What should you know about severe diastasis recti?

The two sides of the rectus abdominis muscles move farther apart as the connective tissue between them stretches. The gap itself is only part of the picture: a clinician also considers tension in the tissue, depth, abdominal control and your symptoms. You may notice a ridge or doming when sitting up, difficulty bracing, lower-back discomfort, pelvic pressure or a feeling that the middle of your body lacks support. Diastasis recti can follow pregnancy, but it can also occur after substantial changes in abdominal pressure or loading. It is not the same as a hernia, although both can be present.

Arrange an assessment with a physiotherapist or doctor familiar with abdominal and pelvic health, especially if symptoms interfere with lifting, walking, exercise or caring for a baby. Treatment commonly starts with breathing, posture and gradual deep-core coordination rather than forceful abdominal exercises. Roll onto your side before getting out of bed, exhale during effort, and avoid movements that produce pronounced doming or pain. Postnatal Physiotherapy can provide individual guidance.

Seek prompt medical advice for a new painful bulge, severe or worsening abdominal pain, vomiting, fever, faintness, or a bulge that becomes firm and cannot be gently reduced. Contact a clinician when weakness, back pain or pelvic symptoms persist, or when you are unsure whether a lump is muscle separation or a hernia.

Ask how the separation and abdominal wall function will be assessed, whether a hernia needs to be excluded, which activities should be modified, and how progress will be measured. If surgery is being discussed, ask what problem it is intended to address, what recovery involves, and whether rehabilitation remains part of the plan.