical therapist, one of the most common things I hear from women is:
“I think I have diastasis recti… can this heal without surgery?”
The short answer?
In many cases, yes.
And despite what social media may tell you, healing diastasis recti is not about doing endless crunches or trying to “close the gap” as fast as possible. It’s about restoring strength, tension, and coordination throughout your entire core system.
What Is Diastasis Recti?
Diastasis recti (also called diastasis rectus abdominis or DRA) is a separation of the right and left sides of the abdominal muscles. During pregnancy, the connective tissue between these muscles — called the linea alba — stretches to make room for a growing baby.
This is a very normal adaptation during pregnancy.
For some women, the abdominal wall regains tension and support naturally postpartum. For others, the separation and weakness can persist longer and contribute to symptoms like:
- A visible abdominal bulge or “mom pooch”
- Doming or coning through the midline
- Low back pain
- Pelvic floor symptoms
- Feeling weak through the core
- Difficulty returning to exercise
- Poor pressure control during lifting or movement
Research suggests diastasis recti affects up to 60% of postpartum women.
It is important to also note that Diastasis recti does not exclusively affect postpartum women as it can also occur in women who’ve never had a pregnancy, as well as in men and children. Other common risk factors for having a DRA include:
- Chronic increase in intraabdominal pressure (chronic coughing)
- Excessive heavy lifting
- Excessive bearing down/straining such as with constipation
- Excess weight gain, especially around the midsection
- Abdominal surgery
- Weak core/poor posture
Is Diastasis Recti Just About the “Gap”?
Not exactly.
One of the biggest misconceptions online is that the width of the gap is the only thing that matters.
As pelvic floor physical therapists, we care much more about:
- How well the connective tissue can create tension
- How your deep core muscles work together
- Whether you can manage pressure during movement
- How your body functions day-to-day
You can have a small gap and still feel weak or symptomatic.
You can also have a wider gap and still function really well.
Healing is about function, not perfection.
Can Diastasis Recti Heal Without Surgery?
Yes! Many women improve significantly with conservative treatment and exercise-based rehabilitation.
Current research supports physical therapy and targeted exercise as effective non-surgical treatment options for improving abdominal strength, function, and inter-recti distance.
In fact, studies show that:
- Deep core strengthening can improve abdominal support
- Coordinated breathing and pressure management matter
- Exercise therapy can improve function and quality of life
- Conservative treatment is often the first recommended approach postpartum
Surgery is typically reserved for severe cases, hernias, or persistent functional limitations that do not improve with rehabilitation.
How Pelvic Floor Physical Therapy Helps
Your core is more than just your abs.
Think of your core as a pressure management system made up of:
- Your diaphragm
- Deep abdominal muscles
- Back muscles
- Pelvic floor muscles
These structures work together every time you breathe, lift your child, exercise, cough, or move.
A pelvic floor physical therapist evaluates how this entire system functions together — not just whether there is a gap.
Treatment often includes:
Breathing and Pressure Management
Learning how to exhale with exertion and avoid excessive pressure through the abdominal wall can make a huge difference.
Deep Core Strengthening
We focus heavily on the transverse abdominis (your deepest abdominal muscle), pelvic floor coordination, and trunk stability.
Functional Movement Training
Healing happens during real life — lifting laundry baskets, carrying toddlers, getting out of bed, exercising, and returning to workouts safely.
Posture and Rib Cage Positioning
Posture is not about standing stiffly. It’s about helping your rib cage, pelvis, breathing, and abdominal wall work together more efficiently.
What Exercises Help Diastasis Recti?
The best exercises are usually the ones that:
- Build deep core control
- Allow you to breathe normally
- Avoid excessive abdominal bulging
- Progress gradually over time
Common starting exercises may include:
- Diaphragmatic breathing
- Pelvic floor coordination
- Heel slides
- Bridges
- Dead bug progressions
- Functional strengthening
Research supports progressive strengthening programs and deep trunk stabilization exercises for improving symptoms and function.
Are There Exercises You Should Avoid?
Early on, some women benefit from temporarily modifying exercises that create excessive pressure or visible doming through the abdomen.
This may include:
- Aggressive crunches
- Sit-ups
- Certain planks
- Heavy lifting without core control
But this is where nuance matters.
Exercise is not “bad” for diastasis recti. In fact, appropriate strengthening is essential for recovery.
The goal is not to avoid movement, it’s to learn how to load the system appropriately.
Does Everyone Need a Binder or Brace?
Not necessarily.
Some women feel more supported temporarily with taping, compression garments, or abdominal support, especially early postpartum. These tools can improve comfort and body awareness, but they do not replace strengthening.
Think of them as a support tool — not the actual treatment.
When Should You See a Pelvic Floor PT?
You do not need to wait until something feels “severe.”
A pelvic floor PT can help if you:
- Feel disconnected from your core postpartum
- Notice persistent doming or bulging
- Have pelvic floor symptoms alongside abdominal weakness
- Want to safely return to exercise
- Feel unsure what exercises are appropriate
- Have back pain or pressure symptoms postpartum
The earlier you address movement patterns and pressure management, the easier recovery often feels.
In Summary
Although Diastasis Reci is common, it is not “normal”. Good news, though, it is treatable without surgery.
Pelvic Floor Physical therapy with WomanWorx is about rebuilding strength, confidence, and function in your body after pregnancy.
With the right guidance, many women can improve diastasis recti significantly without surgery through:
- Pelvic floor physical therapy
- Deep core strengthening
- Pressure management
- Progressive exercise
- Functional movement retraining
Your body is not broken. It adapted to grow a baby. And with the right support, it can be stronger than ever.
References
- “An Overview of the Management of Diastasis of the Rectus Abdominal Muscles”
- Cleveland Clinic: Diastasis Recti Overview
- StatPearls: Diastasis Recti Rehabilitation
- Skoura et al. “Diastasis Recti Abdominis Rehabilitation in the Postpartum Period”
- Oliveira et al. “Effects of Conservative Approaches for Treating Diastasis Recti Abdominis”
