Exercise guide
Diastasis recti is a widening of the gap between the two sides of your six-pack muscle, where the tissue down the middle has stretched and thinned. It's very common in pregnancy and after birth, and it happens in men and older adults too. It isn't a hernia or a tear, and on its own it isn't dangerous.
Exercise is the first treatment, but be realistic about what it does: it makes your tummy muscles stronger, while the gap itself narrows only a little, if at all. Crunches aren't banned: in a trial, curl-ups made the muscles stronger without widening the gap.
This guide shows how to check your gap, a staged plan from the first weeks to full training with a 12-week curl-up workout, what to do about doming, and when a physiotherapist, a support garment or surgery makes sense.
In 300 first-time mothers, a gap of at least two finger widths was found in 33% at 21 weeks of pregnancy, 60% at 6 weeks after the birth, 45% at 6 months and 33% at a year. It isn't only a pregnancy problem: in one Swiss study of adults' computed tomography (CT) scans, 57% had a gap wider than 2 cm, and in one hospital sample of men in China, 30% did. Those two are single studies with their own methods, so their figures may not apply widely.
The tissue down the middle of your tummy (the linea alba) thins and widens, but unlike a hernia there's no hole in it. European surgeons define diastasis as a gap wider than 2 cm. A hernia can happen alongside it and has its own warning signs.
Across reviews of trials after birth, tummy exercises narrowed the gap by about 4 to 5 mm on average, and a 2026 update found no clear difference for exercises aimed at the deepest tummy muscle. No programme has been shown to close a gap. Exercise does make the muscles stronger, which is what most people need.
In a trial of 70 women 6 to 12 months after giving birth, 12 weeks of head lifts, curl-ups and twisted curl-ups on 5 days a week made the tummy muscles thicker and stronger without widening the gap. In the first weeks after birth, the NHS advises avoiding sit-ups and planks to start with, so build up.
A review of 12 studies found no link between a gap and low back or pelvic pain or leaking, a small link with prolapse, and weak evidence that a wider gap goes with weaker tummy muscles, worse back pain and poorer quality of life. In one study, women with a gap had more tummy pain.
European surgeons suggest trying physiotherapy first, and stitching the stretched tissue together if surgery is needed. On the NHS, a tummy tuck is classed as cosmetic and isn't usually available; a hernia is treated differently.
The rectus abdominis is the pair of long muscles down the front of your tummy, joined in the middle by a band of tough tissue, the linea alba. In pregnancy, your growing womb pushes the muscles apart, making them longer and weaker. The gap can be anywhere from just under the ribs to just above the pubic bone, and it can affect men and women of any age.
European surgeons define diastasis as a gap wider than 2 cm, and say a gap of 2 cm or less may be normal. Normal widths vary along the midline and between people: in 150 women who hadn't given birth, up to 22 mm a little above the belly button was normal. In one Swiss study of adults' CT scans, up to 34 mm there may be normal, and the authors warn that the 2 cm cut-off risks over-treatment. With no agreed cut-off, a 2025 review says it may be premature to judge treatments by the width of the gap alone.
Researchers grade by finger widths: 2 to 3 is mild, 3 to 4 moderate, and 4 or more severe. Surgeons grade in centimetres: under 3 cm, 3 to 5 cm, and over 5 cm. It's not known whether a wider gap means worse symptoms.
European surgeons say an examination with finger widths is enough to diagnose diastasis, and suggest ultrasound or callipers 3 cm above the belly button when a precise measurement matters, keeping CT scans for finding a hernia or planning surgery. Finger checks give similar results when the same person repeats them, but two examiners agree only moderately; callipers and ultrasound are more reliable.
After a first birth, a gap of two finger widths or more was found in 60.0% of 300 women at 6 weeks, 45.4% at 6 months and 32.6% at a year. On ultrasound, all 84 first-time mothers in another study had a gap wider than 16 mm at 35 weeks of pregnancy, falling to 39% at 6 months. Beyond pregnancy, 57% of 329 adults aged 18 to 90 had a gap wider than 2 cm, measured 3 cm above the belly button, on CT scans done for suspected appendicitis or kidney stones at a Swiss university hospital. In 1,575 men recruited at one hospital in China, 29.8% had a gap wider than 2 cm and 10.2% wider than 3 cm. Those last two are single studies, and their settings and cut-offs may not apply widely.
After birth, only frequent heavy lifting (20 times a week or more) was linked with a gap at 12 months, and the researchers urge caution because the link was borderline. Weight before pregnancy, weight gained, the baby's weight and the size of the bump weren't linked, and caesarean and vaginal births gave similar gaps. Across 113 studies, exercise in pregnancy wasn't linked with it. In the Swiss study of adults, older age, a higher weight and more births went with a gap; being a man or a woman didn't.
A review of 12 studies (2,242 people) found no link with low back or pelvic pain or leaking, a small link with prolapse, and weak evidence that a wider gap goes with weaker tummy muscles, worse low back pain and poorer quality of life. In the cohort of 300 mothers, women with and without a gap had the same back and pelvic pain at a year, and in 72 women, those with a gap had more tummy pain. In the Chinese study of men, a gap wasn't linked with tummy muscle strength, back pain or quality of life.
European surgeons say how you feel about how your tummy looks, and feeling unsteady through the middle, are the most common complaints. Pelvic, Obstetric and Gynaecological Physiotherapy (POGP), the UK's pelvic health physiotherapists, lists a bulge or doming down the middle when you sit up from lying, discomfort along the middle, and a feeling of a gap. These are good reasons to get checked, even though studies don't show the gap causes back pain or leaking.
The NHS self-check for after a birth; the last step is our advice, because finger checks vary between people (a review of measurement methods). The figure shows the lift; it can't show the gap.
See the movement on the 3D figure: Chest lift (Pilates curl-up)
In a review of 16 trials with 698 women after birth, tummy exercises narrowed the gap by 0.43 cm compared with usual care (6 trials, moderate certainty), and the authors concluded this isn't a clinically meaningful change. A 2025 review found 0.52 cm at rest (low certainty) and 0.35 cm for tummy training alone (moderate certainty). A network analysis of 21 trials found 0.48 cm for exercise alone.
Training the transversus abdominis, the deep muscle that wraps around your middle like a corset, narrowed the gap by 0.63 cm in 2 small trials (very low-quality evidence), but a 2026 update that pooled 3 studies found no difference (0.06 cm). The update found no support for exercise alone as a way to narrow the gap, though it may help function and symptoms.
In 175 first-time mothers, a weekly exercise class plus daily pelvic floor training at home, for 4 months from 6 weeks after the birth, didn't change how many had a gap at 6 or 12 months. About 55% of both groups had one at the start, judged by finger widths.
Source 25
European surgeons say no specific treatment without surgery can be recommended, but physiotherapy may be considered before surgery. Swedish surgeons call physiotherapy the first treatment, and say surgery should only be considered after a 6-month core training programme. The NHS says regular pelvic floor and deep stomach muscle exercises can help to reduce the gap, and your GP can refer you to a physiotherapist.
In 35 first-time mothers, 4 weeks of Pilates (50 minutes a day, 5 days a week) narrowed the gap and the waist compared with no exercise, and a network analysis of 17 small trials ranked Pilates best at the level of the belly button. The trials are small and varied: Pilates is a reasonable way to rebuild strength, but isn't proven to close a gap.
In the curl-up trial, the muscles got thicker and stronger while the gap stayed the same, and reviewers note that exercise may have other physical and psychological benefits. Whether a particular programme improves symptoms and quality of life is still unknown. Aim for a stronger, more comfortable middle rather than a smaller number on a finger check.
70 women 6 to 12 months after a birth, with a gap confirmed on ultrasound, did either a 12-week home programme of head lifts, curl-ups and twisted curl-ups on 5 days a week, or no programme. As registered for the trial, the programme took about 10 minutes, with 3 sets of 8 to 12 repetitions of each move, close to the most they could do, after one session with a physiotherapist. The gap didn't narrow or widen (a difference of 1 mm), the six-pack muscle got thicker and stronger, and effects on pelvic floor problems and pain were trivial or unclear.
Ultrasound studies of women after birth agree: a head lift or curl-up narrows the gap while you do it (by about 10 mm above the belly button in one study of 38 women), while drawing your tummy in, especially as hard as you can, widens it slightly below the belly button, by about 2 to 5 mm. What these short-term changes mean over months is unknown.
In 26 women with a gap, an ordinary curl-up narrowed it but distorted the midline tissue, while gently tightening the deepest tummy muscle first narrowed it less but distorted it less. The researchers suggest this might help the two sides of the tummy work together, though their measure still needs testing. In 20 women, the midline tissue was less stiff in those with a gap. None of this has been linked with long-term outcomes yet.
Physiotherapists teach a gentle draw-in of the lower tummy as you breathe out, held for 2 or 3 breaths, and then using it when you bend, lift or stand. Use it for control and comfort rather than sucking in as hard as you can, which briefly widened the gap below the belly button in studies, and don't expect it to close the gap.
Doming is a ridge or bulge down the middle of your tummy when you lift your head, sit up or strain. UK pelvic health physiotherapists use it as a cue: if your tummy domes, put your fingers on your pelvis and draw your lower tummy in and wide, and ask to see a physiotherapist if your tummy bulges with exercise. No study shows doming harms recovery, and in the curl-up trial 12 weeks of curl-ups didn't widen the gap. Treat it as a sign the move is too hard for now, not as damage.
The NHS advises avoiding sit-ups, planks and high-impact exercise to start with, as well as straining on the toilet and heavy lifting. POGP adds: roll onto your side to get up from lying, build up walking and gentle core exercises, and avoid jumping or running until you're stronger. Our postpartum guide covers timing and the return to running.
No trial has tested a full progression. These stages combine the NHS and POGP's early exercises, the curl-up trial and general strength training. Move on when the current stage feels easy, with no pain, no doming you can't control, no leaking and no heaviness. Men, and anyone who hasn't recently given birth, can usually start at stage 2.
The first weeks after a birth, or if you're starting from nothing. Breathing, pelvic floor exercises, the NHS's side-lying tummy draw-in (hold for a count of 10 while breathing normally, up to 10 times), pelvic tilts (POGP: hold for 3 seconds, up to 10 times, 3 times a day), heel slides, knee folds and knee fall-outs, head lifts (POGP: head only, up to 10 times, up to 3 times a day) and walking.
From about 6 to 8 weeks after a straightforward birth (later after a caesarean), or when stage 1 is easy. Dead bugs, bird dogs, bridges, side planks on your knees, a band press that resists twisting, sit-to-stands, and light lifts and carries, breathing out as you lift. Start with 2 sets of 6 to 10 of each, or holds of 15 to 20 seconds, 2 to 3 days a week (our editorial starting point).
Head lifts, curl-ups and twisted curl-ups: as registered for the trial, 3 sets of 8 to 12 of each, close to the most you can do, on 5 days a week for 12 weeks, about 10 minutes a session. The trial started 6 to 12 months after the birth; start once stage 2 is easy and head lifts feel comfortable. The diastasis recti workout below follows it.
Full planks, push-ups, heavier lifting, running and jumping, once stage 3 is comfortable. The NHS and POGP advise avoiding planks and high impact only to start with, and building up as you get stronger. After a birth, use the postpartum guide's checks before running.
Roll onto your side and push up with your arms to get out of bed. When you lift, bend your knees, keep the load close, gently draw in your tummy, tighten your pelvic floor and breathe out rather than holding your breath. Avoid straining on the toilet: a small step under your feet helps. Stand tall and be aware of your posture.
No trial has tested heavy lifting, running or sport in people with a gap. Frequent heavy lifting was linked with a gap 12 months after birth, but the researchers urge caution. You can lift and run with a gap: build up gradually, breathe out on the effort, and drop back if you get doming you can't control, pain, heaviness or leaking (our editorial advice).
NHS and POGP doses: the draw-in held for a count of 10, up to 10 times; pelvic tilts and head lifts up to 10 times, up to 3 times a day. Lift your head only at first, and add the bridge to the pelvic tilt once the tilt is easy.
3D demoLateral breathing (Pilates breathing)Beginner · No equipment
3D demoPelvic floor exercise (Kegel)Beginner · No equipment
3D demoSide-lying tummy draw-inBeginner · No equipment
3D demoPelvic tilt into bridgeBeginner · No equipment
3D demoSupine heel slideBeginner · No equipment
3D demoKnee foldBeginner · No equipment
3D demoBent-knee fall-outBeginner · No equipment
3D demoChest lift (Pilates curl-up)Beginner · No equipment
3D demoTreadmill walkingBeginner · Cardio machine2 sets of 6 to 10 of each, or holds of 15 to 20 seconds, 2 to 3 days a week (our editorial starting point). Stop short if the middle of your tummy domes.
3D demoDead bug heel tapsBeginner · No equipment
3D demoDead bugBeginner · No equipment
3D demoBird dog, one limb at a timeBeginner · No equipment
3D demoBird dogBeginner · No equipment
3D demoGlute bridgeBeginner · No equipment
3D demoKnee side plankBeginner · No equipment
3D demoHalf-kneeling Pallof pressBeginner · A band + An anchor point
3D demoSit to stand from a chairBeginner · A bench or box
3D demoKettlebell deadliftBeginner · A kettlebell
3D demoSuitcase carryIntermediate · A dumbbell + A kettlebellAs registered for the curl-up trial: 3 sets of 8 to 12 of each, close to the most you can do, 5 days a week for 12 weeks. The chest lift stands in for the trial's head lift: lift your head, with your shoulders coming up only a little.
Bring these in once the curl-up programme feels comfortable. Hold planks for 20 to 30 seconds at first (our editorial starting point).
The diastasis recti workout is the curl-up programme as registered for the trial. In the first weeks after birth, start with the postnatal exercises. If you're pregnant again, use the pregnancy Pilates workout.
A 12-minute tummy routine copied from a trial in women with diastasis recti: head lifts, curl-ups and twisted curl-ups, 5 days a week for 12 weeks.
12 minBeginner5 movesNo equipmentA gentle 25-minute routine for the first weeks after birth: pelvic floor, breathing, tummy and hip exercises on the floor, sit-to-stands and a walk.
25 minBeginner12 movesA bench or box, Cardio machineA 20-minute mat Pilates workout for complete beginners. It covers breathing, spine position and the foundation moves, each with an easier option.
20 minBeginner13 movesNo equipmentA 15-minute beginner core workout on the floor: dead bugs, bird dogs, knee planks, side planks and curl-ups.
15 minBeginner6 movesNo equipmentThe McGill big three for the core: curl-ups, side planks and bird dogs, each held for 10 seconds at a time in falling sets of 5, 3 and 1 reps.
12 minBeginner3 movesNo equipmentA 20-minute Pilates workout for any trimester: seated, standing, all-fours and side-lying moves, with no lying on your back or front and no jumping.
20 minBeginner15 movesA wall, A bench or boxWeekly structure once stage 1 is easy. Keep the curl-up workout going alongside, and leave planks until stage 4.
A free 4-week, 3-day Pilates plan for complete beginners. Two mat days and one wall day, with clear rules for when to move each exercise to its harder version.
3 training days25 minBeginner3 days a weekA weekly workout plan for women: three strength days, cardio and pelvic floor training, with the evidence on periods, pregnancy and menopause.
3 training days45 minBeginner5 days a weekA 12-week workout plan for weight loss: three strength days, two cardio days and daily steps, building to 200 minutes a week, with honest results.
3 training days45 minBeginnerIn 1,575 men recruited at one hospital in China, 29.8% had a gap wider than 2 cm and 10.2% wider than 3 cm, and age, weight, smoking and exercise habits were linked with it. In one Swiss study of adults' CT scans, being a man or a woman wasn't linked with having a gap. Reviews describe men with diastasis as typically over 60, carrying extra weight and inactive. These are single studies or reviews of small studies, so the figures may not apply widely.
In most men it causes no symptoms apart from a bulge down the middle when sitting up from lying. In the Chinese study, a gap wasn't linked with tummy muscle strength, low back pain or quality of life, though a hernia was more common when the gap was wider than 3 cm. Symptoms are more likely when there's a hernia as well.
Danish surgeons put weight loss and exercise first, focusing on the deepest tummy muscle. No exercise trial has been done in men: the stages and curl-up programme here are reasonable but untested in men (our editorial view). Surgery is mainly for a hernia that causes symptoms; the role of stitching the midline alone in men is uncertain.
Small studies disagree on whether diastasis is more common with an abdominal aortic aneurysm, a swelling of the main blood vessel in the tummy: two found it was, and one, in 75 men, found no difference. So a gap on its own isn't a reliable sign of an aneurysm. In England, men are invited for a one-off aneurysm scan in the year they turn 65; if you think you're at higher risk, talk to a GP.
Trials of abdominal binders, kinesiology tape and electrical stimulation, always alongside exercise, found no clinically meaningful change in the gap overall. Exercise narrowed the gap below the belly button by 0.31 cm more than binding. In a network analysis, a corset narrowed the gap by 0.65 cm compared with no treatment, in sparse, varied data.
In the same network analysis, exercise combined with electrical muscle stimulation narrowed the gap by 1.12 cm compared with no treatment, the largest effect, but the data were sparse and the trials measured the gap in different ways. It's a specialist add-on, not a replacement for exercise.
A support garment may feel comfortable early on, but none has been shown to fix a gap. After surgery, surgeons suggest an abdominal binder to ease pain and help you get moving, and after a tummy tuck the NHS says you'll usually wear a corset or tummy-control pants for 6 weeks.
European surgeons suggest physiotherapy first, then stitching the stretched midline together (plication) if surgery is needed, or a mesh repair if there's a hernia, decided together with the surgeon. Swedish surgeons suggest surgery only for problems with function after a 6-month core training programme, with a gap of at least 5 cm (or less with marked bulging or a hernia), at least 2 years after the last birth, and with no more pregnancies planned. German surgeons say a hernia is the real reason to operate. The evidence behind these recommendations is low quality.
In a Swedish trial of 86 patients, repair with mesh or with stitches gave similar results, and both improved pain, quality of life and strength more than 3 months of training, after which the training group still had discomfort and pain. About 5 years after surgery, none of 52 patients followed up had a recurrence. In 60 women with symptoms despite training, 98% reported better trunk function a year after the midline was stitched. These were selected patients.
A tummy tuck (abdominoplasty), which can include realigning the tummy muscles, is classed as cosmetic surgery and isn't usually available on the NHS. It costs about £5,000 to £10,000 privately, needs 4 to 6 weeks off work and exercise, and isn't for people who are overweight. A hernia is different: surgery is usually recommended for adults with an umbilical hernia.
Exercise can't remove loose skin left after a lot of weight loss or pregnancy. Surgeons repair diastasis after weight-loss surgery as well as after pregnancy, with similar complication and recurrence rates in a review of 47 low-quality studies.
Surgeons say no specific rehabilitation programme can be recommended afterwards. Contact the clinic as soon as possible if you have severe pain or any unexpected symptoms.
Call 999, and don't drive yourself to A&E, if you have a hernia (a bulge at or near your belly button) and:
Source 6
If you have a hernia and:
Source 46
A specialist pelvic health (women's health) physiotherapist, through your GP or midwife; in some areas you can refer yourself. After a birth, our postpartum guide lists the urgent warning signs, such as heavy bleeding, wound problems, calf pain and breathlessness.
In a trial of 70 women with a gap, 12 weeks of head lifts, curl-ups and twisted curl-ups didn't widen it and made the muscles stronger, and in the moment curl-ups narrow the gap. Start gently after birth, as the NHS advises, and build up.
Exercise narrowed the gap by about 4 to 5 mm in reviews, a 2026 update found no difference for deep tummy exercises, and European surgeons say no specific programme can be recommended. Exercise builds strength and comfort, which is the point.
Drawing in as hard as you can briefly widened the gap below the belly button in studies, and training the deep tummy muscle had mixed results. A gentle draw-in, as the NHS and POGP teach, is for control and comfort.
No study shows doming harms recovery. Physiotherapists use it as a cue to make a move easier, and in the curl-up trial 12 weeks of curl-ups didn't widen the gap.
There's no hole in the tissue: the midline has stretched and thinned. A hernia can happen alongside a diastasis and has its own warning signs.
A review of 12 studies found no link with low back or pelvic pain or leaking, though a wider gap may go with worse back pain and weaker tummy muscles (weak evidence). Women with a gap had more tummy pain in one study.
In one hospital sample of men in China, 30% had a gap wider than 2 cm, and in one Swiss study of adults' CT scans, being a man or a woman wasn't linked with having a gap. Both are single studies, so the figures may not apply widely.
Trials of these show small or no effects on the gap. A binder may help comfort after surgery.
A third of women still had a gap a year after a first birth, and the curl-up trial started 6 to 12 months after birth and still built strength. Surgery is an option for troublesome symptoms after a proper exercise programme.
Across 113 studies, exercise in pregnancy wasn't linked with a gap, which is a normal part of late pregnancy.
It's a widening of the gap between the two sides of your six-pack muscle, where the tissue down the middle (the linea alba) has stretched and thinned. European surgeons call a gap of more than 2 cm diastasis. It's very common in pregnancy and after birth, and it happens in men and older adults too.
Lie on your back with your knees bent and feet flat, lift your shoulders slightly and look at your tummy, then feel with your fingertips above and below your belly button and count how many fingers fit in the gap. Repeat every so often to see if it's getting smaller. Finger checks are rough: a physiotherapist can measure more precisely with callipers or ultrasound.
In 300 first-time mothers, 60% had a gap of two finger widths or more 6 weeks after the birth, 45% at 6 months and 33% at a year. The NHS says it usually goes back to normal by 8 weeks, and to see your GP if it's still obvious then. Many gaps keep narrowing for months.
Start with pelvic floor exercises, a gentle tummy draw-in, pelvic tilts, heel slides and head lifts, then build up to dead bugs, bird dogs, bridges and side planks. Later, head lifts, curl-ups and twisted curl-ups, 3 sets of 8 to 12 on 5 days a week, made the tummy muscles stronger without widening the gap in a 12-week trial. Walking and general strength training are worth adding too.
Exercise isn't proven to close the gap: across reviews of trials, tummy exercises narrowed it by about 4 to 5 mm on average, and a 2026 update found no difference for deep tummy exercises. It's still worth doing, even years later: it builds strength, which is what most people need. If symptoms trouble you after a proper programme, surgery is an option.
Curl-ups aren't banned: in a trial of women with a gap, 12 weeks of curl-ups didn't widen it and made the muscles stronger. In the first weeks after birth, the NHS suggests avoiding sit-ups and planks to start with, so begin with head lifts and build up. If the middle of your tummy domes, make the move easier.
Yes, in time. The NHS and POGP suggest avoiding planks at first after birth; start with dead bugs, bird dogs and side planks on your knees, then try a knee plank and a full plank once curl-ups feel comfortable (our suggestion). Make it easier or stop if your tummy domes or it hurts.
Doming is a ridge or bulge down the middle of your tummy when you lift your head or strain. UK pelvic health physiotherapists use it as a sign to make the move easier: slow down, breathe out and gently draw your lower tummy in. No study shows it damages anything, but if it keeps happening with exercise, see a physiotherapist.
Yes. In one hospital sample of men in China, 30% had a gap wider than 2 cm, though a single study's figure may not apply widely, and it's linked with older age and a higher weight. In men it's usually painless and may show as a bulge when sitting up; surgeons recommend weight loss and exercise first. See a GP about any bulge that hurts or won't go back, as it could be a hernia.
No: in diastasis the tissue has stretched with no hole, whereas in a hernia part of the bowel or fat pushes through a gap. A hernia can happen alongside a diastasis. Call 999 if a bulge becomes very painful, swollen or discoloured, or you're being sick or can't fart or poo.
No. Trials of binders, corsets, tape and electrical stimulation show small or no effects on the gap. A support garment may feel comfortable early on, and surgeons suggest one after surgery.
Surgeons suggest a physiotherapy programme first; Swedish surgeons suggest at least 6 months of core training, a gap of at least 5 cm or a hernia, and no more pregnancies planned. Surgery stitches the stretched tissue together, and in studies it improved pain, strength and quality of life. A tummy tuck is classed as cosmetic and isn't usually available on the NHS, but a hernia repair is a different matter.
Exercise education, not a diagnosis or treatment plan, and clinical review of these guides is pending. Stop and get advice for chest pain, unusual breathlessness, dizziness or fainting, or new pain, and check with your doctor or midwife first if they have told you to limit activity. Health disclaimer.
