Diastasis recti (DR) is a common condition defined by the separation of the rectus abdominis muscles. This separation occurs at the linea alba, the band of connective tissue that runs down the midline of the abdomen. While a natural widening of this tissue happens during pregnancy, a persistent and excessive separation can affect core stability and function. Determining the extent of this separation informs the most appropriate treatment path, which often involves specialized physical therapy.
Performing the At-Home Self-Check
A simple self-check provides a preliminary screening for diastasis recti. This check involves lying on your back with your knees bent and your feet flat on the floor, which helps to relax the abdominal muscles. Place one hand behind your head for gentle support, and position the fingers of your other hand, palm down, on your midline near your belly button.
Next, take a breath in, and as you slowly exhale, lift your head and shoulders just slightly off the floor, as if beginning a small crunch. This action engages the rectus abdominis muscles, making their edges easier to feel. As you lift, press your fingertips gently but firmly into your abdomen to feel for a gap between the two muscle bellies.
Check for this gap at the belly button, a few finger-widths above it, and a few finger-widths below it. Note how many fingers can fit horizontally into the space between the firm muscle ridges, and also assess the depth or tension of the tissue beneath your fingers. If a wide or deep gap is detected, it suggests a need for clinical confirmation by a healthcare professional.
Methods for Clinical Confirmation
While the self-check is a useful screening tool, clinical confirmation by a trained healthcare professional is necessary for an accurate diagnosis. This professional may be a physical therapist specializing in pelvic health, an obstetrician, or a midwife. The most common method used clinically is manual palpation, where the clinician uses their fingers to measure the width of the inter-recti distance (IRD) along the linea alba. The clinician typically measures the gap at several standard points, including the umbilicus, and a set distance above and below it.
The clinician also assesses the integrity and tension of the linea alba tissue, often described as checking the “depth” of the separation. This depth assessment indicates how well the underlying connective tissue is functioning to stabilize the core. This can be a more significant factor for treatment than the width alone. This manual technique is highly reliable when performed by an experienced practitioner.
For cases where a more precise, objective measurement is required, or when an abdominal hernia is suspected, imaging techniques like ultrasound are used. Ultrasound is considered a gold standard for measuring IRD because it provides a clear, continuous-scale measurement of the separation distance. It is non-invasive and allows for a dynamic assessment, meaning the separation can be measured both at rest and during muscle contraction.
Defining the Degree of Separation
The diagnosis of diastasis recti is confirmed when the measured inter-recti distance (IRD) meets a specific quantitative threshold. Although the exact measurement criteria can vary slightly in medical literature, a separation of 2.7 centimeters (cm) or greater at the level of the umbilicus is widely accepted as the clinical cutoff for DR. This measurement roughly corresponds to a two-finger width gap, which is the common benchmark used in the manual palpation technique.
Measurements are often taken at multiple points, with diagnostic criteria sometimes specified differently for areas above and below the navel. For example, some criteria suggest a separation of 20 millimeters (2.0 cm) at the umbilicus or 14 millimeters (1.4 cm) above it may indicate DR. The measured width of the gap helps classify the severity, with a separation of 3-5 cm often considered moderate, and anything over 5 cm classified as severe.
Beyond the width, the functional assessment of the linea alba’s tension is recognized as an important diagnostic factor. A wide separation with taut, firm underlying tissue may be less functionally significant than a narrower gap with soft, squishy tissue that allows the fingers to sink deep into the abdomen. A confirmed diagnosis based on these measurements typically leads to a referral for specialized physical therapy to address the core muscle function.