Weak Core And Back Pain Postpartum? Physical Therapists Offer Exercises That Can Help. (2024)

Pregnancy does some pretty incredible things to your body, but for many women, it can also leave you feeling a little unfamiliar in your own skin afterward. One of the most common changes is diastasis recti (or diastasis recti for short), which happens when your abs separate down the middle as your belly grows. It happens to more than half of women who’ve had a baby, according to a 2021 study in Hernia. Diastasis recti can leave women with some frustrating side effects after birth, including core weakness and lower back pain, however, you don’t have to live with it forever. With the right exercises, you can help close that gap, strengthen your core, and feel more like yourself again.

Whether you’re pregnant and want to prevent diastasis recti, or you’re already on the other side and ready to reclaim your strength, this guide has got you covered. With the help of Sarah Kostyukovsky, DPT, OCS, a physical therapist and orthopedic specialist, we’ll walk you through what causes the condition, why it matters, and offer safe, effective diastasis recti exercises that you can start doing today to rebuild your core as you navigate postpartum.

Meet the expert: Sarah Kostyukovsky, DPT, OCS, is a physical therapist, orthopedic specialist, and co-founder of Flow Physio, a physical therapy practice rooted in orthopedic training and the treatment of pelvic floor dysfunction.

What is diastasis recti?

Diastasis recti is the separation of the rectus abdominis muscles, commonly known as the "six-pack" muscles, along the midline of your stomach. “There is a fascial or soft tissue connection at the middle of the rectus abdominis muscle that allows for stretching and movement of our abdomen," says Kostyukovsky. During pregnancy, as the uterus and belly expand, the connective tissue between these muscles (called the linea alba) stretches to accommodate the growing fetus. For many women, this stretching leads to a noticeable gap or separation between the muscles, ultimately compromising strength and stability in the core. While this separation is a natural part of pregnancy, issues arise when the muscles don’t naturally come back together postpartum.

Everyone that carries a pregnancy to term will experience some diastasis (a.k.a. separation) of their abs, says Kostyukovsky, with many cases healing on their own with typical training and activity. In fact, anyone—men and women, alike—can develop diastasis recti if they have poor patterns of engaging their abs or poor control, she says.

How To Know If You Have Diastasis Recti

Before addressing diastasis recti, you need to establish if you're actually experiencing it—and how extreme it is. While it’s always best to see a specialized doctor or physical therapist to officially diagnose and address this condition, here's a simple test you can try at home to help you determine if you might be experiencing diastasis recti:

1. Lie on your back on a firm surface with your knees bent and your abdominals relaxed.
2. Use your index, middle, and ring finger to feel the area just below your sternum and down towards your pubic bone.
3. Run your fingers side-to-side across the length of your abs to see if you can feel where the "walls" of the rectus muscles are by pressing down gently to see how deep your fingers will sink.
4. If your fingers sink in significantly and/or you can fit multiple fingers (3+) in between the walls of the rectus abdominis, this is suggestive of a weakening and/or widening of that fascial connection between the abdominal muscles.
5. Then, do a curl up or lift your head and shoulders up to see what happens to the tissue in the middle of the abdomen. You should feel the abdominal walls come closer together as you lift. If you feel like your fingers can sink deep into your abdomen at rest, you also want to feel your fingers being pushed out as you curl up. If you don't feel the muscles "close" or your fingers continue to sink deeper, it's a good idea to have your abdominal wall professionally assessed.

Benefits Of Diastasis Recti Exercises

Abdominal separation can affect your body in ways far deeper than aesthetics. Without the support of a strong core, you’re more vulnerable to back pain, poor posture, and difficulty performing everyday activities such as lifting, carrying your baby, or doing normal household chores. The core isn’t just about having toned abs—it helps stabilize your spine and entire body, so when those muscles are stretched or weakened, it has a ripple effect on your overall physical function. Left untreated, diastasis recti may also lead to pelvic floor dysfunction, hernias, and long-term issues with mobility and balance. Thankfully, there's plenty you can do to address it during pregnancy and postpartum.

After diagnosis, determining what diastasis recti exercises you should be doing is the next most important step for healing, says Kostyukovsky. The thing is, not all core exercises are appropriate for someone with diastasis recti. Some traditional core exercises, such as crunches and situps, can actually worsen the problem. "Doing core exercises that create tension across that linea alba reinforces good engagement patterns and strategies to reduce that ‘leaking’ of tension that perpetuates diastasis recti." Certain core exercises also help build up the muscles of the abdominal wall, which can reduce the depth of the gap, improve the aesthetic and function of your abdominal wall, and better support the way you move your body overall.

To prevent and heal diastasis recti, you'll want to focus on functional core exercises that emphasize breathwork, target the deep core muscles (including the transverse abdominis, pelvic floor, and diaphragm), and focus on controlled muscle engagement.

Best Diastasis Recti Exercises

Now that we’ve established how important it is to determine which exercises are right for healing diastasis recti, below is a list of beginner diastasis recti exercises from Kostyukovsky, specifically designed to gently strengthen the abs muscles without creating too much pressure in your midsection.

Time: 10 minutes or less | Equipment: Mat (optional) | Good For: Deep core muscles

Instructions: Prior to starting any of the exercises listed below, Kostyukovsky suggests you practice a few minutes of diaphragmatic breathing in various positions (supine, sidelying, prone, quadruped, standing, etc.) to establish the connection between your abdominal and pelvic floor muscles. Start with at least one round of the three foundational exercises below before moving into the six functional exercises listed below. Start by incorporating 10 to 15 minutes of these exercises into your routine, aiming for at least three to four days a week.

As you get stronger, you can gradually increase the frequency and duration, but the most important part is to stay consistent. When working out with diastasis recti, it's super important to listen to your body. If any of these exercises feel uncomfortable or lead to “coning” in your stomach (raised area of abdomen while exerting yourself), discontinue exercises and contact a licensed physical therapist.

3 Foundational Diastasis Recti Exercises

1. Diaphragmatic Breathing

What it's good for: Activates the deep core muscles and strengthens the diaphragm.

How to:

1. Lie on your back with your knees bent and feet flat on the floor. Place one hand on your chest and the other on your belly.
2. Inhale deeply through your nose, focusing on expanding your belly (not your chest).
3. As you inhale, feel your belly rise and expand outward. Your chest should remain mostly still.
4. Exhale slowly through your mouth, drawing your belly button in toward your spine and engaging your deep core muscles. That's 1 rep.
5. Repeat for 5-10 reps/breaths, maintaining slow, controlled breathing throughout.

2. Supine Heel Slides

What it's good for: Strengthens the deep core while maintaining stability in the abdominal muscles.

How to:

1. Lie on your back with knees bent, feet flat on the floor, and arms resting by your sides.
2. Engage your core by gently pulling your belly button toward your spine (without arching your back).
3. Slowly slide your right heel along the floor, straightening your leg while keeping your core engaged.
4. Return your heel to the starting position, maintaining core engagement the entire time. That's 1 rep.
5. Repeat with your left leg. Try not to let your pelvis rock from side to side as you do this.
6. Complete 8-10 reps per leg, focusing on slow, controlled movement.

3. Supine Marching

What it's good for: Strengthens the deep core muscles while stabilizing the pelvis.

How to:

1. Lie on your back with knees bent and feet flat on the floor.
2. Engage your core by gently drawing your belly button toward your spine.
3. Lift your right leg, bringing your knee up to a 90-degree angle while keeping your core engaged and spine neutral against the floor. Try not to let your pelvis rock from side to side as you do this.
4. Slowly lower your right foot back to the floor and repeat with your left leg. That's 1 rep.
5. Alternate legs in a marching motion for 10 reps per side, focusing on controlled movement without letting your back arch.

6 Beginner Diastasis Recti Exercises

Once you’ve mastered the foundational exercises above, keep those concepts in mind as you flow into the diastasis recti-safe moves below. While the following is a list of “beginner” exercises, keep in mind that everyone, and every body, is different. If you’ve given birth (or not) and suspect you might be experiencing diastasis recti—or if you just want to rule it out—it is always best to see a licensed physical therapist for a full assessment and personalized treatment plan that takes your entire medical history and fitness goals into consideration.

1. Bird Dog

What it's good for: Strengthens the core, lower back, and glutes while improving shoulder and spinal stability.

How to:

1. Start on all fours, wrists under shoulders, knees under hips.
2. Engage your core by drawing your belly button in.
3. Extend your right arm forward and left leg back, keeping hips level and spine neutral.
4. Hold briefly, then return to the starting position.
5. Repeat with the left arm and right leg. That's 1 rep.
6. Complete 8-10 reps per side, maintaining core stability.

Pro tip: Start with 5 reps on each side, then take a break. If that feels good and comfortable, you can progress to the 8-10 reps.

2. Dead Bug

What it's good for: Engages the deep core muscles while stabilizing the spine.

How to:

1. Lie on your back, arms extended toward the ceiling, knees bent at 90 degrees.
2. Engage your core and press your lower back into the floor.
3. Slowly lower your right arm overhead and extend your left leg toward the floor.
4. Return to the starting position, then switch sides (left arm, right leg). That's 1 rep.
5. Perform 8-10 reps per side, focusing on control and core engagement. Try not to arch your back during the movements.

Pro tip: If you find your lower back is lifting up from the floor, try 5 reps of legs only, or 5 reps of arms only while holding the legs in the tabletop (90-90) position. Once you have the spine position under control, then try putting it all together.

3. Heel Taps

What it's good for: Strengthens the core and stabilizes the pelvis.

How to:

1. Lie on back with knees bent and feet on floor, hands by hips.
2. Lift chest toward the ceiling, keeping neck relaxed and bringing shoulder blades off the ground.
3. Tap right hand to outside of right ankle, flexing right obliques in the process.
4. Come back to center, keeping shoulders off ground.
5. Tap left hand to outside of left ankle. That's 1 rep.
6. Alternate taps for 8-10 reps per side, maintaining core engagement throughout.

4. Standing March

What it's good for: Strengthens the core and hip flexors while improving balance.

How to:

1. Stand tall with feet hip-width apart, core engaged.
2. Lift your right knee toward hip height, balancing on your left leg.
3. Lower your right foot and lift your left knee, alternating in a marching motion.
4. Continue marching for 30-60 seconds, keeping movements controlled and stable.

Pro tip: This can be done with or without a band around your ankles. When first doing this exercise, try it near a countertop or wall so you have something to hold onto if necessary.

5. Alternating Leg Lower

What it's good for: Strengthens the deep core muscles while controlling lower body movement.

How to:

1. Lie on your back with both legs extended toward the ceiling.
2. Engage your core and press your lower back into the floor.
3. Lower your right leg toward the floor while keeping your left leg extended up.
4. Return to the starting position. That's 1 rep. Repeat with the left leg.
5. Perform 5-8 reps per leg, focusing on keeping your back flat and core engaged.

Pro tip: Again, try this with bent knees first. Only progress to the straight leg version if the bent knee version is easy.

6. Glute Bridge

What it's good for: Strengthens the glutes, lower back, and core.

How to:

1. Lie on your back with feet planted hip-width on the floor and knees bent.
2. Squeeze your glutes and lift your hips off of the floor until your body forms a straight line from your knees to your shoulders.
3. Pause at the top, squeezing the glutes a little extra for good measure.
4. Lower back down with control to the starting position to tap hips on the floor before repeating. That's 1 rep.
5. Perform 10 reps, focusing on glute and core activation.

Pro tip: There are many modifications and progressions to the glute bridge. But mastering this version of the bridge is a great place to begin before trying more challenging version like the single leg bridge or bridge with marching.

How To Integrate Diastasis Recti Exercises Into Your Routine

Consistency is key when it comes to healing diastasis recti, but the good news is that you don’t need to spend hours a day on core work to see results.

Diastasis recti recovery takes time. Think of these exercises as a long-term investment in your core strength and overall health. By slowly strengthening your core and retraining your body, you’ll be setting yourself up for lasting strength and stability.

If you’re struggling to find time to do these exercises, try making them a part of your routine by pairing them with other daily habits. Whether it’s doing them first thing in the morning, while your baby is doing tummy time, or when you’re winding down at night, every little bit of work helps.

What To Avoid While Recovering

When recovering from diastasis recti, it’s crucial to steer clear of certain exercises that could worsen the condition. Here are the main movements you'll want to avoid:

• Crunches and situps: These can put excessive pressure on your abdominal muscles and worsen the separation.
• Full planks: While great for core strength, traditional planks can strain the midline.
• Heavy lifting: Lifting weights that are too heavy can stress your core and exacerbate the gap.
• Twisting movements: Exercises that involve twisting or excessive forward bending can also aggravate diastasis recti.

Prioritize healing over intensity. Focus on safe, controlled exercises that engage the deep core, and give your body the time it needs to recover properly. Investing in this recovery will set the stage for lasting core strength and stability in the future.

Bottom line: With consistent practice, diastasis recti exercises can help you feel stronger and more confident, giving you back the strength you need for daily life and allowing you to feel comfortable in your body, whether you’re newly postpartum or working on long-term recovery.