Diastasis recti years after giving birth: what to know

During pregnancy, the connective tissue between the two sides of the abdominal muscles can stretch. A persistent gap may make the midline look domed when you sit up, cough, or lift. Some people notice reduced trunk support, back discomfort, a feeling of weakness, or difficulty coordinating the abdomen with the pelvic floor; others have no pain. The appearance alone does not show how well the muscles function, and a clinician can check for other causes of a bulge, including a hernia.

Arrange an assessment with a physiotherapist or clinician familiar with postnatal abdominal and pelvic function, even if birth was years ago. They can observe breathing, abdominal pressure, posture, lifting, and muscle coordination before suggesting exercises. A gradual programme may include deep abdominal activation, pelvic-floor coordination, breathing control, and progressive strength work. Avoid repeatedly forcing a movement that creates marked doming, pain, or breath-holding. [Postnatal Physiotherapy](/treatments/pelvic-floor-and-rehabilitation/postnatal-physiotherapy/) may be relevant to discuss.

Book a clinical review for a painful or growing bulge, persistent back or abdominal pain, new bowel or bladder difficulty, or weakness that limits ordinary activity. Seek urgent help for sudden severe abdominal pain, vomiting, fainting, or a firm bulge that cannot be gently reduced, because these symptoms may indicate a problem needing prompt assessment rather than diastasis rehabilitation.

Ask: Could this bulge be diastasis recti or a hernia? Which movements should I modify? Would pelvic-floor physiotherapy fit my symptoms? How should I progress strengthening, and what signs mean I should stop an exercise?