Diastasis Recti: What You Should Know

Diastasis Recti: What You Should Know

Diastasis Recti (DR) is common, but it isn’t straightforward. Let’s break it down so you can better understand what’s happening in your body and how to support it.

 What is Diastasis Recti?

Diastasis recti is a separation of the rectus abdominis (your "six-pack" muscles) along the linea alba, the connective tissue down the middle of your abdomen. It’s most commonly seen postpartum, but it can happen in men, athletes, or anyone with excessive intra-abdominal pressure over time.

Diastasis presents as:

●      A visible bulge or doming when doing sit-ups or lifting

●      Core weakness or instability

●      Low back or pelvic pain

●      Digestive issues or constipation

●      Pelvic floor dysfunction

Doming vs. Coning

These terms are often used interchangeably, but there is a difference:

●      Doming usually refers to a generalized ridge or bulge that appears in the midline of your abdomen when you strain or engage the core incorrectly.

●      Coning tends to refer to a sharper, more triangular protrusion. It often indicates that the intra-abdominal pressure is pushing out along the weakest line (your linea alba).

Both are signs that your core is not managing pressure well—and that’s your cue to back off and reassess your movement strategy.

 

 

 When to Consider Surgery

Surgery isn’t the first stop and it’s usually the last. But there are times when surgical repair (like a tummy tuck or functional abdominoplasty) makes sense.

You might consider it if:

●      You’ve done consistent core rehab for 6–12+ months with minimal improvement

●      Your diastasis is wide (often 4+ finger widths) or deep with poor tension

●      You have persistent pain, hernias, or significant functional impairment

●      Your abdominal wall lacks integrity and you’re unable to generate tension through the linea alba
 

Important: Surgery addresses the structure, but it doesn't solve the pressure mismanagement or muscle dysfunction. You'll still need PT before and after for the best outcome.

 

 Binders: Helpful or Harmful?

Positives:

●      Can give you a sense of support and stability, especially early postpartum

●      May reduce discomfort with movement

●      Helpful in short bursts (e.g., during errands, walking, or transitional healing stages)

Negatives:

●      Over-reliance can weaken your core if used too often or too long

●      Can restrict breathing and pressure management if worn tightly

●      Not a substitute for active core engagement or rehab

Pro tip: Use binders temporarily and strategically, and always pair with guided rehab.

 Diastasis and Constipation—What’s the Connection?

Straining on the toilet increases intra-abdominal pressure, and that pressure can:

●      Widen your diastasis

●      Contribute to pelvic floor dysfunction

●      Lead to hemorrhoids, prolapse, or worsen abdominal bulging

Tips:

●      Use a squatty potty or footstool to bring knees above hips

●      Breathe into your belly and exhale gently as you go—never hold your breath

●      Don’t rush, and avoid excessive pushing

●      Increase fiber and hydration, and move your body regularly

With the right support—from physical therapy, stregnth training and intentional movement, you can feel stronger, more connected to your core, and more in control of your body.

And remember: You don’t need a “perfect” core to be functional. Healing is about optimizing function, not flattening your stomach.

Have questions or want to get started with rehab? Reach out to call Solstice Physiotherapy at 929-269-2505 or email us to schedule a free 15-minute consultation.