What Is Diastasis Recti and How Do You Actually Fix It?

If your core doesn’t feel like it came back after pregnancy, you’re not imagining it. Here is what diastasis recti actually does to your body, and how pelvic floor physiotherapy and chiropractic care at Oona in Toronto and Newmarket can help you heal.

Written by Dr. Sarah Mickeler, Founder, Oona Wellness Group

At some point after having a baby, something may start to feel off in a way that is hard to name. At this point you’re probably moving more. You might even feel stronger in certain ways. And still, the center of your body does not feel like it has come back with you. There is a softness that wasn’t there before. A “doming” or bulging in your abs when you sit up. A quiet sense that your core is not responding the way it used to. And almost always, no one has taken the time to explain why.

By the time people find their way to Oona, they have usually been trying to figure it out alone for months, sometimes years. They have done the crunches and the sit ups, hoping effort would be enough to fix it. But often not much has changed, despite their efforts. The back pain that started after birth lingers. Leaking with a cough or a sneeze becomes something you plan your day around, rather than something anyone has helped you resolve.

This is where we begin. Not with blame, and not with a list of things you should have done differently. You did nothing wrong. We start with understanding. A thoughtful, thorough look at what is actually happening in your body, so we can meet you there and move forward in a way that makes sense for you.

Diastasis recti is not something you caused. It is a normal physical response to growing a baby inside your body, and it is treatable.

What Is Diastasis Recti?

Diastasis recti means the two sides of your abdominal wall have moved apart. The “six‑pack” muscles run vertically down your abdomen. In between them is connective tissue called the linea alba. During pregnancy, that tissue stretches to make room for your growing baby.

For most people, that stretch does not fully resolve on its own after birth. Some degree of lingering separation is extremely common. However, what matters is not actually the width of the gap, but rather how well that tissue is functioning. A small gap with poor tension can cause significant problems. A larger gap with good tension might not cause any problems at all. This is why a proper assessment matters, and why the finger‑width test you saw on the internet is only the beginning – and actually not all that relevant.

At Oona in Toronto and Newmarket, our pelvic floor physiotherapists do not just measure the gap. They look at the tension of your connective tissue, how your deep core is activating, what your pelvic floor is doing, and how you breathe. All of these are connected.

Why It Happens

Pregnancy itself is the primary cause. As your baby grows, your abdominal wall is placed under continuous pressure. At the same time, hormonal changes affect the elasticity of your connective tissue. The combination means that for many women, the linea alba does not bounce back the way it should after birth.

This is not something you caused. It is not because you did the wrong exercises during pregnancy or did not try hard enough after. It is a normal physical response to growing a human inside your body. And it is treatable.

What Diastasis Recti Actually Feels Like

We see this every day. Our patients come into Oona and say:

“My core just feels off, like nothing is holding things together.”
“I still look pregnant, even though my baby is six months old.”
“My lower back hurts all the time, and nothing I do seems to help.”
“I leak when I cough or sneeze, and I have just been accepting it.”
“I feel a bulge or ridge in the middle of my belly when I sit up.”

This is about function, not just appearance. Your core and pelvic floor work together. When one is not doing its job well, everything else compensates. That is why diastasis recti so often comes with lower back pain, pelvic pressure, leaking, and a sense of instability that is hard to name but impossible to ignore.

Why Core Exercises May Make It Worse

This is where most people accidentally make it worse. The instinct when you notice a soft, separated middle is to do more core work. Crunches. Sit‑ups. Leg raises. Planks. These are the exercises most people associate with core strength, and they are the exercises that place the most direct load on the linea alba in a way that can widen the separation rather than close it, if they’re not done right.

The reason is intra‑abdominal pressure. Any movement that significantly increases pressure inside your abdomen, particularly while your core is not yet able to manage that pressure, can cause the tissue to become more lax and the gap to widen.

It is not about doing nothing. It is about doing the right things in the right order. The exercises that actually help look quite different from a standard core routine, and they start with your breath.

How Diastasis Recti Is Properly Assessed

A proper assessment of diastasis recti is done by a pelvic floor physiotherapist or a practitioner trained specifically in postpartum core rehabilitation. It is not done with a YouTube video and three fingers, if you are at that point you probably know it is already worth investigating.

At Oona, our pelvic floor physiotherapists in Toronto and Newmarket assess diastasis recti as part of a comprehensive postpartum evaluation. The assessment looks at the width of the separation, but more importantly at the tension and function of the linea alba and the surrounding muscle groups. It also looks at what your pelvic floor is doing, how you are breathing, and what your movement patterns look like, because all of these are connected.

You do not need a specific symptom to justify being assessed. If you have had a baby, a postpartum pelvic floor assessment that includes a diastasis check is simply good care. Our physiotherapists recommend it to every postpartum patient, regardless of how recovery appears to be going.

Our postpartum chiropractic team also assesses and treats diastasis recti, looking at the mechanical compensations that have accumulated in your back, pelvis, and spine as a result of your altered core function.

Learn about pelvic floor physiotherapy at Oona →
Learn about postpartum chiropractic at Oona →

How You Actually Fix It

This is a progression, not a quick fix. It takes time, but it works.

You start with your breath. The way you breathe directly affects intra‑abdominal pressure and how your deep core activates. Diaphragmatic breathing, learning to breathe into your lower ribcage and abdomen rather than only into your chest, is often the foundation on which everything else is built.
You reconnect your deep core. The transversus abdominis, the deepest abdominal muscle, wraps around your spine and plays a central role in spinal stability. In diastasis recti, this muscle is often inhibited. Learning to activate it correctly, without increasing pressure inappropriately, is a central part of early rehabilitation.
You build slowly, with guidance. Once the foundation is established, exercises are progressively loaded. What you can do safely changes as your tissue strengthens and the coordination of your core system improves. Your physiotherapist determines when you are ready for each progression based on what they can observe and assess, not on a standard programme.
You learn to move differently. How you get up from lying down, how you lift your baby, how you carry and transfer weight – all of these involve your core and all of them can be modified to reduce the load on a healing linea alba while strengthening the surrounding structures.
You return to full activity. Running, returning to the gym, lifting heavier weights, getting back to sport – these are all possible after diastasis recti rehabilitation, and they are the goal. The question is the order and the timing. Your physiotherapist will guide you through a return‑to‑activity plan that is built around your specific situation and your goals, not around a generic timeline.

When Should You Start?

Earlier than most people think. You do not need to wait until six weeks postpartum to begin. Breathing work can begin in the early postpartum days. A formal assessment is appropriate from six weeks onward.

If you are currently pregnant and concerned about diastasis recti, a pelvic floor physiotherapy assessment during pregnancy gives you a baseline and teaches you the movement and breathing habits that reduce the likelihood of a significant separation developing.

If your baby is months or years old and you are only now identifying diastasis recti as a possible issue, it is not too late. The tissue responds to rehabilitation at any stage. Women who have been living with an unaddressed separation for years make meaningful progress with appropriate treatment. You do not have to accept the way your core currently feels as the permanent shape of things.

You do not have to have a recent baby to come in. If your core has not felt right since your last pregnancy, whenever that was, come and find out why.

Frequently Asked Questions

These are the questions we hear most often from women who come to Oona with diastasis recti, or who suspect they might have it.

How do I know if I have diastasis recti?

You might notice a doming or ridge in the middle of your belly when you sit up, a softness that was not there before, or a core that does not feel stable. You might also have lower back pain that has not resolved, leaking when you cough or sneeze, or a feeling of pelvic pressure. The most reliable way to know is to have it assessed by a pelvic floor physiotherapist.

Can diastasis recti heal on its own?

The gap often narrows in the first eight weeks postpartum as initial inflammation resolves. But the function of the connective tissue and surrounding muscles does not restore itself through time alone. Most women need guided rehabilitation for full recovery. That does not mean you are stuck with it. It means you need the right kind of help, and that help works.

How long does it take to fix diastasis recti?

Some women notice significant change in four to six sessions. Others with a more significant separation benefit from a longer course of treatment. Your physiotherapist will give you a realistic picture at your first assessment and will update that as your body responds. There is no standard timeline because there is no standard diastasis recti.

Can I exercise with diastasis recti?

Yes, but the type of exercise matters. A pelvic floor physiotherapist can tell you what is appropriate for where you are right now.

Do I need surgery for diastasis recti?

In most cases, no. Physiotherapy and chiropractic care are the first and most effective steps. Surgery is rarely needed and is typically considered only when a significant separation persists after a full course of rehabilitation.

Is diastasis recti connected to pelvic floor issues?

Very often. The pelvic floor and deep abdominal muscles are part of the same pressure management system. Think of your core as a pressurized can of pringles: your diaphragm at the top, your pelvic floor at the bottom, and your transverse abdominus and other core muscles on the sides. If your pelvic floor is compromised, it’s like taking the bottom off of that can, and the pressure system no longer works. If your abdominal muscles are compromised, it causes issues with the pelvic floor, etc. When one is not functioning well, the other is affected. That is why we assess and treat both together at Oona.

Is it too late to fix diastasis recti if my baby is older?

No. We regularly help women who are years postpartum. There is no window that closes on treatment. The tissue responds to rehabilitation regardless of how much time has passed. You are not too late.

Is diastasis recti treatment covered by insurance?

Pelvic floor physiotherapy is covered by most extended health plans that include physiotherapy. Chiropractic treatment is covered under chiropractic benefits. Oona offers direct billing wherever your provider supports it.

A Note from Sarah

Most women are never properly assessed. They leave the hospital after birth with no one looking at their core. The six‑week check, where it exists at all, focuses on the incision or the perineum. No one looks at the midline. No one asks whether your core is holding together the way it should. No one mentions that the exercises you are itching to return to might be making things worse rather than better.

You deserve better than that. Your body went through something significant. It deserves a proper assessment, honest information, and a treatment plan that is built around what you specifically need.

At Oona, you are not expected to figure it out on your own. We meet you where you are and work through it together.

Oona is the part where it gets easier.