Rectus Diastasis (Abdominal Muscle Separation)

• Pregnancy (most common cause, especially after multiple pregnancies or large babies)
• Weight gain or obesity
• Abdominal surgery
• Genetic predisposition or weak connective tissue
• Repetitive heavy lifting or straining

• Physical Exam: A trained provider can often diagnose it by feeling the abdominal wall while the patient lifts their head or legs.
• Ultrasound or CT scan: In some cases, imaging can confirm the diagnosis and measure the separation.

How Wide Is Too Wide?

A separation of more than 2 cm (about two finger-widths) is generally considered abnormal. However, treatment depends on symptoms, not just the width.

• Many people improve with core training and conservative care
• Surgery offers excellent results when needed, especially for functional concerns
• Ongoing exercise and weight management help prevent recurrence

• A visible bulge or ridge running down the midline of the abdomen
• A feeling of abdominal weakness or “core instability”
• Back pain or pelvic discomfort
• Poor posture
• Difficulty with certain exercises or movements
• Cosmetic concerns

Note: Many patients first notice the separation when sitting up in bed or lifting their head while lying down.

Non-Surgical Treatments

• Core strengthening exercises (under supervision)
• Focus on deep abdominal muscles (like the transversus abdominis)
• Avoid traditional crunches and sit-ups early on
• Physical therapy or postpartum rehabilitation
• Supportive garments or abdominal binders
• May help during postpartum recovery

Most mild to moderate cases improve with proper rehab.

Surgical Options

Surgery may be considered if:

• The diastasis is severe
• Symptoms are persistent (e.g., functional limitation, back pain)
• There is a coexisting hernia
• Cosmetic improvement is desired

Surgical repair involves stitching the separated muscles back together, often through:

• A tummy tuck (abdominoplasty) or
• A laparoscopic or open midline plication