Beautiful After the Belly

Diastasis Recti, Hernias, C-section and Ab Scarring, Belly Button, Pelvic Floor

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November 19, 2010

More Questions you have asked!

 The questions keep pouring in – this one was very interesting so I decided to post it also!
From J.H.
My wife M., aged 41, has severe D.R. She is small. Pre-pregnancy she had a 27 in waist, and was very fit, doing yoga, pilates, and gym work. Nearly three years ago, she gave birth to twins, and was left with an umbilical hernia and a D.R. of 13 cm. She tried doing T.A. exercises under the guidance of a pilates teacher, but with very little success. If anything it has got worse over time.
Everyone has told us that the only thing to fix it is a tummy tuck. The plastic surgeon and GP both have said that this is the most severe case that they have ever seen. But the operation looks horrific, and the recovery time is a real problem. Not to mention the fact that it might not work.
What I would appreciate from you is to answer the following for me:
1.       Can a D.R. of this extent be fixed with the Tupler technique and splint?
2.       Is it possible to repair this type of D.R. solely by using Julie’s video, or does it require a trained practitioner?
3.       If it is possible, how long is this likely to take?
I really would appreciate your advice. We are based n South Africa, so taking one of your classes isn’t really an option.
You guys are certainly far away!  13 cm is like a 10 fingerwidth diastasis – that is how they are generally measured.  You can read the story recently on my blog where I had a girl who was a 9 fingerwidth diastasis close hers to a 1 fingerwidth in 5 weeks.  Now, that is really quite fast, but I have seen the diastasis that are 8s all the time close considerably to all the way, depending on how long they work with me (1-2 class sessions of 6 weeks, or 8 weeks, or private sessions of 3 to 5 times).

Pilates generally makes the diastasis recti worse – time and time again.  There are way to many twisting motions which SHEAR the diastasis making it larger, and jacknifing up and jacknifing down motions (rolling like a ball, pilates 100, corkscrew, teaser) not to mentions many more.  Also crunches are a BIG no no.

The Tupler technique is what I use with my clients, and splinting – sounds like M. REALLY REALLY needs to splint – and that will prevent new hernias from appearing – you really have to take precaution with that connective tissue in between the recti at 10 fingerwidths and splint RIGHT AWAY. 

Time wise REALLY depends on several things:  her technique, how often she does the technique (she would need to work up to 10 sets a day of 100 (about 30 min a day) of the seated tuplers at the advanced level), how often she splints, if she puts the splints on, if she avoids the compromising movements – like the ones mentioned in pilates – also getting in and out of bed correctly, being careful to bring the transverse to the spine when she holds the kids, her mind/body connection with the muscles, and her consistency.

At 10 fingerwidths (13 cm) the mind/body connection of the muscle might be very poor – but I would splint right away, get the book “lose your mummy tummy” and make sure the technique is 100% accurate, and she could probably make progress where surgery wouldn’t be needed. 

Julie usually tells people to expect 9 months – I have never had anyone take that long – 2-3 months usually – but 10s can be a little trickier – I would give the full 9 month allowance and if it happens quicker – a pleasant surprise.

FEEL FREE TO WRITE YOUR QUESTIONS IN THE COMMENT SECTION BELOW!!!

 

November 18, 2010

Questions YOU have asked

I have decided to do a weekly or bimonthly post on YOUR questions that I receive either via email or via posts.  Many people have the same questions as you, and I believe this would be the best way spread the info and to learn from other’s questions.  Maybe some questions you hadn’t thought of yourself.  Depending on the length of the question and answer I will post one or several questions.  Feel free to ask your question on the comment section!
H.A. asks
I’ve been looking in to diastasis recti the last few days because I was wondering if the pooch in my lower belly was always going to be there since having my baby 8 months ago. I discovered I have a 4 finger diastasis where my belly button is, and believe it is also in my lower belly. I don’t believe I have any separation in my upper abs. I am serious about starting the Tupler Techniques, and am wondering if the splint will work for someone who has seperation from the belly button down and not higher. I haven’t been able to find this information anywhere and would like to know before I buy it.
Many people I many have a LARGER DIASTASIS ON THE BOTTOM (3 inches below the belly button).  This could be from a variety of things.  The design of your torso, a short torso, how you carried the baby,  how big your baby is, the types of abdominals you do (or did in the past), having a hacking cough, how your abdominal muscles are developed, having your muscle fibers cut (C section) and others can all be contributing factors.
The good news – of COURSE you can bring this type of separation together!!  It’s a little trickier in my experience than having the largest part of the diastasis in the middle or top, but with a few tricks it can be brought together just as effectively.
Wearing a splint is a must – but you will want to TWEAK it slighty differently if possible and angle the splint downward slightly as it crosses over your abs.  This will ensure that the three inches below section of the diastasis is covered with the splint.  Will it magically stay in the perfect position all day?  Of course not!  You will need to adjust the splint of this particular kind of diastasis more than other kinds.  It’s the most susceptible to coming out of place when bending of sitting.  Be diligent with the splinting and do the best you can with adjusting it. 
Also, when you do the Seated Tupler exericises, you will want to put another splint or a scarf or thick resistance band crossed over the abs and holding the splint (aside from the splint you have on) fist over fist.  If its hard to picture, just imagine you are further approximating the muscles by isolating RIGHT at the area of the diastasis that is the furthest split. 

T.H. asks:

I’ve had two kids and had a tummy tuck / diastasis repair six years ago but the surgeon didn’t close it all the way up and now I look like I’m 8 months pregnant !! I also now have a herniated belly button and am facing surgery in January unless I do something about it. I would LOVE to avoid an abdominal surgery if I can correct this on my own and from the pics on your blog it looks doable!  I am VERY interested to learn more about splinting and the tupler technique and need to know about this ‘no crunches’ business. PLEASE help ME! Is there anyone in LA who teaches this or how can I learn more?
Although I am in Chicago and there are lots of people interested in this technique, you can go to www.diastasisrehab.com to find out if there is someone in your area.  If there is not, if you get a group together (20 or so ) than I will fly out and train your group.  In your case, you will DEFINITLEY want to get the book: Lose Your Mummy Tummy by Julie Tupler and learn the Seated Tupler Technique.  You will also want to get a Splint (can be purchased on this site – on the right hand side), which will speed your progress considerably.  
For information about Seated Tuplers and Crunches – click on the sidebar to the right where I have all the topics listed – and you can read about each of those.
One thing they don’t tell you when you go in for surgery to get a tummy tuck and “artificially sew the muscles together” is that they can resplit very easily if you don’t strengthen the muscles, and avoid incorrect movement, which can lead you to BLOW RIGHT THROUGH the stitches.  Either way – surgery or no – you need to do the seated tuplers and head lifts so you can have strong abdominals, have a stronger core, eliminate back pain, keep/bring the muscles together. 
With your herniated belly button (tear in the connective tissue that is between the split recti where the organs poke through)  you may be able to progress to where you won’t need surgery for it – it depends on your particular hernia.  They can sometimes “poke back in” when you bring the recti together, thereby healing the connective tissue (linea alba – which becomes linea negra when pregnant) between the recti. 

Write your other questions below and I will include them in my weekly post of YOUR questions!

November 4, 2010

20 days down, 1 day to go – SUGAR FAST

So I have gone on an on in this blog about the 5 wicked whites – white flour, white sugar, white pasta, white rice and white potatoes – and I have fallen prey to one of them…which happens to me periodically.  Thats right  – SUGAR!  This happens to me several times a year because I grew up with a big sweet tooth.  I find myself not just WANTING, but NEEDING sugar.  After dinner, my mind immediately goes to dessert – even if I choose a healthy one… my body still wants something.

So its during these times that I chose to WEAN my body off of sugar.  Usually I pick just after Halloween to do it – because I am sick of seeing candy everywhere.  AND afterward when I have some AWESOME pie on Thanksgiving, the rest from sugar will allow me to be satisfied with much LESS and enjoy much MORE what I do have.  Then I find I am much better off during the Christmas season when sugar is around every CORNER, from every NEIGHBOR, and everywhere I go!

So – I officially started YESTERDAY – DAY ONE.  My own REST FROM SUGAR or SUGAR FAST rules:

  • No white sugar
  • No high fructose corn syrup if I can help it (it can sneak up in salsa, tomatoe sauce, chicken broth – unexpected places)
  • Sugar in other forms – maltose, sucrose, – all the -ose words, raw tubinado sugar, brown sugar, etc.

Thats really it.  I do allow myself ONE EXCEPTION – that is that I can have a square or two of green and black 85% organic chocolate (my absolute FAVORITE – and very low glycemic)!
 I also allow ALL- fruit, fruit spread on bread if I need something else, and of course there are FRUIT SMOOTHIES with all fruit that are fantastic!

Last night for “dessert” I made a smoothie in my vitamix with frozen raspberries, half a pear, a tangerine, a teeny scoop – size of a raindrop – of stevia, and chia seeds (high in Omega 3s) – I shared it with my 2 year old and we LOVED it!

Getting reacquainted with NATURAL sweetness – that of fruit – is nice because you body will tell you when to stop.  Not so with refined white sugar or chemically processed HFCS.  However, I stick to low glycemic fruits to really flush my body out during my sugar reprieve.

Hardest days? Day 1, Day 3, Day 7 – then it gets easier because you have a chunk of days under your belt already, and your body sheds its withdrawal cravings.

So – if you would like to JOIN me – until TURKEY DAY – chime in and let me know.  You will most likely lose weight and inches around the waist, which is a side perk no one can argue with.  My goal this time around – a HEALTHIER PREGNANCY.  Whatever your reason – you can’t lose!!  Are you in?

November 1, 2010

The latest round! Results on Diastasis Recti

I realized that I have not given updates on the latest results I am seeing, so I am posting those now.  I have gotten several emails about these, especially from women who have been told by docs and practitioners that

1) They need to wait to do ANYTHING about their diastasis recti until they are done having kids

2) There is nothing that can be done for the diastasis recti, apart from surgery

3) A tummy tuck (with the optional stitching the muscles together) is the surgery needed to fix this

Well, I can’t say enough how ill-informed this is.  I have had a COUPLE of you email me that you sought 2nd opinions and were told about exercises they could do  – which is the Tupler Technique (Uh…yeah!!)  So for those that were given the brush off about surgery, GET a 2nd opinion, or just realize that maybe doctors in your area have not been informed.  I see people bring their diastasis together all the time, so it just seems silly to me that people would say you have to get surgery.  I had one girl in a class of mine whose separation was just 1 fingerwidth and she was told she needed surgery for it from her doctor.  Preposterous!  She closed it in 2 weeks.

ANYWAY – after my little rant (;  Here are the latest results:

1) I had a plus size girl (43 inch waist) in one of my classes who had a D.R. of
3 (fingerwidths )on the top
6 in the middle
3 on the bottom

In 7 weeks she was:
closed on top
1 in the midle
closed on the bottom
Waist down 1 inch!

2) I had girl who had TWINS and was a small petite girl (who ROCKED the technique).  She was:
3 on top
5 in the middle
3 on the bottom

In SIX weeks she was
closed on top
closed in middle
closed on bottom
DONE!  WAIST down 2 inches!

3)  I had a girl who has 3 kids and had rocky technique for weeks before her transverse was strong enough for consistency.  She was
3 on top
3 in middle
closed on the bottom

6 week later 
closed on top
1 in middle
closed on bottom
Waist down by 1 1/4 inches!

4)  This next girl isn’t the BEST example, but I thought it interesting.  She was only present half the time, due to a crises in her family.  Due to the same crises, she didn’t do almost any sets the last 3 weeks on her own.  She STILL managed to get decent result – not awesome – but considered she didn’t do much the last 3 of 7 weeks, pretty good.  She was:

1 on top
5 in middle
4 1/2 on bottom

7 SORT OF weeks later
closed on top
3 in middle
3 on bottom
Down FOUR inches in WAIST!

All the ladies in my examples wore splints consistently, except the last girl.  Had the last girl worn her splint consistently AND done her daily sets of seated tuplers, I am sure she would have closed her DR and come in at least another inch on her waist.

October 18, 2010

The importance of VARIETY – food and exercise!

When I work with people for weight loss, one of the biggest things that seems to slow people down, even if they are eating “healthy things” is TOO MUCH REPETITION!!  They tend to eat the same things everyday for breakfast, or everyday for lunch, etc and their body goes into a SLUGGISH mode.  It needs more VARIETY!!

This is the same thing with workouts – your body cannot run as efficiently with the same foods, and it can’t get conditioned as well with the SAME workout!  You must rotate what you do so the body does not go into  a SLUGGISH mode with your progress. Workouts ALSO need VARIETY.  That is one reason the P90X is so sucessful (apart from the horrible abs that are shown in that workout.  skip that abs and your good!)

It has been said variety is the spice of life, and I SO agree.  Here is an article with a study that has shown JUST HOW IMPORTANT variety is to LONGEVITY, QUALTIY OF LIFE, and HEALTH.

In this article they REALLY concentrate on food needing variety.  Some things I have learned that I pass on to my clients are:

1) not having the SAME food for lunch and dinner, that you had the previous day for dinner.  Tempting on those tight-for-time days – but important.

2) Don’t have the SAME veggies and fruits everyday.  Each color of fruit and vegetable – classified in the American system as red, red/purple, yellow, orange, white/green, dark green, and green.  Each different color of vegetable gives off a specific antioxidant.  You need ALL SEVEN to really de-oxidize the aging process of your body. For instance, the antioxidant for the “red” category – tomatoes – is LYCOPENE, which we know is good for keeping the prostate heatlhy, AMONG OTHER THINGS!!  The main antioxidant in the red/purple category for things such as blueberries, blackberries, raspberries, strawberries is VERY GOOD FOR THE SKIN.  So if you have skin problems, load up on these.  Most importantly, give your body variety.

3)  DONT have the same proteins everyday.  One of my clients would eat ground beef for every meal, and it stalled ALL of her weight loss and fitness goals for weeks and weeks.  Your body needs fish, poultry, soy – OTHER THINGS!!  

4)  This one can seem like a beast at first – DONT have dessert everyday!!!  Sugar can really mess up your body if had too often  – it IS a WICKED WHITE, after all.  Rotate it just like anything else.  Or have frozen blueberries or fruit for dessert instead.

5)  Dont have SO MUCH WHEAT!!  The american diet is SO MUCH WHEAT – all the time!  It drives me nuts!  There are SOOOOO many other grains – quinoa (my personal fav), oats (get the steel-cut if  possible!), kamut, spelt (spelt bread is FANTASTIC!), millet (watch this one – high on the GI scale), barley, and others.  With too much wheat  – in everything from bread, to gravy, to soups, to salad dressings, its very easy to O.D. your body and cause it to go in a sluggish mode, especially for weight loss.  Your best bet is to look for a variety of options.  And when you DO have wheat, make sure the INGREDIENT list on the back says:  100% whole wheat. 
If the label says: unbleached flour, wheat flour, durum semolina flour, enriched flour, or anything like that – it TOTALLY refined WHITE flour (a  WICKED WHITE!!).  Know the marketing tricks to make it sound healthy and be SMARTER than the companies who make you THINK you are buying healthy.

Those are my tips for variety!  Let me know what YOURS ARE!!

October 6, 2010

WHAT I WISH I HAD KNOWN WITH MY FIRST THREE PREGNANCIES!

There are many, but as I embark with the pregnancy of #4, some of them are VERY fresh in my mind!
1)      It is possible NOT to have to wear maternity pants.  Is it just me, or does anyone else just not fit RIGHT in maternity pants?  So I buy some baggier pants in a size up and wear them under the bulge.  Other possibilities below!
2)      There are products out there designed for transition stages.  I did not know about THIS one until one of my clients showed me!  There are button expanders:
· ” Button extenders consist of an elastic band with a buttonhole on one end and a button on the other, and work along similar principals as using a hair elastic or rubber band. You can find inexpensive button extenders at fabric or sewing stores, and you can also purchase button extenders designed specifically for pregnancy. Button extenders are only going to hold your pants’ button together, not the zipper, so they must be worn with a long, loose shirt or paired with a belly band for coverage. “

So this may be common knowledge to some, but all I had heard about was doing this same thing with an elastic.  It did not go so well for me!  One I found is Belly Belt – which you can get on target.com, amazon.com and I know Motherhood carries something similar.

3)      There are also BAND EXTENDERS!  I have recently heard several girlfriends mentioning different brands – I got mine for this time around at Target for about $15.  You can also find similar ones online called bella bands – everywhere from amazon to other websites.  My girlfriends have raved because they hold up maternity pants when they are still a little big, hold up prepregnancy pants when a little small – great for those transition periods.  Also great AFTER baby to get yourself back into your normal pants – and to cover up the awkward: 

·  “Band extenders, or belly bands, consist simply of a stretchy fabric band. Surprisingly versatile, they can support and cover unbuttoned pants, hold up too-big maternity pants, and even keep a third trimester belly from pushing down pants. Bands can also serve a dual purpose, giving the appearance of a long layered tank under pre-pregnancy shirts that have become too short. Because bands are often meant to be shown, they come in a wide variety of colors and patterns. However, some women find that bands can slip down or ride up, requiring too-frequent adjustment.”

4) Of course that you can do TRANSVERSE exercises during pregnancy!  So specifically Seated Tuplers are great.  You CAN actually close your diastasis DURING pregnancy.  I have seen it first hand with my pregnant clients.  One took a class with me while she was 7 ½ months pregnant.  The class ended when she was 9 months pregnant and she had TOTALLy closed her 3 fingerwidth (in all 3 areas) diastasis AS HER BELLY GREW!!  How many doctors would not believe THAT is possible – but not only IS IT, it puts the mom to be in SUCH a stronger position for pushing!
5)      Speaking of pushing, My last time around my transverse was so strong it only took one super long and STRONG push!  I had been told luckily before my first baby not to ‘bear down and push” as the nurses will often bark out, but to bring the abdominals BACK to push.  So that helped.  Then STRENGTHING the transverse correctly helped even more!  If you “bear down and push” all the pressure goes into your head – popped blood vessels near the eyes are common – yikes!  Its so important to bring the transverse BACK, RELAX the pelvic floor and NOT feel pressure in the wrong areas. Read “Maternal Fitness” for more in depth info. 
6)      Water births are awesome!  I did the epidural route with the first two – had huge episiotomies, and long recoveries after vaginal births with the first two.  With the 3rd I went natural and did a water birth.  I won’t say it wasn’t painful – it was.  But if I could stand up and walk around it was pretty tolerable.  I gave birth in the birth tub at the hospital and did not tear – it was great.  I literally hopped out of the tub – which was amazing.  I felt great.  ALL I wanted was an icepack.  I felt AWESOME the whole day – totally different than the groggy, frozen and bloated legs I had from being hooked up on drugs and pitocin with the first 2.  So I am sure there will be lots of people who differ – and that’s fine!  But I wish I would have know it was an option with the first two.  I am planning on that route with #4.
7)      Strengthening the pelvic floor between pregnancies is SO important.  If you can’t feel the muscles well, or can’t engage your pelvic floor – consider getting gynoflex – google it.  It is resistance that come in different strengths for your pelvic floor. Other clients of mine have also used Step Free vaginal weights and have liked them.  Both are great if you have trouble with incontinence or if everything is very stretched out (to avoid going into more detail!)
8)      You CAN wear a DiastasisRehab™ splint during pregnancy. I personally find it easiest to wear it during the 1st and 2nd trimesters to minimize splitting in that part of the pregnancy.  I wear the new one at night mostly and I love it!
So I am sure there are more – but those are the ones that come to my mind!  Feel free to chime in – what did you wish you would have know before a prior pregnancy.  SHARE YOUR WISDOM!!!

August 30, 2010

Client with largest diastasis clinically closed in FIVE WEEKS!

So I see women with all sorts of sizes of diastasis.  All affect how the abdominal area looks.  Those with the larger diastasis see a much more pronounced “mommy tummy” look as the organs protrude against the skin and connective tissue, as there are NO MUSCLES to keep those organs in.  It looks strange often times, and unsightly.  In some women it looks “off” or “poochy.” 

I have measured thousands of women.  I did have one class that had several women whose recti were 8 fingerwidths wide of a gap between the recti.  I thought – “”wow we have our work cut out for us in this class!  I, of course, splinted them and taught them exercises, etc.  And they made great progress in the 7 weeks we had.  Those were the largest diastasis recti I have personally measured and worked with…until my last class.

I had quite a large class of 20 women and we only had a short abreviate session for the summer – it was a “6 week course” that spanned 5 weeks from beginning to end.  I had a thin tall girl in my class who was NINE FINGERWIDTHS WIDE of a gap between the recti.    She looked great EXCEPT for an the protrusion of the midsection – the LAST piece of the puzzle for SO  many women!
‘
She came up to me after class as  I fit her for a splint and asked, “Can’t I still do crunches and sit-ups?” She had asked in such a way that I could tell that my forbidding of crunches had really put her out with how she did her normal fitness routine.  I said firmly but nicely, “NO!!  That is why you measure a NINE!  NOOOO Crunches!”  “NEVER???”  She asked.  “NO!  Not unless you want to undo all the work you do in here with me.”  (Please click on side tab of crunches if you are new to this site and can’t imagine why I would be saying this 🙂 )

So this girl had EXCELLENT technique and came every week to the 6 classes.  And on week 6, just 5 calendar weeks later, she had brought her  NINE fingerwidth diastasis to a ONE!!!!!!  While I work with my clients to TOTALLY close everything, this was an amazing EIGHT FINGERWIDTHS CLOSED in 5 WEEKS!  That is by FAR the fastest I have ever had anyone progress.  And yes, she DID work for it, usually doing 7 sets of 100  seated tuplers per day (NOT as  crazy as it sounds – they are very intrinsic.  See article of Fit Pregnancy a couple posts below).

Well that kind of progress is not made without significant WAIST SHRINKAGE!!  She went from a 30 inch waist to a 27 inch waist in those FIVE WEEKS!! 

CONGRATS TO HER PROGRESS!!  I am partially telling this clients story not ONLY because of her amazing results, which are awesome, but also because SO many medical professionals believe surgery is the ONLY FIX for this condition!  That is dangerously misguided information in my opinion.  Why not save people from thousands of dollars, weeks and weeks of recovery time, permanent incision in their body, and a healthy (no pun intended) risk of infection following the surgery.  OUCH!  Any medical professionals that come across this, PLEASE realize that there are so many more avenues for the diastasis recti than surgery!

August 25, 2010

Mother told to clean own room after C section!!

I just could NOT believe this!!  I can’t imagine after a C section – MAJOR SURGERY – that this happened!! Article found HERE.

 Mother told to clean own room after caesarean

Online: http://www.thelocal.se/28512/20100822/
Mother-of-two Elin Andersson has highlighted staffing shortage problems at a maternity ward in Sundsvall in northern Sweden after she was asked to clean out her own hospital room just two days after giving birth by caesarean section.

 

Every time Andersson required medicine she had to call staff to remind them, she told local newspaper Sundsvalls Tidning. The new baby’s father meanwhile was requested to aid in the care of his partner.

Two days after the operation, the recovering mum decided she was ready to go home.

”That was when the midwife said I had one final task to perform. Then she went and got a big white laundry bag and asked me to clean out the room and the bed where I had lain,” she told the newspaper.

Two midwives at the Sundsvall maternity ward admitted that Elin Andersson painted an accurate picture of their workplace.

”She describes precisely those bits that we don’t have time for,” said Gunnel Westerlund.

”Medical safety always comes first and you can’t leave a mother while she’s giving birth. It’s true that we sometimes need to make use of the parents and that doesn’t feel good at all.”

What do you guys think? Me?  I think – YIKES!!