Belly Bulging? Why Your Core Is Separating & Medically Approved Diastasis Recti Next Steps

If you've noticed a bulge in your belly that won't go away — even with exercise — you may be dealing with diastasis recti.

Diastasis recti is common, especially during and after pregnancy. But it can also affect men, people who lift heavy weights improperly, and anyone with chronic abdominal pressure. The good news? In many cases, it's manageable and treatable with the right approach.

Let's break down what's happening in your body, how to recognize it, and what medically approved next steps look like.

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What Is Diastasis Recti?

Diastasis recti occurs when the two large abdominal muscles (the rectus abdominis, often called the "six-pack" muscles) separate along the midline of the abdomen.

These muscles are normally joined by a band of connective tissue called the linea alba. When that tissue stretches and thins — often due to pressure from pregnancy, weight gain, or improper strain — the muscles drift apart.

Instead of a firm, supportive abdominal wall, you're left with:

• A visible or soft bulge in the belly
• A feeling of core weakness
• Reduced abdominal support

This isn't just cosmetic. The abdominal wall plays a critical role in posture, breathing, and protecting your internal organs.

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What Causes Diastasis Recti?

The most common cause is pregnancy. As the uterus expands, it increases pressure inside the abdomen, stretching the connective tissue.

However, other risk factors include:

• Multiple pregnancies
• Carrying twins or multiples
• Large baby or excess amniotic fluid
• Rapid weight gain
• Chronic constipation or straining
• Frequent heavy lifting without proper core engagement
• Obesity
• Chronic coughing
• Aggressive abdominal exercises (like traditional crunches done incorrectly)

Men and non-pregnant women can also develop diastasis recti if intra-abdominal pressure remains high over time.

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Signs and Symptoms of Diastasis Recti

Many people first notice:

• A visible ridge or dome running down the midline when sitting up
• A belly that still looks pregnant months after delivery
• A soft or squishy feeling in the center of the abdomen
• Lower back pain
• Poor posture
• Pelvic floor weakness
• Difficulty lifting objects
• Feeling unstable through the core

In more severe cases, you may also notice:

• Digestive discomfort
• Umbilical hernia (a visible bulge near the belly button)

If you experience sudden severe abdominal pain, vomiting, or a firm painful bulge that won't reduce, seek medical care immediately — that could indicate a hernia complication.

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How Is Diastasis Recti Diagnosed?

A healthcare provider — often an OB-GYN, primary care physician, or physical therapist — can evaluate diastasis recti with a simple physical exam.

They typically:

• Ask you to lie on your back
• Have you lift your head slightly
• Measure the width of separation using fingers or ultrasound

A separation of more than about 2 centimeters (or roughly two finger-widths) is often considered clinically significant.

If there's concern about a hernia or other complications, imaging may be recommended.

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Is Diastasis Recti Dangerous?

For most people, diastasis recti is not life-threatening.

However, it can:

• Increase risk of hernias
• Worsen back pain
• Contribute to pelvic floor dysfunction
• Affect bladder control
• Reduce overall functional strength

It's important not to ignore it — but there's no need to panic.

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Medically Approved Next Steps for Diastasis Recti

1. See a Healthcare Professional

Start with:

• OB-GYN (if postpartum)
• Primary care physician
• Pelvic floor physical therapist

A trained provider can determine:

• The severity of separation
• Whether a hernia is present
• Whether conservative treatment is appropriate

If you have persistent pain, worsening bulging, or bowel/bladder symptoms, speak to a doctor promptly.

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2. Begin Targeted Physical Therapy

Physical therapy is the first-line treatment for diastasis recti.

Evidence supports exercises that:

• Activate the transverse abdominis (deep core muscle)
• Coordinate breathing with movement
• Strengthen pelvic floor muscles
• Improve posture and body mechanics

Examples may include:

• Diaphragmatic breathing
• Abdominal bracing
• Heel slides
• Modified planks (when appropriate)
• Pelvic tilts

A pelvic floor physical therapist can guide you safely. Avoid random online workouts without guidance — some movements can make separation worse.

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3. Avoid Exercises That Increase Abdominal Pressure

Until cleared by a professional, avoid:

• Traditional crunches
• Sit-ups
• Aggressive twisting motions
• Heavy lifting without core engagement
• Full planks (early stages)
• Double leg raises

These movements can increase intra-abdominal pressure and worsen the separation.

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4. Improve Everyday Movement Habits

Small changes matter:

• Roll to your side before sitting up in bed
• Exhale during exertion (don't hold your breath)
• Engage deep core before lifting
• Avoid straining during bowel movements
• Treat chronic cough if present

Core healing is about daily mechanics — not just exercise sessions.

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5. Consider Support Garments (Short-Term)

Abdominal binders or support garments can:

• Provide temporary support
• Improve comfort postpartum

However, they do not heal diastasis recti on their own. Think of them as support tools, not solutions.

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6. Surgery (Only in Severe Cases)

Surgery is typically reserved for:

• Severe separation
• Persistent functional impairment
• Large hernias
• Failure of conservative treatment

Procedures usually involve:

• Suturing the abdominal muscles together
• Repairing hernias if present

Surgery carries risks and recovery time, so it's not the first option for most people.

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Diastasis Recti During Pregnancy

Mild separation during pregnancy is normal. The body is adapting.

However, if you're pregnant and experiencing sharp lower abdominal or groin pain that feels different from general core separation, it could be something else entirely. Many expecting mothers confuse diastasis recti with Round Ligament Pain, a common pregnancy-related discomfort — use a free symptom checker to help identify what you're experiencing and get personalized guidance.

Always speak with your OB-GYN about new or severe pain during pregnancy.

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How Long Does Diastasis Recti Take to Heal?

Recovery depends on:

• Severity of separation
• Tissue integrity
• Consistency with therapy
• Overall health

Many postpartum women see improvement within:

• 8–12 weeks with proper exercise
• Continued improvement over 6–12 months

Some separation may remain, but functional strength can still be fully restored.

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Can Diastasis Recti Be Prevented?

You can't always prevent it — especially during pregnancy — but you can reduce risk by:

• Strengthening deep core muscles before pregnancy
• Avoiding unnecessary abdominal strain
• Practicing proper lifting mechanics
• Maintaining a healthy weight
• Treating chronic constipation

Prevention focuses on managing intra-abdominal pressure.

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When to Speak to a Doctor Immediately

Seek medical care urgently if you experience:

• Severe or worsening abdominal pain
• A painful bulge that becomes firm and tender
• Nausea or vomiting with abdominal swelling
• Fever
• Inability to pass stool or gas

These could indicate a hernia complication or other serious condition.

Even if symptoms are mild, speak to a doctor if:

• Your bulge isn't improving months postpartum
• You have ongoing back or pelvic pain
• You're unsure whether it's diastasis recti or a hernia

It's always better to get clarity than to guess.

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The Bottom Line

Diastasis recti is common, treatable, and manageable.

A bulging belly doesn't mean you've failed at recovery or fitness. It often means your connective tissue was stretched — and now it needs structured, intentional healing.

The most important steps are:

• Get properly evaluated
• Start targeted core rehabilitation
• Avoid exercises that worsen pressure
• Address symptoms early

With the right support, most people regain strength, stability, and confidence in their core.

If you have any symptoms that could be serious or life-threatening, speak to a doctor immediately. Your health deserves professional guidance — especially when it comes to your core, your organs, and your overall function.