What should you know about extreme diastasis recti?

Diastasis recti, also called abdominal separation, often develops as the abdominal wall stretches during pregnancy or with major changes in abdominal pressure. A visible ridge or doming down the centre of the abdomen may appear when you sit up, cough or lift. Some people notice a soft gap, reduced core support, lower-back discomfort, poor posture or difficulty with everyday movements. The size of a gap does not by itself determine how much trouble it causes; control, tension and symptoms also matter.

This is different from a true hernia, although both can occur together. A clinician or physiotherapist can examine the abdominal wall and check for other causes of a bulge. Recovery can vary after birth, and severe symptoms deserve an individual plan rather than forceful abdominal exercises.

Arrange an assessment if the separation is prominent, painful, worsening or interfering with lifting, walking, exercise or caring for your baby. A pelvic health or postnatal physiotherapist can assess breathing, abdominal pressure, posture and the way your deep abdominal muscles work together. Read more about Postnatal Physiotherapy for rehabilitation support.

Until you are assessed, roll to your side before getting out of bed, exhale during effort and avoid exercises that create marked doming or pain. Do not repeatedly test the gap or use a rigid abdominal binder as a substitute for rehabilitation. Gradual activity is usually more useful than complete rest, provided symptoms remain settled.

Seek prompt medical care for a sudden, very painful or firm bulge, vomiting, inability to pass stool or gas, fever, or skin colour changes over a bulge. These features can signal a hernia problem or another abdominal condition rather than diastasis alone. Seek urgent help for severe weakness, fainting or new loss of bladder or bowel control.

Ask whether your symptoms fit diastasis recti or a hernia, which movements currently increase abdominal pressure, and what progression of exercises is suitable for your stage after birth. Ask when you can return to lifting, running or higher-impact activity, and what signs should make you pause rehabilitation.