Ab separation symptoms: what to look for and when to get help

Some people notice a ridge or doming along the centre of the abdomen when sitting up, coughing, lifting, or exercising. Others mainly notice that their trunk feels less supported during everyday movement.

Diastasis recti is a widening between the two sides of the rectus abdominis muscles, with stretching of the connective tissue between them. It commonly becomes more noticeable when pressure inside the abdomen rises. The visible shape can change with posture and muscle use, so appearance alone does not show how well the abdominal wall is functioning.

The condition may present with a central bulge, a gap that can be felt around the navel, difficulty generating tension through the abdomen, back or pelvic discomfort, or a sense of instability. A clinician can assess the width and tension of the midline as well as breathing, movement control, pelvic-floor function, and daily activities.

Start by noticing which movements create doming, pain, breath-holding, or a heavy feeling through the trunk or pelvis. Reduce the load or adjust the movement rather than repeatedly pushing through poor control. Exhaling during effort and moving steadily can make abdominal pressure easier to manage.

A physiotherapist can tailor gradual strengthening to your symptoms, delivery history, activity goals, and examination findings. Rehabilitation may include breathing coordination, deep abdominal and pelvic-floor control, and a staged return to lifting or exercise.

Arrange a routine assessment if the bulging, weakness, pain, urinary leakage, pelvic heaviness, or difficulty with daily tasks persists or limits activity. Seek urgent care for sudden severe abdominal pain, repeated vomiting, a firm tender lump that does not settle, inability to pass stool or gas, fainting, or rapidly worsening swelling. These features need assessment for problems other than uncomplicated muscle separation.

Ask whether your symptoms fit diastasis recti or whether a hernia or another cause should be considered. You can also ask which movements are suitable now, how progress will be measured, whether pelvic-floor symptoms need a separate assessment, and what signs should prompt earlier follow-up.