How Does Diastasis Recti Affect Your Posture?
Diastasis recti is a gap between the two sides of your abdominal muscles. It weakens trunk support, allowing the pelvis to tilt forward and the lower back curve to increase. This changes your standing alignment from head to feet, often causing lower back pain that feels unrelated to the abdomen itself.
Key Takeaways
- Diastasis recti means the left and right halves of your rectus abdominis have separated along the linea alba, the connective tissue running down the midline.
- The resulting loss of core support often leads to anterior pelvic tilt and increased lumbar lordosis.
- Pain commonly appears in the lower back, hips or pelvis rather than the abdomen.
- A standing, weight-bearing image of your whole alignment can reveal compensations that lying-down scans miss.
- Graded loading exercises guided by a specialist physiotherapist are the first-line approach. Surgery is only considered after sustained rehabilitation.
What is diastasis recti?
Diastasis recti is a widening of the gap between the two strips of the rectus abdominis muscle, often called the "six-pack." These strips are connected by a band of fibrous tissue called the linea alba, which runs vertically from the breastbone to the pubic bone. When that tissue stretches and thins, it can no longer hold the two muscle halves close together.
This is most commonly associated with pregnancy, but it also occurs in men and women who have never been pregnant. Repeated heavy lifting, rapid weight gain, or chronic increases in intra-abdominal pressure can all contribute.
The gap is not a tear. The muscle itself is still intact, but the connective tissue between the two halves has become lax. This reduces the core's ability to generate and transfer force, which has a direct effect on your posture.
How do you check for diastasis recti?
A simple self-check involves lying on your back with your knees bent, then gently lifting your head and shoulders. Press your fingers along the midline above and below the navel. If you feel a gap wider than roughly two finger widths, or if the tissue feels soft and unsupportive, you may have diastasis recti. A physiotherapist or GP can confirm this with a clinical examination.
A ridge or dome along your midline when you brace or sit up from lying down.
Persistent aching across the lower back, especially after standing for a long time.
The pelvic floor and deep abdominal muscles work as a unit. When one weakens, the other often follows.
Difficulty standing tall without conscious effort, or feeling that your trunk "sags" forward.
Why does diastasis recti cause back pain and posture changes?
Your abdominal muscles are a key part of your trunk support system. They work alongside your back muscles, diaphragm and pelvic floor to stabilise your spine. When the front wall weakens because of diastasis recti, your body has to compensate.
The most common compensation is an increase in anterior pelvic tilt. Without adequate abdominal bracing, the pelvis tips forward, the lower back curves more deeply, and the upper back rounds to balance. This chain of compensations can cause pain and stiffness in your lower back, hips, or between your shoulder blades, all far from the gap in your abdomen.
This is why lying-down scans can be misleading for posture-related problems. When you lie on a table, gravity flattens the spine, the muscles relax, and the pelvic tilt disappears. The alignment issues that drive your symptoms only show up when you are standing and bearing your own weight.
What causes diastasis recti?
Anything that repeatedly or sustainably increases pressure inside the abdomen can stretch the linea alba. The most well-known cause is pregnancy, but it is not the only one.
The growing uterus stretches the abdominal wall over many months. It is the most common cause of abdominal separation after birth.
Repeated heavy loads without proper bracing technique can overload the midline tissue over time.
Rapid increases in abdominal fat raise intra-abdominal pressure and stretch the connective tissue.
Persistent coughing, constipation, or incorrect exercise form can all contribute to sustained abdominal pressure.
How is posture assessed when you have diastasis recti?
Because diastasis recti changes your alignment while you are upright, a lying-down scan tells only part of the story. A standing, weight-bearing image captures how your skeleton actually loads under gravity, showing pelvic tilt, lumbar curve changes, and any knock-on effects up and down the chain.
ScanAlign standing EOS imaging takes a full-length image of your skeleton from head to feet while you stand naturally. It uses about 90% less radiation than a standard X-ray, around ten times less. The result is a detailed picture of your whole alignment, not just a single region, so your clinician can see where compensations are happening and plan rehabilitation accordingly.
Wondering whether your posture changes are linked to abdominal separation? A free video consultation can help you decide if a standing alignment assessment is the right next step.
Book a free video consultationWhen MRI is the better tool: EOS imaging shows bones, joints and alignment. If your clinician suspects soft-tissue problems such as disc bulges, nerve compression, or muscle damage, MRI is usually the more appropriate investigation. The two types of imaging often complement each other.
What helps with diastasis recti and posture recovery?
The first-line approach is a programme of graded loading exercises, ideally guided by a physiotherapist who specialises in postnatal or abdominal rehabilitation. The goal is to retrain the deep core muscles to generate tension across the linea alba, gradually closing the gap and restoring trunk support.
General principles of rehabilitation
- Graded loading. Exercises start gently and progress as the tissue adapts. Rushing into sit-ups or planks too early can worsen the gap.
- Breath and pelvic floor coordination. Learning to breathe and brace properly helps manage intra-abdominal pressure during everyday movements.
- Posture awareness. Understanding how your pelvis, spine and ribcage relate to each other makes it easier to stand and move without excessive compensation.
- Realistic timelines. Recovery takes months, not weeks. Progress is often measured in how well you function, not just in the width of the gap.
In persistent cases where rehabilitation has been fully explored, surgery may be considered. This is a decision made with a specialist surgeon and is not the starting point.
If your symptoms include sudden numbness, weakness in your legs, or loss of bladder or bowel control, seek urgent medical attention through your GP, 111, or A&E. These are not typical of diastasis recti alone and need prompt assessment.
Frequently asked questions about diastasis recti and posture
Yes. When the abdominal wall cannot support the spine properly, the lower back muscles work harder to compensate. This commonly leads to persistent aching across the lower back, especially after standing or walking for long periods.
Lie on your back with your knees bent. Lift your head and shoulders gently and press your fingers along the midline above and below your navel. A gap wider than roughly two finger widths, or tissue that feels soft and gives way easily, may indicate diastasis recti. A physiotherapist or GP can confirm this clinically.
No. While pregnancy is the most common cause, diastasis recti also occurs in men and women who have never been pregnant. Heavy lifting, rapid weight gain, and chronic increases in abdominal pressure can all stretch the linea alba.
Traditional sit-ups, crunches, and heavy front-loaded movements can increase pressure on the weakened midline. A specialist physiotherapist can assess your individual gap and prescribe safe, progressive exercises that strengthen the core without worsening the separation.
Some mild cases improve naturally within the first few months after birth as the tissue recovers. However, wider separations or those that persist beyond several months usually benefit from guided rehabilitation. Without targeted exercise, the gap and its postural effects tend to remain.
The postural changes caused by diastasis recti, such as increased pelvic tilt and a deeper lower back curve, only appear when you are standing and bearing weight. Lying-down imaging relaxes these compensations and can miss the full picture. A standing EOS scan captures your real-world alignment from head to feet.
Yes. The EOS system uses about 90% less radiation than a standard X-ray, around ten times less. It captures a full-length standing image in a single pass.
No. ScanAlign accepts self-referrals. You can book a postnatal alignment assessment directly through a free video consultation, where a specialist radiographer will confirm whether a standing scan is appropriate for you.
Pricing details are available on the ScanAlign website. You can discuss costs and what is included during a free video consultation before committing to anything.
Yes. A weakened core allows the pelvis to tilt and rotate unevenly, which can overload the hip joints and pelvic ligaments. Pain in the front of the hip, the SI joint, or the groin is not uncommon when diastasis recti is present.
See how your whole body aligns, standing up
A free video consultation takes a few minutes. A specialist radiographer will review your concerns and let you know whether a standing alignment scan could help.
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- Sperstad JB, Tennfjord MK, Hilde G, Ellström-Engh M, Bø K. Diastasis recti abdominis during pregnancy and 12 months after childbirth: prevalence, risk factors and report of lumbopelvic pain. British Journal of Sports Medicine. 2016;50(17):1092-1096.
- Benjamin DR, van de Water ATM, Peiris CL. Effects of exercise on diastasis of the rectus abdominis muscle in the antenatal and postnatal periods: a systematic review. Physiotherapy. 2014;100(1):1-8.
- NHS. Diastasis recti (abdominal muscle separation). NHS guidance on postnatal abdominal recovery. nhs.uk
Written by Abbas Dhami (Specialist Diagnostic Radiographer)
This page is general information and not a diagnosis.
ScanAlign is the trading name of CoreMed Solutions Ltd and operates under The Harley Street Hospital's CQC licence.