QuestionQUESTION: A little info about me: I have 2 children, my youngest just turned 4. My diastasis was initially quite large 3-4 fingers from stem to stern. I did physical therapy,your Bounce Back Fast video, the Tuppler Technique and Peggy Brill's Core Workout book, and easily closed the diastasis below my belly button. That part has never popped back open. The trouble spot is about 2 1/2-3" starting at my belly button and going up. At it's worst, this spot is 3 fingers wide. I work and work and close it mostly just to have it pop open in a week or two. Most recently, I was able to close it all the way and it stayed that way for about 1 month. But, I got bad allergies and was coughing a lot and it popped open again. One cough actually made something pop out of the tiny umbilical hernia I have. I coughed, I felt my already-outie belly button get firmer and tender so I pushed on it and could feel whatever it was that popped through, go back in.
So, I have a couple questions: What is the proper way to cough so as not to reopen my diastasis? Coughing has done it to me before but I've never felt anything pop through. I went for a consult with a laparoscopic surgeon months ago and he said to close the hernia would take 1 stitch so it must not be very big. Also, I am working to reclose it but I wonder will it forever be a battle of reopening when I do something incorrectly (cough, get out of bed wrong, etc) and then working to reclose? Will the diastasis ever become closed so well and the muscles retrained enough that they just stay that way?
Because of the hernia popping out and the diastasis coming and going, I am considering the surgery. (Is the surgery sucessful in closing diastasis and keeping it closed?) It is deflating and discouraging to work hard and have it not stay fixed.
Thanks,
Karen
ANSWER: Sneezing and coughing are very forceful and explosive. I have heard of these types of events causing an umbilical hernia and even uterine and/or bladder prolapse.
Certainly you should splint your mid line, with your hands, to limit the amount of tensile force on your mid line, during coughing events.
You can do rib closure exercises, which can help reduce the stretching forces on the upper part of your mid line.
Here's a basic one:
Wrap the fitness band around your lower ribs and pull it taut. When you exhale, tighten your core as much as you can, and pull the band tighter. As you do this, pull the ribs inward as much as you can too. The band will provide some assistance with this move. Your lower ribs should move into a more beveled shape, and you'll feel a strong core activation. This exercise will also give you a more pronounced hour glass shape over time too. :)
When doing my core exercises, you can also add manual splinting of the lower ribs (pulling them together) so that you train the upper fibers of your transversus and obliques to work together to close and stabilize the top half of your mid line.
Most doctors will not close the mid line in conjunction with a hernia repair (which really doesn't make sense as there's a direct cause and effective with the two conditions) so a diastasis repair would be considered a second procedure. Generally, insurance will not cover this part, even if it means a few more stitches. Surgical repair of diastasis lasts until your next pregnancy, so you should only consider it when you know you are done with family building.
http://befitmom.com/abdominal_separation.html
---------- FOLLOW-UP ----------
QUESTION: Thanks for your quick response!! So it sounds like the surgery could be a permanent fix. Does the exercise fix eventually produce permanent results or will it continue to open and close periodically through my life with every incorrect move or lapse in workout?
Thanks again,
Karen
AnswerYour situation is a bit unusual, since you're 4 years out from being postpartum. I suspect that your upper connective tissues have never really healed, or have continued to be strained, and that's why your mid line has not remained closed.
You should be able to have good functioning, and no bulging, with proper exercise. As to whether or not exercise can offer you a permanent solution, I wish that I could give you a guarantee, but in all honesty I can't, as I'm not there training you, or able to assess the root cause of why your mid line does not stay closed.
http://befitmom.com/abdominal_separation.html
