Comparing Non-Surgical and a Surgical Treatments for Diastasis Recti.

Diastasis Recti is the separation of the Rectus Abdominis muscles (the "six-pack" muscles) along the midline of the abdomen (DRAM), often due to pregnancy, weight fluctuations, or improper core training. It can lead to a bulging belly, core weakness, back pain, and poor posture.

As a Physiotherapist specialising for over 35 years in this area, and having the privilege of presenting at both International and local Conference on the topic of Diastasis Recti - I am always asked by clients:

“What is the best option for gain my core fitness back, repairing my DRAM and getting my PRE-pregnancy belly again?”

So, I thought I would summarise the Pros and Cons available to you and let you decide:

Non-Surgical Treatments

1. Physiotherapy / Core Exercise and Training

What it involves: Real Time Ultrasound Imagery Assessment (@PhysioMatters) and a guided individual core exercises program -focusing on strengthening the Rectus Abdominus, Transverse Abdominis, Pelvic Floor Muscles and improving posture, breathing and body movement patterns.

Examples:

• Deep core engagement (TVA activation)

  
  

• Diaphragmatic breathing

  
  

• Modified sit ups, modified planks, push ups, squats, pelvic tilts.

Who it's best for: Mild to Moderate Diastasis (gap less than 3 fingers), postpartum individuals, or anyone without significant hernia.

Pros:

•  Non-invasive

  
  

•  Low risk

  
  

•  Effective over time

  
  

•  Improves posture, core strength, flexibility and function

  
  

•  Reduces pain – lower back, knees as YOUR core are stronger

  
  

•  Suited for all ages and stages of life (antenatal, pregnancy and menopausal)

  
  

•  Cost Effective – lifetime approach for fitness and health

  
  

•  Covered by some Insurance Policies

Cons:

•  Requires YOU to be consistent with Physiotherapy and YOUR exercises

  
  

•  Results are slow and progressive (8–12 weeks or longer)

  
  

•  May not fully close severe gaps

  
  

•  Doesn’t remove excess / loose skin

2. Support Garments / Belly Binders

• Offers external EXTRA support to improve posture and reduce symptoms temporarily

  
  

• Reduces pain in YOUR back and pelvis, as your spine and pelvis are supported until YOUR muscles are strong enough to do the role



Not a treatment, more of a management tool

Surgical Treatments

1. Abdominoplasty (Tummy Tuck)

What it involves: Cosmetic and functional procedure that surgically sutures the abdominal wall muscles and removes excess skin/fat. Often combined with liposuction. Sometimes done as part of a “mummy makeover.”

Pros:

• Immediate and permanent repair

  
  

• Cosmetic improvements (flatter tummy, tighter skin)

  
  

• Effective for severe cases (gap more than 3–4 fingers) or with hernia

Cons:

• Invasive with general anaesthesia

  
  

• Long recovery (8 weeks to long term 12 months)

  
  

• Risk of complications (infection, bleeding, scarring)

  
  

• Expensive ($25,000+ and upwards in Singapore, rarely covered by insurance unless hernia, spine conditions and or occasionally when bladder or bowel issues are involved).

2. Laparoscopic or Robotic Repair

A less invasive option to stitch abdominal muscles back together using small incisions (especially for hernia repair).

Less scarring and shorter recovery than open surgery.

Effectiveness Comparison:

Factors	Non-Surgical	Surgical
Effectiveness	Moderate (Mild-Moderate Cases)	High (All Cases)
Time to See Results	Weeks to Months	Immediately (After Recovery)
Risk	Low	Moderate to High
Cost	Low ($0 to $2,000)	High ($25,000+)
Downtime	None to Minimal	8 Weeks to 12 Months
Cosmetic Benefits	Minimal	Significant

Which One Should You Choose?

Try non-surgical first if:

• Your gap is mild to moderate

  
  

• You’re postpartum (6 weeks onwards come into Physiotherapy with us (@PhysioMatters)

  
  

• You don’t have a hernia

  
  

• You want to avoid surgery and its risks

Consider surgery if:

• The gap is large/severe or persistent

  
  

• You have a hernia

  
  

• You’ve completed physiotherapy and developed STRONGER CORE MUSCLES as this will prepare you for a quicker post-surgical recovery

  
  

• You’re seeking a cosmetic improvement too

  
  

• If you have completed your family and are not planning further pregnancies

I hope this helps YOU when deciding on what option is best for you in closing your Diastasis Recti.

Please DM me @physiomatters and come in for an assessment with our team. With knowledge and years of experience - we will guide you on the best fit for you.

We look forward to meeting and assessing you soon.

Danielle Barratt (Senior Physiotherapist @Physiomatters)