What is abdominal separation or rectus diastasis?

Rectus diastasis happens when the two sides of the rectus abdominis muscles move further apart along the linea alba, the connective tissue in the middle of the abdominal wall. It is especially common during pregnancy because the growing uterus stretches the abdominal wall.

Some people notice:

• a gap or doming through the middle of the tummy

• weakness through the abdominal wall

• difficulty with core control

• a feeling of instability or reduced support

• back discomfort or postural strain

• concern about return to exercise or lifting

A small separation often improves in the weeks after birth, while a larger or more persistent separation may need more guided rehabilitation.

How abdominal separation may affect daily function

Abdominal separation affects each person differently, but it may impact:

• core strength and abdominal control

• posture and body mechanics

• lifting, carrying and rolling in bed

• return to exercise

• confidence with movement

• abdominal doming or bulging during activity

• back or trunk discomfort in some people

Some postnatal guidance also advises avoiding straining, heavy lifting and exercises that cause the abdominal wall to bulge while rebuilding deep core support.

How Palms Physiotherapy & Allied Health may help

Physiotherapy

Physiotherapy may support people with abdominal separation where there are goals related to core function, posture, movement confidence, return to activity or postnatal recovery. Depending on the person’s needs, physiotherapy may include:

• assessment of abdominal wall function

• guidance on deep core muscle activation

• gradual strengthening and movement progression

• support for posture and body mechanics

• strategies for lifting, rolling, getting out of bed and daily movement

• return-to-exercise planning

• advice on activities that may increase abdominal doming or strain

Early postnatal guidance often recommends beginning with gentle abdominal activation, particularly of the deeper abdominal muscles, before progressing to more demanding exercise.

Occupational Therapy

Occupational therapy is not routinely needed for abdominal separation itself, but it may be relevant where pain, fatigue, parenting demands or daily routine difficulties are affecting function at home.

Exercise Physiology

Exercise physiology may be appropriate for some people who are further along in recovery and want structured support with graded return to exercise, strength or conditioning, once they are medically and physically ready.

Speech Pathology

Speech pathology is not usually relevant to abdominal separation unless there is a separate feeding or swallowing issue unrelated to the abdominal wall concern.

Postnatal recovery considerations

Abdominal separation is particularly common after pregnancy. NHS guidance explains that this separation is common and often improves within the first weeks after birth, although not everyone recovers at the same rate. Some resources suggest that larger separations may take longer and may benefit from specialist physiotherapy input.

abdominal separation is common

not every gap needs intensive treatment

the width of the gap is not the only issue; function matters too

rehabilitation should be based on symptoms, movement control and daily function, not just appearance

Our approach

At Palms, we take a function-focused, goal-directed approach. That means we look at how abdominal separation is affecting the person in everyday life and what practical support may help. Therapy may focus on:

improving deep abdominal support

reducing abdominal doming during movement

supporting posture and body mechanics

building confidence with lifting and activity

returning to exercise gradually

improving day-to-day function during postnatal recovery

We also recognise that support often works best when it is tailored to the person’s stage of recovery, birth history, symptoms and goals.

FAQ

What is rectus diastasis?

Rectus diastasis is a separation of the rectus abdominis muscles along the linea alba, usually seen during or after pregnancy.

Is abdominal separation normal after pregnancy?

Yes. Some abdominal separation is common during and after pregnancy. NHS guidance notes that the separation often improves over the early postnatal period.

Does everyone need treatment for abdominal separation?

Not always. Some people recover well over time without needing much support. Others may benefit from physiotherapy if the separation is affecting function, movement control, posture or return to activity.

Can physiotherapy help with rectus diastasis?

Physiotherapy may help support abdominal wall function, deep core activation, posture, body mechanics and return to activity for people with abdominal separation.

Can exercise make rectus diastasis worse?

Some exercises or movement patterns may increase abdominal doming or strain if introduced too early or performed without enough core support. Postnatal guidance often advises avoiding exercises that make the abdominal wall bulge.

When can I start exercises for abdominal separation?

This depends on your recovery, symptoms and medical advice. Many postnatal resources recommend starting with gentle core activation before progressing to more demanding exercise.

Can abdominal separation cause back pain?

It can contribute to reduced trunk support or body mechanics issues in some people, which may be associated with discomfort or a feeling of instability. Some postnatal guidance mentions back discomfort where the abdominal wall remains weak.

Will rectus diastasis always need surgery?

No. Many people improve with time and appropriate rehabilitation. Surgery is not the routine first option for most postnatal abdominal separation concerns. This is consistent with common conservative postnatal physiotherapy guidance.

When should I seek help for abdominal separation?

It may be helpful to seek physiotherapy if you notice persistent doming, reduced core control, difficulty returning to exercise, ongoing weakness, or discomfort affecting daily activities.

If you are concerned about abdominal separation or rectus diastasis and would like support with core recovery, posture, movement or return to activity, our team can discuss whether physiotherapy may be appropriate for your needs. 

Important disclaimer: This webpage contains general information only and is not intended to be relied upon as personal clinical advice. While we aim to keep information accurate and up to date, it may not reflect the most current research or your individual circumstances. Palms Physiotherapy & Allied Health does not accept liability for decisions made based on this information without an individualised assessment by an appropriately qualified health professional. If you have concerns, please contact us to book an assessment or speak with your GP/medical team.