What Is Diastasis Recti (Abdominal Muscle Separation)?

Diastasis recti is a separation of the two straight abdominal muscles (the rectus muscles) along the midline of the abdominal wall. It is most common after pregnancy but can also occur in other situations, such as marked weight changes. Many people link it to why their abdomen still protrudes despite exercise and weight loss. In this article we cover diastasis recti in general terms.

Why does it occur?

During pregnancy the growing uterus stretches the abdominal wall and thins the connective tissue between the two muscles. After birth, the separation decreases considerably on its own within months for many people. In some, particularly after multiple or closely spaced pregnancies, it can become permanent. Genetic tissue characteristics and conditions that raise abdominal pressure may also play a role.

How is it recognised?

• a bulge around the navel and along the midline, particularly noticeable when tensing the abdominal muscles (for example, lifting the head while lying on your back),
• a protruding abdomen that persists despite weight loss,
• in some people, a feeling of weakness in core support.

A definite assessment is made by a physician; if needed, the width of the separation can be measured with ultrasound. It is also important to check whether a hernia is present along the midline.

Which approaches may be considered?

In the early postnatal period, targeted exercises with a suitable physiotherapist are often recommended as a first step. For people with a marked separation and accompanying excess skin that has not improved sufficiently with exercise and time, bringing the muscles together with stitches along the midline during a tummy tuck (abdominoplasty) may be considered. For surgical planning, it is generally recommended that family planning is complete and weight has been stable for some time. The appropriate approach is decided individually.

Frequently Asked Questions

Can diastasis recti improve with exercise?

In mild separations, targeted exercises can bring noticeable improvement. In marked and long-standing separations the effect of exercise may be more limited; assessment is individual.

Are sit-ups harmful?

Some classic abdominal exercises can increase pressure along the midline and make symptoms more noticeable. It is best to decide with a physiotherapist or physician which exercises suit you.

Should I have surgery if I plan another pregnancy?

Because a later pregnancy can stretch the abdominal wall again, surgical correction is usually considered after family planning is complete. Discuss this with your surgeon at the consultation.

For more information, visit our Body lift surgeries page and our Mommy Makeover article, and reach us via our contact page.

This article is for informational purposes only; a medical examination by a physician is required for diagnosis and treatment.