Separated Abdominal Muscles: Causes, Symptoms, and Treatment

Diastasis recti is a common condition where the space between the left and right recti widens, often showing as a tummy “pooch”. It affects about two thirds of women in pregnancy and can appear in newborns, usually resolving on its own.

Men may develop diastasis from incorrect sit-ups, heavy lifting or fluctuating weight. The gap often narrows after birth, but in some people it persists beyond a year and needs attention.

Healthcare guidance in the UK favours gentle, deep-core movements and physiotherapy before surgery. Binders can support posture and comfort but will not heal the gap.

If a two-finger or roughly 2 cm gap remains at six weeks postpartum, a GP appointment is advised for possible referral to a physiotherapist.

Key Takeaways

Diastasis recti causes a visible separation and is common in pregnancy.
Most newborn cases resolve; some adults need assessment if the gap persists.
Start gentle, guided core work and seek physiotherapy before considering surgery.
Binders aid posture but do not close the gap.
See a GP at six weeks postpartum for a 2 cm or two‑finger gap.

Separated abdominal muscles explained: what diastasis recti is and why it happens

The term diastasis describes a gap that forms along the linea alba as the recti are pulled to either side. In diastasis recti the rectus abdominis halves move apart and the central connective tissue at the front becomes the main support. This creates a visible midline bulge or tummy pooch in many people.

Definition and how the rectus moves

Diastasis means separation; recti refers to the paired rectus abdominis. When the tissue stretches, the two halves no longer meet tightly. The degree of separation varies from a small gap to several centimetres.

Common causes in pregnancy, postpartum, and beyond

Pregnancy puts steady pressure on the belly and can stretch the wall to accommodate a growing baby. Many women see around 5 cm of separation after birth, which often improves with time.

Risk rises with older maternal age, multiple pregnancies, closely spaced births or larger babies. Men may develop diastasis from heavy lifting or poor exercise technique. Newborns sometimes show a gap that usually resolves naturally.

Who is affected: women, men, and newborn babies

This condition mainly affects women in pregnancy and postpartum, but anyone who loads the core can be affected. Symptoms include lower back pain, pelvic issues, and changes to posture or breathing. Severe separation can sometimes link to hernia and may need clinical assessment.

Key point: early recognition helps with targeted recovery and reduces long‑term problems.

How to tell if you have diastasis recti: signs, symptoms, and a safe self-check

Checking for diastasis need not be complicated. A simple, gentle self-test can highlight a gap and flag symptoms that merit professional review. Keep movements slow and stop if anything hurts.

Step-by-step self-test

Lie on a comfortable surface with the knees bent at about 45° and feet on the floor. Gently lift the head and shoulders a little, as if starting a small crunch.

Place two to three fingers vertically just above the belly button, then repeat just below it. Note how many fingers fit between the recti and whether the stomach domes when lifting the head.
Move the fingers up and down the midline to find the widest gap and record whether it feels deep or shallow.
Repeat the check at different times of day, but avoid forceful movements; the aim is to sense the gap without straining the area.

Symptoms to watch

A visible midline bulge or “pooch” when rising or straining, persistent lower back pain, constipation or urine leaking can all suggest diastasis. Difficulty with breathing or some movements is another warning sign.

“If a 2‑finger or roughly 2 cm gap persists at around six weeks postpartum, book a GP appointment for possible physiotherapy referral.”

Healthcare providers can measure separation more precisely using finger widths, tape or ultrasound to track progress and guide treatment. Use the self-check as a gentle guide, not a formal diagnosis.

Treatment and recovery: safe exercises, movements to avoid, and when to seek help

Recovery focuses on gentle, repeatable actions that restore control without overloading the midline. Start slowly and link breathing to each movement to protect the tissue and reduce doming of the belly.

Foundations first

Begin with breathing drills that coordinate the diaphragm and pelvic floor, then practise gentle engagement while lying on the floor with knees bent. This set-up helps reintroduce tension through the midline without heavy strain.

Evidence-informed exercises

Pelvic tilts and hip bridges — slow, controlled ranges to recruit the abdominis and pelvic floor.
Knee raises and all‑fours holds with shoulders over hands and knees under hips.
Supported head lifts using a towel or scarf crossed at the belly, timed with breathing, up to ten repetitions.

What to avoid early on

Avoid crunches, sit-ups, front planks and other moves that cause a visible ridge at the button. Skip heavy press-ups, double leg lifts, scissors, downward dog and boat pose until control improves.

Daily movement tips

Roll to the side to get out of bed. Exhale on effort when lifting the baby or small loads.
Use an elastic belly band for temporary posture support, but remember it does not close the gap.
Keep loads close, hinge at the hips and avoid breath‑holding during lifts.

Professional support and timelines

If discomfort continues, or a gap remains more than two fingers after several weeks, seek a GP for referral to a physiotherapist or pelvic floor specialist. Conservative care usually suffices, but in select cases surgical options such as abdominoplasty may be discussed.

Conclusion

A structured programme of gentle exercise often restores control and confidence. Many people reduce the visible pooch from diastasis recti with guided moves that recruit the rectus abdominis and deep core without causing doming at the belly button.

Simple habits help daily recovery. Roll to the side to get out of bed, keep baby and small loads close, and exhale on effort to protect the front of the body and ease back pain.

If pain persists, a clear gap remains or progress is slow, see a GP for possible physiotherapy referral. Where conservative care fails, surgical options such as abdominoplasty or laparoscopy may be discussed, especially if a hernia is present.

It is never too late: with consistent exercises, good technique and occasional professional support most people make meaningful gains.

FAQ

What is diastasis recti and how does the rectus abdominis separate?

Diastasis recti is a gap that develops along the linea alba when the rectus abdominis muscles move apart. The connective tissue thins and stretches under pressure, such as the weight of a growing uterus in pregnancy, repeated strain or sudden increases in intra‑abdominal pressure. This causes a visible midline bulge or gap, most often above and below the belly button.

Who can develop this condition?

Anyone can develop diastasis recti, though it is most common in pregnant and postpartum women due to hormonal and mechanical changes. Men, newborn babies and people who lift heavy loads or perform repetitive core straining can also be affected. Risk rises with multiple pregnancies, carrying large babies, older maternal age and heavier bodyweight.

How can someone test at home for a gap safely?

Lie on your back with knees bent and feet flat. Place fingertips vertically just above and below the belly button. Gently lift the head and shoulders a few centimetres while breathing out and feeling for a gap or soft tissue separation. Note the number of finger widths and any doming or bulging—if unsure, stop and seek professional assessment.

What symptoms commonly indicate a problem?

Symptoms include a midline bulge or “pooch”, lower back pain, pelvic floor weakness such as urine leakage, constipation and difficulty with breathing or movement. Some people notice poor posture and a sense of instability during daily tasks.

Which exercises are safe to start with?

Begin with gentle foundations: diaphragmatic breathing, pelvic floor engagement and core activation with knees bent on the floor. Evidence‑informed options include pelvic tilts, heel slides or knee raises, supported head lifts with hands or a towel, and controlled all‑fours core engagement. Focus on quality, not repetitions.

Which movements should be avoided early on?

Avoid high‑load, forward‑flexion or twisting moves that increase intra‑abdominal pressure, such as crunches, sit‑ups, planks and some advanced yoga or Pilates transitions that cause doming. Heavy lifting and sudden strain should be modified until strength and control improve.

How should a person modify daily activities to protect the midline?

Use abdominal support by engaging the core and pelvic floor when lifting or picking things up. Roll onto one side to get out of bed rather than sitting straight up. Avoid heavy lifting, hold objects close to the body and consider a maternity or support belt during physically demanding tasks.

When should someone see a GP or physiotherapist?

Seek professional help if the gap is wide, if there is persistent pain, bowel or bladder problems, or if function does not improve with basic exercises after a few weeks. A physiotherapist who specialises in pelvic health can assess core and pelvic floor function and provide a tailored rehabilitation plan.

What role does the pelvic floor play in recovery?

The pelvic floor works with the deep core muscles to stabilise the trunk. Strengthening and coordinating the pelvic floor can reduce symptoms, improve continence and support recovery. Rehabilitation often integrates breathing, transversus abdominis activation and pelvic floor training together.

How long does recovery usually take?

Recovery varies widely. Many people notice improvement in weeks with consistent, appropriate exercises. For others, especially after multiple pregnancies or long‑standing gaps, progress can take months. Surgical repair is a consideration only when conservative treatment fails and symptoms significantly affect quality of life.

Is surgery ever necessary and what does it involve?

Surgery is an option when conservative care does not restore function or when the separation causes severe symptoms or hernia. Procedures typically involve suturing or reinforcing the linea alba, sometimes with mesh. A surgical opinion and full assessment are necessary to weigh risks and benefits.

Can breathing and posture changes help?

Yes. Learning diaphragmatic breathing and improving posture reduces strain on the connective tissue. Good posture supports the midline during movement, while coordinated breathing helps maintain appropriate intra‑abdominal pressure during daily tasks and exercise.

Are there specific signs that require urgent medical attention?

Seek urgent care for severe abdominal pain, sudden worsening of the bulge, signs of bowel obstruction, fever, or significant bleeding. These may indicate complications such as an incarcerated hernia and need prompt assessment.

Can wearing a belly band or support help?

A support garment or belly band can provide temporary comfort and external support during activity, but it does not cure the gap. It may help reduce symptoms while the person follows a progressive rehabilitation plan under professional guidance.

How should exercise intensity progress during recovery?

Progress gradually from gentle activation to functional strengthening and then to more demanding activities. Increase intensity only when control is maintained without doming or bulging. A specialist can set milestones and adapt exercises for safe progression.

Are there reliable resources or organisations for more information?

Reputable sources include the NHS, Chartered Society of Physiotherapy and pelvic health physiotherapy clinics. Academic journals and professional pelvic health associations offer evidence‑based guidance. Seek clinicians with pelvic or women’s health specialism for personalised care.