Bulging Belly

[joey123]

I have a 13 year old, a 3 year old and a 16 month old. I train/exercise 6 days a week and compete in triathlons. I consider myself very fit. I am 163cm tall and weight 56kg, but ... I look like I am 4-5 months pregnant! I have a small separation in my stomach muscles and a very small belly button hernia. I have just been to the hospital (after being referred by my GP) - I was seen by a dr in the colorectal department. He has said that the hernia and the muscle separation has nothing to do with the 'bulge' that I have. Also I tummy tuck wouldn't fix it cause I don't have any flabby skin. He doesn't know what is causing it and wouldn't recommend trying to fix it. (I don't know why, if he doesn't even know what it is).

Anyway, obviously I'm going back to the GP for another referral to someone who will know what it is and may be able to give me some advice! But just wondering if anyone else has experienced/knows someone who has experienced the same problem. Basically, when I lay down, I have a flat stomach, when I do a sit up, you can see the ridge, vertically, down my belly where the muscles don't meet, my belly button is always an 'outie' (none of these things really bother me) but when I stand or sit up, my belly hangs out and it looks like I'm pregnant. It's not flabby, it relatively hard, and round like a beach ball.

I would love some opinions/suggestions/anything on what I could do, who I could see, what you have experienced. I know there's worse problems in the world and I am very lucky this is all I have to worry about. But at the same time I hate being asked when my baby is due. It hurts my feelings so much.

Thanks!

[Phteven]

Maybe it's some kind of bloating? Is it the same at all times of day?

[joey123]

The more I eat/drink, the bigger I get. I sometimes feel bloated, but not often

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[HotI]

Anyway, obviously I'm going back to the GP for another referral to someone who will know what it is and may be able to give me some advice! But just wondering if anyone else has experienced/knows someone who has experienced the same problem. Basically, when I lay down, I have a flat stomach, when I do a sit up, you can see the ridge, vertically, down my belly where the muscles don't meet, my belly button is always an 'outie' (none of these things really bother me) but when I stand or sit up, my belly hangs out and it looks like I'm pregnant. It's not flabby, it relatively hard, and round like a beach ball.

Thanks!

My tummy is similar and i believe it is due to my abdominal seperation and hernia. That really sucks, what do you think about the info you were given, did it sound right? do you think you were listened to and examined properly? If not, maybe seek a second opinion.

Have you seen a women's physio?

[~clover~]

A friend of mine was similar with IBS. She looked about 6 months pregnant, but only for a few days to a week at a time.

[joey123]

Did she have any other symptoms?

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[~clover~]

TBH I can't remember what they were. I'm sure she did. This was 6 or 7 years ago..

[Pholi]

Hi Joey,

I'm a physio with experience in musculoskeletal and women's health. What you're describing sounds like a classic case of abdominal diastasis, common name 'tenting' (from the shape you see when you do a sit-up! It's caused almost always by pregnancy,a nd happens to about 70% of women in late pregnancy, but to different degrees. If you've still go that level of separation 16 months after the birth of your last baby, you were probably at the more severe end of the scale. It's also more commonly worse in women who have babies close in age one after the other, and more so if you don't work really hard to restore good abdominal muscle strength in between babies. What happens is that as your belly gets bigger, the abdominal muscles don't have enough sideways stretch to get around the bump, so they separate in a vertical line straight down the middle of your belly, sometimes just above the belly button, sometimes below as well. After baby is born, retraining your abs to work helps the separated edges to come closer together - they never actually 'fuse' or heal together again, but the edges lie close enough to each other that it make no difference. If your abs never really get retrained after pregnancy, the separation remains, and when you try to use them (such as in a sit up) they stay separated, and allow the mass of internal organs to bulge between them.

I would have thought that a colo-rectal surgeon would have been familiar with this fairly common problem... though, to be fair, it's not so common to still be a problem 16 months after the birth of baby.

Ask your GP for a referral to a Women's Health Physiotherapist (you'll need a referral to go public, but if you are in a financial position to do so, you can 'self-refer' to a private women's health physio - just give them a call,) as the first step is to use conservative (ie, non-surgical) measures to try and improve your abdominal function. Basically that means exercises, but it's really important that you do the right exercises in the right way to help the edges of the muscles come together, If you do lots of situps, it can potentially make things worse, and at the very least, puts you at risk of injuring your low back through doing repeated flexion movements with the support of strong abs.

It sounds like you're really keen to do something about this, and in almost every case that I've treated (over 15 years) the right exercises make a massive difference over time.

I understand that the surgical solution is also very successful, but is a major operation, done under GA, leaving significant scarring, usually, and is not to be taken lightly, and any good surgeon would insist that you spend time and effort on exercise first. The surgery, if you eventually needed it, would probably be the domain of a plastic surgeon.

I hope that helps.

[joey123]

Thanks so much everyone. Does anyone have any suggestions for a good post pregnancy experienced physio in brisbane? Preferably north side

[joey123]

I may have an answer!!!

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[joey123]

Here is a cut and paste with the info...


Diastasis Recti
 symptoms & information can be confusing. A particular area that often causes concern is when your post pregnancy belly is not squidgy, or jelly-belly like, but rather hard & protruding, as if you were 5 months pregnant again  Is this diastasis recti? Or could something else be causing it?
This can be more confusing when the rest of your body is relatively lean or slim, but the mummy tummy hasn’t gone away. It doesn’t *feel* like excess fat, because it’s firm & sticks out, literally like when you were pregnant.
Sometimes it gets worse throughout the day, getting bigger at the end of the day or after a big meal.
Bottom line, you’re fed up with being asked when the next one’s due, & can’t understand why the rest of your body has pretty much ‘gone back’, but the belly is still a BIG problem.
OK, well there are a few factors which could be contributing:
Firstly, & this applies especially if your belly seems to get bigger throughout the day, or if you feel bloated or uncomfortable after eating: there could be excess sugar in your diet, &/or you could have developed an intolerance to certain foods. All of these will cause swelling & bloating, as undigested food in your intestine is literally ‘pushing’ your stomach outwards.
Cut out processed foods, including sugar, & try cutting out wheat & dairy as well for a few weeks. None of these foods are necessary for healthy diet so you won’t come to any harm by removing them for a while! And try to monitor when it feels worse. Very often women complain of bloating which varies throughout the day – if this is the case for you, then your muscles are not to blame, this is a digestive issue
.
Clean up your diet as much as you can, drink plenty of water & herbal teas to encourage digestion & eat plenty of fibre in the form of whole fruits & vegetables & wholegrain carbs such as wholegrain rice, quinoa, rye, oats & spelt (Note: the last 3 grains on this list contain gluten… you may be intolerant to all gluten containing foods, so if the problems persist, you may need to go totally gluten free).
You can get propoerly tested for gluten or other allergies – I found this really informative site
which very clearly explains a lot of food intolerance issues & conditions.
But sugar
 is the place to start… it may well be all you need to cut out, to see a dramatic difference & to make you feel a whole lot more comfortable.
Second possible cause is your posture. The posture of pregnancy & mothering doesn’t do the profile of our tummies any favours! Imagine your pelvis is a bowl of water, which you have to keep upright to stop the water spilling… If you are over-arching your back (& consequently sticking out your belly), you’ll need to level out your pelvis by tilting it back towards you. When this over arched back & protruding belly is a permanent postural state (as it is for many mums), then the outward pressure on the rectus muscle (the one that splits with a diastasis) is increased. It also further weakens your transverse muscle, the important one to strengthen to get a flat tummy.
Thirdly, you may be doing your core exercise
, but it is possible to go through the motions of these exercises without engaging the transverse muscle correctly. The key is what your lower abdomen looks like as you do them. Does it bulge out at all? If so, you are unknowingly increasing intra-abdominal pressure & training the muscles to push outward still further. You may be ‘bearing down’ or pushing (yes, this relates to your pelvic floor muscles too!) when you want to be achieving the opposite. When you engage your transverse muscles correctly, the lower abdomen should hollow inwards as the muscle contracts.
And the fourth factor is of course, diastasis recti… plenty more on diastasis recti here.

Lastly, a bloated, painful & swollen abdomen CAN be a sign of something very serious like ovarian cancer
 – this is not to scare you, but simply to say that there’s no harm in getting checked out if you’re really concerned. Remember this is much less likely, & the above are  much more likely causes, but I want to make sure I cover every possibility!
I hope this helps! Are YOU fed up with being asked when the next one’s due?

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[joey123]

Have got some exercises for my transverse abdominis muscles and have cut out several possible allergens from my diet and have lost 1cm off my stomach over night, after one day. Could be the start of something very exciting!!!

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[HotI]

There is a really great blog that someone here directed me too, and from there i found a great website with video exercises. i am trying to find it again and will post or pm. they snd me regular e-mails too.

[joey123]

There is a really great blog that someone here directed me too, and from there i found a great website with video exercises. i am trying to find it again and will post or pm. they snd me regular e-mails too.

Fantastic! Thanks, that would be great!!

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[HotI]

ok, found the website . google "fit2b studio"

[joey123]

ok, found the website . google "fit2b studio"

Awesome! Thanks!!

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