The Tenacious Belly Pooch
The Tenacious Belly Pooch
Diastasis Recti Series: Part 2
by Tanya Feke, MD
Do you have a belly pooch that won’t go away? Even after diet and exercise? You could have diastasis recti.
Diastasis recti is a medical condition where the connective tissue between the six-pack rectus abdominus muscle stretches out, thins, and widens. This causes separation of the abdominal muscles and leaves a weak area in the center of your core. Your inner organs may be at risk without strong enough support here and could bulge through the thinned tissue leading to any or all of the following symptoms:
• Abdominal bloating
• Abdominal pain
• Back pain
• Poor posture
• Urinary leakage
Before you panic, diastasis recti is not only fixable in some cases it is also preventable. Your abdominal muscles are not broken. Your connective tissue is weak. You can improve your situation by strengthening the muscles around that connective tissue.
Do You Have Diastasis Recti?
Diastasis recti is common in women who have been pregnant or in anyone who has had rapid weight gain, but it is not the only reason you could have a belly pooch. Obesity could be the problem. Diets too are notorious. Even people who think they eat healthy would be surprised at the amount of added sugar that sneaks in there. Hormonal issues could also be to blame.
Before you take measures to treat diastasis recti, know whether or not that is actually the problem. A healthcare provider can perform an exam to check for a gap. An ultrasound could confirm the diagnosis but this is not always necessary.
There are many videos available on YouTube to help you diagnose diastasis recti at home. I am hesitant to recommend these as many people still get confused about what they feel on these self-exams. It is easy to give yourself false assurances if you perform the test incorrectly. Likewise, you could scare yourself into thinking your diastasis is wider than it actually is. I prefer you have someone more objective check things out for you, if possible.
Learn to Move Correctly and Stop Your Diastasis Recti from Getting Worse
Once you know you have diastasis recti, it is important to prevent things from getting out of control. Putting excess strain over your abdomen could lead to symptoms.
Any movements that increase pressure over the front part of your abdomen or that stretch it out too much could worsen and widen your diastasis recti. Examples of exercises to avoid include:
• Activities on all fours
• Activities bending over backwards, i.e. over a Swiss ball
• Activities where you jack-knife the body
• Downward dog in yoga
• Front planks
• Pilates 100s
This list is not all-inclusive by any means but gives you a sense of some positions that strain this area of our body.
Exercise Safely and Help Heal Your Diastasis Recti
Take a look at the list above. All those exercises you have been taught to strengthen your abs will actually help you to KEEP the belly pooch in place if you have diastasis recti. Oh, the irony.
If the connective tissue between your rectus abdominus remains weak, you will continue to be at risk for symptoms. The trick is to bring your muscles closer together so that the gap between the muscle can close. Not everyone’s gap will close down to a normal 1-2 cm but keeping it as narrow as possible will help you in the long run.
This is done by performing exercises that strengthen the abdominal muscles beneath the rectus abdominus. This transverse abdominus (TVA) muscle is essentially a deep horizontal belt around your tummy. It holds you in place like a girdle. When these muscles are tightened, they can help to squeeze your core closer together and narrow the gap.
Sadly, planks are one of the most effective exercises for the TVA but these are a no-no with diastasis recti. One exercise you can do is referred to as the stomach vacuum.
1. Exhale all the air from your body and suck your abdomen up and in as far as you can.
2. Hold your breath for ten seconds.
3. Breathe in and relax.
4. Repeat ten times.
There are many programs available to guide you to healing your diastasis recti. One online program that worked for me is the MuTu System. The program allows you to progress at your own pace and has a wonderful team to guide you each and every step of the way, including a Facebook support group. However, an online program may not be for everyone.
Some people may need one-on-one supervision to get results. You may consider training with a physical therapist who can make sure you are engaging your muscles properly and maintaining good form throughout a personalized exercise routine. Performing exercises incorrectly could make things worse.
As with any exercise program, you should consult with a doctor before starting. If you have a hernia, certain exercises could put you at risk for complications.
Holding In Your Diastasis Recti
Think of a stress ball. When you squeeze it, the ball gets smaller, tighter, thinner. When you let go of the ball, everything goes back to its original shape. You have made no progress, even if you think it looks better in the short term.
Abdominal binders do not allow you to engage or strengthen your abdominal muscles because the binder is doing all the work. Your diastasis can never improve under those circumstances. In fact, if applied too tightly, binders can even weaken your abdominal muscles.
Your best bet is to strengthen your core, though sometimes exercise alone is not enough to get the job done. It will take time. It will take effort but it can be done. You have to want it.
This is the second in a series of articles to discuss how to recognize, approach, and treat diastasis recti.
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- Bursch SG. Interrater reliability of diastasis recti abdominis measurement. Phys Ther. 1987; 67(7), 1077-9.
- Chiarello CM, Falzone LA, McCaslin KE, Patel MN, and Ulery KR. The effects of an exercise program on diastasis recti abdominis in pregnant women. J Womens Health Phys Ther. 2005; 29 (1), 11–16.