Abdominal muscle separation doesn't only affect women after childbirth — it affects adults and children of all ages. This condition, called diastasis recti, can be treated using the Tupler technique.
What Is Diastasis Recti?
Strong abdominal muscles do more than just give you a nicely chiseled midsection to show off at the gym or on the beach. In particular, the rectus abdominis muscle, running from your ribs down to your pelvis, helps support your internal organs, according to a StatPearls article last reviewed in April 2019.
The rectus abdominis, or famous "six-pack" muscles, are separated by a line of connective tissue called the linea alba. This structure can become overstretched, leading to a split between your two rectus muscles — a condition called diastasis recti.
Although this condition develops most often with pregnancy, it can also occur after a person loses a significant amount of weight, as a side effect of obesity or from repeated lifting with poor technique. According to a February 2018 article published by [Ginekologia Polska](https://www.researchgate.net/publication/323640495_Diastasis_recti_abdominis-Areview_of_treatment_methods),_ programs that include abdominal exercises are often prescribed as part of diastasis recti treatment — including the Tupler technique.
Do You Have One?
If you aren't sure whether or not you have a diastasis recti, there's a simple way to find out, according to NHS Barts Health.
- Lie on your back on a firm surface with your belly exposed.
- Lift your head and shoulders off the ground with your chin tucked.
- Look for "doming" of your belly. This will appear lengthwise in the middle of your abdomen near your belly button.
Doming of your belly occurs as your internal organs bulge through the weakened connective tissue. The wider the gap between the two halves of your rectus muscle, the more severe your condition is. With your belly relaxed, you can estimate the size of your separation by the number of finger widths you can fit between the muscles.
If you are unsure if you have a disastasis recti, see a physical therapist for confirmation. A therapist can also help direct you through diastasis recti exercises, such as those used in the Tupler technique.
The Tupler Technique
The Tupler technique for diastasis recti treatment was developed by a registered nurse, certified childbirth educator and certified personal trainer named Julie Tupler, according to her website, Diastasisrehab.com. The Tupler technique program lasts for 18 weeks, but exercises need to continue beyond that time frame to maintain your results.
There are four steps in the Tupler technique — exercises; splinting; contracting your transverse abdominis muscle during everyday tasks; and getting up and down with proper form. Tupler instructs program followers to wear the Diastasis Rehab splint at all times — except when bathing — until your muscles are no longer separated. She likens this to a cast worn while a broken bone is healing. The splint holds your muscles together to improve the effectiveness of your strengthening exercises.
For the first six weeks of the program, Tupler recommends that her exercises be your sole workout, with the exception of walking. At that point, you will have learned how to incorporate the Tupler technique into your regular exercise routine.
If you have difficulty "finding" your transverse abdominis muscle, try this technique. Lie on the floor with your knees bent and feet resting on the ground. Place your hands on your hips. Tighten your abs and pull your belly button back toward your spine. You should feel the muscles under your fingertips tighten. This is your target muscle during Tupler exercises.
Diastasis Recti Exercises
Diastasis recti exercises are key to correcting the condition. Prior to beginning your program, Tupler recommends taking "before" pictures so you can monitor your progress along the way.
Tupler also recommends picturing your transverse abdominis muscle as a sideways elevator with five floors. When your muscle is relaxed, the elevator is at the first floor. To hit the fifth floor, picture your belly button touching your spine. The sixth floor hypothetically brings the belly button out your back, behind your spine.
Move 1: Elevators
- Sit with your legs criss-crossed, either in an armless chair or up against a wall for back support.
- Breathe deeply into the bottom of your belly, then exhale as you tighten your abs, bringing your belly button back toward your spine. Stop at the "fifth floor" position.
- Hold this contraction for 30 seconds, then draw your belly in farther to the "sixth floor."
- Slowly count to five, then return to the starting position.
Move 2: Contractions
- Begin in elevator position with one hand resting on your chest and the other just below your belly button.
- Breath in with your belly in the first floor position, then exhale until you are at the third floor position. This is the starting position for this exercise.
- Tighten your abs to the fifth floor position and squeeze.
- Return to the third floor starting position, and repeat.
As strength improves, progress your contractions to the fifth and then sixth floors.
Move 3: Standing Pelvic Tilts
- Stand with your back flat and knees partially bent.
- Place your hands on your thighs to support your upper body weight.
- Tighten your abs into the fifth floor position — your tailbone will tuck under as you do this.
- Count to five, then return to the starting position (flat back).
- Perform 10 repetitions.
Move 4: Head Lifts
- Lie on your back on a firm surface. Bend your knees and place your feet on the floor.
- Breathe into your belly, then exhale and tighten your abs to the fifth floor position. Your low back should flatten into the ground.
- Keeping your abs tight, tuck your chin and lift your head off the ground.
- Lower down slowly and repeat 10 times.
Move 5: Leg Slides
- Lie on your back with your knees bent and feet flat on the floor.
- Place one hand under your low back and the other on top of your belly.
- Tighten your abs to the fifth floor position and lift both feet off the floor until your knees are directly over your hips.
- Place one foot back on the floor and slowly slide your heel along the ground until that leg is straight.
- Bend your knee and slide back to the starting position. Repeat on the opposite leg.
- Do 15 repetitions, alternating sides.
Move 6: Low Back Stretch
- Lie on your back with knees bent and arms resting at your sides.
- Tighten your abs and slowly drop your knees to one side.
- Turn your head to the opposite side and hold for 15 breaths.
- Repeat on the opposite side.