Diastasis recti (DR) is a common condition involving the separation of the large abdominal muscles, most frequently occurring during or after pregnancy. This muscle separation affects a significant number of people who have carried a child, often appearing in the later stages of gestation. While not a hernia, DR can create a noticeable bulge and affect core function. This article provides steps to understand the signs of abdominal separation and perform a self-check.
Defining Diastasis Recti
Diastasis recti is defined by an increased distance between the two parallel bands of muscle known as the rectus abdominis. These muscles, often called the “six-pack” muscles, run vertically from the sternum down to the pubic bone. They are normally connected by the linea alba, a dense band of connective tissue.
The separation occurs because the growing uterus exerts continuous outward pressure on the abdominal wall during pregnancy. Hormones like relaxin also cause the linea alba to soften and stretch to accommodate the expanding abdomen. This thinning allows the muscles to move apart. The separation becomes a concern when the linea alba loses tension and fails to return to its pre-pregnancy state post-delivery.
Visual and Physical Clues
One of the most obvious signs of DR is a persistent abdominal bulge or “pooch” that remains long after childbirth. This bulge is often most noticeable just above or below the belly button. Unlike general weight gain, this appearance is caused by internal organs pushing against the weakened midline tissue.
A characteristic visual cue is doming or coning of the abdomen when core muscles are engaged. This ridge running down the midline appears when performing actions like sitting up from a lying position, coughing, or straining. Physically, many people report generalized weakness or instability through their midsection. This lack of support can contribute to secondary symptoms, including low back, hip, or pelvic pain due to compromised core stability.
Performing the Self-Check Test
The self-check test assesses the width and depth of the gap along the linea alba. To begin, lie flat on your back with your knees bent and your feet flat on the floor to relax the abdominal muscles. Place one hand behind your head for support. Use the index and middle fingers of your opposite hand to gently press down on your abdomen.
Position your fingers perpendicular to the midline, pointing toward your pelvis, starting just above your belly button. Slowly lift your head and shoulders a short distance off the floor, as if beginning a small crunch, ensuring your neck remains relaxed. This slight lift causes the edges of the rectus abdominis muscles to contract. As the muscles tense, gently feel for the gap between the muscle edges.
You must assess the separation in three distinct locations along the midline: above, at, and below the belly button. Repeat the process at the level of the belly button and then again about two inches below it. Note how many fingers fit horizontally into the gap at each point, and pay attention to the depth of the space. Ideally, the tissue underneath your fingers should feel firm and taut when the muscles are contracted.
Interpreting Results and Seeking Professional Guidance
The self-check provides a strong preliminary indication, but it is not a formal diagnosis. If you can fit two or more fingers comfortably into the gap when the muscles are contracted, it suggests the presence of diastasis recti. A separation of 2 to 2.7 centimeters, roughly equivalent to two finger-widths, is the clinical benchmark used to diagnose the condition.
It is important to consider both the width and the depth of the separation, as a shallow gap may be less symptomatic than a deep one. If your self-assessment indicates a separation of two fingers or more, or if you are experiencing associated symptoms like back pain or core weakness, consulting a professional is the next step. A women’s health physical therapist is trained to provide an accurate assessment and create a personalized rehabilitation plan. They can confirm the diagnosis, rule out other abdominal wall issues like a hernia, and teach safe core exercises to restore function and tension to the linea alba.