Twinfant Tuesday: Twin Skin, Back Pain, and Why You Still Look Pregnant

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Categories Health, Medical, Mommy Issues, Parenting, Pregnancy, Twinfant TuesdayTags , , , ,

Disclaimer: I am not a medical professional. Speak to a doctor or other certified professional before making medical decisions.

I, for one, gained 60 pounds and was 52″ around by the end of my twin pregnancy. At 61″, I was nearly as round as I am tall. My belly itched something awful from about 10 weeks until 35 weeks, when my skin sort of went numb. I don’t know exactly what I expected would happen to all that extra flesh, but the real mystery was what was happening underneath it.

What you need to know is this: twin pregnancy + c-section = jelly belly

A year later, the skin is still there – but (glamor secret!) I can tuck most of it into my panties. The fat under the skin is mostly gone. I’m surprised that I didn’t have to do much to make that happen, aside from nursing every waking hour for 6 months and most of the time after that. Oh and lugging a couple kids around everywhere.

But the muscle itself required a more hands-on approach.

An avid Pilates-goer pre-pregnancy, I figured I’d hit the Hundred and things would start to firm up. Oh, the naivete. First of all, if I had time to lie down, I wasn’t doing ab work, I was sleeping. Secondly, my abdominal muscles were sort of…missing. I couldn’t even feel them. When I was still having trouble sitting upright at 8 weeks post-partum and my back pain was becoming unbearable, I discovered the underlying cause: diastasis recti.

Basically, your abdominal muscles have two sides (picture a six-pack and think right and left pack). Normally, the sides are held together by a thin membrane. During pregnancy, the membrane stretches, causing the two sides of muscle to separate. This separation is called diastasis recti. Many women will have a little pooch after becoming mothers, and this is why. Without that firm membrane, the organs behind the muscle are no longer firmly held in place, creating a mild protrusion. Sometimes it also causes an “outie” belly button that never pops back in. My friend describes hers as a “lion’s nose belly button.” There is a spectrum of severity, measured in finger widths.

Here’s how to test yourself for diastasis recti.

Many mild cases heal on their own over time, or go unnoticed because they don’t cause any problems. In my case, after a gigantasaurus twin pregnancy, that little membrane didn’t stand a chance. I had a 4-finger-wide, 3-knuckle-deep diastasis at the belly button (my widest point), and my abs were weakened from pregnancy and surgery. I needed some help to rebuild strength that would protect my back (and slim down that 6-month pregnant look I was still sporting).

Some facts about diastasis recti:

  • It can be prevented or kept very small by avoiding excessive abdominal work in the first trimester of pregnancy and doing certain exercises during pregnancy. Not all women get diastasis recti during pregnancy, but multiple babies certainly up your risk.
  • It can be healed and even cured.
  • It’s never too late to start correcting your diastasis.

There are three proven interventions that can improve a diastasis recti:

  1. Surgery. This is super expensive and has a pretty extensive recovery period. Plus I’m not sure if I’m done having kids, so this was out for me.
  2. Wear a support device. For months, I wore the giant elastic band given by the hospital after my c-section. Not all the time, but when I knew I would be walking any distance or doing a lot of baby carrying. I later learned that a compression garment is less effective than a specially designed splint, but it did give me some much needed support as my abs healed.
  3. Tupler Technique. This is a special workout designed to heal diastasis recti. The technique has undergone rigorous scientific testing, and was found to be quite effective. Here is an interview with Julie Tupler for details. I found a local Pilates studio that specialized in Tupler Technique, and signed up for a 12-week series. It was AMAZING. Not only did I get some much needed me-time each week, I gained valuable information and moral support. Through the series, I developed a baseline of strength that greatly reduced my back pain and reconnected my awareness to my core. It was the best thing I could ever have done to recover from twin pregnancy. And it cost approximately one billion dollars. I would 100% recommend going to special classes for diastasis patients, but if you can’t afford it, use the information available online to learn the basics and do them yourself at home. It is worth it!

Need the quick version? In order of importance:

  • Avoid crunches and twisting motions (yeah right, but as much as possible). These move your abs further away from each other.
  • Aim to get up from your side rather than jack-knifing forward, especially if you are supporting the weight of a baby too (i.e., rolling over to nurse side-lying on the other side).
  • Learn how to do Elevators and Contractors (from Tupler Technique) and work them into your day.
  • Base your post-partum workouts around cardio and safe ab-strengtheners, like planks or, my personal favorite: get onto hands and knees. Tuck your toes under. Make sure your back is straight, tighten your abs, and lift your knees a millimeter off the floor. Hold. (I could not do this for weeks. Keep trying, the effort is working!)

Following my Tupler series, I continued doing the exercises at home, when I could. My diastasis has shrunken down to 1-finger-wide and 2-knuckles-deep. I only look one trimester pregnant, not two! Even bigger than this improvement is how I feel.

Do you have experience with diastasis recti? What is working for you?

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RebeccaD has 8 month old fraternal twin boys, R and M. She’s a teacher-turned-SAHM in San Francisco who loves dance, quilting, and geeking out over DIY projects. Having twins is challenging her perfectionism in the best possible way.

6 thoughts on “Twinfant Tuesday: Twin Skin, Back Pain, and Why You Still Look Pregnant”

  1. A friend with 3 singletons was told BY HER DOCTOR that there was nothing to be done for abdominal separation and she’d just have to live with it. By her doctor!! Thanks for raising awareness. I was fortunate to have only very minor separation that I was able to address, but then again, I only made it to 33 weeks.

    1. That is crazy!! I hope she was able to find some information on her own. My OB was not particularly helpful either. I think this is an example of the gulf between internal medicine and sports medicine – and possibly also of some doctors’ wariness of non-medical approaches to healing.

  2. Thanks for sharing!! I really need to start doing some of these exercises. I’ve read up a bit on the Tupler Technique, and heard that it was basically exercises working your trans-abdominal muscles. I need to start doing some because this sad sack of skin just isn’t working for me. Plus, I have a hernia, which I’m sure would be lessened if I close the gap.

    Someday I might have surgery, but I’m not done having kids…

  3. I went numb too! No one really understand what you mean by that unless it has happened to them! I am going to look into the Tupler Tech. Thanks!

  4. Funny I read this post today. After months of lower back pain, I finally couldn’t stand it anymore and went to see the doctor. Turns out my misery has been caused by over exertion (carrying around two 20lb+ squirmers?) that has resulted in a mildly herniated disc. Treatment: strengthen my core. I will check out this Tupler method.

  5. Back and neck pain can have several underlying causes. For example, any changes in the spine’s anatomy can lead to back pain, such as lumbar degenerative disc disease, lumbar disc herniation, sacroiliac joint dysfunction, or osteoarthritis.

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