The “DR test” refers to the self-assessment for Diastasis Recti (DR), which is the separation of the rectus abdominis muscles. This assessment is widely performed, particularly by postpartum individuals, to check for a widening gap in the connective tissue of the abdomen. Understanding this simple, at-home evaluation provides a starting point for managing a common physical change that often occurs during pregnancy.
The Condition Being Tested For
Diastasis Recti (DR) is the excessive widening of the gap between the two vertical bands of muscle, the rectus abdominis. These muscles are normally joined by a strip of collagenous tissue called the linea alba. When this midline tissue stretches and thins due to increased pressure, the muscles move apart, creating the separation.
The primary cause of DR is the significant increase in intra-abdominal pressure and hormonal changes during pregnancy. As the uterus expands, it places mechanical stress on the abdominal wall, stretching the linea alba. Other factors, such as a high body mass index, rapid changes in weight, or performing exercises with improper core engagement, can also contribute to the condition.
Symptoms often include a visible bulge or “pooch” in the midsection, which may appear more prominent when contracting the abdominal muscles, known as “doming” or “coning.” This separation can lead to core instability, manifesting as low back pain or hip pain. The compromised integrity of the core is also associated with pelvic floor dysfunction, including urinary incontinence or constipation.
Performing the Self-Assessment Test
The self-assessment test begins with the individual lying flat on their back with their knees bent and feet placed flat on the floor. This position provides a clear surface for palpation. Place the fingers, palm facing toward the feet, directly over the midline of the abdomen.
The test requires a gentle engagement of the upper abdominal muscles to make the edges of the rectus abdominis more palpable. This is achieved by taking a breath in and then, while exhaling, performing a slight head lift, raising the head and shoulders only about an inch off the floor. It is important not to perform a full sit-up, as this can compress the separation and give a false reading.
While the head is slightly lifted, use the fingertips to gently probe the midline of the abdomen—above, at, and below the belly button—to feel for a gap between the muscle bellies. The goal is to determine how many fingertips can fit horizontally into the space. After noting the width, lower the head and repeat the process in the different locations.
Determining the Severity of Separation
The measurement of the separation is described in finger widths, although medical professionals may use calipers or ultrasound for a more precise measurement in centimeters. A separation that allows two or more fingertips to fit comfortably into the gap is accepted as clinically significant Diastasis Recti. This two-finger-width measurement correlates to a distance of about 2.7 centimeters.
Beyond the width, the depth and tension of the linea alba are important indicators of severity. After establishing the width, press down gently to assess the integrity of the connective tissue beneath the fingertips. A shallow, taut gap suggests that the linea alba still has good tension and structural integrity, even if the muscles are separated.
A more severe separation is indicated if the fingers sink deeply into the abdomen, feeling soft or “squishy.” This suggests a compromised and thin connective tissue. This lack of supportive tension is often a more accurate predictor of functional core issues than the width alone. The assessment involves evaluating both the horizontal distance between the muscles and the vertical firmness of the tissue at the midline.
Next Steps After Diagnosis
Discovering a separation of two or more finger widths should prompt a consultation with a healthcare professional, such as a physical therapist specializing in women’s health. Conservative management, guided by a physical therapist, is the most common first-line treatment for Diastasis Recti. This therapy focuses on restoring the function of the deep core muscles, particularly the transverse abdominis, through specialized exercises and core breathing techniques.
Specific movements must be avoided, as they increase intra-abdominal pressure and can worsen the separation by causing the abdomen to dome or bulge outward. Standard abdominal exercises like crunches, sit-ups, and planks should be temporarily eliminated from a routine. Individuals should also practice rolling onto their side before pushing themselves up to a seated position, avoiding the “jackknifing” motion of sitting straight up from a lying position.
If the separation is severe, or if conservative management does not resolve the condition and symptoms like significant back pain or a suspected hernia are present, a physician or surgeon may need to be consulted. Most cases are managed successfully through targeted physical therapy. The goal is to improve the tension and function of the linea alba rather than solely focusing on narrowing the gap.