What 12 Years of Providing Physical Therapy Taught Me About Treating Mummy Tummy (Diastasis Recti Abdominis, DRA)

Pssst…Magic bullet healing and exercise alone is not going to make a sustainable or recognizable difference…you might even cause more damage

As a physical therapist and expert in pelvic floor health, I believe that all “disease” is multifactorial and involves multiple systems including the spirit and soul.

The recent NPR article “Flattening The ‘Mummy Tummy’ With 1 Exercise, 10 Minutes A Day” by Michaleen Doucleff hit a nerve with several professionals in my line of work, myself included. There was a fury of action with rebuttals and opinion pieces. So when I read one exercise cures the Diastasis Recti Abdominis (DRA) it got me thinking. Can this really be the magic bullet everyone is looking for?….in a dream world yes, it is.

But then I woke up from the dream. DRA is a condition I have seen every day in my practice for the last 12 years. This condition is complex, and it has taken me some time to understand and how to treat it. I can say with all honesty; I have never seen DRA be corrected with just one simple exercise. Mummy Tummy needs to be addressed and treated from multiple angles if you are going to treat it properly. DRA healing requires; no it demands, a combination of these four elements:

  • Bodywork and fascial release
  • Pelvic floor therapy
  • Behavior modification and breath work
  • Total body conditioning exercises

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DRA is a Health Threat to Women

For instance, women with DRA are more likely to suffer from back pain, pelvic organ prolapse, incontinence and sexual pain.

How is this possible that having a mummy tummy can contribute to so many female issues?

The abdominals are deeply connected to the pelvic floor muscles through the fascial system, and they are not only there just to look pretty, but also to help support our pelvic lumbar and hip girdle region including our female organs.

When DRA is present, it can also lead to abdominal trigger points that can refer to the vulvar-vaginal area and contribute to urinary urgency. DRA is a threat to women’s physical, mental and emotional well-being and it cannot be whittled down to a one-size-fits-all exercise.

As practitioners, we need to take a holistic approach to healing and correcting the DRA. I can go on and on, but that’s not the point of this blog.

When I first read the article I was taken aback by the recommendations that included “pull in your abdominals as hard as possible” (a recipe for increased organ prolapse) or “press your lower back into the floor” (which creates poor biomechanics and reinforces poor function and posture). I am confident in saying that these recommendations rarely work in correcting Diastasis Recti Abdominis or any other physical problem.

The recommendations suggested in the article are not based on sound biomechanical principles and are microscopic in nature.

After 14,704 healing I can say with all honesty that DRA requires a macroscopic, holistic full body approach that includes the pelvic floor muscles. But this blog is not about how to heal a DRA. I want to address a much bigger issue that women are dealing with and many times get sucked into thinking.

Magic Bullet Healing Syndrome

My big concern is the “Magic Bullet Healing Syndrome”  that is plaguing us. This conditions women to think and believe that everything can be taken care of with little or no effort. And many times, there is little or no medical evidence to provide solid proof that these methods are effective and have minimal or little side effects and risk. It also makes women feel that if we don’t heal in a nanosecond, then there’s something wrong with us.

The “Magic Pill Healing Syndrome” leads women to believe that healing is supposed to be easy, fast and bulletproof. Over and over again, this type of thinking has gotten us further away from our truths and long lasting health benefits.

All we have to do is look at the pharmaceutical industry and the opioid epidemic to know there is no magic bullet that will heal you. Then take a look at the Kardashian’s and other movie stars and know that social media plays a head game on women who are desperate to get the bodies back.

Healing takes effort, time and smarts. We have to be smart enough not to fall for gimmicks and false promises. If it seems too good to be true, then it probably is.

Healing is not about what we look like on the outside; it’s so much more than pretty. Healing is about how we function and how we live each day in awareness and consciousness. Healing doesn’t happen overnight; it can take a long time and it can be an arduous journey. But it’s your journey, and as the goddess of your queendom, it is important to listen closely to your intuition and to follow the exercise programs that works for you. So the next time you are in a class, and you are promised nirvana, listen carefully to the messages of your body because I can tell you it will not lie to you.

I have included here some guidelines that will help you to conquer your DRA in a safe manner, and that will simultaneously provide you with long term success.

Trade Secrets of a DRA Healer

  1. Don’t hold your breath –  it compromises the linea alba which is the connective tissue that holds the recti abdominal muscles together and it negatively affects the pelvic floor muscles.
  2. Don’t forcefully pull your abdominal in unless you want your organs to prolapse into your vagina. A forceful inward pull creates a downward piston effect on your organs and pushes them out of place and into your pelvic floor.
  3. Get on a balanced pelvic health program that includes kegel and reverse Kegels. Depending on your symptoms, this will determine whether you should pursue Kegels or Reverse Kegels or a combination of both. As an experienced healer, I only prescribe a combination of both Kegel / Reverse Kegel in conjunction with pelvic floor massages.
  4. Massage your abdominals to release restrictions and any trigger points you find in these muscles. These restrictions are keeping your your DRA from healing.
  5. If you have had a caesarian, or have a myomectomy, hysterectomy, or laproscopic scar you must address the scar tissue as well. Many women have scar tissue that prevents a DRA from closing. Seek help from a trained pelvic therapist if needed.
  6. Train your transverse abdominal muscle. This muscle helps keep a DRA closed and provides functionality. When training this key abdominal muscle also perform a low level kegel at 30% effort. I find this combo effective in DRA healing. Perform this combo exercise in different positions such as all fours, in planks, etc.
  7. Avoid traditional crunches, which make a DRA wider. Instead use a more functional approach to training your core. I reveal how train your core properly in great detail in my online course, Female Pelvic Alchemy Online. Make sure that you are training the abdominal muscles in a comprehensive and balanced manner and avoid over-activation of the external obliques, which can keep the DRA from healing. (see photo above)
  8. Avoid unsupported forward flexion such as sun salutes in yoga, which will widen your DRA. Posture counts with DRA healing too, so avoid slump sitting and forward head posture. Make sure to align your pelvic bones. I cover this in detail in my latest book and in my classes. Pay close attention to your standing posture as well.
  9. Avoid jack-knifing out of bed. Instead log roll to maintain a closed DRA. To log roll turn to your side from a laying down and then sit up from that position.
  10. Use a belly splint in the postpartum period and wear it slightly below the pubic bone to support your uterus and bladder. A splint helps to bring awareness to the way you are using or not your abdominals with everyday activities. Splints also help support the abdominals after abdominals surgeries and it’s a good idea to utilize them. In my culture, every woman wears a splint and we call it a “faja.”
  11. Don’t forget that nutrition also matters when healing in the post-partum period. I often recommend a good bone broth and putting collagen powder in smoothies. Make sure it’s all grass fed and organic.

If it sounds too good to be true, then…

Fads have come and gone for as long as I can remember and they will continue to entice us to take advantage of them. The problem and challenge is that even though it sounds good and looks good and all the information is presented in a compelling way….it doesn’t necessarily equate to being the right thing to pursue.

I feel it is my responsibility as someone who has been there and done that, to let you know the truth, the consequences, and the risks associated with any type of new practice or technique that people may be flocking to.

Proceed with caution, at the end of the day we are talking about your life, your health, and your vitality. It’s important to me that you are informed and educated.

Sign up for the first chapter of my book, Female Pelvic Alchemy, which is full of trade secrets for energizing your pelvic health, and go deep into finding out what it takes to heal today.

UPDATE: – After the NPR article was written,  the writer has posted an update as a response to the numerous comments of her readers. Here is a link to that article as well, “Getting To The Core Of Exercises Said To Strengthen ‘Mum Tum'”

About the Author
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ISA HERRERA, MSPT, CSCS

Isa Herrera, MSPT, CSCS is a New York City-based holistic women’s pelvic floor specialist, author of 3 books on pelvic health, including the ground-breaking self-help book, Ending Female Pain, A Woman's Manual. She has dedicated her career to advancing awareness of pelvic floor conditions so that more people can find relief from this silent epidemic that affects over 30 million people in the US alone. Ms. Herrera holds a BA in Psychology and Biology from Fordham University and also a Masters in Physical Therapy from Hunter College. Click here for a complete bio.