What women describe
- A persistent "pooch" or doming down the front of the abdomen, especially with sit-ups or crunches
- A feeling that the core "doesn't reconnect" after pregnancy
- A visible gap or ridge along the midline when lifting the head off a pillow
- Low back pain that started or worsened after pregnancy
- Pelvic floor symptoms (leaking, heaviness) alongside the diastasis
- An umbilical hernia or pulling sensation around the belly button
- A sense of being weaker or less stable than before pregnancy, even after returning to exercise
What current research actually says about diastasis
The "no crunches, no sit-ups, no twisting movements ever" advice that dominated postpartum recovery for the last decade is no longer supported by research. Current evidence shows that:
- Progressive loading of the rectus abdominis — including crunch-pattern exercises — can help close diastasis
- The quality of the linea alba (the connective tissue between the muscles) matters more than the visible gap
- Functional restoration is more important than absolute closure of the gap
- Generic "transverse abdominis only" exercises rarely produce significant change on their own
- Pressure management, breath coordination, and pelvic floor function all need to be addressed alongside the abdominal wall
None of this means crunches are right for everyone, immediately, or in unlimited volume. It means the right answer is individualized to your tissue, your strength, and what you're trying to do with your body. Blanket rules don't fix individual diastasis.
How diastasis is treated at Bremen Pelvic Health
The first visit is one full hour. It includes:
- Manual assessment of the gap, depth, and linea alba tension
- Pressure and breath assessment — how is your system managing intra-abdominal pressure?
- Pelvic floor screening (internal or external, your call) — diastasis and pelvic floor dysfunction commonly travel together
- Movement screen — squat, hinge, brace under load
- Discussion of what you were doing before pregnancy and what you want to get back to
Treatment then involves a progressive program of loading, often including breath work, bracing patterns, gentle rectus activation, and graded crunch-pattern movements when indicated. Manual therapy may also be used to address fascial restrictions or scar tissue when present.
How long it usually takes
Most diastasis patients see meaningful improvement in four to six visits. The work continues at home — the gym time and home training matter as much as the in-clinic sessions. Severe cases or those with significant tissue laxity may take eight to ten visits.
If diastasis is part of a broader picture
Diastasis rarely lives alone. It commonly comes with postpartum recovery, C-section recovery, or incontinence. Those threads get treated together rather than as separate care.
For athletes trying to return to lifting, running, or CrossFit while managing diastasis, see the return to sport page for how that work is structured.
Common questions
- What is diastasis recti?
- Diastasis recti is a separation of the rectus abdominis muscles along the linea alba (the connective tissue down the front of the abdomen). It is normal during pregnancy. It becomes a treatable condition when it doesn't close back up postpartum, or when the linea alba doesn't restore its tension and the abdominal wall can't generate proper pressure.
- Should I avoid crunches if I have diastasis?
- The blanket "no crunches ever" advice is outdated. Current research shows that progressive loading of the rectus — including crunch-pattern exercises — can actually help close diastasis when done correctly. The right answer depends on your specific presentation, your tissue quality, and your training experience.
- How long does treatment take?
- Most diastasis cases see meaningful improvement within four to six visits. Severe diastasis with significant tissue laxity or umbilical involvement may take longer. Plans are honest about your specific tissue and goals.
- Will my diastasis ever fully close?
- Most diastasis can be functionally closed — meaning the linea alba restores its ability to generate tension and the abdominal wall functions normally — even when there is some residual gap. Visual closure is sometimes possible, sometimes not, depending on tissue quality. Functional closure is the more important goal.