Seeing your stomach muscles protrude when doing sit-ups can be alarming. So, if you’re wondering why your stomach bulges during sit-ups, there are two likely causes for these protrusions: diastasis recti or a hernia.
Diastasis recti is a separation of your abs that often occurs during pregnancy and can continue for months or years postpartum, according to Cleveland Clinic, but can also be due to lifting heavy weights or rapid weight gain. A hernia is a bulge that is due to a weakness in the wall of your abdominal tissue, according to Cleveland Clinic.
Both conditions aren’t a sign of a serious health issue, but it’s still important to talk with your doctor for a diagnosis and treatment plan.
Below, we’ll get into the specifics of how to identify, treat, and prevent both diastasis recti and hernias so you can get back to doing sit-ups — and your other favorite exercises — worry-free.
Diastasis Recti
What Is Diastasis Recti?
Your abs are divided into a left and right side. The linea alba (a line made up of connective tissue and tissue fibers that runs vertically through the midline of the abdominal wall) connects these two sides, according to the Cleveland Clinic. If it widens enough, it bulges under pressure of the abdominal contents (like when you do a crunch) and can look like a hernia.
Diastasis recti can make you look pregnant long after having your baby. It also shows up as a football-shaped dome that causes an abdominal bulge when doing sit-ups and other abs exercises.
Identifying Diastasis Recti
Diastasis recti isn’t typically painful, according to Cleveland Clinic, but “you may feel weakness in your core when doing once easy tasks, like lifting a laundry basket. Some people feel a jelly-like texture in the space between the left and right abdominals when contracting the ab muscles.”
You should get a doctor’s confirmation that you have diastasis recti and not a hernia, but there’s also a self-test you can perform, according to Cleveland Clinic.
Lie on your back with your knees bent and your feet planted on the floor. Place one hand on your belly and put your finger right at your navel. Press your fingers down and lift just your head and neck up as if you were starting a crunch. Feel for a space between the two sides of your rectus abdominis, the front abdominal muscle.
You likely have the separation if you feel a finger’s width or more distance between the two sides of the muscle.
Treatment for Diastasis Recti
Diastasis recti is a benign condition, meaning it doesn’t immediately affect your health. In rare cases, however, surgery is required to repair the gap, but usually you can pull the muscle back together with deliberate exercises. Regardless of the severity of your diastasis recti, it’s important to talk to your doctor to come up with a treatment plan.
Some exercises, including sit-ups, make the gap worse (more on that below), so do other types of exercises instead:
- Squat with a ball: Place an inflated mini exercise ball — about the size of a soccer ball — between your thighs and squeeze as you squat.
- Bracing: Sit in a comfortable position and place your hands on your abs. Breathe normally as you pull the ab muscles in toward your spine. Hold for 30 seconds.
- Bridging: Lie on your back and bend your knees with your feet planted hip-distance apart. Squeeze your abs in as you lift your hips up to create a line from your knees to your shoulders.
- Leg slides: Lie on your back with your knees bent and feet planted. Draw your navel in toward your spine as you slide your right leg out straight on the mat. Use control to pull it back in and repeat with the left leg. Alternate for the desired number of repetitions.
In many cases, diastasis recti heals on its own and needs no specific intervention.
Tip: If you’re pregnant or postpartum, get clearance from your doctor before starting an exercise program.
Prevention for Diastasis Recti
To reduce your risk of developing diastasis recti, there are a few things you can do, according to Cleveland Clinic:
- Avoid certain core exercises: Crunches and sit-ups can put pressure on your abs after 12 weeks of pregnancy and postpartum. Doing moves like planks (or modified planks), farmer’s carries, or glute kickbacks during your pregnancy are typically safe, but it’s important to chat with your doctor to figure out the best workout plan for you.
- Maintain proper posture: It’s best to stand up straight with your shoulders back as much as you can.
- Practice deep breathing: Take deep breaths that allow your ribs to expand — not just your stomach.
- Don’t put unnecessary strain on your abs: Take special care when performing day-to-day activities like lifting heavy bags or boxes, pets, children, etc.
- Use caution when getting out of bed: If you’re pregnant or postpartum, it’s best to roll to one side and use your arms to push yourself up out of bed.
Hernias
What Is a Hernia?
A hernia can occur anywhere in the body but happens most often in the abdominal area, particularly the inguinal, or pelvic, region. With a hernia, there’s a defect in the abdominal wall itself allowing intestines, fat, etc. to poke through, making your stomach bulge during sit-ups.
Anywhere there is muscle, it’s possible to have a defect — and therefore a hernia. With that said, there are some common weak points where hernias tend to occur. The most common areas are the groin (inguinal hernias) and the belly button (umbilical hernias). But sometimes hernias are seen in other areas of the abdomen. They also occur at surgical sites (incisional hernias).
Any activity that puts pressure on the abdominal area can lead to a hernia, especially if you have had surgery in the area or an injury. Can you get a hernia from sit-ups? Sit-ups and over-training before you’re ready may be the cause according to the American Council on Exercise, if you are doing a lot of them, or they may just be making the hernia worse or more noticeable.
Other common causes of hernias are obesity or sudden weight gain, chronic coughing, lifting heavy weights, pregnancy, chronic constipation, and any other activity that causes you to constantly strain the abdominal muscles. Poor nutrition, cystic fibrosis, smoking, and overexertion can also lead to a hernia.
Identifying a Hernia
Many times, hernias have no symptoms, and you may not notice it until you put pressure on the abdomen, such as when you perform a sit-up or bend over at the waist. Some hernias can cause discomfort, and the discomfort can get worse when you put pressure on the belly.
If the discomfort increases, or you start to feel pain, the tissue, organ or intestine that is causing the protrusion may be caught in the hole in the peritoneum. You should seek immediate medical attention.
Treatment for a Hernia
It’s important to talk to your doctor about treatment. Your doctor may decide to simply monitor the hernia if it is small and not causing you any discomfort. If there is a risk of further damage, or the hernia is causing you discomfort, you may need to have laparoscopic surgery.
Laparoscopic surgery uses a camera and smaller incisions. Most surgeries are done using stitches or a synthetic mesh to plug the hole, according to Cleveland Clinic. If the hernia is painful, turns red or purple, or you have nausea and vomiting along with the pain, seek immediate medical attention.
Another reason to seek immediate medical attention is if you cannot manually push the hernia back into your abdominal cavity with gentle pressure, even if there is no pain.
Prevention for a Hernia
There are a few cases in which you may not be able to prevent a hernia from occurring, according to Mayo Clinic — for instance, if you have a family history of hernias or a congenital health issue that makes you susceptible to them.
However, there are a few things you can do to decrease your chances of developing one:
- Maintain a healthy weight.
- Prioritize high-fiber foods, like fruits and vegetables, to prevent constipation.
- Lift heavy objects carefully by bending from your knees, or avoid heavy lifting if possible.
- Stop smoking to prevent intense coughing that can lead to or worsen a hernia.
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