Running down the centre of your abdomen are two long muscles — the rectus abdominis muscles, sometimes called the "six-pack" muscles — which are held together along the midline by a band of connective tissue called the linea alba. Diastasis recti (also known as divarication of the recti) is what happens when those muscles drift apart and the gap between them widens. The result is often a noticeable ridge or soft bulge running down the middle of your tummy — most visible when you sit up from lying, cough, or strain. It is not quite the same as a hernia (there is no hole that bowel can push through), though it can sometimes occur alongside a small umbilical or epigastric hernia.
Diastasis recti is extremely common after pregnancy — some estimates suggest it affects 30–60% of women by the third trimester. For many, it improves naturally in the months after delivery, especially with the right exercises. But for some people it persists and continues to cause problems. It is not only a post-pregnancy condition — it can also affect men, particularly those who have had significant weight changes, and people with a natural looseness in their connective tissue. You are not alone, and it is not your fault.
Many people with diastasis recti feel completely fine and just notice the cosmetic change — a soft ridge or "dome" appearing when they sit up. But others experience real functional problems: lower back pain, a sense of core weakness or instability, difficulty with activities that require core strength, urinary leakage when coughing or straining, and pelvic floor symptoms. If any of these are affecting your daily life, it is worth getting assessed — these symptoms are very real and there is help available.
In most cases, a physical examination is enough to confirm diastasis recti — Mr Nguyen can feel and measure the gap while you do a small "head lift" from lying down. This is straightforward and not uncomfortable. If the picture is not clear, or if there is a suspicion of an associated hernia, an ultrasound or CT scan can give a more detailed look at what is going on.
The first step is almost always physiotherapy — specifically, targeted rehabilitation of your pelvic floor and deep core muscles with a physiotherapist who has experience in abdominal rehabilitation. This kind of focused programme can produce meaningful improvement, particularly for mild to moderate separation. You will be guided on which exercises help and which ones to avoid — in particular, traditional sit-ups and crunches increase intra-abdominal pressure and can actually make the gap worse, so they are usually put on hold initially.
Surgery is considered when your symptoms are significant and have not improved enough after a proper course of physiotherapy, or when there is an associated hernia that needs attention. The operation involves stitching the widened gap in the linea alba back together — restoring a stronger, more stable midline. This can be done through a traditional open incision down the midline, or in suitable cases using a keyhole (laparoscopic or robotic) approach, which tends to have a faster recovery. Mesh is often added to reinforce the repair and reduce the chance of the gap reopening. This is a form of abdominal wall reconstruction, and it is important that it is done by a surgeon experienced in this area.
Recovery depends on how extensive the repair is. Most people stay in hospital for 1–3 days. Returning to a desk job is usually possible within 2–4 weeks. Getting back to full physical activity — including core exercise — takes several months, and post-operative physiotherapy is an important part of the recovery to make the most of the repair. Mr Nguyen will give you clear guidance on what to expect at each stage.
Mr Nguyen always starts with physiotherapy — abdominal wall rehabilitation with an experienced women's health physiotherapist is the right first step, and for many people it makes a real difference without ever needing surgery. Surgery is only considered once a proper course of physiotherapy has been completed and symptoms remain significant. If surgery is right for you, Mr Nguyen will discuss this on an individual basis — explaining what the procedure involves, what to expect during recovery, and what the realistic outcomes are. Where technically appropriate, he prefers a laparoscopic approach, which achieves a precise repair with less disruption and a more comfortable recovery.
Your GP will send a referral and most patients are seen within one to two weeks. At the consultation, Mr Nguyen will examine the abdominal wall, measure the separation, and check for any associated hernia. For almost everyone, the first step is a structured physiotherapy programme with a women's health physiotherapist experienced in abdominal wall rehabilitation — and a great many patients improve enough that no surgery is needed at all.
If symptoms remain significant after a proper course of physiotherapy, or if there is an associated hernia that needs repair, Mr Nguyen will see you again to discuss surgical options in detail. Surgery is planned as a day-case or short-stay procedure, with a clear post-operative physiotherapy plan to make the most of the repair. Follow-up appointments are arranged at each stage so progress can be reviewed properly.
Yes, often — particularly in the first 6–12 months after delivery. Mild to moderate separation frequently improves naturally during this time, especially if supported by targeted physiotherapy. If significant symptoms are still present beyond 12 months, it is less likely to resolve completely without some help, and that is when it is worth seeking a specialist opinion.
Not at all. Many people manage very well with physiotherapy and do not need surgery. Surgery is only considered for those whose symptoms remain significant after completing a proper physiotherapy programme, or those who have an associated hernia that needs repair. The decision is always made together, not pushed on you.
Traditional sit-ups and crunches create a lot of downward pressure inside the abdomen — and that pressure pushes directly on the weakened midline, which can make the gap wider rather than narrower. A physiotherapist experienced in abdominal rehabilitation will teach you safer alternatives that activate the deep core muscles (particularly the transversus abdominis) in a way that supports the midline instead of loading it.
Yes, they can. Although it is most talked about in the context of pregnancy, diastasis recti can affect men too — particularly after significant weight gain followed by weight loss, or in those with naturally looser connective tissue. The assessment and treatment approach is essentially the same.
If you would like to discuss your symptoms or find out whether surgery might help, Mr Ba Nguyen is happy to see you. He consults at his rooms in Heidelberg and operates at Warringal Private Hospital and Epworth Eastern, Box Hill. A GP or specialist referral is needed to make an appointment.