Postpartum Belly Bulge? Why you need to stop doing crunches

Written by Anne Martens, Owner of Bella Bellies; bellabellies.com 

Do you find yourself asking the question: " I am no longer pregnant, but why the tummy bulge?". It's embarrassing and we all want full bragging-rights when graduating from elastic, waistband pants.

As it turns out, there may be a physiologic basis for this belly "bulge" called diastasis recti. Healing a diastasis recti has nothing to do with crunches. In fact, crunches -or any exercise including forward flexion of the spine while lying down- can make your abdominal muscles MORE saggy. 

  

What is diastasis rectus abdominus?

The rectus abdominus muscle is two "bands" of muscles fibers. Both bands / halves of the rectus abdominus insert into the ribcage and stretch vertically down to the pubic and hip bones. In between these halves is connective tissue, referred to as the linea alba.

Before a diastasis recti (on the left), after a diastasis recti (on the right)

During pregnancy the growing uterus and shift in hormones softens and stretches the rectus abdominus. This causes the rectus abdominus to "unzip" or pull apart. This separation allows your growing uterus to move forward. A slight separation of 1-2 centimeters is normal. However a separation greater than 3 centimeters (depending on the individuals frame) may contribute to the postpartum belly bulge. This postpartum bump, is commonly called a diastasis rectus, and it is the protrusion of the internal belly underneath the muscles protruding  through.

How does a diastasis recti effect my abdominal strength and tone?

Healing a diastasis rectus abdominus will improve the appearance of your abdominal wall, as well as, improve posture, increase back strength and so much more.

How do I heal a diastasis?

 A healthy lifestyle is key. Meaning a balanced diet, cardiovascular activity, resistance training and PROPER core strengthening exercises.

--Eat a healthy, balanced diet, free of unhealthy foods. Excess food is stored all over the body, especially the abdomen region. This excess fat/weight puts forward pressure on your stretched and weakened abdominal muscles, stretching them even further apart.

--Cardiovascular activity

 --Resistance training. The stronger your muscles are the more calories you will burn in a given day. Sometimes up to an additional 300 calories a day. Energy required for cardiovascular activity (or any activity) is stored as fats, glycogen and protein. Hence the common statement, "cardiovascular activity burns" . "Burning" fat reduces your overall circumference measurements, including the abdomen region. The burning of excess fat will help reduce pressure against the stretched rectus abdominus.

 --Proper core strengthening exercises. If you have a diastasis recti, the abdominal muscles (particularly the rectus abdominus) must heal. Exercises (such as a crunch) involving forward flexion of the spine in a supine (lying down) position, un-supported plank, un-supported all-fours exercise and jack knifing of the legs will aggravate the weakened abdomen muscular region. It is imperative to avoid these types of exercise until your diastasis recti heals. To heal a diastasis practice isometric abdominal exercises such as plank over an exercise ball, pelvic tilt and bridge from pilates/yoga.

Once you have your health care providers approval to exercise check out this video, highlighting postpartum exercise routines that will strengthen your core. These exercises are safe to practice with or without a diastasis recti. I composed this video at home to highlight some of my favorite Bella Bellies exercises for postpartum  http://www.youtube.com/watch?v=KIb7ydkzhpo

Or purchase the Bella Bellies, downloadable Book with a variety of key exercises designed for women at any age or stage of life who have had babies. Email, info@bellabellies.com for more information.

Also, here is a blog I put together on how to check for a diastasis rectus. http://bellabellies.blogspot.com/2013/07/checking-for-diastasis-recti-are-you.html

Postpartum; Get Your Belly Back!

Introduction:
At 4 months postpartum, I celebrated fitting into my size two jeans by throwing out my "belly belt" and donating my size fours. For years I have been exclusively personal-training pre/postnatal women, and doing so, I have witnessed women attain their goal of fitness. But personally experiencing (for the second time) the results from proper, postnatal core-conditioning, re-confirmed the fact that postnatal women are able to say "good-bye" to the "jelly belly" (and all the back pain associated with it), and "hello" to a "bella belly." Believe me if I can do it, you can too. At birth, my first baby weighed an amazing, 10+ pounds. You can imagine how, after delivering my second-equally-large baby, my belly looked 3/4 months pregnant. However, by balancing free weight exercise, cardiovascular exercise and (most importantly) PROPER core conditioning, I was spared cosmetic surgery and confidentially wear a bathing suit.

It may feel overwhelming at first. But you have to begin somewhere, and the first step, is to check for a diastasis recti...

Why the belly bulge?
As it turn out, there is a physiologic basis for this bulge. One reason why you may have a pooch after delivery could be related to diastasis recti.

What is diastasis recti?
The rectus abdominus muscle is two "bands" of muscle fibers. Both halves of the rectus abdomnus insert into the ribcage and stretch vertically down to the hip bones and pubic bones. In between these halves is a connective tissue referred to as the linea alba. During pregnancy the growing uterus and shift in hormones softens and stretches the rectus abdominus. This causes the rectus abdominus to "unzip" or pull apart. This stretching of the abdominus allows your growing uterus to move forward, thereby relieving pressure off the spine and lower back. The problem is overstretching and separation of the rectus abdominus, termed diastasis recti. Prenatal, diastasis recti may be prevented by proper core conditioning, and postpartum may be healed with proper core conditioning.

How does a diastasis rectus effect my abdominal strength and tone? A diastasis recti will create a distension of the abdominal wall, and if not addressed properly, a potential hernia. Healing a diastasis will improve the appearance of your abdominal wall, as well as improve posture.

How do I heal a diastasis recti?
A healthy lifestyle is key. -Meaning a lifestyle which includes a healthy diet, cardiovascular activity, resistance training and proper core conditioning exercises.

Will crunches resolve my belly bulge?
No, resolving your postpartum belly bulge has nothing to do with crunches. In fact crunches, or any exercise with unsupported forward-flexion, may make your abdominal muscles even more saggy.

How do I check for a diastasis recti?
-Lie on your back with knees bent, feet flat on the floor and legs touching.
-Place all four of your fingers over your navel/belly button, with the palm of the hand facing your head and the finger tips touching.
-Lift the head and tips of the shoulders directly up toward the ceiling and slightly off the floor. You should be looking directly up toward the ceiling and NOT at your breasts.
-Touch the fingers against the navel, apply firm pressure down toward the spine. Gently glide your fingers from side-to-side (laterally). If you notice ridges on opposite sides of each other (with a gap in-between) than this is a diastasis. Note how far apart the diastasis is in finger length, for instance 2 fingers apart, 3 fingers apart, 4...
- With your fingers, continue pressing directly down toward the spine. Note how far you can press without feeling some resistance from the underlying musculature. Eventually you should feel the musculature underneath the recti, tightening and preventing you from further pressing down.
-While pressing down, if you notice any lumps which protrude forward, consult your Health Care Provider immediately.
-Repeat this exercise by bringing your chin to your chest and shifting your gaze to your abdomen.

As you practice your modified, postnatal core-routine, continue to check your diastasis recti separation over your navel. As your core strength improves, your diastasis recti should reduce itself in finger-tip-length (for example: reducing itself from a measured 4 finger separation to a measured 1 finger separation). Also as your core strength improves, your toned abdominal muscles should become more able to resist pressure from your finger tips when pressing directly down toward the spine.

What do I do if I have a diastasis recti larger than 2 fingers and/or I feel no musculature resistance when pressing down to the spine?
It is not so much what you do, but what you do-not-do that is important. The muscle has stretched to a different position and therefore functions/works differently. When lifting the shoulder blades off the floor and coming into forward flexion (like a crunch), the muscles will pull away from the mid-line of the body and further separate. This crunch-like action will widen your diastasis recti, thereby creating a wider belly bulge and make you more vulnerable to a hernia. With this in mind, avoid crunches and any forward flexion movement that lifts the shoulders off the floor, without proper support such as: manual traction of the hands, splinting and other important methods reviewed in Bella Bellies Classes. Also, avoid "jack-knifing" of the legs and forward flexion with "criss-cross" action, this too will further widen your diastasis and make for a larger belly bulge.

If you are in Hoboken, and would like to set-up an appointment for diastasis checking and/or a Bella Bellies "Get Your Belly Back" private appointment, contact: info@bellabellies.com