Post-pregnancy pouch! Are the exercises you are doing helping or hurting you?

Congratulations! You have given birth to a beautiful healthy baby and are now on the way to recovery. You get the ok from your doctor to start an exercise routine. You eat right, exercise regularly and the pounds start coming off. However, you look in the mirror 4-6months postpartum and you still have a little protruding belly like you did at 4 months pregnant! You think, what the heck is going on here? I work out and strength train, train my abdominals and still I do not have a 'flat' tummy (or close to what you might call flat). Truth is, some of the exercises you are doing, may actually be hurting you, rather then helping you. To understand this, you first have to understand the problem. YEARS ago when I started out as a personal trainer, I used to train postpartum clients quite a bit. After months of strength and interval training, I would get them down to their pre-pregnancy weight. They felt great, fit into their prebaby clothes, but there was one problem. Somehow they still had the dreaded little pouch in their midsection. I couldn't understand it. I knew how to test for an abdominal separation, but didn't really know the protocal for training a client who has that separation. After several courses and seminars, but MOST importantly for me, giving birth myself, I figured it out. There is a separation of the rectus abdominis that occurs during pregnancy. This can create numerous problems if untreated, and is also the cause of that post-pregnancy pouch. This separation of the abdominal wall (rectus abdominis), is commonly known as diastasis recti.
  1. WHAT IS DIASTASIS RECTI? When you are pregnant (especially after your 1st pregnancy, or with multiples), with your growing abdomen, it's inevitable that you will put continuous pressure on the connective tissue that joins your rectus abdominis. This tissue, or linea alba, can thin out, causing a 'gap' between your rectus abdominis (or 6 pack). With the muscles separated, the tissue then becomes the support system for your internal organs instead of the strong thick muscles of your rectus. This tissue now has to support not only your organs, but your back as well. Think about it like having a buckled belt on. Then you unbuckle the belt. Now everything that was secure and held in place by that belt, is now loose and unsupported.
  2. WHO CAN GET DIASTASIS RECTI? Truth is, anyone can get it. It's common with woman during pregnancy, but truth is children and men and women of any age can get it, or have it and not even know it. You are actually born with it, but the gap closes in the early years of childhood. Your belly button is a weak spot of the connective tissue (hence the 'outie' that can appear during pregnancy). Continuous force, pressure or stretching of this area, can cause the separation.  Certain sports can make it worse or even cause a diastasis (i.e. tennis, swimming and golf), but even exercises like crunches, full sit ups, oblique crunches, and Pilates 100 can aggravate it even more.
  3. HOW DO I KNOW IF I HAVE IT? First sign is usually a bulging belly. This was also the first sign I knew I had it! Abit, not too wide, my diastasis was right around my navel. How do you know that you have this and not just flab around your belly (since they are two completely different things). First, lie down, knees bent. There are 3 places you need to check, and you do this with your fingers. Right around your navel, and about 3 inches above and 3 inches below. Now with picking up your head only (not your shoulders), press your fingers down the midline of your body. The small gully you will feel after birth is a diastasis. The more fingers you fit in this gully, the worse it is. It may be more narrower in some places and wider in others. For me, I had it right around my belly button and not too much up my rectus abdominis. Also, how far your fingers may go down in that gully will determine the condition of the connective tissue. If you still are not sure if you have it, ask your doctor to check you on your next visit.
  4. HOW CAN I WORK ON REPAIRING THIS SEPARATION BEFORE MORE DAMAGE IS DONE? One of the most important muscles of your core/abdominals, and one that the focus should be placed on in diastasis recovery is the transverse abdominis. This is the deepest muscle in your core, and one that attaches itself to your linea alba and rectus in front and pelvis in the back. It acts like a corset, so engaging and activating this muscle will help to make a  diastasis smaller, not to mention help with back pain among other conditions. When your trainer says, "Ok now engage your abdominals!", this is also the muscle they are speaking of. To feel this engage, place your hand on your belly and expand it by taking a deep breath in. Now breathe out. Those muscles you feel going in and out are your transverse. You should focus on 'engaging' these in all your activities no matter what you are doing. The great HIIT workouts on, going for a run, sitting in a chair, standing up, picking up groceries, picking you anything really, pushing, pulling etc etc. When I first realized I had it, I did a lot more research on repairing it, and found Julie Tupler online and began her diastasis recovery program. It was working great, and then I became pregnant with my third and current pregnancy!! I am still doing the rehab however, to not make it worse. You can start recovery at any point as well. Whether you have had it for years, gave birth 20 years ago, or just gave birth 5 days ago.
  If you read this and realize you may have it, it's NOT the end of the world by any means! The great thing is that now you can begin the process of repairing the connective tissue and closing that gap of the diastasis. You can STILL have great abs with a diastasis as well. Before I knew a diastasis was my problem and my regular exercise routine wasn't cutting it, I still was able to get my diastasis down to about a 1 finger separation without incorporating the Tupler technique (see attached photos). However, where I really had the larger separation and a belly bulge at my navel, is where I needed to focus. This is where the recovery process came in handy, and my waist actually started to get smaller, closing that gap at my navel. If you have a diastasis after birth, first focus on losing the baby weight by eating right, exercising regularly and remembering to 'engage' those abdominals! If after that, you do the recovery and still have a lot of back pain, protruding/tender areas of your abdominals, it may be time to see a health care professional to make sure you don't have anything more serious like a hernia, which may require medical attention. Many think that they automatically have to have surgery to repair the diastasis and this is not the case. First work on repairing and strengthening the connective tissue. It's all about persistence and patience and getting blood flow to that area to work on closing that gap and strengthening your core. Work your abdominals correctly by always engaging your transverse, and avoiding certain exercises if you DO have a diastasis, and you will see a difference!

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