diastasis recti

Our Response to NPR Article About Fixing "Mum Tum"


NPR recently published an article entitled "Flattening the 'Mummy Tummy' with 1 Exercise, 10 Minutes a Day" (read it here) that has been getting a lot of attention. We wanted to give our patients and readers our take on this abdominal strengthening program.

First of all, the "mum tum" or "mommy pooch" as the article calls it, is a real thing. They do a great job describing diastasis recti (read our article on this topic here)  and it's known to cause lower back pain as well as a lot of other pain or dysfunction. Strengthening the abdominal muscles is the best way to correct this problem. In severe cases, a mesh can be surgically applied to essentially replace the ruptured tissue, but this is generally only done if the patient has developed a hernia.

In the article, Leah Keller, fitness coach and creator of this particular exercise program, states that the abdominal muscles need to be realigned in order to resolve this issue. For her exercise, she has her clients sitting cross-legged on the floor. She then has them take a deep inhale and expand their bellies. Then, as they exhale they pull in their abdominals by pulling their belly toward their spine. Next, they take short inhales followed by an exhale in which they try to pull their belly button closer to their spine. Every 2 minutes they change position, sitting on their heels, hands and knees, squatting, etc. until they've exercised for 10 minutes.

In our opinion, the basic component of this exercise is good. By having these women pull their belly button toward their spine as they exhale, they are engaging their transverse abdominis (TA) and internal obliques (IOs). This is essential in correcting a diastasis recti. Although the problem itself lies in the overstretched or ruptured linea alba that lies between the two sides of the rectus abdominis muscle (or six pack muscle), exercising the rectus itself will not improve things at all. The TA and IOs have to be targeted as those are the muscles that create a natural corset around our core, cinching in our waists and giving support to our spine and abdomen.

One problem that we have is initiating this exercise while sitting cross-legged on the floor. This places the thigh bone in too much external rotation in the hip and will draw the pelvis forward, arching the back, and placing the abdominals in an elongated position called "positional stretch". Trying to contract a muscle this way is very difficult and not very efficient.

The main problem we have this exercise is the breathing technique. By taking in small breaths, ribcage motion is restricted, utilizing accessory respiratory muscles from the neck and shoulders is encouraged, and poor respiratory mechanics are being taught during abdominal activation. Sure, this may cause some TA an IO strengthening as the muscles are being contracted for some time, but it's completely nonfunctional. It is essential to learn proper respiration while activating the core. This not only allows the client to strengthen the abdominals, but to teach them to keep them engaged, subconsciously, while they walk, talk, and breathe throughout the day. That is fully correcting the problem and stabilizing the core. The former is simply contracting the abs for 10 minutes a day with poor mechanics.

Want more information or to learn to correctly recruit your core while breathing normally? This is a pillar in all of our treatment programs at Integrate 360 Physical Therapy. Call us at 314-733-5000 or email Lesley@integrate360pt.com or Nancy@integrate360pt.com today!