What it is
The two strap muscles at the front of the abdomen, the rectus muscles, are joined down the middle by a band of tissue called the linea alba. In pregnancy this band stretches to make room. In many women it narrows again after the birth; in some it stays wide. The European Hernia Society defines a rectus diastasis as a widening of the linea alba of more than 2 centimetres, and suggests measuring it by ultrasound or with callipers about 3 centimetres above the navel.1
A diastasis is not a hernia: there is no hole, and nothing can become trapped in it. But the two often occur together, particularly at the navel, and that changes the treatment.
What it can cause
For some women a diastasis is purely a matter of appearance. Others describe a feeling that the core is weak or unsupported. The guideline group found that body image and a sense of core instability appear to be the symptoms that matter most to women. Back pain and pelvic floor problems are sometimes attributed to diastasis, but the evidence linking them is not strong.1
Physiotherapy first
The European Hernia Society guideline states that no specific non-operative treatment for diastasis can be recommended on present evidence, but that physiotherapy may be considered before surgery.1 In my practice, a period of supervised exercise with a physiotherapist experienced in the postnatal abdomen is usually the first step. It costs little, carries little risk, and for many women is enough.
When surgery has a place
For women with persisting symptoms, the guideline suggests that, where there is no hernia, the diastasis can be repaired by stitching the stretched linea alba together (plication), and that the choice of technique should be a shared decision between the woman and her surgeon. Where there is also a midline hernia, a repair that uses mesh is suggested.1 These recommendations are graded as weak, which means the evidence behind them is limited. I will tell you plainly what an operation can and cannot be expected to change.
Repair can be done through a keyhole or minimally invasive approach, or as part of an abdominoplasty when there is also a large amount of loose skin. The diastasis page on my practice site covers the operations and their risks in more detail.
If you plan another pregnancy
As with hernias, a future pregnancy can stretch a repair. If you are planning more children, it is usually sensible to wait until your family is complete before considering surgery for diastasis alone.
Sources
- Hernández-Granados P, Henriksen NA, Berrevoet F, Cuccurullo D, López-Cano M, Nienhuijs S, Ross D, Montgomery A. European Hernia Society guidelines on management of rectus diastasis. Br J Surg. 2021;108(10):1189–91. doi:10.1093/bjs/znab128. PMID 34595502.
Questions women ask me
Is diastasis the same as a hernia?
No. A diastasis is a stretched, widened band between the rectus muscles, with no hole. A hernia is a defect through which tissue can push. They often occur together, which is why an examination, and sometimes an ultrasound, is worthwhile.
Will exercises close my diastasis?
Exercise and physiotherapy improve symptoms for many women and are a reasonable first step. Current evidence does not show that any particular exercise reliably closes the gap.
Is diastasis repair covered by Medicare?
That depends on the operation, the findings and current Medicare rules, which have specific criteria for some abdominal wall procedures. We discuss eligibility and costs in writing before any surgery.
Seeing me
HERnia is the name I give to the care of women with hernias and abdominal wall problems. Appointments are made through my practice, and consultations are in Balwyn North, Coburg and Williamstown. A referral from your GP is needed for a specialist consultation to attract a Medicare rebate.
Request an appointmentCall (+61) 493 091 911Written and reviewed by Prof. Ramana Balasubramaniam, general surgeon, Melbourne. Last reviewed 31 October 2026. This page is general information, not medical advice, and it cannot replace an examination. If you have a painful, hard lump that will not go back, with vomiting or severe pain, go to your nearest emergency department.