Diastasis Recti Isn’t Just a Postpartum Problem: Understanding the Role of Abdominal Pressure
As a physical therapist, one of the most common misconceptions I hear is that diastasis recti (DR) is a “pregnancy problem.” While it’s true that many postpartum individuals experience it, diastasis recti can affect anyone, including men, children, athletes, and people who have never been pregnant. The common thread? Poor core pressure management.
Let’s break it down.
What Is Diastasis Recti?
Diastasis recti is a separation of the rectus abdominis—the "six-pack" muscles—along the midline, known as the linea alba. This connective tissue can thin and widen when subjected to excessive or poorly managed pressure from within the abdominal cavity.
Now here’s the key point: diastasis isn’t just about the muscles separating—it’s about what caused the excessive strain on that tissue in the first place. That’s where pressure distribution comes into play.
The Core: More Than Just Abs
Your core is a pressure system, not just a collection of muscles. It includes:
The diaphragm at the top
The pelvic floor at the bottom
The deep abdominal muscles (like the transverse abdominis)
The back muscles and spinal stabilizers
These components must work together to manage intra-abdominal pressure during everyday tasks like breathing, lifting, sitting, standing, and moving.
How Poor Pressure Distribution Leads to Diastasis
When your body isn’t managing this internal pressure effectively, that pressure has to go somewhere. If your diaphragm, core, or pelvic floor aren’t properly engaged or coordinated, pressure gets displaced forward (bulging the belly), downward (straining the pelvic floor), or upward (creating breathing dysfunction).
Over time, chronic forward pressure creates stress on the linea alba. This can stretch and weaken the tissue, leading to a gap between the abdominal muscles: diastasis recti.
Who’s at Risk (and Why It’s Not Just About Pregnancy)
Diastasis recti can affect:
Weightlifters and athletes who bear down improperly during lifts
Men with central obesity or poor postural habits
Women who have never had children but have chronic bloating, constipation, or perform high-intensity training without core control
Children with connective tissue disorders or poor motor development
In all these cases, the common factor is the same: pressure is not being distributed or controlled correctly by the core system.
Signs You May Be at Risk
You might not have a visible “gap,” but if you notice:
A doming or bulging of your abdomen during exertion
Chronic lower back pain
Poor posture or breath holding during movement
Pelvic floor issues like leaking or pressure
…it could be a sign that your core is not stabilizing efficiently, and diastasis may already be present or developing.
The Good News: It’s Treatable and Preventable
The most effective way to address diastasis recti is to retrain your body to manage pressure well. This involves:
Re-educating breathing patterns (starting with diaphragmatic breathing)
Activating deep core muscles like the transverse abdominis
Learning to brace appropriately for movement without bulging the abdomen
Incorporating functional movement patterns that reinforce healthy alignment and pressure control.
Final Thoughts
Diastasis recti is not a cosmetic issue—it’s a pressure management issue. And it’s not limited to pregnancy or postpartum bodies. Understanding and optimizing abdominal pressure distribution is key for everyone, from elite athletes to everyday movers.
If you're concerned about core dysfunction or diastasis recti, working with a physical therapist trained in core and pelvic floor rehab can help you restore function, reduce symptoms, and prevent future issues.
Your core isn’t just your “center”—it’s your foundation. And like any foundation, it must be stable, responsive, and well-managed to support the structures above and below.
Written by: Dr. Byanca Madrigal