Response to The "Mummy Tummy"

It’s been a few days since NPR’s article (link) “Flattening the ‘Mummy Tummy’ With 1 Exercise, 10 Minutes a Day” came out and as you can imagine, its everywhere with that catchy title. It’s being discussed in all of my women’s health circles and I wanted to write down my response to it because I’ve been asked to do so by many friends and clients.

  • Yay for publicity that exercise is a great way to address the issues that many women experience after having babies. We need these issues to be seen and we need women to know that they can find people to help them achieve their goals.
  • Yay for the great consumer education on what a diastasis is.
  • But this article went about it the wrong way, and in my opinion, a harmful way. The summary of the article is that pulling your stomach in “tighter and tighter” will melt inches off your waist. And guess what? You only have to do this one exercise! That’s it!

Not So Fast.

  • First and foremost. Pulling your tummy in “tighter and tighter” is not a safe way to address postpartum strengthening because our muscles do not function like this! Pulling your belly in this tight will also create pressure downward onto your pelvic floor so if you already have a pelvic floor dysfunction (leaking urine/gas/stool, prolapse, pelvic floor pain and tension) than method this will make that dysfunction worse, or create a dysfunction where there was none before.
  • Pelvic Floor. There is no mention of the pelvic floor in this article. The pelvic floor and the abdominals work together and you cannot address one without addressing the other. Doing so is irresponsible for someone who specializes in postpartum women. Without attention to the pelvic floor, a diastasis may improve immediately, but what I have seen over the years is that women who have tried this type of technique (pulling in tighter and tighter, over and over) come to me because their immediate results did not last. This can be explained because the pelvic floor is necessary to stabilize the abdominals. As someone who actually puts my fingers on the pelvic floor and the abdominals at the same time, I can tell you that MANY women lose their pelvic floor control when they engage their abdominals, and especially when they engage them with the type of cues mentioned in this article. And if this continues, a woman might get a flat tummy immediately but what about the long term effects on the pelvic floor……we know there is an increased risk of leaking and prolapse once a woman goes through menopause. Shouldn’t we focus on healing women so that they have long term pelvic health instead of immediate aesthetic benefits?
  • Flat back. There is a mention of flat back in the article, which in my opinion, is not the position of the spine that we want to train these women in. Flat back biases the brain to use the six-pack muscle instead of the deeper layers and that deeper layer is what is responsible for holding the spine and pelvis together as well as flatten the stomach without spinal compensation.  Flat back also is considered to increase pelvic pressure so someone with a pelvic floor dysfunction would not want to be in this position as they engage their abdominals at maximum force.  I want women to train their deep core layer in a neutral spine to optimize pelvic pressure, breathing pressures and enhance the ability to connect to the desired muscles.
  • The research. The article states that the research found that “100 percent of women achieved full resolution” and “all the women had fixed their diastasis”. This sounds like everyone fully closed their separation, right? Looking at the research, “full resolution” is defined as a separation <2cm, so the article needed to be transparent on what the definition of “full resolution” is so that women do not think that every separation will fully close. Anyone who works with this population intimately will tell you that not all separations close fully and the final size of a gap is not the only thing to focus on. And I’d like to see the long term results of this method. How do these muscles respond in the long run when they have to do more than contract harder and harder in a stationary position?
  • Abdominal gripping. The cues in the article and the cues I heard in the Dia Method videos I could find on YouTube are to pull the belly in as hard as you can: this can and will lead many women to become abdominal grippers, which is not how the muscle is designed to work and is not going to train for muscle strength. If you walked around with your bicep muscle pulled up tight all day, would that muscle be ready to receive a heavy load?
  • The exercise described in the article is not enough. What mother stands or sits still? Training a muscle to activate in stationary will not prepare a mother to live in her real life where she is dynamically moving. Clinically I see many women who can perform their core connection lying down but once I ask them to do it standing and with movement, it falls apart…so that’s where we work, to improve her ability to use her core while she is bending, lifting, carrying, running, etc.  It looks like the Dia Method does include more than this one exercise in her online material but the article did not mention that there is more to the story. 
  • Measuring tape. This part made me the most upset….as a woman with a body image disorder history and as someone who hears my clients express their concerns with their physical bodies on a daily basis. Are we really going to measure a woman’s waist in front of other women and give her a number that means what exactly? This article supports that skinnier equals more fit, which is absolutely not true. I’ve had clients who have healed their separations and are dynamically very strong but have not lost their baby weight. I’ve had clients who have no inches to lose yet have a wide separation and no core control. This gives me flashbacks to when I had my fat tested with those pinchers in high school PE class, giving me a number to memorize, to compare to my friends, a number to measure my fitness, not the number of miles I could run. In a world that already pressures women to “get their body back” and look like they never had a baby, this method of measuring one’s results is feeding into a body image disorder culture. 
  • Losing inches does not mean you are stronger. She isn’t measuring a woman’s strength or her ability to lift her kids with better body mechanics or  run without leaking.  We need to move the fitness industry away from targeting mothers with the goal of being skinny and towards the goal of strength and confidence in one’s ability.  This article was a big step away from that goal. I get it, the fitness industry uses the promise of being skinnier to sell, but as women who take care of women, we have a responsibility to fight that message whenever we can….to teach our daughters and our sons that the size of a woman’s waist is not a measure of her worth or her strength.

I think this article had a huge responsibility to expose the issue of healing postpartum women but it did not do this important topic justice. I do not know the Dia Method other than this article and what I could find online and I do think there is more to the story of this method that was not represented here. I hope that we find out more of the story and that the attention this article has gotten gives us a platform to discuss the bigger picture here. The real story of what it means to heal women fully and integratively and unfortunately, it takes more than 1 exercise, 10 minutes a day……..because aren’t we worth more than that?