Diastasis Recti (Abdominal Separation)
What is diastasis recti?
Diastasis recti — also called abdominal separation, rectus diastasis or DRAMS (diastasis of the rectus abdominis muscles) — is the separation of the two halves of the rectus abdominis (the "six-pack" muscles) along the linea alba, the connective tissue band that runs vertically down the centre of the abdomen. During pregnancy, the growing uterus stretches and widens the linea alba to accommodate, and this separation is a normal and necessary part of pregnancy. The question is not whether separation occurs — it does in virtually all pregnancies — but whether it resolves adequately after birth.
Clinically significant diastasis recti occurs when the inter-recti distance (the gap between the muscle bellies) remains wider than normal, or when the linea alba loses its ability to effectively transfer load between the two halves of the abdomen — a functional impairment that matters more than the width of the gap alone. Research now emphasises that the quality and tension of the linea alba tissue is as important as its width, which is why self-assessment by measuring the gap with fingers is an incomplete picture of whether treatment is needed.
How common is it?
Diastasis recti is present to some degree in the majority of women in the third trimester and in the weeks immediately after birth. Studies suggest clinically significant separation persists in approximately 40% of women at six weeks postpartum and around 30% at six months. It is more common in women who have had multiple pregnancies, those carrying multiples, those with a history of abdominal separation in previous pregnancies, and those with generalised connective tissue laxity.
It is worth noting that diastasis recti is not exclusively a postnatal condition — it also occurs in men, in women who have never been pregnant, and in people with significant intra-abdominal pressure from conditions such as obesity or chronic constipation. However the postnatal context is by far the most common presentation in physiotherapy practice.
What are the symptoms?
Many women with diastasis recti have no symptoms at all — the separation is identified incidentally during a postnatal assessment. For others, symptoms include a visible bulging or doming along the midline of the abdomen with activities like sit-ups, getting up from lying, or lifting — which is the classic sign of inadequate linea alba tension. Lower back pain, pelvic girdle pain, and pelvic floor dysfunction are associated with diastasis recti in some women, though the relationship is not straightforward and these symptoms have multiple potential causes.
The emotional impact of diastasis recti should not be underestimated — the visual appearance of the abdomen postpartum, combined with difficulty returning to exercise, can significantly affect body image and postnatal mental health. Part of good diastasis management is helping women understand what is actually happening and what realistic progress looks like.
How is it assessed?
A physiotherapy assessment of diastasis recti involves both measurement of the inter-recti distance — using fingertip palpation or, more accurately, real time ultrasound — and assessment of linea alba tension and functional performance under load. Real time ultrasound is the gold standard assessment tool, providing direct visualisation of the gap, the tissue quality and the muscle activation patterns during functional tasks. It removes the subjectivity of fingertip measurement and allows the physiotherapist to monitor change objectively over the course of rehabilitation.
Assessment also includes evaluation of deep core muscle activation — the transversus abdominis and pelvic floor — as these are the primary active stabilisers of the linea alba and their function is central to diastasis rehabilitation.
Does diastasis recti always need treatment?
Not necessarily — many cases resolve spontaneously with appropriate activity modification and gradual return to exercise. However professional assessment is valuable for all postnatal women to establish a baseline, identify those who would benefit from specific rehabilitation, and provide evidence-based guidance on which exercises are appropriate and which should be modified or avoided during recovery.
The old advice to avoid all crunches, sit-ups and "diastasis-worsening" exercises has been substantially revised in recent years. Current evidence supports a graduated loading approach — using exercises that progressively challenge the linea alba's ability to transfer load — rather than avoidance of specific movements. The goal is to build capacity, not to protect indefinitely.
How can physiotherapy help?
Physiotherapy for diastasis recti is highly effective and most women achieve meaningful improvement with a structured program. The approach focuses on retraining deep core muscle activation — particularly the transversus abdominis and pelvic floor — to restore the active tensioning of the linea alba, then progressively loading the system with exercises that challenge this control in a graded way.
Real time ultrasound is used throughout rehabilitation to guide exercise technique, provide biofeedback on muscle activation quality, and monitor objective improvement in gap width and tissue behaviour. This makes the rehabilitation both more effective and more motivating — women can see the changes occurring in their own tissue as the program progresses.
Education is a critical component — understanding what diastasis recti is, what makes it better or worse, and how to modify daily activities (lifting, carrying, getting up from bed) to protect the healing linea alba while rehabilitation builds capacity.
Our Mums and Bubs Postnatal Pilates course incorporates diastasis-aware exercise progressions as a core component of the program, and our instructors are experienced in providing appropriate modifications for women with ongoing separation. For women with more significant diastasis or associated symptoms, individual postnatal physiotherapy assessment and treatment is recommended before or alongside group classes.
Our physiotherapists Emma Cameron and Bethany Kippen, and exercise physiologist Ash O'Regan both have experience in postnatal rehabilitation and diastasis recti management.
To book or find out more, call us on 07 3706 3407 or book online below. We see patients from across Brisbane's southside including Tarragindi, Coorparoo, Holland Park, Greenslopes and Mt Gravatt.
Diastasis recti — also called abdominal separation, rectus diastasis or DRAMS (diastasis of the rectus abdominis muscles) — is the separation of the two halves of the rectus abdominis (the "six-pack" muscles) along the linea alba, the connective tissue band that runs vertically down the centre of the abdomen. During pregnancy, the growing uterus stretches and widens the linea alba to accommodate, and this separation is a normal and necessary part of pregnancy. The question is not whether separation occurs — it does in virtually all pregnancies — but whether it resolves adequately after birth.
Clinically significant diastasis recti occurs when the inter-recti distance (the gap between the muscle bellies) remains wider than normal, or when the linea alba loses its ability to effectively transfer load between the two halves of the abdomen — a functional impairment that matters more than the width of the gap alone. Research now emphasises that the quality and tension of the linea alba tissue is as important as its width, which is why self-assessment by measuring the gap with fingers is an incomplete picture of whether treatment is needed.
How common is it?
Diastasis recti is present to some degree in the majority of women in the third trimester and in the weeks immediately after birth. Studies suggest clinically significant separation persists in approximately 40% of women at six weeks postpartum and around 30% at six months. It is more common in women who have had multiple pregnancies, those carrying multiples, those with a history of abdominal separation in previous pregnancies, and those with generalised connective tissue laxity.
It is worth noting that diastasis recti is not exclusively a postnatal condition — it also occurs in men, in women who have never been pregnant, and in people with significant intra-abdominal pressure from conditions such as obesity or chronic constipation. However the postnatal context is by far the most common presentation in physiotherapy practice.
What are the symptoms?
Many women with diastasis recti have no symptoms at all — the separation is identified incidentally during a postnatal assessment. For others, symptoms include a visible bulging or doming along the midline of the abdomen with activities like sit-ups, getting up from lying, or lifting — which is the classic sign of inadequate linea alba tension. Lower back pain, pelvic girdle pain, and pelvic floor dysfunction are associated with diastasis recti in some women, though the relationship is not straightforward and these symptoms have multiple potential causes.
The emotional impact of diastasis recti should not be underestimated — the visual appearance of the abdomen postpartum, combined with difficulty returning to exercise, can significantly affect body image and postnatal mental health. Part of good diastasis management is helping women understand what is actually happening and what realistic progress looks like.
How is it assessed?
A physiotherapy assessment of diastasis recti involves both measurement of the inter-recti distance — using fingertip palpation or, more accurately, real time ultrasound — and assessment of linea alba tension and functional performance under load. Real time ultrasound is the gold standard assessment tool, providing direct visualisation of the gap, the tissue quality and the muscle activation patterns during functional tasks. It removes the subjectivity of fingertip measurement and allows the physiotherapist to monitor change objectively over the course of rehabilitation.
Assessment also includes evaluation of deep core muscle activation — the transversus abdominis and pelvic floor — as these are the primary active stabilisers of the linea alba and their function is central to diastasis rehabilitation.
Does diastasis recti always need treatment?
Not necessarily — many cases resolve spontaneously with appropriate activity modification and gradual return to exercise. However professional assessment is valuable for all postnatal women to establish a baseline, identify those who would benefit from specific rehabilitation, and provide evidence-based guidance on which exercises are appropriate and which should be modified or avoided during recovery.
The old advice to avoid all crunches, sit-ups and "diastasis-worsening" exercises has been substantially revised in recent years. Current evidence supports a graduated loading approach — using exercises that progressively challenge the linea alba's ability to transfer load — rather than avoidance of specific movements. The goal is to build capacity, not to protect indefinitely.
How can physiotherapy help?
Physiotherapy for diastasis recti is highly effective and most women achieve meaningful improvement with a structured program. The approach focuses on retraining deep core muscle activation — particularly the transversus abdominis and pelvic floor — to restore the active tensioning of the linea alba, then progressively loading the system with exercises that challenge this control in a graded way.
Real time ultrasound is used throughout rehabilitation to guide exercise technique, provide biofeedback on muscle activation quality, and monitor objective improvement in gap width and tissue behaviour. This makes the rehabilitation both more effective and more motivating — women can see the changes occurring in their own tissue as the program progresses.
Education is a critical component — understanding what diastasis recti is, what makes it better or worse, and how to modify daily activities (lifting, carrying, getting up from bed) to protect the healing linea alba while rehabilitation builds capacity.
Our Mums and Bubs Postnatal Pilates course incorporates diastasis-aware exercise progressions as a core component of the program, and our instructors are experienced in providing appropriate modifications for women with ongoing separation. For women with more significant diastasis or associated symptoms, individual postnatal physiotherapy assessment and treatment is recommended before or alongside group classes.
Our physiotherapists Emma Cameron and Bethany Kippen, and exercise physiologist Ash O'Regan both have experience in postnatal rehabilitation and diastasis recti management.
To book or find out more, call us on 07 3706 3407 or book online below. We see patients from across Brisbane's southside including Tarragindi, Coorparoo, Holland Park, Greenslopes and Mt Gravatt.
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