Rectus diastasis

Abnormal distance separating the two rectus muscles

• Sometimes defined as >2cm
• No transversus fascial defect - not a hernia

Risk factors

• Weak connective tissue
• Increased intra-abdominal pressure (pregnancy, obesity)
• Prior abdominal surgery

Management

• Young women, small, fit, who have carried a large fetus or twins to term
  • Initially: postpartum abdominal wall strengthening exercises
  • If conservative measures fail, consider abdominoplasty +/- rectus plication
• Middle-aged and older men
  • Weight loss, exercise, abdominal wall strengthening
  • Consider abdominoplasty +/- rectus plication