By Julie Tupler, RN | Updated September 20, 2026
Sometimes surgery is needed. But separated muscles do not always mean you need an operation. First learn what is causing the bulge. Then ask if a full core program is a good choice for you.
A gap is not the whole story
When I check a diastasis, I look at the gap between the two front muscles. I also check how deep the middle tissue feels. Then I watch what happens when you move.
Some people have a wide gap and can learn to make it smaller with the Tupler Technique®. Other people may have a tear, a painful hernia, or loose skin that hangs down. Those problems may need different care.
When a nonsurgical program may be worth trying
The middle tissue may be stretched without being torn. If your clinician says exercise is okay, you may want to try a full program before you decide on surgery.
The Tupler Technique® is not a list of random ab moves. It has four parts. You work the deep abdominal muscle. You use a splint as part of the program. You use the deep muscle during the day. You also learn to get up and down without pushing the belly forward.
Give the work time. Measure the gap and depth before you start. Then re-check them. Your own progress gives you better information than a promise from the internet.
When surgery may still be needed
In Together Tummy, I explain when surgery may be needed. One reason is a tear in the middle tissue. Another is a hernia that causes serious pain or other warning signs. A third reason is loose skin that hangs down. Exercise cannot remove extra skin.
A surgeon—not a blog article—must help you decide if an operation is right for you. Ask what will be fixed. Ask what healing will be like. Ask what you can do before and after.
Prepare your core before an operation
We prepare knees and shoulders before surgery. Your belly muscles need help too. You use them when you stand, cough, laugh, use the bathroom, and get out of bed.
Learn to control pressure before surgery. This can help you move with less strain as you heal. It also teaches you not to push hard against the healing area.
Protect the repair after surgery
- Follow your surgeon’s instructions and lifting limits.
- Use the log-roll to get out of bed.
- Breathe out instead of holding your breath when you move.
- Ask when it is safe to restart Tupler Technique® work.
- Report increasing pain, redness, fever, vomiting, or a new bulge.
The goal is not to talk everyone out of surgery. The goal is to help you know your choices. If you do need surgery, you can go into it with a core that knows how to work.
Explore the pre- and post-surgical program
Learn how the Tupler Technique® prepares abdominal muscles before surgery and teaches protected movement after surgery.
VIEW PRE- & POST-SURGICAL OPTIONSJulie Tupler sources used
- Together Tummy, Chapter 3 and Chapter 7: “Ab Rehab—Preparing for Abdominal Surgery” — Julie Tupler, RN
- Pre- and Post-Surgical Tupler Technique® Programs — DiastasisRehab
