Diastasis Recti Abdominis: Moving Beyond Assumptions Toward Evidence-Informed, Patient-Centered Care

Diastasis recti abdominis (DRA) is a common and highly visible concern in postpartum rehabilitation, yet its assessment and management remain influenced by inconsistent definitions, fear-based messaging, and interventions not always supported by evidence. Moving beyond the goal of “closing the gap” requires an evidence-informed, patient-centered approach. Current literature does not establish DRA as a consistent cause of urinary incontinence, pelvic organ prolapse, low back pain, or pelvic girdle pain, although DRA may be relevant to abdominal wall function, discomfort, and task-specific trunk performance. Emerging evidence also challenges routine avoidance of abdominal exercise and does not support hypopressive exercises as a primary intervention to reduce inter-rectus distance or as a replacement for pelvic floor muscle training. The manuscripts in this special issue emphasize individualized assessment, functional outcomes, cautious interpretation of anatomical change, and recognition of patients’ lived experiences. Pelvic health physical therapists are well positioned to provide clear education, reduce fear, and support rehabilitation that prioritizes function, confidence, movement participation, and patient goals.