Diastasis Recti Abdominis (DRA) is one of the most common—and misunderstood—changes that happens to the body during pregnancy and postpartum. If you’ve noticed a lingering abdominal gap, a doming or coning of your belly, or a feeling of weakness through your core, you’re not alone.
Let’s break down what actually causes DRA during pregnancy and why it sometimes doesn’t resolve on its own.
What Is Diastasis Recti, Really?
Diastasis recti occurs when the two sides of the rectus abdominis (the “six-pack” muscles) separate more than usual along the linea alba, the connective tissue that runs down the center of your abdomen.
Some separation is normal and necessary during pregnancy. Your body is adapting to:
- A growing baby
- Changes in posture
- Hormonal shifts that affect connective tissue
DRA becomes a concern not just because of the gap, but because of how well the abdominal wall is functioning—how it manages pressure, supports your spine, and coordinates with the pelvic floor.
What Causes DRA During Pregnancy?
1. Normal Physiological Changes
Pregnancy hormones (especially relaxin) soften connective tissue to allow for growth and delivery. This makes the linea alba more stretchy and less able to resist pressure.
This is not a flaw—it’s biology.
2. Increased Intra-Abdominal Pressure
As the uterus grows, pressure inside the abdominal cavity increases. When that pressure isn’t well managed, it pushes outward on the abdominal wall.
Contributing factors can include:
- Breath-holding
- Chronic constipation or straining
- Poor pressure management during daily movements
- Repeated abdominal bracing instead of coordinated core engagement
3. Changes in Posture and Movement
Pregnancy shifts your center of gravity. Many people compensate by:
- Flaring the rib cage
- Over-arching the lower back
- Letting the abdomen push forward for balance
Over time, this can increase strain on the midline of the abdomen.
4. Core Muscle Coordination (Not Strength)
DRA is less about “weak abs” and more about how the muscles work together.
If the deep core system (diaphragm, transverse abdominis, pelvic floor) isn’t coordinating well, pressure is more likely to be directed outward instead of contained.
Why Isn’t My DRA Getting Better?
This is the question commonly asked and it’s rarely about not trying hard enough.
1. The Gap Closed, but Function Didn’t Improve
Many people are told to focus only on “closing the gap.” But a smaller gap doesn’t always mean better support.
You can have:
- A narrow gap that’s still weak and domes
- A wider gap that functions well and causes no symptoms
Function matters more than distance.
2. Overdoing Traditional Core Exercises
Crunches, planks, or aggressive “ab workouts” can sometimes make DRA worse if pressure isn’t managed well.
If you notice:
- Doming or bulging during exercise
- Holding your breath
- Bearing down through your pelvic floor
your core may be reinforcing the problem instead of solving it.
3. Pelvic Floor Dysfunction
The pelvic floor and abdominal wall are a team. If the pelvic floor is:
- Too tight
- Not coordinating with breathing
- Weak or fatigued
the abdominal wall often struggles to respond appropriately and vice versa.
4. Scar Tissue or Birth History
Cesarean birth, abdominal surgery, or complicated deliveries can affect how the abdominal wall heals and reconnects.
Scar tissue can limit mobility and disrupt muscle activation if not addressed properly.
5. Lack of Progressive, Specific Rehab
Healing DRA isn’t just about “being careful” or doing gentle exercises forever.
It requires:
- Gradual loading
- Skillful pressure management
- Progression toward real-life demands (lifting, carrying, sports)
Without this, improvement can stall.
What Actually Helps DRA Improve?
From a PFPT perspective, effective recovery focuses on:
- Breath coordination (not breath holding)
- Deep core engagement without rigidity
- Pelvic floor function, not just strength
- Posture and movement strategies
- Progressive loading, not avoidance
Most importantly, it’s individualized. What helps one person may not be right for another.
When to Seek Help
You may benefit from seeing a pelvic floor physical therapist if you experience:
- Persistent doming or bulging
- Back, hip, or pelvic pain
- Leaking, heaviness, or pressure
- Difficulty returning to exercise
- A feeling that your core “isn’t supporting you”
Early support can make a big difference—but it’s never too late to improve function.
Looking to optimize your well being with pelvic floor physical therapy? Reach out to us at Pelvic Health Center in Madison, NJ to set up an evaluation and treatment! Feel free to call us at 908-443-9880 or email us at [email protected]