How Pelvic Floor Physical Therapy Can Help With Diastasis Recti

Diastasis recti is a common condition that can occur during and after pregnancy, but it can affect people at other stages of life as well. It happens when the two sides of the abdominal muscles move farther apart, creating increased tension or stretching of the connective tissue along the midline of the abdomen.

While diastasis recti is not simply a cosmetic concern, it can sometimes contribute to changes in abdominal strength, core stability, posture, breathing, and pelvic floor function. The good news is that pelvic floor physical therapy can be an important part of recovery and restoring functional core strength.

What Is Diastasis Recti?

The abdominal wall is made up of several muscles, including the rectus abdominis—the muscles commonly referred to as the "six-pack" muscles. These muscles are connected along the center of the abdomen by a band of connective tissue called the linea alba.

During pregnancy, the growing uterus and hormonal changes place increased stress on the abdominal wall. This can cause the linea alba to stretch and the abdominal muscles to move farther apart.

Diastasis recti may be associated with:

• A visible bulge or "doming" along the middle of the abdomen

• A feeling of weakness through the core

• Difficulty returning to exercise after pregnancy

• Low back discomfort

• Pelvic pressure or pelvic floor symptoms

• Changes in posture or breathing mechanics

• Difficulty with lifting, carrying, or other functional activities

Importantly, the distance between the abdominal muscles is only one part of the picture. A physical therapist also evaluates how well the abdominal wall manages pressure and tension during movement.

How Does Pelvic Floor Physical Therapy Help Diastasis Recti?

Your abdominal muscles and pelvic floor muscles work together as part of your body's core system. Rather than treating the abdomen and pelvic floor as completely separate areas, pelvic floor physical therapy looks at how the entire system works together.

1. Restoring Deep Core Coordination

A strong core isn't just about performing traditional abdominal exercises.

The deep abdominal muscles, pelvic floor, diaphragm, and muscles around the spine work together to provide stability and manage pressure inside the abdomen.

A pelvic floor physical therapist can teach you how to coordinate these muscles during activities such as:

• Getting out of bed

• Lifting your baby or child

• Squatting

• Exercising

• Coughing or sneezing

• Getting up from a chair

• Returning to running or strength training

The goal is to help your core function effectively—not simply to "tighten" your stomach.

2. Learning Proper Pressure Management

One of the most important aspects of diastasis recti rehabilitation is learning how to manage intra-abdominal pressure.

Certain movements can cause excessive pressure to push outward against the abdominal wall, sometimes creating visible doming or bulging.

Your physical therapist can teach you breathing and movement strategies that help distribute pressure more effectively through the abdominal and pelvic regions.

3. Improving Breathing Mechanics

Your diaphragm is an important part of your core system.

Breathing affects how pressure moves through the abdomen and how the pelvic floor and abdominal muscles respond. If you consistently hold your breath or brace excessively during movement, you may place unnecessary stress on the abdominal wall and pelvic floor.

Pelvic floor physical therapy can help you reconnect breathing with movement so your core can work more efficiently.

4. Strengthening the Core Progressively

Not everyone with diastasis recti needs to avoid abdominal exercises.

In fact, progressive strengthening can be an important part of rehabilitation.

Your physical therapist can help determine which exercises are appropriate for your current level of strength and control and gradually progress you toward more challenging movements.

Treatment may include exercises targeting:

• Deep abdominal muscles

• Obliques

• Glutes and hips

• Back muscles

• Pelvic floor muscles

• Functional whole-body strength

The goal is to help you safely return to the activities you enjoy.

5. Addressing Pelvic Floor Dysfunction

Diastasis recti and pelvic floor dysfunction can occur together, particularly after pregnancy and childbirth.

Some people experiencing diastasis recti may also experience:

• Urinary leakage

• Urinary urgency or frequency

• Pelvic pressure

• Pelvic organ prolapse symptoms

• Pain with intercourse

• Difficulty controlling bowel movements

• Difficulty relaxing the pelvic floor

A pelvic floor physical therapist can evaluate these symptoms and create an individualized treatment plan rather than focusing exclusively on the abdominal separation.

6. Improving Functional Movement

Your physical therapist can also evaluate how you move during everyday activities.

Sometimes the goal isn't simply to make the abdominal muscles "come back together." Instead, rehabilitation focuses on improving the strength, tension, coordination, and function of the abdominal wall so you can confidently perform the activities you need and want to do.

Do I Need to Avoid Crunches?

Not necessarily.

You may have heard that people with diastasis recti should never perform crunches, planks, or other abdominal exercises. The reality is more individualized.

Some exercises may temporarily increase abdominal pressure or cause noticeable doming, especially when performed before you have adequate strength and coordination. However, exercises can often be modified and progressively reintroduced as your control improves.

Your physical therapist can help determine what your body is ready for now—and how to safely progress from there.

When Should You See a Pelvic Floor Physical Therapist?

Consider an evaluation if you notice abdominal separation or bulging along the midline, especially if you also have core weakness, back discomfort, pelvic floor symptoms, or difficulty returning to exercise.

You don't have to wait until symptoms become severe.

A pelvic floor physical therapy evaluation can identify contributing factors and provide an individualized plan based on your goals, lifestyle, stage of recovery, and physical findings.

Pelvic Floor Physical Therapy for Diastasis Recti

Pelvic floor physical therapy can help women understand how their pelvic floor, abdominal wall, breathing mechanics, and whole-body movement work together.

Whether you're recently postpartum, years beyond childbirth, or experiencing core and pelvic floor symptoms at another stage of life, you don't have to simply "live with" abdominal weakness or changes in your core.

If you're looking for pelvic floor physical therapy for diastasis recti, an individualized evaluation can be the first step toward rebuilding strength, improving core function, and getting back to the activities you love.