How do I determine if I am getting the right size?
When should a splint NOT be worn?
What is a diastasis recti?
Is it normal to get a diastasis recti during pregnancy?
Can I wear a splint during pregnancy?
How is the head lift different from a crunch?
Can I do the Tupler Technique® during pregnancy?
Question: How do I determine if I am getting the right size?
Answer: By measuring both your back and the circumference of your body over your belly button. Your back size is most important because that will determine if the pad will be the right size. Measure at the level under your breast from one side seam and then across your
back to the other sideseam. The pad should rest on each side of your body. If it rests on the front of your belly it is too big. If it is just on your back it is too small and it will be difficult for you to attach it. If you see that your back size is a small or a medium and your circumference is a large then you will need to make the arms of the splint longer. That is why we have created the extenders to attach to the arms of that size splint so it will fit you until your belly gets smaller from doing the program. The extenders will give you 8-12 more inches on the length of the arms. If you need less than this you can make a hem in the elastic of the extenders. The extenders are also good for pregnant women so the splint can grow with their expanding belly. We now also have short torso splints for short torso individuals and children. You measure from the bottom of your sternum to your belly button. If this measurement is 5" or less you may want this model splint.
Question: When should I measure the circumference of my body over my belly?
Answer: Measure the circumference of your body around the belly button in the evening when your belly is the largest. Your abdominal muscles should be relaxed when you measure.
Question: What if my back size is a large and my belly size is a small?
Answer: You will have to get the larger size splint and hem the elastic arms of the splint. It is important that the pad of the splint be the right size.
Question: What if my back size is a small and my belly size is a large?
Answer: You will need to buy the small splint with the extenders. The extenders will give you anywhere from 8 to 12 inches more on the arms. If you need less than 8 inches you can put a hem in the extenders.
Question: When should a splint NOT be worn?
Answer: The purpose of the Diastasis Rehab Splint® is approximating or bringing the two separated muscles together. This will put the displaced organs back in their original position. If you have had a diastasis for a long time then your organs may have “settled” in this position. Putting them back in their original position would then disrupt these organs. This may affect the organs above it (heart) and the organs below it (pelvic floor). So if you have any serious breathing issues such as emphysema or heart issues, it is recommended that you do not wear the splint. You can do the other 3 steps of the program and also “hold” a splint (scarf or arms of sweater) while doing the exercises. If you have any type of pelvic floor prolapse, you can wear a splint if it does not put any pressure on your pelvic floor. The splint should not be worn too tight and the exercises must be modified. You need to count out loud when doing the exercises, hold the pelvic floor muscles in at the same time while doing the exercises and decrease the number of repetitions for the contracting exercise to around 25 contractions instead of 100. As both your abdominal an pelvic floor muscles get stronger you can increase the number of repetitions. If you feel any pressure in your pelvic floor that is a signal to stop right away. If you have any other serious medical conditions please consult your physician before wearing the splint. We are always glad to speak with your physician to make sure the splint is right for you.
Question: How often should I wear the splint?
Answer: Unless you have some sort of medical issue, you should wear the splint all the time. Just taking it off to bathe. If you broke your leg or arm you would wear a cast to continuously keep the two separated bones close together. It is the same with wearing the splint. You want to keep the connective tissue and muscles continuously close together.
Question: Are there any side negative effects when wearing a splint?
Answer: If you wear the splint too tight or too low over your hips you can cause pain, swelling and numbness. There are two side effects that people do experience when wearing the splint. Nausea and acid reflux and back pain in the morning after sleeping in the splint. The nausea may occur because your stomach is now in its original position. Your stomach is now squeezed in between your other organs and not able to expand the way it used to when it was unsupported. You have to eat less now because of this inability to expand. This will help prevent the nausea and reflux. Back pain after sleeping in it can be caused by wearing it too tight or the position of your body while sleeping. Sleeping with straight legs will arch your back. Arching your back will flare your ribs and stretch your connective tissue and also create the back pain. Sleep with your legs bent no matter what position you are sleeping. In a side lying position, place a pillow between your knees. When sleeping on your stomach or in a back lying position put the pillow under your lower legs.
Question: Will wearing a splint weaken my abdominal muscles?
Answer: Absolutely not. The purpose is approximation (pulling together) not compression. It puts the connective tissue in a better position to heal and the muscles in a better position making the exercises more effective. Wearing a splint is just one of the 4 steps of the program. Wearing the splint makes doing the exercises easier because you are able to feel the muscles working.
Question: How long should my splint last?
Answer: Elastic wears out when you are continuously stretching it and Velcro wears out when you continuously pull the hook part of velcro (end of elastic arms) away from the loop velcro (pad of splint). If it is too small on you it will be continuously pulling. The loop is made of many filaments. Each time the hook is pulled away from the loop the loop loses some of these filaments. When it loses too many of these filaments, it loses its ability to hold the hook and will not stay attached. How long it lasts depends on how often you take it off. That is why it is important to look in a mirror when you are putting it on so you put it on correctly the first time and don’t have to readjust it several times. If it bunches up just pull it down. You don’t have to take it off. So limit the amount of times you take it off to no more than 3 times a day. That is why many people use two splints. They wear one and wash one. If you have two, there is half the wear and tear on it. It is important to hand wash and air dry it to make it last longer. To help preserve the elastic, you do not have to stretch the arms too much to attach it. Stretching the arms a lot when attaching it will also make it too tight. Wearing the splint too tight can cause negative side effects.
Question: How do I put the splint on correctly?
Answer: Please watch the DVD that is on all the pages in the shopping cart that have a splint on them. You can also read the instructions. Always stand in front of a mirror so you can see where you are attaching it. It is important to be attached in the right place. The top of the splint should lay at the bottom of your ribs. The bottom of your splint should lay above your hip bones. If you are continuously pulling the hook away from the loop to re-adjust it, the hook Velcro at the end of the arms will no longer attach to the pad. Also you do not want to attach it where the hook is touching your skin. This will cause a rash.
Question: How tight should I wear the splint?
Answer: You do not have to wear the splint that tight. It will cause a decrease in circulation creating numbness and swelling. It will also not stay in place. When you are attaching the elastic arms to the pad you should not have to pull on the elastic that much to fasten it. If you have to pull on the elastic too much the arms may be too short. In this case you would need to get the Splint Extenders.
Question: When I splint my belly bulges out the bottom. Should this happen?
Answer: Yes, this is what happens when you pull the two halves together. It will not cause the diastasis to get bigger. Just pull the bottom part of the splint down as much as you can. In week 4 of the program you will be double splinting. This means wearing a splint and holding another one (scarf or arms of your sweater). You can then hold the splint over the lower area. If you are long waisted you may want to wear a second splint. The one we recommend to wear for a second splint is the short torso model.
Question: Can I carry on with normal everyday activities while wearing the splint?
Answer: Yes. However, you need to start developing an awareness of how to use your abdominals, how to move your body and how to protect your connective tissue while doing these activities. For example, before you move engage your abdominal muscles, make sure you bend with a flat back and when you bend over put your hand on your belly to protect your connective tissue.
Question: After six weeks does one need to continue wearing the splint? What about after 18 weeks?
Answer: You have to wear the splint until your diastasis is closed. If you have a severe diastasis it may take anywhere from 6 months to a year or more for it to close. Healing a diastasis is not an overnight process.
Question: After I have closed my diastasis do I need to wear a splint?
Answer: No. However, you do need to continue the other three steps of the program to “maintain” the results you have gained. Doing the Tupler Technique ® exercises are good for your belly, back and pelvic floor.
Question: If I can’t wear the splint will the program still be effective?
Answer: Yes. If you can hold a splint (scarf or arms of sweater) while doing the seated and back lying exercises you will make progress. However, it may be slower than if you wore the splint all the time. If you cannot even hold a splint doing the exercises will help.
Question: Why do I need to wear the splint all the time?
Answer: Wearing a splint takes the stretch off the connective tissue putting it in a narrow position to heal. It also puts the muscles in a better position making the exercises more effective. Wearing a splint all the time can be compared to wearing a cast for two broken bones. The bones have to be kept in the same position continuously in order for them to heal. It is the same with the connective tissue. So you will have the fastest and best results if you wear it all the time.
Question: Is it normal to have back pain in the morning after wearing it all night?
Answer: No. This is not normal. You are most likely wearing the splint too tight. Besides making it looser, sleep with bent knees. For side lying position, put pillow between knees. For belly lying or back lying position, put a pillow under your lower legs.
Question: If I have a pelvic floor prolapse will this program have an effect on it?
Answer: Yes. If you hold your transverse in on the “work” of everything you do you can prevent the prolapse from getting worse. If you do the exercises incorrectly you can make the diastasis worse! If you have any type of prolapses you can wear the splint if you do not feel any pressure in your pelvic floor. If you do feel pressure, then just "hold" a splint when doing the seated or back lying exercises. If you are wearing the splint, make sure it is not too tight. Also make sure when you do the exercises that you do the following:
Question: Can I close my diastasis by just wearing the splint?
Answer: No. Wearing a splint is just “one” of the four steps of the Tupler Technique® program. It will only give you “temporary results. You must do ALL four steps of the program to close your diastasis. The purpose of the splint is to put both the connective tissue and muscles in a better position. The other steps involve protecting the connective tissue and strengthening the abdominal muscles.
Question: What is the difference between and splint and a girdle or other abdominal binders or body shaping garments?
Answer: The purpose of the splint is approximation (pulling together) the two separated muscles and taking the stretch off the connective tissue. The purpose of the girdle, abdominal binders and body shaping garments is compression (pulling back) of the abdominal muscles.
Question: What is double splinting?
Answer: Double splinting is wearing a splint all the time and holding a splint (scarf or arms of sweater or top) while doing the seated and back lying exercises. Double splinting is started in week 4 of the program after the transverse muscle has been strengthened.
Question: If I use a splint can I do regular type of abdominal exercises (crunches) to work the outermost abdominals?
Answer: No. Absolutely not. The purpose of the splint is just to put the muscles and connective tissue in a better position. It is physically impossible to engage the transverse muscle with the shoulders off the floor when doing a crunch. If you cannot engage it you are not working your core correctly and this will make the diastasis larger if you have one or create one if you don’t have one.
Question: Can I wear a splint during pregnancy?
Answer: Yes. Wearing a splint will not hurt your baby. Wearing a splint plus doing the other 3 steps in the Tupler Technique® will prevent you from getting a diastasis or will make it smaller if you have one. A small diastasis will prevent back problems during and after pregnancy and keep the uterus and cervix in the proper alignment
Question: When should I start wearing the splint during pregnancy?
Answer: We recommend wearing the splint in your second trimester. In the first trimester women usually have nausea. Wearing a splint can sometimes cause nausea since you are putting the displaced organs back in their original position. However, you can start the exercises in the first trimester.
Question: How do I determine the size of the splint during pregnancy?
Answer: As per the size chart on the splint page of the website, you need to get the correct back size. Then you get your circumference size. If you are starting early in your second trimester you may get a splint to fit you. However, you will need to get the Splint Extenders to make the arms of the splint longer to accommodate for your growing belly. The extenders will give you 8-12 inches to add to the arms of your splint.
Question: Would the Tupler belt be an adequate and safe alternative to a maternity belt?
Answer: A maternity belt has the function of lifting up the belly. The function of the Diastasis Rehab Splint® is to approximate (pull together) the muscles and connective tissue.
Question: Do I need to get several splints during my pregnancy?
Answer: You can have one splint with the Splint Extenders. However, the Velcro may wear out with continuous use. We do recommend to get two during pregnancy so you can wear one and wash one.
Question: Should I wear my splint in labor?
Answer: Yes you should definitely either wear one, hold one (scarf or arms of sweater) or do both! Keeping the muscles close together will keep the uterus in the in proper position. If the weak connective tissue (instead of the muscles) is supporting your top heavy uterus it will tilt forward. The cervix will then be pointing “sideways” instead in downward. A downward (not sideways) pointing cervix gives your baby direct access out the vaginal canal.
Question: Can I wear a splint right after delivery?
Answer: You can wear the splint right after a vaginal birth. If you have a c-section you should wait until the incision is healed as the splint will pull on the scar. It usually takes around 6 weeks. You can, however, start doing the exercises right away with both a vaginal and cesarean birth.
Question: How is the head lift different from a crunch?
Answer: When you do a crunch you are lifting your shoulders off the floor. When you do a headlift you are just lifting your head. When you lift your shoulders off the floor it is impossible to hold in your transverse. If you can’t hold in your transverse muscle it will go forward forcefully making the diastasis larger if you have one or creating one if you don’t have one.
Question: How does the TT close a diastasis?
Answer: This program closes the diastasis by healing the connective tissue. As the connective tissue becomes shallow, the muscles come together. Healing connective tissue is all about putting it in the right position as well as protecting it.
Question: What can I expect in the first six weeks of the program?
Answer: If you follow all 4 steps and do only cardio exercise as described below, you will see the healing process beginning. Your diastasis will may get one finger smaller, your connective tissue will feel shallower and your belly circumference will be 1-2 inches smaller. Make sure you take those before photos of your belly from the front and the side so you can see the changes in week 3 and week 6.
Question: Why am I not supposed to do any other program during the first six weeks?
Answer: You use your abdominals with every move you make. You have to develop the awareness and the strength of how to use them correctly to be able to heal your connective tissue. It takes six weeks to do this. In week six once you have this abdominal strength and awareness of how to use your abdominal muscles, you are taught how to incorporate the Tupler Technique® into an exercise routine. During the first six weeks we recommend only cardio exercise such as walking, treadmill, stationary bike, and the elliptical machine. No running, weights or exercise classes .It is important to be belly breathing while doing cardio exercise.
Question: Can I play golf and tennis again once my diastasis is closed?
Answer: If you play these sports you need to make sure you engage your transverse and keep your ribs in as you do the crossover movement in tennis and golf. Check yourself before and after the game and to make sure you are not opening your diastasis back up again. Some people wear a splint while playing to remind them to hold the transverse in.
Question: After week 18 what do I do to maintain the program?
Answer: If you have not closed your diastasis you need to continue doing what you are doing. Double splint as much as you can when doing the seated and backlying exercises. If you have closed your diastasis you do not have to wear a splint but you need to continue the other three steps of the program. For the contracting exercise do anywhere from 10-20 sets of 100 a day.
Question: Does one need to have returned to pre-pregnancy weight in order to start the program?
Answer: No. Weight has nothing to do with the separation of the muscles. Many people mistake the “bulging belly” that is a sign of a diastasis for fat.
Question: How do I know if I am doing the exercises correctly?
Answer: You may want to look in a mirror while doing the seated exercises. For the headlifts you may want to have a friend put their hand on your belly to make sure you are working the muscles correctly. If you have a Licensee in your area it is always best to have someone see you in person. If you don’t you can also do the Six Week Online Support Program for all your questions or an individual skype session with Julie Tupler, RN so she can see how you are doing the exercises.
Question: In the Tupler Technique® Guidebook there are no elevators. Is this a typo?
Answer: No. The contracting exercise is now at 5th to 6th so there is no need to do the elevators anymore unless you want to.
Question: Can I do the seated exercises standing?
Answer: No. In the first six weeks it is not recommend to do this. The back must be supported and not move. It is much harder to control this in a standing position.
Question: Why does my back have to be supported?
Answer: The back needs to be supported with a pillow or back of chair so it does not move and so it can rest and let the abdominals do the work. If it is not supported the back muscles need to work to maintain correct posture.
Question: Why do I need to count out loud when doing the exercises?
Answer: It forces you to breathe. If you hold your breath it puts intra-abdominal force on both your abdominal and pelvic floor muscles.
Question: Why should I do The Tupler Technique® before having abdominal surgery?
Answer: To maintain the integrity of the sutures after your surgery. It is important to strengthen your abdominal muscles and know how to use them correctly in the recovery process. Intra-abdominal force on the stitches makes them come undone. You are told by your doctor not to lift anything heavy after surgery. When you go from a seated to a standing position if you do not use your abdominals correctly while doing this you are putting your whole body weight on your sutures!
Question: Do you recommend using the Tupler Technique® between pregnancies or after child-rearing?
Answer: Ideally it is best to do the Tupler Technique® before you even get pregnant. If this is not done then the Tupler Technique® program should be done during pregnancy to keep the diastasis as small as possible. If this is not possible then the Tupler Technique® should be done after the pregnancy. With each pregnancy the diastasis will get larger.
Question: Why is a hands and knees position bad?
Answer: All the weight of your organs is putting pressure on the weak connective tissue. Pressure on connective tissue weakens it and does not allow it to heal.
Question: Does sex have to be modified while doing the program?
Answer: Yes. The seated position is the best position to be in while having sex to protect the connective tissue. The hands and knees position puts pressure on the connective tissue. In the back lying position with your legs in the air it is too difficult to hold in your transverse muscle.
Question: What is the best position to sleep?
Answer: Back lying with knees bent. Whatever position you sleep it is always important to have your knees bent. In a side lying position it is important to have a pillow between your bent knees. A pillow should be under your lower legs whether you are back lying or lying on your belly. This keeps the top of the pelvis from tilting forward. When this happens it flares the ribs and stretches the connective tissue.
Question: If I close my diastasis at six weeks should I continue the program until I finish week 18?
Answer: Once you close your diastasis your do not have to wear our splint. You do have to continue doing the exercises for 18 weeks and then for the rest of your life. These exercises are the BEST way to strengthen your abdominal muscles. Strengthening your abdominal muscles means shortening them. This program shortens them from front to back and from top to bottom.
Question: Why do I feel short of breath when doing the seated exercises? What can I do about this?
Answer: When you do the seated exercises you will be “chest breathing”. With chest breathing you do not get as much oxygen as when you belly breathe. Therefore, it is important to count out loud. This forces you to breathe. The louder you count, the more oxygen you get. Also, people get out of breath because they are doing the exercises too fast. So you may want to slow down when doing the exercises.
Question: Does the program help the loose skin?
Answer: No. The program is all about closing the diastasis. This will give you a flatter belly and smaller waist. The loose skin is a lack of collagen issue.
Question: After I close my diastasis will I need to continue to do the exercises to maintain strong abdominal muscles or will the program be enough?
Answer: There is a weak spot in the connective tissue that joins your outermost abdominal muscles. With continuous force and pressure on this weak spot you can separate the muscles again. Intra-abdominal force comes from using the abdominal muscles incorrectly. Doing the exercises make the transverse muscle strong so you can then hold the transverse muscle in during activities of daily living, sporting activities and your exercise routine.
Question: How do I pick up and carry a little toddler while doing the program?
Answer: If your toddler can climb up on a chair so they are at a higher place and you do not have to bend over that is the most ideal way of picking them up. Always hold your transverse in right before you lift them. If that is not possible then bend over with a flat back and bent knees. Again, transverse is in at 5th floor before you lift them. This is demonstrated in the exercise portion of the DVD.
Question: Once I close my diastasis by doing your program can I go back to doing crunches?
Answer: NO. Crunches create a diastasis or make a diastasis larger if you have one. A diastasis is caused by a forward forceful movement on the outermost abdominal muscles (rectus abdominis). When the shoulders come off the floor it is impossible to engage the transverse muscle. If you cannot engage the transverse muscle then it is going forward forcefully making the diastasis larger or creating one. Besides working the muscles in the wrong direction they also work the discs of the spine in the wrong direction. Solution to safely increase the intensity of your abdominal work: When doing the head lifts, bring your feet away from the buttocks. This brings the small of the back off the floor. The higher the small of the back is off the floor, the harder it is to use your abdominals to put it on the floor.
Question: How does one effectively breathe abdominally (belly breathing) while doing the Tupler Technique® seated exercises?
Answer: When doing the seated Tupler Technique® exercises we always start and end with a belly breathe. However, it is not possible to belly breathe while doing the exercises with holding the transverse at 5th floor. You must chest breathe. That is why it is so important to count out loud. This forces you to breathe. If you don’t count out loud you will then put pressure on both your abdominal and pelvic floor muscles.
Question: When I do my seated elevators and transverse contractions, I feel it in my upper back and between my shoulder blades. Am I doing something wrong?
Answer: This is common when you first start doing the exercises. If a muscle is weak it will ask another muscle to help. In this case, it is your shoulders. So when you feel it in your shoulders just relax them. Also make sure your head is not forward when doing the exercises. Think of bringing the chin back as you are doing the exercises. When the head is forward it rounds the shoulders and then you will feel it there while doing the exercises.
Question: Will the seated Tupler Technique® exercises help me with toning my transverse abdominals even if I have a small diastasis? Or is this technique only for correcting a large diastasis?
Answer: The Tupler Technique® is a great exercise for toning even if you do not have a diastasis.
Question: I have a question, or more like a concern. I'm worried that all my hard work with the exercises will be for nothing if I ever move the wrong way. I'm trying to make sure I get out of bed properly, sneeze, and pick up my baby properly. However, I'm not sure with all that I do in my day that it all comes out perfect. Is it really that easy to un-do all the progress from the exercises?
Answer: We use our abdominal muscles with everything we do. A forceful forward movement makes the diastasis larger. However, some forward forceful movements are worse than others. A jack knife and a roll back are the worst and will undo your hard work. So you need to be especially careful not to do these things as they will undo all your hard work.
Question: Can I do pushups and planks if I have a diastasis?
Answer: In a hands and knees position gravity put all the weight of the organs on the already weakened connective tissue. Engaging the muscles in this position will not take the weight off the connective tissue. So planks and pushups should be done against the wall where there is no pressure on the connective tissue and gravity makes it easier to engage the transverse muscle.
Question: How do I perform the Tupler Technique® exercises while I exercise on a treadmill, elliptical, rowing machine?
Answer: When you are doing aerobic exercises it is important that you belly breathe to get as much oxygen as possible. Remember to expand and fill the lungs up with air as your bring the muscles forward and then bring the belly back to the spine on the exhale part of the breath. You will be working the transverse if you use the transverse on the exhale part of the breath
Question: Will the Tupler Technique® exercises help with low back pain?
Answer: Yes. One of the functions of the recti muscle is to support the back. When the muscles separate it weakens the support for the back and causes back problems. When you engage the transverse is shortens the recti (outermost muscle) from the middle and makes the diastasis smaller. Also when you engage the transverse muscle you are also working the lumbar multifidus muscle. Working this muscle also helps with low back pain.
Question: How do I take classes that encourage ab work such as crunches?
Answer: Very carefully! You cannot do crunches or any back lying exercises with your shoulders off the floor. You must tell the instructor that you have a diastasis recti and you must do your abdominal work differently.
Question: Once I close my diastasis can I do sit-ups, crunches or the Pilates 100’s?
Answer: No. It is physically impossible to bring the transverse to the spine and hold it there when doing these exercises. Working the core means bringing the transverse to the spine and holding it there. If you can’t do that with any exercise then you will be making the diastasis larger (if you have one) or creating one if you don’t have one.
Question: Is it necessary to space out the exercises throughout the day or can I do them in one daily session?
Answer: We recommend that you space them out during the day initially as the muscle will get fatigued if you do too many at once. Once the muscle is fatigued, you will not be able to do the exercises effectively. Once the muscle is strengthened you can do more each time you do them during the day.
Question: Can I do the Tupler Technique® during pregnancy?
Answer: This program was created for pregnant women to prepare them for the marathon of labor. It is very important to do this program as early as you can in the pregnancy. A diastasis recti can put you at risk for a c section. Strong abdominal muscles will also help you push more effectively in labor and prevent back problems during and after pregnancy.
Question: Will the abdominal exercise hurt my baby?
Answer: No. The uterus is very thick and the baby is surrounded by amniotic fluid. Strong abdominal muscle will prevent back pain and will help you push better in labor.
Question: Can I do the exercise routine in the Diastasis Rehab Lose Your Mummy Tummy® DVD during pregnancy? Are there any modifications?
Answer: Yes, this routine can be done during pregnancy. Motionless standing and a back lying position are not good positions for a pregnant woman. So upper body exercise should be done seated and the amount of time in a back lying position when doing the headlifts should be limited to no more than 3 minutes. If you feel lightheaded or dizzy in a back lying position roll to the side until you feel better.
Question: Can this program help me have a VBAC (Vaginal Birth After C-Section)?
Answer: Yes. Having strong abdominals and knowing how to use them correctly while pushing can accomplish this. Many of my clients have had successful VBAC’s. Learning how to push is taught in the Tupler Technique® Perfect Pushing DVD.
Question: Can the Tupler Technique® exercises help me during my pregnancy if I know I will be having a c-section. Can I do them after I have a c-section?
Answer: Yes. Stronger abdominal muscles will help with your recovery. Also, strengthening your abdominals during pregnancy will give you the “muscle memory” to make it easier to do the exercises after the birth. After a c-section birth it is important to engage the transverse muscle as a forward forceful pressure on the stitches can undo the stitches. It will be a bit uncomfortable as you will feel a little pulling on the stitches. Once the stitches have healed you will want to mobilize the scar. Tissues are meant to move freely. With a scar it will stick to the underlying layer of tissue. Your job is to pull the top layer away from the layer underneath it.
Question: Can I get pregnant again with a diastasis?
Answer: It is recommended to make your diastasis smaller before getting pregnant again, however, if you do get pregnant and have a diastasis, you need to start doing the exercises right away to keep the diastasis from getting larger. You may even want to wear a splint during your pregnancy.
Question: Can I start the Tupler Technique® exercises late in my pregnancy?
Answer: Yes. You can start them late in your pregnancy. It will be harder to do them later in your pregnancy but they will still be helpful.
Question: When can I start the Tupler Technique® exercises after birth?
Answer: You can start them within 24 hours of giving birth. A great time to do them is while you are feeding the baby. The sooner you start them the faster your diastasis will close.
Question: When can I start in the Tupler Technique® exercises in pregnancy?
Answer: The sooner the better. Wait till the nausea passes. If you start early in your pregnancy the exercises will be easier to do and you will prevent your diastasis from getting larger. You may even make it smaller!
Question: What is a diastasis?
Answer: The word diastasis means separation. The recti muscles are the outermost abdominal muscles. So it is a separation of the outermost abdominal muscles. When the muscles separate the connective tissue joining these muscle stretches sideways.
Question: What causes a diastasis?
Answer: Everyone is born with a diastasis. Usually it comes together at around 3 years old when the nervous system of the child has developed. The belly button is a weak spot in the connective tissue. Continuous stretching, pressure or intra-abdominal force on this weak spot of the connective tissue can cause the muscles to separate. Examples of what can create a diastasis or make a diastasis larger are: Pregnancy, extreme belly weight gain, abdominal surgery, exercises like crunches, pilates 100 and backbends; and sporting activities like swimming, softball, tennis and golf.
Question: What are the effects of a diastasis on the body?
Answer: The outermost muscles (rectus abdominis) support your back and organs. When they separate, the connective tissue then becomes your support system for your back and organs. Thin connective tissue, unlike thick muscles, is not a good support system for your back and organs. So it makes sense that the side effects from this ineffective support by the connective tissue would be back pain and displacement of your organs causing gastrointestinal disturbances such as bloating and constipation. This displacement of your organs will also cause poor posture. The lack of support of your belly button will cause your belly button to become an outie. This is known as an umbilical hernia. A diastasis may also cause pelvic floor problems such as incontinence and prolapses.
Question: When I check myself for a diastasis what am I checking for?
Answer: When you check for a diastasis you are checking for two things. The first is the “distance” between the two muscles. You want to see how many fingers fit between the two separated muscles. If you have a protruding belly button, feel a pulsing or have the half-football like bulge you will need to use two hands. The second thing you are checking is the “condition” of the connective tissue. The deeper your fingers go, the weaker the connective tissue. The pulsing, protruding belly button and half football like bulge are all signs of weak connective tissue. You check at the belly button and 3 inches above and below the belly.
Question: When I check myself why does it hurt?
Answer: This is a sign that your connective tissue is very weak.
Question: What is the “pulsing” that I feel when I am checking myself for a diastasis?
Answer: This pulsing you are feeling is coming from your organs. This is a sign of very weak connective tissue.
Question: What is the half-football like bulge when I get up from a backlying position?
Answer: When the muscles separate the connective tissue stretches sideways and it now supporting your organs. When you get up from a backlying position this bulge is your organs moving forward against this weak connective tissue. This bulge is a sign of a very severe diastasis which needs two hands to check.
Question: Do some people’s diastasis close faster than others if they do the program exactly the same way?
Answer: Yes. This is because everyone’s connective tissue is not the same quality. Weaker connective tissue will take longer to heal. Hormones such as relaxin (pregnancy related) or steroid injections weaken the connective tissue. Multiple births and steroid treatments will weaken connective tissue. Naturally flexible people and people that get stretch marks also have weaker connective tissue. Weaker connective tissue takes longer to heal.
Question: Can a diastasis close on its own?
Answer: In my experience of checking women during and after pregnancy for over 20 years, I have never seen it close on its own. After a first birth it may come together a little but not close. Closing a diastasis is all about healing the connective tissue. To heal the connective tissue, you have to put it in a better position, protect it and bring blood flow to it.
Question: How long does it take to close a diastasis?
Answer: How long it takes depends on the severity of your diastasis and your commitment to all 4 steps of the program. It can take anywhere from 6 weeks to a year or more. However, you will start seeing the healing process starting within the first 3 weeks.
Question: Is it ever too late to close a diastasis recti?
Answer: No. It is never too late to close a diastasis. There is a myth that you can only close your diastasis right after you have had your baby. This is not true. Pregnancy is just one of the causes of a diastasis. Men and children have this condition also.
Question: Can you close a diastasis at any time?
Answer: Yes. Anyone can close a diastasis at any time. It is all about healing the connective tissue. Pregnancy is just one of the causes of a diastasis so it does not matter how long ago you had your baby. During pregnancy you can make it smaller but probably not close it.
Question: How do I know my diastasis is closed?
Answer: Closing a diastasis is all about healing the connective tissue. Shallow connective tissue is the most important indicator that you have closed your diastasis. You know your connective tissue is shallow when you put your fingers in to check your diastasis and they do not go down that deep. As the connective tissue becomes shallower the muscles come together. A one finger diastasis with shallow connective tissue is what you are striving for.
Question: Does a diastasis cause back pain?
Answer: Yes. The function of the outermost abdominal muscles (recti muscles) is to support your back and organs. When the muscles separate the connective tissue stretches sideways and now becomes the support system for the back. Back pain occurs because connective tissue is not a good support system for the back.
Question: Does a diastasis cause constipation?
Answer: Yes. When the muscles separate the organs (i.e. intestines) get displaced. This displacement puts the bowel out of alignment which is a cause of constipation. Splinting the muscles and putting your feet up on a foot stool with help with treating constipation.
Question: Can a diastasis come apart once it is closed?
Answer: Yes. There is a weak spot in the middle of the connective tissue that joins the outermost abdominal muscles. This weak spot is your belly button. Continuous intra-abdominal force and pressure on this weak spot will separate your muscles.
Question: Can a diastasis get worse from doing incorrect exercises?
Answer: Yes. Stretching of and Intra-abdominal force and pressure on connective tissue can make a diastasis worse if you have one and create one if you don’t have a diastasis. Examples of exercises and sporting activities that do this are crunches, Pilates100, swimming, golf, tennis and softball.
Question: When is surgery necessary?
Answer: Surgery is necessary when the connective tissue has torn away from the muscle and the organs are exposed. This is called a ‘ventral” hernia. It is also necessary when the organs associated with the abdominal hernia becomes “strangulated.” This means there is no blood to them.
Question: Is an umbilical hernia related to a diastasis?
Answer: Yes. An umbilical hernia is a side effect of a diastasis recti. When the connective tissue stretches sideways it becomes thinner and your belly button is not supported so it will become an “outie”.
Question: Should I surgically repair my umbilical hernia?
Answer: Unless you are having extreme pain from your umbilical hernia it is best to wait with your surgery and do the Tupler Technique® program first to see if it will help. You have nothing to lose and everything to gain. If you repair it with the Tupler Technique® then surgery is not necessary. If the program does not work, you are still ahead of the game as you will be prepared for the surgery. Strengthening your abdominal muscles and learning how to use them in the recovery process will make your recovery faster and also maintain the integrity of the sutures. This is very important as without this preparation many umbilical hernia surgeries come undone. An umbilical hernia is a side effect of a diastasis. When surgically repairing the hernia, the diastasis is not repaired at the same time. So if you are separated above and below the umbilical hernia and you repair just the hernia the surgery will come undone easily with intra-abdominal pressure. The Tupler Technique® will teach you how to avoid intra-abdominal pressure after surgery.
Question: Should I use mesh to repair it?
Answer: The FDA is now investigating the mesh. Here is a link so you can read more about it.
Many people are allergic to the mesh. There is no test to perform before the surgery to find out if you are. Mesh is usually absorbable which means it co-mingles with your connective tissue. Once it does this there is no way to take it out. If you are allergic to it your body will keep trying to reject it. This rejection process is very painful and there is no solution other than medication. Make sure you are an informed consumer before using mesh.
Question: If I have had surgery with mesh can I still close my diastasis?
Answer: Yes, you can get closure. Depending on the type of mesh you may not be able to close it all the way. With the absorbable mesh you can definitely get more closure.
Question: Is it normal to get a diastasis during pregnancy?
Answer: Yes, it is “normal” but not “necessary”. The muscles can stretch without separating.
If you start doing the Tupler Technique® early in your pregnancy you can prevent a diastasis from occurring or make your diastasis smaller. You can start doing the exercises in your first trimester. We recommend that you start wearing the splint in
your second trimester when you are feeling better. Wearing a splint can sometimes cause nausea.
Question: Can a diastasis cause a c-section?
Answer: Yes. Weak connective tissue cannot support a top heavy uterus. The top of the uterus then tilts forward. This forward tilt makes the cervix face sideways instead of vertically. The cervix must be lined up with the vaginal
canal in order to provide a path for the baby to come out.
Question: Do all pregnant women get a diastasis?
Answer: In my experience of checking pregnant women from 1990 to 2009, only a small percentage of women do not get a diastasis. Women that do the Tupler Technique® early in pregnancy can prevent themselves from getting one.
Question: Can pushing incorrectly in labor cause a diastasis?
Answer: Yes. It can create a diastasis or make a diastasis worse. It can also cause pelvic floor prolapses. Pushing is a learned skill and must be practiced during pregnancy so it is second nature in labor. You cannot learn a new skill (pushing) while in pain. It takes around 21 days to learn a new skill. To protect their abdominals and pelvic floor muscles women must learn how to push with their strengthened and splinted abdominal muscles while relaxing their pelvic floor muscles.
Question: Is wearing a front loading baby carrier bad for my diastasis?
Answer: Yes. Absolutely! You cannot heal the connective tissue when you have all the baby’s weight putting pressure on the weak connective tissue.
Question: How does a diastasis effect my pregnancy and birth?
Answer: A diastasis can cause back pain and constipation during pregnancy and make pushing much less effective in labor. With a diastasis the top of the uterus tips forward and the cervix then faces sideways.