Rectus diastasis, also known as diastasis recti, is a separation of the abdominal muscles that can develop due to pregnancy, weight fluctuations, aging, and certain exercises or lifting habits. While it is extremely common, many people live with rectus diastasis for years without realizing the source of their symptoms. Others are mistakenly told it is only a “cosmetic” problem, even though the condition can weaken the core, affect posture, contribute to back pain, and change the shape of the abdomen.
At Lampert MD Plastic Surgery, many patients come to Dr. Joshua Lampert seeking answers about abdominal bulging, difficulty engaging the core, or changes to their midsection after pregnancy or weight loss. Determining whether you have rectus diastasis is the first step in choosing the right treatment.
Below, we break down what rectus diastasis is, what it looks and feels like, how to test for it at home, and when it is time to see a board-certified plastic surgeon.
What Is Rectus Diastasis?
Your abdominal muscles include two long bands called the rectus abdominis, commonly referred to as the “six-pack” muscles. These muscles run vertically from your ribs to your pelvis and are connected in the middle by tissue called the linea alba.
During pregnancy, intense abdominal pressure, weight gain, or improper lifting can stretch and thin the linea alba. When that tissue does not fully return to its original position or strength, the rectus abdominis muscles remain separated—this is rectus diastasis.
Rectus diastasis is not a hernia, though the two conditions are often confused. A hernia involves a defect in the abdominal wall through which tissue or organs can protrude. In rectus diastasis, the connective tissue is stretched but not torn. It does not respond to diet or “tightening up” exercises in the way many people expect.
Common Causes of Rectus Diastasis
While rectus diastasis most frequently occurs after pregnancy, anyone can develop the condition. Contributing factors include:
- Pregnancy, especially multiple pregnancies or those with large babies
- Significant weight gain or rapid weight loss
- Genetic predisposition to weaker connective tissue
- Abdominal obesity
- Incorrect abdominal workouts that increase intra-abdominal pressure
- Repetitive heavy lifting
- Chronic coughing (smoking, respiratory illness)
Understanding the cause may help confirm the diagnosis, but symptoms are usually the clearest signal.
What Does Rectus Diastasis Look and Feel Like?
Patients describe their symptoms in different ways. Some of the most common signs include:
A Persistent Abdominal Bulge
Many people with rectus diastasis notice a domed or cone-shaped bulge along the midline when rising from a lying position, getting up from a chair, or coughing. Some describe their abdomen as still looking “pregnant,” even months or years after childbirth. This bulge often becomes more noticeable during activities that engage the core.
Weakness in the Core
Rectus diastasis affects how the abdominal muscles function together. As a result, patients may feel instability through the torso, struggle to maintain proper posture, or experience difficulty performing exercises that once felt manageable. The core may feel uncoordinated or unable to generate strength effectively.
Lower Back Pain
Because the abdominal muscles play a significant role in supporting and stabilizing the spine, a weakened abdominal wall can shift the workload to the lower back. Over time, this compensation can lead to discomfort, chronic strain, or worsening back pain during daily activities.
Pelvic Floor Symptoms
Some individuals with rectus diastasis also develop pelvic floor issues. These may include stress incontinence, pelvic heaviness, or difficulty engaging the pelvic floor muscles properly. This is because the core and pelvic floor work together; when one weakens, the other is often affected.
Poor Tolerance for Certain Exercises
Movements that require strong abdominal engagement, such as planks, crunches, or sit-ups, may trigger discomfort, visible bulging, or a sensation that the abdomen cannot activate correctly. Many patients report that core-focused exercises feel ineffective or even counterproductive when rectus diastasis is present.
Not everyone experiences all symptoms; some patients discover the separation only through examination.
When Should I See a Plastic Surgeon?
You should consider consulting Lampert MD Plastic Surgery if you experience:
- Persistent abdominal bulging that doesn’t improve with exercise
- Lower back pain that may be linked to core weakness
- Difficulty engaging your core or completing workouts
- Cosmetic concerns after pregnancy or weight changes
- Uncertainty about whether the bulge is a diastasis or a hernia
Dr. Lampert frequently evaluates patients who have already attempted core-strengthening routines, physical therapy, or lifestyle changes without improvement. Rectus diastasis does not usually correct itself once the tissue has been stretched beyond its natural limits.
How is Rectus Diastasis Diagnosed?
During an appointment, Dr. Lampert performs a thorough physical evaluation. In some cases, imaging such as ultrasound or CT scans may be used to check for:
- Width and depth of the separation
- Condition of the linea alba
- Presence of hernias
- Abdominal muscle function
His goal is to determine whether surgical repair is appropriate and what approach would achieve the most natural, functional outcome.
Can Physical Therapy Fix Rectus Diastasis?
Targeted exercises may strengthen the surrounding muscles and improve function, but they cannot restore the stretched connective tissue once it has lost structural integrity. Some people experience mild symptom improvement with physical therapy, while others see little to no change.
If you have a large separation, significant functional concerns, or cosmetic goals, surgery is typically the most effective option.
Surgical Repair: What to Expect
Rectus diastasis repair is often performed as part of a tummy tuck (abdominoplasty), though it can also be completed without a full tummy tuck in select cases. During the procedure, Dr. Lampert tightens the stretched linea alba and brings the separated rectus muscles back to the midline, restoring the natural integrity of the abdominal wall.
When needed, excess skin or tissue is removed to enhance contour and create a more refined silhouette. The repaired abdominal wall is then reinforced to improve strength, stability, and long-term function.
Many patients notice significant improvements after surgery, including better posture, less lower back pain, enhanced core support, and a flatter, smoother abdominal appearance. These functional and cosmetic benefits often lead to greater confidence and comfort in daily activities.
Why Choose Lampert MD Plastic Surgery for Rectus Diastasis Evaluation?
Dr. Joshua Lampert is known for his meticulous attention to detail, advanced surgical training, and patient-centered approach. Because rectus diastasis involves both functional and aesthetic components, choosing a board-certified plastic surgeon with deep experience in abdominal anatomy is essential.
At Lampert MD Plastic Surgery, patients benefit from:
- Accurate diagnosis
- Customized surgical plans
- Artistic contouring to restore natural harmony
- A focus on safety and long-term function
- Modern techniques that minimize recovery time
Dr. Lampert tailors every procedure to the patient’s unique anatomy and goals, ensuring results that look natural and restore confidence.
Seek a Professional Opinion at Lampert MD Plastic Surgery
If you suspect that you may have rectus diastasis, whether due to abdominal changes, core weakness, or persistent bulging, the next step is a professional evaluation. Self-tests can provide helpful clues, but only a trained medical specialist can determine the exact severity and recommend appropriate treatment.
Lampert MD Plastic Surgery offers comprehensive evaluation and advanced surgical repair options to help restore both function and appearance. If you are ready to learn more about your abdominal health, schedule a consultation and take the first step toward renewed confidence and strength.
