Hernia Care & Surgery by Julie Tupler

different types of diastasis rectus abdominus - fit2b.com


Surgery was thought to be the ONLY way to fix a wide and deep diastasis recti for a long time. We now understand that surgery isn’t always necessary, and when it is needed, some “prehab” is still beneficial. Hernia is a hole in the abdominal’s connective tissues, and diastasis recti is a thinning of the same tissue. The two are connected, and the protocol that helps one can help the other! If you do need abdominal surgery of any sort, here are some things you should know!

Why does abdominal surgery, more than any other surgery, need preparation?

Because we use our abdominal muscles with every move we make. So, If we don’t know how to stabilize our core correctly after surgery, the stitches will likely come undone.

When stitches come undone following abdominal surgery, this is called an incisional hernia, and it requires another surgery to repair those stitches again!

Preparing your core before abdominal surgery, and not just relying on the surgery to fix you abs, will prevent an incisional hernia and ensure a successful outcome. Going through programs like mine to strengthen your core and narrow your diastasis may even reduce your need for surgery.

 So how do you prepare your damaged abdominals for surgery?

Preparation then means strengthening the abdominal muscles and having an awareness of how to use your abdominal muscles in the recovery process.  After abdominal surgery, your surgeon will say, “Don’t lift anything heavy or over 5 pounds.”  But when you go from a seated position to a standing position you are lifting  a whole lot more than 5 pounds! You’re lifting your whole body weight.

If you don’t know how to first consciously engage your transverse abdominal muscles which is moving them in a backwards position away from the stitches, then the force of your whole body weight will be going forward forcefully on the stitches.

Here on Fit2B, Beth brings the transverse abs into all of her routines, and you can watch her video about the transverse here to learn some basics.

However, I have a program devoted exclusively to training the transverse and healing diastasis called The Tupler Technique. The research done by Columbia University Program in Physical Therapy using the Tupler Technique® Program has been published in the Journal of Women’s Health Physical Therapy. This research done with 1200 clients showed that clients made their diastasis 55% smaller in six weeks.

Why is it important to make your diastasis smaller before surgery? 

Why can’t you just rely on the surgery to fix your gap? Well, first of all, you need strong abdominal muscles so you can keep these muscles engaged when doing activities of daily living immediately after surgery because self-care and perform motions like sitting, standing and using the bathroom

Also, take an umbilical hernia for example. An umbilical hernia is a side effect of diastasis recti. If your muscles are separated and open above and below your belly button, and you just fix the hernia that is in the  middle, the surgery will probably come undone. The likelihood of those stitches staying in place is not so good.

Making the diastasis smaller is accomplished by strengthening the connective tissue and muscles.  Strong connective tissue is easier to sew and strong muscles will maintain the integrity of the stitches.

The last and best reason that you should make your diastasis smaller before abdominal surgery, especially an umbilical hernia, is because narrowing your diatasis – which may also narrow your hernia – may mean that you do not need the surgery after all! I go into more detail about preparing for abdominal surgery in my Ab Rehab DVD which you can purchase here.

Also, I would like to share with you my talk about making a diastasis smaller at the First World Hernia Conference in Milan.  Please click here to watch that on my website.


Experts on Diatasis Recti: Hernia and Surgery Care by Julie Tupler - fit2b.com

The above set of 4 images is from a client of mine who was able to AVOID surgery altogether. Juliette Spencer gave me permission to share what she wrote:

“Hi Julie, I wanted to update you with my wonderful news. I visited the hernia surgeon at NYU and have been told I do not need the hernia surgery to repair the umbilical cord hernia. It’s gone! As you can imagine, I’m absolutely over the moon and cannot thank you enough for your knowledge and support. I’m so thrilled. The surgeon had said that she’s never seen anything like and would love you as a resource for her patients. I’ve forwarded your details to her.Thanks!”

Let me wrap up this lesson with a video that sums up my thoughts. Diatasis recti has a direct impact on hernia and surgery. You can reverse umbilical hernia and not need surgery, or if you have to have the surgery you can make the muscles and connective tissue stronger beforehand so you have the strength and awareness to use them in the recovery process to maintain the integrity of the sutures.

The impact of diastasis on hernia and abdominal surgery

As I finished writing this lesson, I just got an email from a woman who has had several unnecessary surgeries. It just about made me cry when I read it.  Surgeries keep on coming undone!!! And they don’t have to. They shouldn’t.

I hope I’ve given you hope. And I’m here for you if you have any further questions. Beth and I were able to have lunch together when she was in New York recently, and we were nose to nose over the table. We are both so passionate and want to help all the bellies. Thanks for reading and learning with us!

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