The Activcore Blog

Why is My Belly Bulging or Pooching Out in the Middle? It Sort of Looks Like I’m Still Pregnant.

Posted by Dr. Rachel Newall, Physical Therapist at Activcore on September 23, 2019 at 12:33 AM

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Are you frustrated with trying to get your pre-baby body back? Are you seeing your belly bulge out when you do abdominal exercises or even when you just sit up? Are you nervous and feel like you can’t start exercising because you don’t want to make the bulge worse, have back pain, urinary leakage or just don’t know where to start? If this at all sounds familiar, you may be experiencing symptoms of something called diastasis recti (DR).

Diastasis recti is basically when the connective tissue (linea alba) between the front abdominal muscles (rectus abdominis), commonly referred to as the six-pack muscle, becomes too lax or stretched out as a result of the abdomen growing to accommodate for the increased size of the uterus and fetus during pregnancy. It’s important to recognize this as a normal response for the body, especially considering this fun fact: “At 38 weeks gestation, the length of the abdominal muscles increase a mean of 115% compared to the beginning of pregnancy.” Studies have also found that DR can affect up to 70% of women postpartum — so you’re not alone!  When you engage the muscles, such as during a sit up, the fascial tension is unable to counteract the increased abdominal pressure sufficiently enough, thus allowing abdominal viscera, or simply put, the soft tissue between the muscle to bulge/balloon/tent out. 

When measuring the width of the LA (that gap in the middle of the 6-pack muscle) it is considered normal to have a width of 2 finger breadth, while a severe DR would be considered 4 to 5 finger widths. Take a look at this video to learn how you can check your own abdomen.

 

 

So now that you’ve watched the video, if you’ve discovered you do indeed have excessive laxity in between the muscle, don’t worry, we can help! You will want to address this ASAP so you can start restoring the stability within your deep core, making the most out of your workouts and start fixing the belly bulge!

 

Diastasis Recti

 

If you are currently doing crunches in attempts to get rid of the baby belly, please take a step back. Doing crunches may narrow the width of the LA but since the tissue is too lax, it can make the abdominal bulge even worse, especially when done repeatedly. Contrary to popular belief, it’s not all about closing the gap, but restoring the fascial tension so it can support your abdomen, lumbar spine and pelvic floor. You will first want to learn how to engage your transverse abdominis (most easily felt at the lower portion of your belly) and coordinate that with your pelvic floor. This can be done by doing a gentle pelvic floor muscle contraction and drawing your belly button in towards your spine. Sometimes imagining drawing your two hip bones together can be helpful as well. This will give your core better stability all around and improve the tension along the LA so that your core is able to efficiently work in your favor. You should not see any belly bulge while you’re doing this. You can also add support by giving manual pressure to the sides of your abdomen to help approximate the muscle while doing a gentle head lift.

Take a look at my other exercise videos to give you a clearer idea of how to do this properly. This will put you on the road back to flattening that bulge!

 

 

 

We will also want to be sure to address the deep core as a whole and build your foundation up properly before overloading it with all of those other fun activities we love to do! Most people usually think of your core as your lower belly; however, the core is really comprised of 4 main areas and make up a canister of sorts - the top is your diaphragm, bottom is your pelvic floor, front is the transverse abdominis (TA) and back are the deep multifidi. Again, don’t worry about the specifics of these muscles or their names, that’s my job :)  But in order to appropriately address this and get you back up and running again (figuratively and literally for some of you!) we will be working with all of these muscle groups. You will be doing your body a disservice if you only address one or some. We will work on restoring tension and narrowing the gap with a series of progressive front core exercises, focusing on the TA, while also getting your ribs and diaphragm to move in coordination for proper breathing, strengthen your supportive back muscles and make sure that your pelvic floor is not only able to contract, but has endurance, quick engagement and the ability to relax. 

As we get the core functioning properly again, we will also be working on the rest of the body! A huge function of the core is to be able to support your body while you move. So it makes sense to train it that way right?! We will be incorporating mobility, stability and strength training throughout your limbs, pelvis and core to retrain the body to safely accept and transfer load so that when we lift our cute little ones up, we do it confidently and without pain; when we go for a run, our core supports us from all angles; and when we go out with the girls to dance for the night, you can do all those crazy dance moves without worrying about that middle belly bulge and how it’s affecting the rest of your body!

If this sounds like you, please find an Activcore location so we can make that baby bulge a thing of the past and get you back up and safely moving again!

Learn more about optimizing your health and performance by checking out our Pelvic Health page.

 

Additional resources:

Diastasis Recti Abdominis - diagnosis, risk factors, effect on musculoskeletal function, framework for treatment and implications for the pelvic floor.  Werner, L. A. & Dayan, M. Current Women’s Health Reviews, 2019, 15, 86-101.

Topics: Pain Relief Treatments, Pelvic floor physical therapy, Pelvic Floor Dysfunction, Pelvic Health, Pregnancy, Post-partum