April 28, 2026
Let's be honest. No one who has just gone through pregnancy and childbirth is expecting to look down and see a six-pack of muscles where they were just carrying the equivalent of a large watermelon. But discovering a bulge in your abdomen — and learning that those muscles are no longer as functional as they should be — can be disheartening.
Diastasis recti is a separation of the rectus abdominis ("six pack") muscles, and it's a common concern during and after pregnancy, says MU Health Care physical therapist Katie Skibiski, PT, DPT, CPH. The rectus abdominis consists of two long vertical muscles attached by connective tissue (fascia). When pregnancy and childbirth cause the fascia to weaken, thin and stretch, the muscles separate.
"For some people, the separation heals on its own during the postpartum period, and they may never even know there was an issue," Skibiski says. "For others, separation gets to a degree that is so problematic that they have to work two or three years to pull those muscles back together."
The good news is that diastasis recti is not permanent. Having the facts may help you recognize and treat it before associated health conditions develop. Skibiski shares five things about diastasis recti every woman should know.
1. Everyone Experiences Some Degree of Muscle Separation During Pregnancy
It's natural and normal for the fascia connecting the rectus abdominis muscles to get stretched during pregnancy. (Is there anything that doesn't stretch during pregnancy?)
How much your fascia stretches and thins is highly individual, and a physical therapist can recommend exercises during pregnancy to minimize your risk.
Factors that put you at higher risk for more severe separation include:
- Carrying multiples, since carrying more weight can weaken the fascia
- History of pelvic floor dysfunction or back pain, because poor body mechanics can put more pressure on abdominal muscles
- Hypermobility syndromes, such as Ehlers-Danlos syndrome, that affect connective tissue
- Impaired skin integrity, which can be triggered by rapid growth
- Midline incision, from a cesarean section or prior abdominal surgery
"During the postpartum period, you're not only healing, but you are constantly picking up and holding the weight of your newborn, which can increase the pressure on your core and abdomen," says Skibiski. "Maintaining connective tissue is really about pressure management and decreasing your risk of the fascia failing. When fascia is not doing its job, it can lead to herniation, pain and incontinence."
While most separation fixes itself within six to 12 months postpartum, more severe separation may need a helping hand to heal. There is a way to self-test for diastasis recti, but evaluation by a medical professional is always the best way to assess your situation.
2. It's Important to Differentiate Between Diastasis Recti and Hernia
After pregnancy and childbirth, a bulge in your abdomen is likely caused by diastasis recti or a hernia — an actual hole in the abdominal wall where tissue or organs can poke out.
Many people see the bulge and assume they have a hernia. But Skibiski says it's critical to have a medical professional check it out. Both are treatable, but the approach and immediate health risk are very different.
"A hernia can be a serious issue," says Skibiski. "You may need surgery or additional treatments to repair it."
3. Everyone Should Consider Screening for Diastasis Recti After Giving Birth or Having Surgery
Since every pregnancy causes some degree of abdominal muscle separation, Skibiski suggests every woman get screened for diastasis recti by a physical therapist after childbirth. Your OB/GYN can refer you to a physical therapist or you can call directly.
"There's no specific timeline, and with a newborn, you may not have the bandwidth at six weeks postpartum," Skibiski says. "But don't put it off too long. You may see better recovery and a quicker return of core strength if you address issues earlier."
A physical therapist can also educate you about exercising after pregnancy and childbirth. Certain movements can help align your body to encourage proper recovery during the postpartum period.
Pregnancy isn’t the only cause of diastasis recti, and men can develop it too. Any surgery or procedure that involves a midline abdominal scar can lead to separation and warrants screening by a physical therapist.
4. Physical Therapy Is the Best Way to Heal Diastasis Recti
Diastasis recti that does not heal on its own requires guidance from a physical therapist. All the sit-ups in the world cannot help — in fact, they may make the condition worse.
Strengthening the fascia to reconnect the rectus abdominis requires a personalized care plan that teaches you to move the right way and engage the correct muscles. It's especially critical postpartum, after the muscles have been slowly stretched for nine months.
"Treatment involves a lot of functional movements," Skibiski says. "I rarely start anyone on their back. It is difficult to have good awareness in that position, so we tend to overload the rectus abdominis muscles and worsen the separation."
Skibiski uses taping methods and biofeedback ultrasound to manually pull the abdominal muscles together so you can see what it should feel like. Exercises to resolve diastasis recti include planks, arm work, learning to control the respiratory diaphragm and engaging the pelvic diaphragm.
"When you are repairing diastasis recti, it's important to 'mind the bulge,'" Skibiski adds. "That means trying not to strain, being mindful of how you are moving and gently engaging your core."
5. Ignoring Diastasis Recti Puts You at Risk for Other Health Issues
A larger separation can put you at increased risk for herniation — in some cases, the fascia can only stretch so far before it breaks. More mild separation can also cause additional health issues as you compensate for that weakened core area.
"We see people who never realized they had diastasis recti, so they never got it checked out or addressed," Skibiski says. "But it can be the underlying cause of the pelvic floor dysfunction, urinary incontinence or back pain they are experiencing now."
Skibiski stresses the importance of getting screened early so you get treatment earlier.
"In the first six to 12 months after childbirth, most women will typically respond quickly to intervention," she says. "It also just minimizes those compensatory issues. However, even though the outcome may be better with early intervention, we can improve diastasis recti at any age. It's never too late."
Next Steps and Useful Resources
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