Diastasis recti: how to check for it, what exercise can do and when surgery is the answer

The most common cause is pregnancy: the growing uterus pushes the abdominal wall forward and hormones soften connective tissue. A degree of separation is normal in late pregnancy and often narrows in the months after birth. It can also be seen after major weight changes, in people with a lot of abdominal fat and occasionally in men.

Typical signs include:

• a stomach that looks pregnant months after birth, especially by the end of the day;
• a ridge or dome along the midline when you sit up or strain;
• a soft, deep feeling above or below the navel;
• lower back discomfort or a feeling of a weak core in some people.

1. Lie on your back with knees bent and feet flat on the floor.
2. Place your fingertips across the midline, just above the navel, pointing towards your feet.
3. Lift your head and shoulders slightly off the floor, as if starting a small crunch.
4. Feel how many fingers fit into the gap between the muscle edges, and how deep your fingers sink.
5. Repeat at the navel and a few centimetres below it.

A gap of about two fingers or more, or a soft area where your fingers sink deeply, is worth showing to a doctor. An ultrasound scan can measure the width precisely and also look for an umbilical hernia, which often accompanies diastasis.

The limits come from anatomy. Training strengthens muscle, but the problem in diastasis is stretched connective tissue between the muscles. Once the linea alba has thinned and lengthened, it does not shrink back on its own. Exercise also does nothing for loose skin, which is often present after pregnancy.

So if you have trained consistently for several months, the gap is still wide and the bulge remains, it is reasonable to ask a surgeon whether repair makes sense.

An umbilical hernia, if present, is usually repaired at the same time. Surgery is done under general anaesthesia. It is not a weight-loss operation, and results are most stable when weight has been steady for several months.

Any scar is red at first and fades over a year or more. It does not vanish, so it is worth discussing its likely length and position with your surgeon before deciding.

If the gap is still wide a year after birth despite good exercise, it is unlikely to close by itself. Whether to treat it is your choice: diastasis is not dangerous in itself, but many people are bothered by the bulge, back discomfort or an associated hernia. If you plan another pregnancy, it is usually better to wait, as pregnancy can stretch the repair again. More about the operation is on our tummy tuck page.

The clinic works with patients from abroad. The first consultation is free and can be held online: send photos of your abdomen from the front and side, an ultrasound report if you have one, and tell us about pregnancies and weight changes. The doctor assesses your case and names the price, which is then fixed in the contract. A personal coordinator stays with you from your first message to the end of recovery, and photos and questions can be sent via Telegram. Read more on our tummy tuck page.