Untitled

Diastasis Recti: What the Evidence Really Says

McCann Physiotherapy – Sale & Hale, Cheshire

Specialist Pelvic Health & Advanced Musculoskeletal Physiotherapy

Introduction

Diastasis recti abdominis (DRA) is a very common condition during and after pregnancy. As your baby grows, the abdominal muscles naturally stretch and move apart to accommodate these changes. This separation occurs along the midline of the tummy, known as the linea alba.

DRA can begin as early as 16 weeks of pregnancy and affects the majority of women—around 70% in the final trimester, 60% at six weeks postpartum, and still 30% at one year after birth.

Traditionally, DRA has been described and measured by the gap between the abdominal muscles (inter-recti distance). However, more recent research highlights that recovery is not just about the size of the gap, but more importantly about how well the linea alba can generate tension and transfer load.

In simple terms, it’s not just about how far the muscles are apart—but how well your core can function, support movement, and manage pressure. A smaller gap doesn’t always mean better function, and a wider gap isn’t always a problem if the tissue is strong and responsive.

At McCann Physiotherapy, a large number of patients come in saying:

“Can you check my gap?”

“Is my stomach swollen because of my tummy gap?”

“My PT said my gap will close in 6 weeks…”

“I had a Mummy MOT but didn’t get clear advice”

“I’ve been told I have a large gap but i'm unsure to what to do about this”

If this sounds familiar, you’re not alone.

This blog will give you a clear, evidence-based understanding of diastasis recti — focusing on what actually matters: strength, function, and confidence.

What Actually Matters in Assessment?

One of the biggest misconceptions is that the gap size is the most important factor.

At McCann Physiotherapy, assessment focuses on:

👉 Abdominal wall function

👉 Linea alba tension

👉 Load transfer and control

👉 Movement quality

Function matters far more than the measurement of a gap.

What Does the Research Say?

Current evidence shows:

💡 Gap size does not strongly correlate with pain or symptoms

💡 There is no single “normal” gap measurement

💡 Many people function very well with a visible or measurable gap

• 
  

This means:

⭐ Gap does not automatically mean weakness or dysfunction

⭐ Closing the gap is not the primary goal of rehab

Exercise and Rehabilitation

Exercise is safe, appropriate, and recommended and there is no single “best” DRA programme. Just like any rehabilitation programme, this should be individualised to the person who has been assessed appropriately.

Progress comes from:

⭐ Building strength progressively

⭐ Improving abdominal wall coordination

⭐ Restoring confidence in movement

The goal is not just appearance — it is how your body functions in real life and enjoy the process!

Rehabilitation in Real Life

Recovery doesn’t happen in isolation—it happens alongside work, family, and everyday life.

👉 Recovery isn’t just about structured exercise—it’s about movement, balance, and reducing stress.

Walking, fresh air, and time with your family all support your recovery.

👉 Rehabilitation doesn’t need to be perfect—it needs to be realistic.

Short sessions at home, even with interruptions, still count.

👉 Let your little ones see you becoming stronger.

Returning to exercise builds confidence, resilience, and sets a powerful example.

Myth Busting

Let’s clear up common myths:

❌ You must close the gap

❌ Exercise will long-term make it worse

❌ You should avoid movement long-term

⚠️ None of these are supported by current evidence.

The Role of Specialist Physiotherapy

Pelvic health physiotherapy should provide:

👉 Clear explanation of your condition

👉 Individualised assessment (not just a measurement)

👉 Practical, realistic rehab guidance

👉 Confidence to return to normal activity

At McCann Physiotherapy, the focus is always on education, empowerment, and long-term outcomes — NOT dependency or unnecessary treatment packages.

Why Education Matters

One of the biggest gaps in care is education.

Without clear guidance, many people are left:

😞 Fearful of movement

😞 Unsure what is safe

😞 Spending money without clarity

Education has been shown to:

😊 Reduce fear

😊 Improve confidence

😊 Lead to better outcomes

👉You should leave physiotherapy feeling informed — not confused.

Reassurance

You do not need a perfectly closed gap.

What you do need is:

✅ Strength

✅ Function

✅ Confidence in your body

Evidence Summary

💡 Weak link between gap size and symptoms (Keshwani et al., 2018)

💡 No clear “normal vs abnormal” measurement for diastasis recti (Benjamin et al., 2019)

💡 Exercise improves function more than gap size (Gluppe et al., 2021)

💡 Recent evidence supports individualised, function-focused rehabilitation over gap closure alone (Systematic review & network meta-analysis, 2025)

Recovery isn’t about perfection—it’s about finding what works for you and your body.

If you’re feeling unsure or overwhelmed by conflicting advice, I’m here to help guide you with clear, honest, evidence-based support.

Tricia McCann

Specialist Pelvic Health and Advanced Musculoskeletal Physiotherapist

McCann Physiotherapy

🫶