When the ache in your back starts in your middle
Many mums notice back pain and a tummy gap at the same time. Here is what the connection really is, and what actually helps.
Quick answer
Diastasis recti and lower back pain often show up together, and there is a plausible mechanical link: your deep core, including the transverse abdominis and the linea alba, helps stabilise your spine and pelvis, so when that system is weak or cannot transfer load well, some mums feel it as back or pelvic strain. That said, the research is mixed and a separation does not automatically cause back pain. Rebuilding deep-core strength is a sensible, low-risk first step, and persistent or severe pain should always be assessed in person. Results vary from mum to mum.
If your lower back has ached since having your baby and you can also feel a gap down the middle of your tummy, it is natural to wonder whether the two are linked. It is one of the most common questions mums bring to physiotherapists. The honest answer is nuanced, so this guide explains how the core and spine work together, what the evidence does and does not show, and the practical steps that tend to help.
How your core and spine work together
Your trunk is stabilised by a group of deep muscles that work like a canister: the diaphragm on top, the pelvic floor at the base, and the transverse abdominis wrapping around your middle like a corset. The linea alba, the connective tissue that runs down your centre, is what these muscles pull against to create tension and support your spine. In pregnancy this tissue stretches and the abdominal wall lengthens, which can reduce how effectively the deep core braces the lower back, at least until strength is rebuilt.
of women had diastasis recti at 6 weeks postpartum
still had it at 6 months postpartum
still had it at 12 months postpartum
Source: Sperstad et al., British Journal of Sports Medicine, 2016.
Is diastasis recti actually causing my back pain?
This is where honesty matters. Some studies in specialist clinic populations have observed diastasis recti alongside pelvic floor and lumbopelvic symptoms (for example, Spitznagle et al., International Urogynecology Journal, 2007), but an association is not the same as proof that one causes the other. Back pain after birth has many possible drivers, including hormonal changes to ligaments, altered posture from feeding and carrying, sleep deprivation, and reduced overall activity. Diastasis recti may be one contributor for some mums, and irrelevant for others. What physiotherapists broadly agree on is that a strong, coordinated deep core supports the spine, so restoring that strength is rarely a wasted effort.
| More likely core-related | Get it checked in person |
|---|---|
| Ache builds with lifting, carrying or long standing | Sharp, severe or worsening pain |
| Midline domes or feels weak under load | Pain radiating down a leg, or numbness and tingling |
| Feels better on days you do gentle core work | Pain with bladder or bowel changes |
| Eases as your deep strength returns | Fever, or pain after a fall or trauma |
How rebuilding your deep core can ease the load
The aim is not to crunch your way to a flat stomach, which can actually increase pressure on a healing midline. It is to retrain the deep system so it braces automatically. A typical progression looks like this:
- Breathing first. Diaphragmatic breathing reconnects the diaphragm and pelvic floor so they work in rhythm.
- Gentle transverse abdominis activation. Learning to draw the lower belly in without holding your breath or gripping.
- Add movement. Heel slides, dead bugs and bird dogs teach the core to stay stable while your limbs move, which is exactly what your back needs during daily life.
- Build load gradually. Progress to functional strength like bridges and squats once the midline holds firm without doming.
Rebuild your deep core in the right order
Core Reconnect is Mumma Glow's affordable, one-time programme that walks you through this exact progression, from breathing to functional strength, with no subscription and no app fee. It is the budget-friendly alternative to programmes like MUTU. Use code GLOW20 for 20% off.
When to see a professional
Book an assessment with a women's health physiotherapist or your GP if your back pain is severe, worsening, or radiates down your leg; if you have numbness, tingling, or any change in bladder or bowel control; or if pain does not ease over several weeks of gentle rebuilding. The NHS encourages mums to raise ongoing postpartum symptoms at their check-ups, and a physio can assess both your back and your abdominal separation and tailor a plan to you.
Frequently asked questions
Can diastasis recti cause lower back pain?
It may contribute for some mums, because the deep core helps stabilise the spine, but the evidence is mixed and a separation does not automatically cause back pain. Rebuilding deep-core strength is a reasonable first step, and persistent pain should be assessed in person.
Will closing my ab gap fix my back pain?
Not necessarily, and not always completely. Some mums find their back feels more supported as deep strength returns, while others have back pain from unrelated causes. Focus on function and coordination rather than the gap measurement alone.
Which exercises should I avoid if I have both?
While the midline is still weak, traditional crunches, sit-ups and full planks can increase pressure and cause doming. Deep-core breathing and gentle activation are usually better starting points.
How long until my back feels better?
It varies widely. Many mums notice gradual improvement over several weeks of consistent gentle work, but timelines depend on your starting point, sleep, and overall activity. There is no fixed deadline.
Should I use a support belt for my back?
A belt may feel supportive short term, but it does not rebuild strength on its own. If you use one, pair it with progressive core work, and check with a physio if you rely on it daily.
Sources: Sperstad JB et al., British Journal of Sports Medicine, 2016; Spitznagle TM et al., "Prevalence of diastasis recti abdominis in a urogynecological patient population," International Urogynecology Journal, 2007; NHS, "Your body after the birth"; Cleveland Clinic, Diastasis Recti.
This article is general education, not medical advice, and is not affiliated with any named programme. Postpartum recovery varies from mum to mum. Always check with your GP, midwife, or a women's health physiotherapist before starting or changing an exercise routine, and seek in-person care for severe, worsening, or radiating pain.