As pelvic health therapists, should we be focused on “How big is the gap?” or on “What can this person's abdominal wall do?” In today’s episode of the Birth Healing Summit Podcast, Dr. Nina Theodorsen, associate professor at the University of Bergen in Norway, practicing physiotherapist, and diastasis recti researcher, shares the latest on what current research tells us about exercise, pregnancy, and postpartum recovery. Her research discoveries challenge what practitioners have been taught to focus on with abdominal health, and she provides new insights on how we can better support clients to become stronger and more confident in their bodies after birth. Key Discoveries from this Episode: Diastasis during pregnancy may be adaptation – not pathology.We may be blaming exercise for something exercise doesn't cause.IRD measurements and “doming” do not tell the whole story.Large persistent diastasis may have less to do with what they did – and more to do with who they are.The clinical goal should shift to what can this person's abdominal wall do.Exercise should be encouraged, not restricted.You don't necessarily have to “close the gap” to improve strength and function.Using better language and updating your practice. Clinical Takeaway Treat the person, not the centimeter measurement. A large IRD does not automatically mean weakness, pain, dysfunction, or injury risk. Conversely, a relatively small separation can be highly distressing or functionally significant. Clinical decision-making should be driven by symptoms, strength, function, goals, and patient concerns – not IRD or abdominal appearance alone. Today’s conversation challenges the fear-based approach many women have been given around lifting, abdominal exercise, and movement with pregnancy. Instead of treating a measurement, we can help women become stronger, more capable, and more confident in their bodies. Frequently Asked Questions Does abdominal exercise cause or worsen diastasis during pregnancy? Current evidence does not support the idea that normal abdominal exercise causes or meaningfully worsens pregnancy-related diastasis. Nina's research found no significant difference in diastasis development between women who performed abdominal exercises and those in a control group. Exercise should generally be encouraged rather than restricted solely because of concern about diastasis. Should clinicians measure interrectus distance? IRD can provide useful information, but it shouldn't be the primary measure of whether someone has a clinical problem. A measurement alone doesn't tell us whether someone has pain, weakness, functional limitations, or distress. The more important question is: What is this person experiencing, and what do they want to be able to do? What should postpartum rehabilitation focus on? For people with persistent symptoms or functional limitations, progressive strengthening and loading may be more valuable than trying to mechanically “close” the separation. The goal is to improve capacity, strength, confidence, and function. Persistent large diastases also warrant more research into who may benefit from rehabilitation, surgery, or a combination of both. Studies Mentioned Theodorsen, N.-M., Donnelly, G., &. Bø, K., (2026). Diastasis Rectus Abdominis: Time to Reconsider Our Approach. A Scoping ReviewJournal of Women's & Pelvic Health Physical Therapy https://doi.org/10.1097/JWH.0000000000000383Theodorsen N-M, Moe-Nilssen R, Bø K, Haukenes I. Associations with the inter-recti distance at gestation week 37: a prospective cohort study among healthy pregnant women. BMC Pregnancy Childbirth. 2025 May 29;25(1):630. doi: https://doi.org/10.1186/s12884-025-07741-7. PMID: 40442641; PMCID: PMC12123851.Marander V, Råheim M, Haukenes I, Theodorsen N-M. Mothers` experiences living with diastasis recti abdominis-an interview study. BMC Women`s Health. 2024 24-292. https://doi.org/10.1186/s12905-024-03131-xTheodorsen N-M, Bø K, Fersum, K V, Haukenes I, Moe-Nilssen R. Pregnant women may exercise both abdominal and pelvic floor muscles during pregnancy without increasing the diastasis recti abdominis: a randomised trial. J Physiotherapy. 2024/03/11 2024; https://doi.org/10.1016/j.jphys.2024.02.002Theodorsen N-M, Moe-Nilssen R, Bø K, Haukenes I. Effect of exercise on the inter-rectus distance in pregnant women with diastasis recti abdominis: an experimental longitudinalstudy.Physiotherapy.2023/12/01/2023;121:13-20. https://doi.org/10.1016/j.physio.2023.08.001Theodorsen, N., Strand, L-I., Bø, K. Effect of pelvic floor and transversus abdominis muscle contraction on inter-rectus distance in postpartum women: a cross-sectional experimental study. Physiotherapy 2018;https://doi.org/10.1016/j.physio.2018.08.009 About Today’s Speaker Dr. Nina Theodorsen, PhD, is a physiotherapist, researcher, and Associate Professor at the University of Bergen in Norway. Her work focuses on women’s health, with expertise in pregnancy, postpartum care, pelvic floor dysfunction, and musculoskeletal health. Her PhD research on diastasis recti has challenged common misconceptions about exercise during pregnancy and helped shape evidence-based clinical practice. Nina is an internationally recognized educator and speaker passionate about translating research into better care for women. Connect With Lynn Have a comment or question about today’s episode? Message Lynn on Instagram or Facebook, or Email Lynn. Subscribe to the Birth Healing Summit Podcast Don’t miss an episode! If you enjoyed today’s podcast and are interested in more topics to support your clinical practice and treatment sessions, find us on your favorite podcast app. Follow or Subscribe to the Birth Healing Summit Podcast on: SpotifyYouTubeApple PodcastsBuzzsproutAmazon PodcastsTo learn more visit: InstituteforBirthHealing.com Visit Institute for Birth Healing to learn more about how to care for the pregnant and postpartum body: CLICK HERE
