It was one of those days in which something in you finally cracks, or maybe you’ve just had some really good coffee, and your spirit becomes filled with light. There, in my Los Angeles apartment, I felt flooded with resolve: Today, four years after giving birth to my baby, I will do those mom-centric HIIT workouts. The ads had been following me around, popping up in my news feed, for years, offering to help “get my body back,” as if I’d misplaced it. Bounty hunters for mothers haunted by the ghosts of their former physiques. I lay down on the floor without even bothering to drag the dusty yoga mat from beneath my bed, wanting to do something before the inspiration dissipated. As I lifted myself into my first abdominal crunch in hundreds of weeks, I gazed down the length of my body, and what I saw stopped my heart cold. It looked like there was a creature of sorts, an alien, probably, trying to push its way out of my belly.
My belly — my sweet belly, which held my baby as well as all manner of snacks through the years — was not tightening with the effort of my exercise; it was doming, popping up into a strange fleshy mound vaguely football-shaped. Looking at my literal stomach, my metaphorical stomach dropped. I knew what this misshapen flex signified.
Diastasis recti names the condition of your abdominal walls separating. For many women, during pregnancy the uterus begins pushing intensely on the rectus abdominis, a.k.a. your abs. This muscle runs in twin swaths, one on the left side and one on the right, from the middle of your rib cage down to your pelvis. The two halves are kept together by the linea alba, fibrous connective tissue formed mainly of collagen. When people have been repeatedly pregnant, or pregnant with multiples, or perhaps not pregnant at all, just possessing a body in which body fat is stored in a way that puts pressure on the muscles, that tissue can stretch and thin out, allowing the muscles to weaken and slide and say bye-bye to your core. Even after a single pregnancy, some people find their six-pack splitting, and folks whose body has never carried a baby can find themselves with the domed or coned pooch that commonly results from weight lifting or heavy manual labor, actions that can unduly stress the abdominals and cause that tissue to thin. While everyone is potentially vulnerable to diastasis recti, the condition is seen overwhelmingly in those who have experienced pregnancy.
By the third trimester of a pregnancy, all those carrying a child will experience their separation; there’s no other way for your body to accommodate the beloved parasite. For many formerly pregnant people, after childbirth their bodies do indeed “return.” But for one in three gestational parents — or double that, according to a Norwegian study — those abdominal muscles do not in fact rejoin, and they find themselves studying the conical dome of their new “mummy tummy” with a mixture of fascination and horror.
With now only a stretched-out band of connective tissue holding their internal organs in, folks with diastasis recti find themselves suffering lower-back pain as other muscles exert themselves to compensate for their new nonexistent core (hip and pelvis pain are also common). The pressure the condition creates on the weakened muscles can cause constipation (and the straining associated with constipation in turn exacerbates diastasis). Without the snug hug of a healthy pair of abs, both the bladder and the uterus can slide downward. This bladder migration is likely to cause moments of incontinence, such as when a person coughs or sneezes, or laughs with gusto, or joins their child on a trampoline on a sunny afternoon. Not that I’d know about that.
I would definitely know about one of the worst outcomes of having diastasis recti, which would be suffering a hernia, which is when your emboldened intestine decides to go over the wall and pokes grotesquely right through the linea alba. I had a surgery to poke the little fucker back in and patch up the vandalism with some mesh. Insurance paid for it, as it would surely do in the event that my uterus or bladder decide to prolapse. But would insurance pay to fix the underlying cause of all these maladies? Not so fast.
When I brought up my diastasis tummy to my general practitioner, she dismissed my shock and horror with a flip of the wrist. “All mothers have it,” she said with a shrug. “There’s nothing you can do about it — unless you get a tummy tuck.” I thought about the wear and tear I experienced, both physically and emotionally, after my hernia surgery, the long and painful recovery period. How my most favorite ways to be in my body — battling the weight machines at the local Y, getting sweaty at a yoga class, having athletic sex — were now fraught, if not off-limits, for their likelihood of making the condition worse. Yeah, I know a lot of mothers have diastasis recti, but that flip of the wrist hardly soothed the despair I felt at these new limitations on my body. I was utterly left to my own devices to find a way to care for a condition that, if left untreated, will only worsen, the possible side effects growing in probability. And yet that tummy tuck (in other words, a classic abdominoplasty) my doctor casually suggested costs anywhere from about $7,500 to $15,000 and, as it is considered a cosmetic surgery, is not covered by insurance.
The surgery that actually heals diastasis recti once and for all is not a tummy tuck. In the diastasis surgery, a doctor takes the edges of the separated ab muscles and sutures them back together. In an abdominoplasty, the same is done, plus the doctor gets rid of now-excess fat and skin. The fact that these two procedures are so similar and that one is to heal a common and potentially severe health problem, while the other is to assuage personal vanity (no shade; I’m vain too) — plus the reality that it mainly afflicts women’s bodies — gives insurance companies an easy out, claiming the surgery is not “medically necessary.” At what point, I wonder, does health care become “necessary”?
When I bemoaned all this to my sister, she told me about a miracle worker of sorts, someone she has heard about through her own decade-plus of dealing with diastasis. Finally, some hope. Maybe.
Julie Tupler is a middle-aged white woman with a dark, chin-length bob and business-casual style (unless she’s demonstrating exercises, when she prefers a snug cami). She got involved in the belly business in 1987 while teaching a prenatal class at a New York fitness club. Already both a personal trainer and a registered nurse, the experience of working with pregnant women inspired her to add childbirth educator to her résumé and wrap all her skills up in a business venture called Maternal Fitness. Working with the physiques of so many formerly pregnant women put her in close contact with a lot of diastasis recti, and by 1990 she developed her patented Tupler Technique, a system of movement and exercise that didn’t cure the condition but managed to get it under control, keeping all the accompanying side effects at bay. By 2009, Tupler had moved from Maternal Fitness to a new endeavor, Diastasis Rehab, which aimed to help — in addition to moms — men and children afflicted with the condition. She has written books and produced videos, been blurbed by celebs such as Dr. Oz and Elle Macpherson, trained a number of health-care and fitness workers in her techniques, developed a handful of products, and currently offers an 18-week virtual boot camp for diastasis sufferers like me, ready to do something proactive about their body bummer.
Compared to surgery, the Tupler Technique is cheap, ranging from $240 to $427, with packages for men and women, pregnant women who want to achieve “perfect pushing” during labor, folks undergoing abdominal surgery who want optimal recovery, and kids. Tupler’s Basic package for women, the $240 option, gets you splints and videos, a guidebook, online support, Corrective Connective Tissue Cream, and TogetherTape (basically some longish Band-Aids used to tape both sides of my stomach together — hilarious). For an additional $140, Basic Plus, she throws in a splinted tank top. The Premium option gets you another book, a “dyna band,” and a wonky Diastometer: a scratchy Velcro band that measures your belly while an attached bulky plastic finger cot is plunged into your diastasis canyon to measure the depth. (All packages appear to be perpetually on sale, knocking $15 to 30 off.) This is where I’d love to tell you I immediately clicked Basic and signed up for my 18 weeks of diastasis rehab, but I’m a skeptical cheapskate — skeptical not only of magic cures touted on the internet but also my own ability to stick with a fitness program meant to last the rest of your life. That’s correct. Because the Tupler Technique, like all exercise-based diastasis interventions, doesn’t cure the conditions but merely checks them, so you must commit to doing these exercises every day, from now until you go to the big fitness studio in the sky.
According to claims, if you stay on top of the regimen, the results are real and exciting. Also according to claims, if you slack off and drop your routine, your Mommy Dome rears its conical head once more, bringing along all its possible side effects. As much as I liked seeing there was a path to dealing with this, I trembled at the commitment and shut my laptop.
Flash forward three years to 2021, when a round of back pain and constipation brought me to a very witchy chiropractor who took one look at my abs, jammed her fingers in the crevasse where they split, and exclaimed, “You have diastasis!” I returned to Tupler’s website, which assaults the eyes with red bands of type shouting “WANT A FLAT BELLY? INNIE BELLY BUTTON?” and close-up photos of flat white bellies sporting little winking bellybuttons.
Having just signed a book deal about my pregnancy, I decided to invest some of my advance in the belly that made it all possible. Feeling splurgy, I bought in at the top tier, which guaranteed I’d get every piece of useless swag Tupler was toting.
What I did use, every single freaking day, was the Diastasis Rehab Splint: A core tool in Tupler’s regimen, the many-armed swath of black elastic is corseted around your middle for the full 18 weeks of the program. The splint, per the instructions within the enclosed book, Together Tummy: Closing Your Diastasis Naturally With the Tupler Technique, was to be removed only for showering.
The bulk of Tupler’s program focuses on the same thing as any of the newer diastasis-resolving programs that have cropped up in the decades since Tupler developed hers — the Goop-y Every Mother app; the Mutu System, which employs bands, balls, and straps; the high-impact, class-based Bloom Method — your transverse muscles, the deepest of your six-pack. But only in the Tupler Technique do you keep your midsection corseted like a Victorian babe as you suck that transverse muscle back in toward your spine, compressing in tiny bursts, and eventually you graduate to diastasis-safe crunches, whereby you simply lift only your head from the floor.
It wasn’t exactly easy to put the thing on: wrenching in my transverse, awkwardly holding one arm of the three-armed splint between my knees while I worked to perfectly bind another around my torso; failing, ripping the gravity-defying Velcro’d arms back off, all while being haunted by Tupler’s warning to go easy on the Velcro, as to not wear it out. Observing all this, my fiancée finally Googled a goddamn video, and I watched Tupler maneuver the garment with maximum chill, tucking in her transverse muscles cozily beneath the stiff neoprene. Watching the tutorial helped, but a little poof of my pooch kept popping out between two of the wrapped arms. Apparently, some women with longer torsos or more pronounced diastasis are encouraged to wear two splints — a notion that breaks my heart, for life in a single splint was frustrating enough. While it did provide a nice, smooth landscape from which to easily, say, zip up an ornery pair of jeans, once I started about my day, the splint would ride up, ride up, ride up so that I was constantly tugging it back down, futzing with my clothing, or just giving up and letting it sit around my natural waist like an odd belt, doing me no good whatsoever and making my clothes look annoyingly bulky. Little wounds sprouted on my back and sides from where the Velcro was not perfectly lined up and chafed me or from how the splint rearranged itself upon me throughout the day.
While it did feel oddly pleasant at the very start — soothing and slightly erotic, like a cross between an anxious dog in a ThunderShirt and a corseted sexpot — the good vibes vanished as soon as my belly started poking out from the gaps.
“How am I going to sleep in this?” I moaned onto the Tupler Ongoing Online Support Program, a website that encouraged folks going through the program to commiserate and aid one another. I waited for a chorus of You go, girl! optimism from my fellow Mummy Tummies but soon realized that the other comments on the board had been posted months ago. Perhaps I was the only person currently enrolled, or at least seeking company for my misery. I was contacted by an older gentleman who shared it was his second time going through the Tupler program and assured me that I would grow accustomed to the malevolent nocturnal embrace of The Splint. I never really did.
You can ditch the splint at the end of the 18-week program, though the exercises must be continued for ten minutes a day for the rest of your life to hold on to what is only a temporary fix for your abs. While the splint gives the illusion of helping — yes, my pooch is far less poochy strapped in under yards of neoprene — and it does, of course, support your muscles somewhat while you work to heal them, Google after Google insisted there is no real benefit to splinting, knowledge that tore at my heart as I tossed and turned each night in my Neoprene Maiden, determined to stick with the program.
Five weeks in, and while I may have adjusted to the physical chafes and bruises from the splint, hereby known as Splinty, the insults to my sex life were harder to assimilate. As I made my way through Together Tummy, I learned I’d surely exacerbated my condition by having sex in all the most fun ways, manners that, as it happens, are super-harsh on a weakened transverse muscle, such as doggy style or with your legs stretched straight up against your lover’s tattooed torso. Apparently not good for the diastasis. So now sex was only permitted if gentle, as I recline on my side, Splinty sliding around my trunk, bits of belly bulging out where the wrap has loosened. As you can imagine, one does not feel super-desirable in such a costume. Sex, my fiancée and I’s shared No. 1 love language, ceased in its frequency.
By week seven, I’d had it. It was inconceivable that I was not even halfway through the program — the three-times-a-day exercise, the endless splinting, my belly eternally reddened and itchy and craving liberation. I’d started flinging it off to engage in some much-needed, actually sexy sex, and perhaps that was the slippery slope that nudged me to abandon the program entirely. I looked at Splinty, lying on the floor beside the rest of the Tupler merchandise I’d never figured out how to use. I felt the familiar guilt and shame of having wasted some hard-earned money — the guilt and shame that came with a special frisson of embarrassment, as I had wasted money on something that promised to improve my body. What a classic female chump I was!
I was also nagged by the understanding that I was quitting the program long before the promised results were meant to appear. Perhaps, rather than a sucker, I was just lazy? Whatever. The Tupler Technique felt like too big a lifestyle adjustment to endure for almost half a year. If this meant I had to just live with my diastasis, so be it.
And I do need to live with diastasis — again, until insurance companies allow the majority-female sufferers of this syndrome access to real healing, there is no cure for it, only daily maintenance to keep it in check. After detoxing from my Tupler experience, I hit the internet to see if there were other, simpler, friendlier ways to help my abs. After all, it’s simply the daily, disciplined contracting of the transverse that resolves the issue. There had to be a way to incorporate these exercises into my life without suffering useless and unwieldy gizmos and gadgets. That the Tupler Technique was the first diastasis program to hit the market unfortunately shows in its dated aesthetic, branding, and tech. Such elements may seem like shallow considerations, but when you’re dropping a chunk of change on something as vulnerable as your body — being expected to persevere physical discomfort and override your own resistance — a cozy aesthetic, relatable branding, and up-to-date technology feel supportive.
Eventually I bought into the Every Mother app, with its intensely beige aesthetic and simple, non-alarming instructions. It costs $40 or so for a year, and though I’ve only just begun working with it, I feel optimistic. It feels like less of an undertaking than Tupler’s program, with no box of books and garments and, Lord help us, DVDs, which arrived in my mailbox after signing up; this program lives on my phone, where my eyes always are, rather than in a workbook. The delivery of the extremely blonde, extremely thin white woman who narrates is sort of relaxing, even when she is exhorting us not to jackknife out of bed in the morning, and the extremity of her thin, blonde whiteness is alleviated somewhat by the women of different races and body types she brings in to model the exercises. But most important: There is no splint. All of these add up to what feels like a more sustainable regimen.
Even with the negative effects I’ve already experienced as a result of my diastasis, I know I’m fairly lucky. My diastasis is visibly smaller than many people who suffer from it, and I can easily imagine the intense frustration, even despair, that comes with having a visible physical pain point you’re powerless to heal unless you have a spare 15 thou just lying around.
Prominent diastasis has an effect on every area of a sufferer’s life, impacting how they feel about their body, the way their clothes fit them, and how they feel sexually. It interferes with basic movements — not only the daily exacerbation of getting up and getting down but picking up children, or delivery boxes, a pile of books — that impact and worsen diastasis, raising the likelihood of its side effects. To know there is a solution out there, just out of reach, is infuriating; more so is the suspicion that if it weren’t women’s bodies — sorry, moms’ bodies — that were the primary sufferers, help would probably be more easily accessed.
But until the U.S. busts out a just and feminist health-care system, I’ll be over here doing Kegels when I sneeze, like the lady in the Every Mother videos taught me to. And I’m slowly — slooowwwwly — remembering to move my body more mindfully, rolling on my side to get in and out of bed, sucking my bellybutton toward my spine when I cough. And when I forget and jackknife out of bed in the morning, or engage in a sex position that is not so hot for my linea alba, I shoo away that pang of guilt or fear, the feeling of having fucked up and compromised my already compromised body. Like all body-centric regimens, it’s too easy to fall into shame or perfectionism or loathing. I remind myself I love my little mummy tummy and the kid it temporarily housed.