What is rectus diastasis and how do you know if you have it?
In this blog, Professor Ahmed Ahmed, Consultant GI and Bariatric Surgeon, explains what rectus diastasis is, the symptoms to look out for and the treatment options available.
Pregnancy, significant weight changes, and abdominal surgery can affect the muscles of the abdominal wall. For some people, these changes result in a condition known as rectus diastasis, or diastasis recti.
While rectus diastasis is not usually dangerous, it can affect core strength, posture and body confidence, and in some cases contribute to discomfort and functional difficulties.
In this blog, Professor Ahmed Ahmed, Consultant GI and Bariatric Surgeon, explains what rectus diastasis is, the symptoms to look out for and the treatment options available.
What is rectus diastasis?
Rectus diastasis occurs when the two vertical muscles that run down the front of the abdomen, known as the rectus abdominis muscles, separate and move further apart than normal. The rectus abdominis muscles when well-developed give rise to the “6 pack” appearance.
These muscles are connected by a cord of fibrous tissue called the linea alba. When excessive pressure is placed on the abdominal wall, this tissue can stretch, causing the muscles to separate.
This separation can leave a visible bulge or gap down the middle of the abdomen, particularly when straining, sitting up or exercising.
What causes rectus diastasis?
The most common cause of rectus diastasis is pregnancy.
As the baby grows, the abdominal wall naturally stretches to accommodate the uterus. This places increased pressure on the connective tissue between the abdominal muscles, which can lead to separation.
Other factors that may contribute include:
- Multiple pregnancies
- Carrying twins or larger babies
- Significant weight gain
- Rapid weight loss
- Previous abdominal surgery
- Repetitive heavy lifting
- Age-related weakening of connective tissues
- Obesity
Although rectus diastasis is commonly associated with pregnancy, it can also occur in men and in women who have never been pregnant.
What are the symptoms of rectus diastasis?
People with rectus diastasis may experience:
- A visible bulge or ridge running down the centre of the abdomen
- A persistently protruding stomach despite exercise and weight loss
- A feeling of weakness in the abdominal muscles
- Poor core strength
- Back pain
- Poor posture
- Pelvic instability
- Difficulty performing certain exercises or physical activities
Some people have very few symptoms, while others find the condition affects both function and confidence.
How do you know if you have rectus diastasis?
Many people first notice rectus diastasis when they observe a bulge or "doming" appearance in the middle of their abdomen when sitting up from a lying position.
A simple self-check can sometimes help identify a separation:
- Lie flat on your back with your knees bent.
- Gently raise your head and shoulders from the floor.
- Place your fingers along the centre line of your abdomen.
- You may feel a gap between the abdominal muscles.
However, self-assessment cannot determine the full extent of the separation or whether other conditions are present.
If you have ongoing concerns, a specialist assessment can provide a more accurate diagnosis.
Is rectus diastasis the same as a hernia?
Although the two conditions can sometimes appear similar, rectus diastasis is different from a hernia.
A hernia occurs when tissue or part of an organ pushes through a tear or opening in the abdominal wall.
With rectus diastasis, the abdominal wall remains intact, but the connective tissue between the muscles has stretched.
Some patients may have both a hernia and rectus diastasis at the same time, which is why a specialist assessment can be important.
Can rectus diastasis heal naturally?
In some cases, particularly following pregnancy, mild rectus diastasis can improve over time as the body recovers.
Targeted physiotherapy and exercises designed to strengthen the core may also help improve symptoms and abdominal function.
However, significant muscle separation is less likely to resolve completely without intervention.
If symptoms persist, or the separation remains noticeable months or years after pregnancy, specialist treatment may be considered.
Physiotherapy and rehabilitation
Many patients benefit from specialist physiotherapy focused on:
- Core strengthening
- Improving abdominal function
- Postural correction
- Reducing back pain
Exercises should be guided by an experienced healthcare professional, as some movements may worsen symptoms.
Surgical repair
For patients with significant separation, ongoing symptoms or concerns about abdominal function and appearance, surgery may be an option.
Rectus diastasis surgery involves repairing the separation between the abdominal muscles and restoring the abdominal wall to a more natural position.
Depending on the individual patient, this may be performed using minimally invasive / keyhole surgery techniques or as part of a more comprehensive abdominal wall reconstruction procedure.
A specialist consultation can help determine the most appropriate treatment approach.
When should you seek specialist advice?
You may wish to seek medical advice if:
- You have a visible abdominal bulge that does not improve
- You experience weakness or reduced core strength
- You have ongoing back pain that may be related to abdominal weakness
- Exercise has not improved your symptoms
- You are concerned about the appearance of your abdomen following pregnancy or weight loss
- You think you may also have a hernia
A specialist assessment can help establish the cause of your symptoms and discuss the most appropriate treatment options.
Expert rectus diastasis treatment at Cromwell Hospital
At Cromwell Hospital, our specialist consultants provide expert assessment and treatment for rectus diastasis and related conditions, including hernias.
Patients benefit from personalised care, advanced diagnostic assessment and access to the latest surgical techniques, helping restore abdominal function, strength and confidence.
If you think you may have rectus diastasis, seeking specialist advice can help you understand your options and find the treatment that is right for you.
About the author
Professor Ahmed Ahmed is a Consultant GI and Bariatric Surgeon at Cromwell Hospital and an Associate Professor of Surgery at Imperial College London. He specialises in upper gastrointestinal conditions, including acid reflux, hiatus hernia and weight-related disorders, with particular expertise in laparoscopic (keyhole) and minimally invasive surgery. Professor Ahmed is a leading authority in bariatric and metabolic surgery and serves as President of the British Obesity and Metabolic Specialist Society (BOMSS). He is committed to delivering personalised, evidence-based care, helping patients achieve the best possible outcomes through both surgical and non-surgical treatments.
