Your primary care doctor, OB-GYN, or midwife can diagnose diastasis recti during a standard physical exam. A pelvic floor physical therapist can also assess the condition and is often the specialist you’ll work with most closely for treatment. In more severe cases, a general surgeon or plastic surgeon may evaluate you for surgical repair.
Your First Stop: OB-GYN or Primary Care
For most people, the diagnosis happens during a routine visit. If you’ve recently had a baby, your provider will likely check for diastasis recti at your six-week postpartum appointment. The exam is simple: you lie on your back, lift your head slightly, and the provider feels along the midline of your abdomen for a gap between the two sides of the rectus abdominis muscle. A separation greater than 2 centimeters (roughly two finger widths) at any point along the midline is the standard diagnostic threshold.
Providers typically check at three spots: about 3 centimeters above the belly button, right at the belly button, and about 3 centimeters below it. The gap can vary at each location, and knowing where the separation is widest helps guide treatment. If your provider confirms diastasis recti, they’ll often refer you to a physical therapist or pelvic floor specialist for targeted strengthening.
Pelvic Floor Physical Therapists
A pelvic floor physical therapist provides the most thorough functional assessment of diastasis recti. While a primary care provider confirms whether the gap exists, a physical therapist evaluates how the separation affects your core stability, posture, and daily movement. They measure the gap both at rest and during specific movements like a head lift or modified curl-up, because the distance between the muscles can change depending on what you’re doing. This tells them not just how wide the gap is, but how well your connective tissue can generate tension across it.
Beyond the gap itself, physical therapists assess related issues that commonly travel with diastasis recti. They may evaluate pelvic floor function, low back pain, abdominal muscle endurance, and overall physical function. This broader picture matters because diastasis recti rarely exists in isolation, especially postpartum. Treatment typically involves 4 to 6 months of guided exercises, though some cases take a year or longer to resolve.
When Imaging Is Used
Most diastasis recti cases are diagnosed by touch alone, without any imaging. But clinical assessment by hand can be difficult when someone carries more tissue over the abdomen, making it harder to feel the edges of the muscles. In those situations, or when a precise measurement is needed to plan treatment, ultrasound is the go-to tool.
Ultrasound is noninvasive, repeatable, and considered the best initial imaging option for measuring the distance between the rectus muscles. It has good to excellent reliability when different examiners measure the same person, particularly above the belly button. CT scans and MRI both produce comparable results, with measurements falling within a few millimeters of ultrasound readings. However, CT and MRI both slightly underestimate the actual separation, and they’re generally reserved for patients being evaluated for surgical repair or when a hernia is suspected.
Surgeons for Severe Cases
If physical therapy doesn’t close the gap, or if the separation is very wide (greater than 5 centimeters), you may be referred to a surgeon. Both general surgeons and plastic surgeons repair diastasis recti, but they approach it differently based on your primary concern.
General surgeons tend to focus on the structural repair itself, plicating (stitching together) the separated fascia without additional cosmetic work. Plastic surgeons more commonly combine the repair with an abdominoplasty, addressing both the muscle separation and any excess skin or tissue. For very wide separations, the connective tissue may be too stretched to hold stitches reliably, and a mesh reinforcement placed behind the muscles may be recommended. Patients without excess skin who want a less invasive approach may be candidates for minimally invasive repair techniques.
At some institutions, patients with large separations are first referred to a hernia specialist, who then decides whether a plastic surgeon should also be involved. Your path depends on whether your main concerns are functional (core weakness, back pain, bulging) or aesthetic (appearance of the abdomen), or both.
Can You Check Yourself at Home?
A basic self-check can give you useful preliminary information. Lie on your back with your knees bent, place your fingers horizontally across your midline just above your belly button, and slowly lift your head. If you feel a gap of two or more finger widths, that’s worth bringing up with a provider. One finger width is roughly 1.3 centimeters, so two finger widths puts you near the 2-centimeter diagnostic threshold.
Self-assessment has some support as a screening tool, but it has real limitations. You can feel whether a gap exists, but you can’t accurately measure its depth, assess how well the tissue generates tension, or evaluate related pelvic floor issues. A professional assessment gives you the full picture and, more importantly, a treatment plan tailored to the severity and location of your specific separation.
Timing of Diagnosis
The abdominal muscles naturally separate during pregnancy and often come back together on their own after delivery. This process can take up to a year. That’s why many providers wait until the six-week postpartum visit to do an initial check, and why a diagnosis made in the early weeks after birth doesn’t necessarily mean the separation is permanent.
If you’re years past your last pregnancy and still notice a bulge along your midline or feel core weakness, it’s not too late to get assessed. Diastasis recti can be evaluated and treated at any point, whether it’s been six months or six years since delivery. The condition also occurs in men and in people who have never been pregnant, typically from repeated heavy lifting, significant weight changes, or chronic abdominal pressure. The same providers (primary care, physical therapy, surgery when needed) diagnose and manage it regardless of the cause.