DIASTASIS RECTI RESEARCH AND EVIDENCED BASED EXERCISE PROGRAM | TUPLER TECHNIQUE®
A ROADMAP TO CLOSE SEPARATED MUSCLES WITH THE MEDICALLY ENDORSED NON- SURGICAL TUPLER TECHNIQUE®PROGRAM
DEFINITION OF DIASTASIS RECTI
Separation of the outermost abdominal muscles (rectus abdominis).
CAUSES OF DIASTASIS
Everyone is born with their muscles separated. Usually the muscles come together around three years old after the nervous system has developed. Because of the weakness in the connective tissue at the belly button, continuous force on this weak spot can separate the muscles again.
Force on the abdominal muscles that stretch the connective tissue either in a forward or sideways direction will separate the muscles. Pregnancy, abdominal surgery where they blow your belly up with air, improper exercises such as crunches and gymnastics, automobile accident can all create this force on the connective tissue.
EFFECTS ON YOUR BODY
The job of the outermost abdominal muscles is to support your back and organs. The muscles must be close together to do this. When the muscles separate and the connective tissue joining these muscles stretches sideways, it cannot provide this support system anymore causing side effects like back pain, constipation, bloating after eating, umbilical hernia, poor posture, and pelvic floor issues. A diastasis can put a pregnant woman at risk for a C-section and a patient having abdominal surgery at risk for an incisional hernia.
WHY YOU NEED TO CLOSE YOUR DIASTASIS RECTI?
To have a strong core your muscles need to be close together. You need to close your diastasis because it will only get larger as you age and by doing improper exercises. The larger your diastasis, the more side- effects you will have and the longer it will take to close it.
WHY THE TUPLER TECHNIQUE®?
The Tupler Technique® program will close your diastasis recti no matter how you got your diastasis or how long you have had it! It is both research and evidenced based. Our statistics show that if you follow all 4 steps of the program your diastasis will close 55% in six weeks! You can see what that looks like by checking out our before and after photos. You can also check out our testimonial page and read what doctors and our clients have to say about the Tupler Technique®. Julie Tupler, creator of the Tupler Technique®, is a registered nurse, certified personal trainer and childbirth educator, and has been treating diastasis recti since 1990 when she started with her Maternal Fitness® Program to prepare women for the marathon of labor and motherhood. Julie has written three best selling books on diastasis recti (Maternal Fitness, Lose Your Mummy Tummy and Together Tummy). She has produced five videos (Lose Your Mummy Tummy, Say Goodbye to Your Gut Guys, Perfect Pushing, Ab Rehab and Belly Button Boogie) Her program has been translated into 6 languages (Spanish, Portuguese, Italian, German, Danish and Czech). She has developed the Diastasis Rehab Splint®, Diastometer for measuring diastasis, TogetherTape, Corrective Connective Tissue Cream and TogetherWear. She speaks at medical and fitness conferences all over the world and trains medical and fitness professionals all over the world her Tupler Technique® Program. Dr Oz says she is an expert on diastasis recti as well as many other physicians.
LOGISTICS OF THE TUPLER TECHNIQUE® PROGRAM
How does the program work?
The Tupler Technique® Program is all about healing the connective tissue (linea alba) between your separated muscles. Here is the “big picture” of how it works. It heals connective tissue by:
- Re-positioning (or realigning) the stretched out connective tissue AND your separated muscles with the Diastasis Rehab Splint®. Re-positioning the connective tissue is important to take the stretch off the stretched out connective tissue and continuously keep it in a narrow position while it is healing. Continuously wearing a splint is like continuously wearing a cast when you have a broken bone. It differs in that wearing a splint will NOT weaken your abdominal muscles. Repositioning the muscles and bringing them close together is important so the muscles move in a front to back direction instead of a sideways direction which stretches the connective tissue and does not strengthen the muscles. When the muscles are close together you can “feel” them working.
- Protecting your connective tissue from getting stretched either in a forward or sideways direction. That is why the first six weeks of the program is about developing transverse muscle awareness while allowing your connective tissue to heal. You use your transverse muscle (innermost abdominal muscles) with every move you make and every breath you take. When you engage your transverse muscle it prevents a forward stretching of your connective tissue. That is why to protect the connective tissue you need to engage your transverse muscle with all activities of daily living and then in Week 6 of the program while working out.
- Strengthening your connective tissue and transverse muscle with the Tupler Technique® Exercises. The muscles and connective tissue must be aligned before doing the exercises, so the muscles move in the right direction and the connective tissue does not get stretched. In Week 1 and Week 2 of the program, the seated contracting and elevator exercises are done. In Week 3, the contracting exercise increased from 5 sets of 100 to 10 sets of 100. Then every three weeks the number of contracting exercises is increased and progresses to 20 sets of 100 in Week 18 of the program. In Week 4 of the program after the transverse muscle has been strengthened in a seated position the back lying head lift is started. This is because it is much more difficult to engage the transverse muscle in a back lying position. Double splinting is also started in Week 4 of the program. Double splinting is wearing one or two splints and holding another splint (scarf) while doing the seated and back lying exercises.
How to check for a diastasis
To check a diastasis correctly you need to check for two things:
- The distance between the two separated muscles
- The condition of the connective tissue
You check the diastasis in three places:
- At the belly button
- Above the belly button (halfway between the belly button and the bottom of the sternum
- Below the belly button (halfway between the belly button and the pubic bone)
Before you check the diastasis:
- You have client lift the head and shoulders and see if there is any doming of the abdominal muscles (looks like a half football)
- You check to see if the clients belly button is in or out.
- If the client has either of the above symptoms you know the client has a very large diastasis and you need to use two hands to check the diastasis or the
- It is important to remember that you want to check the diastasis at its largest. The higher the head and shoulders come off the floor the closer the muscles come together. You want to check the distance when the muscles first start to move together.
Steps for checking for diastasis recti by individual or healthcare provider:
- The client is laying on back with knees bent
- Person checking puts either one or two hands in the first location that is being checked.
- Client needs to relax the muscles
- Then the client engages their muscles and person checking to feel the muscles coming together.
- Then they relax the muscles and you follow the separating muscles sideways to see how many fingers it is. If you must spread your fingers you should sue the Diastometer and measure each side in centimeters.
- Do this a few times so you can feel the movement of the muscles.
- If you have a difficult time, then the head can be lifted just a little. You can even feel the movement with just the intention of lifting the head. Remember, you want to check the distance when the muscles first move so you can check the separation at its largest.
- Then you check for the condition of the connective tissue. You can use your finger or the Diastometer finger cot that measures the condition in centimeters.
- You measure in the same three places.
- Again, the muscles are relaxed. Then, a finger (or finger cot) is put on the skin or the belly button and you see how deep the finger goes. The deeper the finger does, the weaker the connective tissue.
- The numbers are written down in their Tupler Technique® Guidebook. This guidebook is the “cliff notes” of the Tupler Technique®
- Besides measuring the distance and the condition of the connective tissue, it is important to measure the circumference of the body in three places (under breast, waist and over belly) and take before belly photos of the belly from the front and the side. Seeing the images of the belly changing as well as seeing the decreasing numbers will provide motivation to continue the program.
Four steps of the program
The four steps are:
- Tupler Technique® Exercises (Contracting, Elevator & Head lift)
- Splinting with Diastasis Rehab Splint® (The purpose is to approximate the muscles and connective tissue. Most binders are for compression which is very different). The splint must be worn all the time (except for 15 minutes when you bathe) until the connective tissue is strong enough to keep the muscles close together. Make sure to dry your belly button before putting it back on. You don’t want to close a waterlogged belly button as it puts you at risk for a rash.
- Development of transverse muscle awareness with activities of daily living and then with an exercise routine.
- Getting up and down correctly (seated to standing; standing to seated; seated to back lying; back lying to seated.
- The program progresses over 18 weeks. How long it takes to close a diastasis depends on the severity of the diastasis and the commitment to doing all 4 steps of the program.
- During the first six weeks, it is important to develop transverse muscle strength and awareness while allowing the connective tissue to heal. So, it is important to do only aerobic exercises like walking outside or on a treadmill, upright stationary bike, or elliptical machine. No running or jumping or exercise classes.
Diastasis Safe Workout
In week six of the program, whether the diastasis is closed or not closed, the Tupler Technique® Program teaches how to do a “diastasis safe” workout in order to maintain the gains that have been made in the first six weeks of the program. Because of the weakness in the connective tissue at the belly button, if you start putting forward abdominal force on this weak spot the muscles will separate again.
A diastasis safe workout means:
Having a strong transverse muscle so it can be used with every repetition of every exercise. If you cannot hold your transverse in it means either your transverse is not strong enough OR you are exercising in a position where it is impossible to engage the transverse muscle. An example is crunches, roll-ups, and rollbacks.
You also must avoid exercises that stretch your connective tissue in a sideways direction. These are ANY exercises where you are arching your back. When you arch your back, you are flaring your ribs. When you flare your ribs, it is impossible not only to engage your transverse muscle, but it also stretches your connective tissue in a sideways direction. The other movement that stretches your connective tissue in a sideways direction is a forward crossover movement. This is a shearing movement.
In week six if you start exercising and you have not closed your diastasis, you will not want to do downward facing down abdominal exercises. In this position, all the weight of the organs stretches the connective tissue. So, exercises like pushups or planks can be done standing against the wall.
Closing your diastasis will not only give you a better- looking belly, but it will give you a strong core and a strong core supports your whole body. Yes, closing a diastasis will change the way you look and feel.