Diastasis Recti: Not All Separation Is Created Equal

If you've had a baby in the last decade, there's a good chance someone has mentioned diastasis recti (DRA) to you. Maybe your OB noted it at your six-week visit. Maybe you found it yourself doing some late-night research. Maybe a well-meaning friend mentioned it after you said your core "just doesn't feel right."

DRA is real, it is common, and for many postpartum women it does require attention. But here's something that doesn't get said nearly enough: not all abdominal separation is a problem that needs to be fixed. And the number your provider measures (the gap width) is only part of the story.

The distinction I want to walk you through today is one of the most important and most misunderstood concepts in postpartum rehab: functional DRA versus structural separation.

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What Is Diastasis Recti?

Your rectus abdominis, the "six-pack" muscle, runs in two columns down the front of your abdomen, connected in the middle by a band of connective tissue called the linea alba. During pregnancy, as your uterus expands, this connective tissue stretches to accommodate your growing baby. This is completely normal and expected.

After birth, the gap between those two columns of muscle (the inter-recti distance, or IRD) may remain wider than pre-pregnancy. That's diastasis recti. Studies suggest it affects the majority of women postpartum to some degree.

What's often missing from the conversation is this: the width of the gap tells you very little on its own. What matters more is the tension and function of the linea alba itself.

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Structural Separation vs. Functional DRA

Think of the linea alba like a trampoline. The trampoline has a certain size (that's the gap width). But what makes it functional is the tension across the surface. A trampoline with a wide frame but taut mesh works perfectly. A trampoline with a narrow frame and saggy, slack mesh is a problem.

Structural separation means there is measurable widening of the inter-recti distance. This is what imaging and palpation measure, and it is what many practitioners focus on exclusively.

Functional DRA means that the connective tissue itself lacks the tension and load transfer capacity to support movement and intra-abdominal pressure effectively, regardless of gap width.

This is why I have patients with a 3cm gap who have excellent core function and no symptoms whatsoever. And I have patients with a "normal" 1.5cm gap who can't generate tension across their midline, leak with exercise, and feel like their core has completely abandoned them.

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How to Know If You Have a Functional Problem

In my assessment, I'm not just measuring the gap. I'm evaluating:

• Can you generate tension across the linea alba when you engage your core?

• Can you manage intra-abdominal pressure during movement without coning, doming, or tenting at the midline?

• Are you experiencing any symptoms, including leakage, pelvic heaviness, low back pain, or hip pain?

• Does your abdomen feel stable during daily activities and exercise?

Coning or doming (a visible ridge or peak at your midline when you perform exercises or transitions) is one of the most important observable signs of functional DRA. It tells you that your system is not managing pressure well through the midline.

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What Does Rehab Look Like for Each?

For structural separation without functional impairment, the goal is maintenance: continuing to build whole-body strength, managing intra-abdominal pressure well, and monitoring for any changes in symptoms.

For functional DRA, the goal is to restore tension and load transfer through progressive, intentional loading. This is not about avoiding all pressure or "closing the gap." It's about rebuilding the system's capacity from the inside out.

This means starting with breath and pressure management, learning to connect to the deep core before adding load, and then systematically reintroducing the movements you want to get back to: lifting your kids, running, returning to strength training, doing yoga without that weird midline dome.

The exercises that were told to you to avoid, crunches, sit-ups, Pilates, heavy lifting? In most cases, they aren't permanently off-limits. The question is whether your system is ready for them and whether you're approaching them with the right mechanics.

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The Bottom Line

DRA assessment requires more than a tape measure. If you've been given a gap width and a list of exercises to avoid, but nobody has evaluated how your core actually functions, there's more work to be done.

Your goal is not a smaller gap. Your goal is a body that works: one that can carry, lift, run, and live without pain or leaking. That is achievable. And I'd love to help you get there.

Ready to take the first step? Book your free consultation at https://app.pteverywhere.com/woven/bookingonline. Woven Pelvic Health and Wellness is located in Denver, CO and serves women throughout the Denver metro area.

Dr. Ashley Castellanos, PT, DPT is the owner and founder of Woven Pelvic Health and Wellness in Denver, Colorado. She specializes in pelvic floor physical therapy for women across all stages of life, with advanced training in manual therapy, dry needling, orthopedics, and trauma-informed care.