Diastasis Recti: Understanding the Causes, Symptoms, and Treatment of Abdominal Muscle Separation

Diastasis Recti is a common condition that occurs when the abdominal muscles separate, leading to the separation of the rectus abdominis muscles. This condition mostly affects women during and after pregnancy, but it can also affect men. The condition can result in a noticeable bulge in the abdominal area and cause pain and discomfort. In this article, we will delve into the causes, symptoms, and treatment options for Diastasis Recti. We will also discuss non-surgical and surgical treatment options that can help to restore the abdominal muscles to their normal position. Understanding the causes, symptoms, and treatment of this condition can help patients to seek timely diagnosis and treatment. In the subsequent sections, we will provide more details about this condition and how to address it.

The Causes

Diastasis Recti is a common condition that affects millions of people worldwide. It happens when the rectus abdominis muscles that run down the middle of the abdomen separate, creating a gap. The gap can cause discomfort or pain and is most noticeable when you sit up or strain your abdomen. Understanding the causes of Diastasis Recti is essential in developing a suitable treatment plan.

Risk Factors, including Pregnancy and Obesity

The abdominal muscles have to expand during pregnancy, which can cause them to separate. The growing uterus and the increased hormones can lead to abdominal wall laxity, making it prone to Diastasis Recti. Obesity also increases the risk of developing Diastasis Recti, as the extra layers of fat around the midsection can weaken the muscle structure.

Hormonal Changes

Hormonal changes can also lead to the development of Diastasis Recti. The hormone relaxin can cause the muscles to stretch and loosen, which, combined with the pressure of a growing uterus, can worsen Diastasis Recti during pregnancy.

Activities that can lead to Diastasis Recti

Certain activities can put excess pressure on the abdominal muscles, leading to muscle separation. Activities that require intense pushing or lifting, such as weightlifting or heavy lifting, increase the risk of developing Diastasis Recti. Abdominal exercises, like crunches, can also increase the pressure on the muscles, leading to separation.

How to prevent it

Maintaining a healthy weight, exercising regularly, and adopting appropriate exercise techniques during pregnancy are some of the ways to prevent Diastasis Recti. Avoiding certain activities that put a strain on the abdominal muscles, such as heavy lifting or crunches, can also decrease the risk of developing Diastasis Recti. It is crucial to seek guidance from a healthcare professional or specialist with expertise in Diastasis Recti to develop an effective prevention plan.

Understanding the Symptoms of Diastasis Recti

Diastasis Recti occurs when the abdominal muscles separate, which can cause a visible bulge or protrusion in the abdomen. However, visible bulging is not always present, and many people with Diastasis Recti have no visible symptoms. Other common symptoms include:

  • Lower back pain
  • Weakened pelvic muscles
  • Posture issues
  • Bloating or constipation
  • Discomfort during physical activities such as lifting heavy objects, coughing, or sneezing

In addition to these symptoms, Diastasis Recti can also lead to abdominal pain and discomfort. This is because the separation of the abdominal muscles can cause a strain on surrounding muscles, such as those in the back. It can also affect the way that the pelvis functions, leading to discomfort.

Diagnosis of Diastasis Recti is straightforward and can be done by a specialist in this area. A physical examination will enable your doctor to detect any separation in the abdominal muscles. In some cases, imaging tests such as an ultrasound or MRI may be ordered to identify the separation more clearly. Early diagnosis of Diastasis Recti is essential, as it allows for treatment to start early, reducing the risk of further complications and discomfort.

Understanding Treatment

After diagnosis, there are several treatments a person with Diastasis Recti can pursue. Depending on the severity of the condition, a healthcare professional can recommend a course of treatment. It is crucial to consult a specialist for accurate diagnosis and treatment.

Non-surgical treatment options exist for people with mild cases of Diastasis Recti. These include posture and body mechanics correction, as well as physical therapy. Additionally, wearing an abdominal binder, a type of compression garment that wraps around the midsection, can improve structural support and help close the separation.

Exercises that strengthen the muscles of the abdominal wall can also be incredibly useful in the management of Diastasis Recti. For instance, several physical therapy exercises, including pelvic tilts, bridges, and core compressions, can help strengthen the core muscles.

There are specific exercises that a person can do to treat Diastasis Recti. One example is the "Hoover Technique," named after Australian physiotherapist Julie Tupler. This exercise involves lying on one's back with knees bent and feet flat on the ground and imagining pulling the belly button towards the spine.

It is essential to consult professionals to determine which exercises may be most effective. Fitness trainers, physical therapists, and other healthcare professionals specializing in Diastasis Recti can help to develop an individualized exercise plan for optimal results.

In severe cases of Diastasis Recti, surgery may be necessary. Surgery may be considered when a person experiences discomfort, has difficulty performing daily tasks, or is concerned about the appearance of their abdomen.

It is crucial to note that not all surgery is the same, and recovery time can vary depending on the procedure. Additionally, there are potential risks and side effects associated with surgical treatment, making it essential to consult with a qualified healthcare professional for guidance.

When to consider Surgery

Sometimes non-surgical treatments aren't enough, and surgery may be necessary to correct diastasis recti. If your abdominal muscle separation is severe, surgery may be the only option. Let's discuss the need for surgery and its risks and benefits.

The Need for Surgery

Surgery for diastasis recti is usually recommended for those with a significant hernia and large separation between the abdominal muscles that have not improved with exercise and physical therapy. A surgeon may perform a surgery called "abdominoplasty" or "tummy tuck." This procedure involves joining the muscles by sewing them together, strengthening the abdominal wall, and removing any excess skin and fat in the surrounding areas. However, surgery should be considered only after trying non-surgical treatment options.

Risks and Side Effects

As with any surgery, there are potential risks and side effects associated with treating diastasis recti. Complications associated with surgery include infection, excessive bleeding, adverse reactions to anesthesia, and blood clots. There may also be delayed healing of the incision, scarring, or nerve damage. Therefore, it's important to discuss the risks versus benefits with your doctor carefully.

Examples of Patients who underwent Surgery

Many individuals with diastasis recti have successfully undergone surgery and managed to regain muscle function and toned abdominal muscles. For example, Mary, a 44-year-old mother of three, was diagnosed with diastasis recti after enduring back pain and discomfort for years. Though she tried corrective exercises, it was not successful and opted for surgery. After the procedure, Mary's symptoms significantly improved, and she felt more confident in her appearance.

Benefits of Surgery

Though surgery is not always an individual's first choice, it can bring significant benefits for diastasis recti sufferers, including improved abdominal strength, reduced back pain, and improved quality of life. It can also improve an individual's appearance and confidence.

In conclusion, surgery for diastasis recti should be considered only after non-surgical approaches have failed. As with any other surgical procedures, there are potential risks and side effects that can be discussed with a surgeon. However, successful results have been achieved, and those suffering from diastasis recti may find relief from the benefits of surgery.


In summary, Diastasis Recti is a condition where the abdominal muscles separate, leading to a visible bulge in the stomach. While it is common in pregnant women, it can happen to anyone. There are several causes of Diastasis Recti, including hormonal changes, carrying multiple pregnancies, and obesity. Symptoms of Diastasis Recti can include lower back pain, difficulty in standing up, and a visible bulge in the stomach.

Early diagnosis and treatment are key to managing Diastasis Recti. Non-surgical treatments like exercise and physiotherapy can prove to be effective in some cases. However, some individuals may require surgery if the condition does not improve. It is essential to consult a specialist or a doctor to rule out any underlying medical issues.

Remember, a prompt diagnosis can enhance the prognosis of the treatment. If assisted earlier, it improves the chances of the muscles recovering entirely. A physiotherapist specializing in treating Diastasis Recti could aid in the treatment plan. Only experienced physicians can guide you through surgery-related decisions, as it is an extreme measure in exceptional cases only.

Frequently Asked Questions

1. What is Diastasis Recti?

Diastasis Recti is a medical condition where the right and left rectus abdominis muscles separate due to increased tension on the connective tissue.

2. What causes Diastasis Recti?

Diastasis Recti is caused by factors such as pregnancy, obesity, hormonal changes, and activities that put pressure on the core muscles.

3. What are the symptoms of Diastasis Recti?

The symptoms of Diastasis Recti include a protruding belly, abdominal pain and discomfort, and weakened core muscles that can affect posture and movement.

4. Can Diastasis Recti be treated without surgery?

Non-surgical treatment options include exercises that strengthen the core muscles, physical therapy, and the use of support garments to reduce pressure on the affected area.

5. When should surgery be considered for Diastasis Recti?

Surgery is recommended when non-surgical treatment options have failed to produce significant results or when the abdominal separation is severe and causing significant discomfort or health problems.

William H. McDaniel, MD

Dr. Robert H. Shmerling is the former clinical chief of the division of rheumatology at Beth Israel Deaconess Medical Center (BIDMC), and is a current member of the corresponding faculty in medicine at Harvard Medical School.

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