I've seen this a fair amount of times in my work as a chiropractor and a fitness coach. The "belly pooch" young women will refer to it as, "it never goes away no matter how many sit-ups I do."
This bulge you are referring to may very well be a condition known as diastasis recti, which means a separation (diastasis) of the recti (your rectus abdominis or "6 pack" muscle). This condition occurs most commonly in pregnant and postpartum women, newborns and in some cases, men. In women, a sign that you have a diastasis is an observable ridge through the centre of your abdomen, anywhere from your xiphoid process (bottom of sternum) down to the umbilicus (belly button). If you continue to have a pregnant looking belly, or a larger bulge post partum, a diastasis recti may be partly to blame.
A diastasis is a problem when it causes the tummy "pooch," when it contributes to a weak core, your back hurts, or your tummy sticks out and you can't seem to make a change. It's a problem when the connective tissue is stretched and your muscles can no longer support your abdominal and pelvic region(2).
The population that is the most likely to have a diastasis is women who have given birth, and especially multiparous women (pregnant more than once) because of the repeated stretching of the stomach muscles. Pregnancy puts pressure on the belly and the muscles cannot maintain their shape. When the separation happens, there is only a thin band of connective tissue to hold everything in place. While the separation can resolve on it's own, often times women are not made aware of this condition and it can last for several years post partum. Some studies suggest that 66% of women have it in the third trimester and 53% of women continue to have it immediately post partum. At 5-7 weeks, 36% of women continue to have it, and at 8 weeks, no further closure will happen without intervention(3). Another study suggests that 66% of women with diastsis recti also have some level of pelvic floor dysfunction (Spitznagle et al 2007)(2)….. I happen to know a number of CrossFitting Moms who have trouble with leakage when doing skipping or box jumps (stress incontinence).
So what can you do?
What should you not do?
Exercise like crazy - Perhaps this "pooch" is driving you crazy and you are spending extra time in the gym to get rid of it. If it is deemed that you do have a diastasis, be very careful with some exercises. Crunches, sit-ups, poorly done push-ups and front planks can make the abdominal separation worse. While lifting is effective exercise, the straining that is often associated with it can make the separation worse.
Ignore it - If you have a diastasis, while diet and a regular exercise routine can help, if you are not doing the proper exercises you will not get rid of that "pooch."
Disclaimer: this blog is meant for educational purposes only. It is not meant to diagnose or prescribe. Always talk with a trusted health professional before undergoing a new health program.
Image from: https://mutusystem.com/you-can-have-a-flat-tummy-and-a-small-diastasis-recti-i-have.html
Dr. Alli Cain Team
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