Russian twists and diastasis recti: what to know

Diastasis recti is stretching and thinning of the connective tissue between the abdominal muscles. A Russian twist combines trunk rotation with a braced or lifted position, which can make pressure push forward through the midline. A visible ridge, tenting, or doming along the centre of the abdomen is a useful warning sign. It does not by itself show how severe the separation is, and the exercise is not automatically unsafe for every person.

Symptoms can include a feeling of weakness, back discomfort, or difficulty controlling the trunk. Pregnancy, recent birth, abdominal surgery, and changes in conditioning can all affect how an exercise feels.

Stop the twist when you notice doming, breath-holding, pelvic pressure, or pain. Keep your feet supported and practise gentle breathing with controlled movements such as heel slides or marching, if these remain comfortable. Move slowly and keep the ribs stacked over the pelvis rather than forcing the abdomen flat.

A pelvic-floor and rehabilitation specialist can assess your movement, breathing, strength, and goals, then progress exercises gradually. See [Postnatal Physiotherapy](/treatments/pelvic-floor-and-rehabilitation/postnatal-physiotherapy/) for related support.

Arrange an assessment if abdominal separation is accompanied by persistent back pain, a painful bulge, increasing weakness, or difficulty with everyday lifting. Seek urgent care for sudden severe abdominal pain, vomiting, fainting, or a firm bulge that cannot be gently reduced.

Ask whether your symptoms fit diastasis recti, which exercises match your current control, how to recognise excessive pressure, and when twisting can be reintroduced. Mention pregnancy, birth, surgery, or pain that changes your programme.