Mind the Gap (Part 2): How to Exercise with Diastasis Recti, Without Making It Worse

If Part 1 left you thinking, “Great… so what do I actually do?” you’re not alone. We know more than ever about diastasis recti abdominis (DRA), and at the same time, we are still piecing together the full picture. What we do know is this: You cannot “close the gap” with one magical exercise. You can, however, train your body to manage pressure, generate tension, move well, better input and reorganize. This is what improves function, and often, appearance follows. We want a system that responds, a body that can manage pressure, and strength that shows up when you need it. A narrower gap that cannot manage load is not more useful than a wider one that can.

The real goal: Tension + timing

The linea alba does not just need to be “closer.” It needs to tension and respond.

Think less about squeezing and more about organizing. That comes from:

• Coordinated abdominal muscle activity

• Breath that matches movement

• Gradual exposure to load

Step 1: Learn to feel the system

Before strengthening, you need awareness.

360 breathing (foundation)

• Lie on your back with knees bent or sit supported

• Inhale through your nose

• Feel expansion in the front, sides, and back ribs

• Exhale slowly through your mouth

• Let the abdomen gently recoil

You are not sucking in. You are not pushing out. You are creating a system that can expand and recoil. Practice for 2 to 3 minutes daily.

Step 2: Gentle activation without gripping

Supine transversus abdominis (TrA) activation

• Start in the same position

• Exhale

• Gently draw the lower abdomen inward, like zipping up snug jeans

• Hold 3 to 5 seconds without breath holding

• Relax fully

This should feel subtle. If your ribs flare or your pelvis tucks aggressively, you are overdoing it. Work on a 25%, then 50%, then 75%, then 100% contraction. Make it "easy".

Step 3: Add movement (this is where it matters)

Strength is built when the system is challenged like in the Sahrmann progression.

Bent knee fallout (BKFO)

• Lie on your back, knees bent

• Engage gently through the lower abdomen

• Slowly let one knee fall out to the side

• Keep pelvis stable

• Return and switch sides

Goal: Maintain control without bracing or bulging.

Heel slides

• Start in the same position

• Slide one heel away while maintaining abdominal control

• Return slowly

Watch for doming or bulging through the midline. That is your body telling you the load is too high.

Noble technique + diaphragmatic breathing

• Use your hands (or a towel/sheet) to gently approximate the abdominal wall

• Pair this with a small curl-up or breath

• Focus on tension, not force

This gives your body a reference for what “support” can feel like without overworking.

Step 4: Build coordination in gravity. This is where real-life strength begins.

Quadruped (hands and knees)

• Gentle abdominal engagement

• Maintain neutral spine

• Breathe

• Progress to: Arm lift: Lift one arm without shifting weight, then Opposite arm and leg (bird dog): Only if you can control without compensation

Step 5: Planks, but smarter

Planks are not bad. They are often just introduced too early or performed with poor strategy.

Modified plank

• Start elevated (hands on a bench or wall)

• Engage abdominals gently

• Breathe

• Hold 10 to 20 seconds

Progress by lowering the surface or increasing time.

Side plank

• Start on knees

• Focus on length through the body, not gripping

Side planks are often better tolerated early because they challenge the system differently.

Step 6: Rotation and real life

Your core is designed for movement, not stillness.

Add:

• Reaching

• Carrying (especially asymmetrical loads)

• Rotational patterns with squats and lunges

• Turkish get-up

Examples:

• Carrying a child on one hip

• Reaching overhead for a dish

• Walking with arm swing

This is where the system integrates.

What to watch for

These are signs to modify:

• Midline bulging or doming

• Breath holding

• Rib flaring

• Pelvic gripping

• Pain

These are not “failures.” They are feedback.

What about crunches?

Crunches are not inherently harmful, but they are often overused and poorly timed.

They:

• May decrease IRD temporarily

• May increase distortion through the linea alba (Lee 2016)

If used, they should be, pain-free, controlled, part of a larger program, Not the foundation.

What about wraps, binders, and taping?

These can:

• Provide short-term support

• Improve comfort early postpartum

They cannot:

• Retrain muscle coordination

• Restore load transfer

Use them as a bridge, not a solution.

How often should you do this?

At first, consistency beats intensity.

• 10 to 15 minutes most days

• Integrate into daily life

• Progress every 1 to 2 weeks based on control

When to get help

Individual variability is high. A tailored approach matters. Consider pelvic health physical therapy if you notice:

• Persistent doming

• Pain with movement or intimacy

• Pelvic pressure or heaviness

• Urinary leakage

• No improvement after several months

Final thought

You are not trying to “fix” your body. You are teaching it how to adapt again. The abdominal wall, the linea alba, the pelvic floor, and the diaphragm are all part of a responsive system. When they work together, strength returns in a way that feels natural, not forced. And yes, usually the gap narrows. Just as important, your body starts to feel like yours again.

Looking for Pelvic Floor Physical Therapy in Philadelphia?

If you are experiencing pelvic girdle pain during pregnancy or postpartum pelvic pain, individualized care can make a meaningful difference.  At Hazel Physical Therapy, we provide pelvic floor physical therapy, prenatal physical therapy, and postpartum care in Philadelphia to help you move with less pain and more confidence. Schedule an evaluation to get started.