HEXACORETM

TRAINING PROGRAM

for

DiastasisRecti

450 North Roxbury Drive, #224 • Beverly Hills, California 90210TEL 310.358.5020 FAX 310.358.5025

beverlyhillsherniacenter.com

WhatisDiastasisRecti?

Theword“diastasis”isGreek,meaning“toseparate.”So,adiastasisrectiisaseparationoftherectusmuscles.Yourrectusmusclesarebasicallyyoursix-pack.Thereisaleftandrightsetofrectusmuscles.Theyareconnectedinthemiddlebyacenterline,calledthelineaalba.Separationofthemusclesfromthecenterlineresultsinarelativethinnessinthemiddle,whichmayappearasabulgingareawithanytypeofstraining,evensuchassittingupfromlyingposition.Also,theseparationmaycausearoundingoutoftheabdomen,losingtheflatlook.

WhatCausesDiastasisRecti?Diastasisrecticanoccurinbothmenandwomen.Thereisastronggeneticcomponentastowhoismostpronetodiastasis.Also,repeatedstretchingortensionontheabdominalmuscles,cancausediastasis.Examplesinclude:

• Pregnancy• Obesity• Improperweighttraining• ChroniccoughduetoCOPD

ShouldIBeConcernedifIHaveDiastasisRecti?

DiastasisrectiisNOTahernia.Thereisnoholethroughwhichorganscangetentrapped.Thereisnopainassociatedwithdiastasis.Thereisgenerallynomedicalneedtoaddressdiastasisrecti.Insituationswithverywidediastasisrecti,theremaybeassociatedbackpain.ThisisbecausetheCOREisdisrupted.Yourcoreincludestheabdomenandthebackmuscles.Anyimbalanceinyourcorecancausepainand/orinjury.Ifyouhaveanabdominalwallherniawithinadiastasis,yoursurgeonmayrecommendclosureofthediastasisinadditiontotheherniarepairasanadvancedmethodtorepairthehernia.Thismayimproveresultsfromtheherniarepair.

WOMENwithDiastasisRectiThemostcommoncausefordiastasisamongwomenispregnancy.Astherectusmusclesarestretchedoutawayfromthecenterline,theymaynotrecoilbacktothemiddleafterdelivery.Somearemoregeneticallypronetothiseffectthanothers.Thisismoreoftenseenwithlargeormultiparous(e.g.,twins,triplets,etc.)pregnanciesorafterthesecondpregnancy.Thediastasismaybelocalizedaroundthebellybuttonorextendfromtheupperabdomentothelowerabdomen.Somerefertothisasthe“mommypooch.”MENwithDiastasisRectiAmongmen,diastasistendstobemostlyintheupperabdomen.Thechancesmayincreaseinsizewithage.Itseemsthatthegeneticpredispositiontosuchabodychangeisstrongerwhenitoccursinmen.Theresultisabarreltypeorroundedlooktotheupperabdomen,asopposedtoaflatabdomen.Also,youmayseeatriangularmoundthatcanbulgewhenstrainingortryingtositup.

WhatExercisesCanHelpwithDiastasis?

Specifictypesofexercisesthatfocusoncoretrainingaremostbeneficialtohelpreducethesizeandriskforwideningofadiastasis.Theseexercisesfocusonstrengtheningthetransversusabdominis,the“innergirdle”oftheabdomen.Byengagingthetransversusabdominis,youcanhelpreturntherectusmusclestowardthecenterline.

WhatExercisesShouldI

Avoid?• Anyexercisesthatrequirelyingbackwardorextendingoveralarge

exerciseball.• Yogaposturesthatextendtheabdomen,e.g.,cowpose,up-dog,

bellybreathing,backbends.• Abdominalexercisesthatinvolve

flexingoftheupperspineoffthefloor,e.g.,crunches,obliquetwists,bicycles,roll-ups,roll-downs.

• PilatesandReformerexercisesthatusetheheadfloatposition,upperbodyflexion,doublelegextension,planks,100’s.

• Anyexercisethatcausesyourabdominalwalltobulgeoutuponexertion

• Liftingandcarryingveryheavyobjects• Quadrupedexerciseswithoutadequateabdominalsupport

HEXACORETM

TRAINING PROGRAM for Diastasis Recti

--6steps--

1 CoreContractionSituprightandplacebothhandsonyourabdomen.Inhaletoexpandyourabdomen.Feelyourhandsmoveout.Exhaleandcontractyourabdominalmuscles.Imagingpullingthosemusclesallthewaytoyourspine.Maintainthiscontractionfor30seconds,whilecontinuingtobreathe(don’tholdyourbreath).Thendo10smallextrasqueezesbeforeyourrelaxyourmuscles.

2 SeatedSqueezeSitsimilartoStep1.Restonehandonyourupperabdomenandtheotherbelowyourbellybutton.Inhaletoexpandyourabdomen.Exhaleandcontractyourabdominalmuscles.Thistime,drawthemusclesevenmoredeeplytowardyourspine.Atthisstartingpoint,contractyourabdominalmusclesabitmoretowardyourspine.Holdfor2seconds.Returntothestartingcontractedposition.Repeat10times.

3 HeadLift

A-Lieonyourbackwithkneesbentandfeetflatonthefloor.Inhaletoexpandyourabdomen.Exhaleandcontractyourabdominalmusclestowardyourspine.B-Withyourabdominalmusclescontracted,tuckyourchinandraiseyourheadoffthefloor.Holdfor2seconds.Returnyourheadtothefloor.Repeat10times.

4 UprightPush-Up

A-Standarm’slengthfromawallandplaceyourpalmsflatagainstit.Inhaletoexpandyourabdomen.Exhaleandcontractyourabdominalmusclestowardyourspine.B-Withyourabdominalmusclescontracted,doapush-upagainstthewall,keepingyourelbowsclosetoyoursides.Whenpushingbackup,contractyourabdominal

musclesevenmoredeeplytowardyourspine.Repeat20times.

5 SquatAgainsttheWall

A-Standwithalargeexerciseballbetweenyourbackandthewall.Stepforwardandplaceyourfeethipdistanceapart.Inhaletoexpandyourabdomen.Exhaleandcontractyourabdominalmusclestowardyourspine.B-Withyourabdominalmusclescontracted,bendyourkneestolowerintoasquat.Then,straightenyourlegstostandandcontractyourabdominalmusclesevenmoredeeplytowardyourspine.Repeat20times.

6 SquatwithSqueeze

A-Standwithyourbackagainstthewall.Stepforward.Placeasmallexerciseballorfirmpillowbetweenyourknees.Inhaletoexpandyourabdomen.Exhaleandcontractyourabdominalmusclestowardyourspine.B-Withyourabdominalmusclescontracted,bendyourkneestolowerintoasquat.Then,squeezetheballwithyourthighswhilecontractingyourabdominalmusclesevenmoredeeplytowardyourspineandholdfor2seconds.Repeat20timesbeforestanding.

WhyHEXACORETM?TheHEXACOREphilosophywasbuiltaroundthefocusofcoretrainingandsupportforbothmenandwomen.ItispromotedbyDr.ShirinTowfigh,Board-certifiedsurgeonandherniaspecialist.Shetreatspatientswithallsortsofabdominalwallpathologies.Asaresult,sheisanexpertiseinthemedicalandsurgicalimportanceofarestoredcore.UsingtheHEXACORETrainingProgram,youcanconfidentlyfollowexpertrecommendationstorestoreyourcoretowardnormalcy.Theseriesofprogramsfocusonavarietyofcore-basedproblems,includingdiastasis,inguinalhernia,ventralhernia,andsportshernia.Thegoalofthetrainingprogramsistopreventcoredisruptionandinjurywhileprovidingregimenstoimproveoutcomeaftersurgerythatisfocusedonrestoringthecore.Jointheconversationon:

Followuson: