A woman’s body post-pregnancy can be full of surprises – hello to still looking 7 months pregnant when you leave the hospital, leaky boobs, and night sweats – but most of these surprises are the result of our bodies natural healing process as hormone levels shift, organs contract, and our focus shifts from growing a human on the inside to caring for a newborn on the outside.
However, some “surprises” linger longer than others and a diastasis recti is one such surprise. What is it, you ask? In a nutshell, the term refers to the separation of the left and right halves of your abdominal muscles. Normally these two halves are joined via connective tissue but during pregnancy, the growing uterus often weakens this connective tissue, causing your abdominal muscles to shift and the weakening of muscles that play a key role in supporting your back and your organs.
A diastasis can result in cosmetic issues like the dreaded “mummy tummy” and can also lead to back pain, pelvic weakness, and other issues which stem from a weakened core. As such, it’s something many women in New York and beyond are eager to avoid or repair, and when the time comes, Julie Tupler is usually the first person they call.
A registered nurse, certified childbirth educator and certified personal trainer, Tupler is a pioneer in the field of maternal fitness, with a special focus on the prevention and repair of diastasis recti. Her practice takes women through a comprehensive program, either in person or online, that has been proven to significantly help heal their abs.
Below, Tupler tells us more about diastasis recti, how women can care for their bodies during and after pregnancy, and how they can regain their strength in the months following their little one’s arrival.
How did you come to focus on caring for this unique aspect of women's health?
While teaching a prenatal exercise class for pregnant women, I was surprised to learn that most childbirth classes focus on preparing a woman’s mind for labor and skip the very important task of training a woman’s body for labor, too. Labor is just like running a race –- you need to train both your mind and your body!
In 1990 I started Maternal Fitness and began working with women early in their pregnancies to train them for the “race” of labor by focusing on the proper use of their ab and pelvic floor muscles. In the process of working with pregnant women and new moms, I discovered the condition diastasis recti and I could not find anything about how to treat this condition that caused back pain, poor posture, and put women at a higher risk for a C-section. This led me to develop the Tupler Technique® for treating diastasis recti and preparing women for the marathon of labor.
How do you help clients repair a diastasis?
The goal of my work with clients is to heal the weakened connective tissue that joins your outermost abdominal muscles. As the connective tissue becomes stronger and shallower, the muscles gradually come together. A key component of my technique involves the Diastasis Rehab Splint, which is like wearing a cast when you have a broken bone -– you want to keep the connective tissue in your abs in the same position so they will heal. We also work on putting the muscles in a better position while working to strengthen the transverse abdominal muscles that are key to performing every-day movements.
What does a typical rehab/recovery process look like for women who are diagnosed with a diastasis?
Once your doctor gives you the all-clear to return to exercise, you can begin working on treating your diastasis. However, this often takes time. While a smaller diastasis can be closed in 6-8 weeks, a more serious separation may require 6-12 months of work. Know that it’s never too late to begin healing your diastasis!
How do I know if I have a diastasis?
Many women do not know they have a diastasis as abdominal separation is not something OB-GYNs routinely evaluate. If a woman has had a baby, there is a good chance she has a diastasis and that it will get worse with each baby. The symptoms can be seen easily if a woman has severe diastasis –- a protruding belly or belly button or large bulge when you get up from lying on your back –- but can also be more subtle, with obvious signs only appearing in subsequent pregnancies.
Try this easy self-test to see if you have a diastasis and note that you’re checking for the distance between your ab muscles and the condition of the connective tissue that joins them:
1. Lay on your back with your knees bent and your feet on the floor.
2. Put one hand slightly above your belly with your fingertips pointing down to the floor. If you have a protruding belly button or a bulge when you bring your head and shoulders up, you will need to use two hands to check your diastasis.
3. With your abdominal muscles relaxed, gently press your fingertips down while you lift up your head. When the muscles first start to move, evaluate how many fingers fit between the two separated muscles to determine the distance between your ab muscles. Also check how deep your fingers go, which will determine the condition of the connective tissue. The deeper your fingers go, the weaker your connective tissue. If you feel a pulsing when you check, this is also a sign of weak connective tissue.
4. Repeat step 3 two more times, with your fingers three inches above your belly button and three inches below.
5. If you have 2 fingers and the connective tissue is shallow, you likely do not have a diastasis. However, if you have room for 2+ fingers and your fingers go deep into your abdomen or you feel pulsing, you most likely have a diastasis.