Exercising with Diastasis Recti: Safe Movement and Pelvic Floor Health
Sophie Mason, PT, MSc. PT BSc (Hons)
Registered Physiotherapist – Pelvic Health
Many new moms are surprised to learn that it is not only safe but also beneficial to return to exercise after pregnancy, even with a diagnosis of diastasis recti. At Proactive Pelvic Health Centre, we often see clients who have been told they should avoid core work or heavy lifting altogether. The truth is very different: with the right guidance, you can exercise, build strength, and support your pelvic floor health—you are not fragile.
What is Diastasis Recti and Why Does It Matter?
During pregnancy, it is normal for the abdominal muscles to stretch and for the connective tissue between them (the linea alba) to thin. This creates more room for your growing baby. For many people, the tissues gradually regain tension in the postnatal or postpartum stage. For others, the linea alba remains thinner and the abdominal wall feels weaker or less supported. This is known as diastasis recti.
It’s important to remember:
Diastasis recti is not an injury.
It does not mean you have permanently damaged your abdominal muscles.
It does not prevent you from regaining strength or safely exercising.
The main concern is often functional—if the abdominal wall is less supportive, it may contribute to pelvic floor symptoms like back pain, feelings of pressure, or reduced bladder function. That’s why many people benefit from a pelvic floor physiotherapy program that looks at the whole system: the pelvic floor muscles, core, breath, and posture.
Coning, Bulging, and Pelvic Floor Function
You might have noticed a bulge or ridge appear along your midline when you sit up, lift, or perform certain exercises. This is often called coning or doming. It happens when the pressure inside your abdomen pushes outward through the thinned linea alba.
Here’s the empowering truth:
Coning does not mean you are damaging your tissues.
It is simply feedback that the way you are doing the movement could be adjusted.
By changing your breathing, posture, or the load of the exercise, you can usually reduce this bulging.
For example, exhaling as you lift or focusing on gentle activation of your pelvic muscles and deep core can help your body manage pressure more effectively. Over time, this improves not just your abdominal support but also your pelvic floor function.
Exercising with Diastasis Recti: Principles for Pelvic Health
Exercise is one of the most effective ways to improve your core and pelvic floor health. In fact, avoiding movement altogether can sometimes contribute to ongoing weakness, stiffness, or even pelvic pain. The key is learning how to move in a way that supports your pelvic floor rehabilitation.
Here are some guiding principles we often share in pelvic physio sessions:
1. Start with Awareness
Before jumping into planks or crunches, learn how to connect your pelvic floor muscles and deep core. A pelvic floor physiotherapist may use an internal assessment or internal exam to help you understand whether your muscles are weak, tight, or not coordinating well. This assessment helps build a personalized treatment plan.
2. Use Breath as a Tool
Exhale during effort (for example, when lifting weights or standing from a chair). This simple strategy reduces downward pressure on the pelvic floor and helps prevent symptoms like stress incontinence, bulging, or pelvic organ prolapse from worsening.
3. Modify, Don’t Avoid
If an exercise causes discomfort, coning, or increased pelvic floor symptoms, try adjusting the movement rather than eliminating it. For instance, you might perform a bridge instead of a sit-up, or use a side plank instead of a front plank while your strength builds.
4. Progress Gradually
Your body adapts with consistent training. Beginning with foundational exercises—bridges, gentle core activations, supported squats—allows you to build strength in a safe way. Over time, you can progress to running, lifting heavier weights, or high-intensity workouts without compromising your pelvic floor or core health.
Why Work with a Pelvic Floor Physiotherapist?
Recovering from diastasis recti isn’t just about “closing the gap.” It’s about restoring function, confidence, and long-term pelvic health. A trained pelvic floor physiotherapist can guide you through:
Pelvic floor assessment – understanding whether your muscles are weak, overactive, or uncoordinated.
Tailored treatment plans – exercises that fit your lifestyle and goals.
Education on kegel exercises (and when they’re appropriate—or not—for your needs).
Support for related concerns like pelvic organ prolapse, sexual dysfunction, or chronic pelvic pain.
Guidance in returning to the activities that bring you joy, whether that’s yoga, running, or lifting your toddler.
The Empowering Truth
Diastasis recti is common after pregnancy. It does not mean you are weak or broken. With the right strategies, you can build strength, restore function, and feel confident in your body again.
At Proactive Pelvic Health Centre, we believe in empowering clients with knowledge and tools, not restrictions. Safe, supported movement can improve your core and pelvic floor function, and help you return to the activities you love.
References:
Gluppe, S. L., Hilde, G., Tennfjord, M. K., Engh, M. E., & Bø, K. (2018). Effect of a postpartum training program on the prevalence of diastasis recti abdominis in postpartum primiparous women: A randomized controlled trial. Physiotherapy, 104(3), 234–240. https://doi.org/10.1016/j.physio.2017.06.001
Keeler, J., Albrecht, M., Eberhardt, L., Horn, L., Donnelly, C., & Lowe, D. (2012). Diastasis recti abdominis: A survey of women’s health specialists for current physical therapy clinical practice for postpartum women. Journal of Women’s Health Physical Therapy, 36(3), 131–142.
Spitznagle, T. M., Leong, F. C., & Van Dillen, L. R. (2007). Prevalence of diastasis recti abdominis in a urogynecological patient population. International Urogynecology Journal, 18, 321–328. https://doi.org/10.1007/s00192-006-0143-5