Building Strong Cores from the Start: Why Children Need Diastasis Care with Julie Tupler

>> Dr. Laura: Welcome to another episode of well Adjusted Mama. This is a podcast dedicated to educating and empowering women from preconception, pregnancy, birth and through early motherhood on wellness lifestyle. I’m your host, Dr. Laura Brayton. I’m um, a maternity pediatric chiropractor, a functional medicine practitioner and mother who’s hand selected experts in natural holistic healthcare specialties to shine light on options and choices during this exciting phase of a woman’s life. And today for the third time, I have my special guest Julie Tupler on the show to speak about rehabbing diastasis recti. But this time we’re going to speak to specifically helping children with diastasis recti Building strong cores from the start why children need diastasis care Julie Tupler is a registered nurse, certified childbirth educator and certified personal trainer. She developed the Tupler technique program in 1990 and for over 30 years has been treating diastasis recti for women, men and children. Dr. Oz calls Julie an expert on diastasis recti and Elle McPherson credits the Tupler technique for a 20 minute delivery and her fast recovery. The Tupler Technique, a research and evidence based program, has now been translated into six different languages. Julie trains medical and fitness professionals all over the world in her proprietary program. Her program is designed for women during and after pregnancy, men and children. Julie has written three best selling books, Maternal Fitness, Lose youe Mummy Tummy and Together Tummy and now her children’s book called Will youl Be My Belly Buddy. She’s produced five videos on diastasis including Belly Button Boogie for children. She invented the Diastasis Rehab Splint Diastometer for measuring a diastasis Corrective Connective Tissue Cream and Together Tape. Her program works the best when moms do the program with their children. Sholy also has developed an 18 week ongoing online support program for her clients all over the world. She’s on the advisory board of Fit Pregnancy Women’s Health foundation and the Women’s Sports foundation and Medical Fitness Network. She’s a frequent speaker at medical and fitness conferences including the American Hernia Society where she spoke in 2015 in Milan and 2019 in Hamburg on preparation before abdominal surgery to prevent incisional hernia. Her website is diastasrehab.com and I don’t know if you heard the exciting news, but my virtual functional medicine practice has launched. For more information, check out drlaurabrayton.com click Become a Patient. You can get all the information about how to work one on one with me. For, for all support around women’s health, preconception fertility, using the lens of functional medicine to help your body heal from the inside out and to have optimal health, ideally before getting pregnant. Hi Julie. Welcome to the show for round three. How are you?

>> Julie: Wonderful. Thanks for asking me back.

>> Dr. Laura: Yes, we always have such a good time when you come on and share your wisdom, passion, enthusiasm for all things diastasis rehab related. So today we’re focusing on kids. And a lot of people out there might not know that kids can also have a diastasis. This is not just pregnant and new moms. Men can have it, kids can have it. And you have, uh, a new book that is launching that says will you be my belly buddy? And a matching video that teaches families how to help their child heal their diastasis recti. So let’s just start off with somebody who maybe doesn’t know who you are. Just explain a little bit about how you got into becoming an expert in diastasis recti rehab.

>> Julie: Well, I’m a registered nurse, certified personal trainer and childbirth educator. And when I moved to New York many, many, many, many years ago, uh, I was teaching exercises at a health club and they said, you’re a nurse, uh, will you teach pregnant women? And at that point in time, nobody was doing exercise. This was in the late 80s, nobody was doing exercise, uh, for pregnant women. ACOG, the American College of Obstetricians and Gynecologists, had just written their guidelines, uh, for exercise and, uh, uh, pregnancy. So it was a challenge figuring out how to do an exercise program for pregnant women. In the process of working with pregnant women, I saw the diastasis and I said, what is that? And besides just a definition, there was really not too much about it. When the women in the class found out I was a nurse, they started then picking my brain about labor. So then I became a childbirth educator and realized that childbirth education comes at the end of the pregnancy and only prepares your mind. Now, uh, you wouldn’t run in a race and not train. Why would a woman do the hardest thing she’s ever going to do, labor and not have that mind body connection? So in 1990, I started my business called Maternal Fitness, preparing women for the marathon of Labor. And in 2009, when I saw that it just wasn’t women during and after pregnancy that had a diastasis, that it was men, children, and people before and after abdominal surgery had a diastasis as well, um, I changed the name of my business to diastasis rehab instead of maternal fitness to Include that whole population. And as you know, um, I have, you know, several books and videos, and I train medical and fitness professionals all over the world in it. But children are being ignored. Children with a diastasis are being ignored, and it affects their growth and development. So this is why I wrote the children’s book and I’m really focusing on, and the title of the book is will you be my belly buddy? Because I’m wanting the mother and or father to work with their child and have it be sort of like a group experience, um, which would be much more fun. And if the child saw the parents wearing the splint, they would wear it as well.

>> Dr. Laura: So, yeah, it’s a group, team effort. Right. And especially for kids, they don’t want to have to do something that feels like isolated or hard work. Right. It should be fun and a game and enjoyable and. And the whole family benefits.

>> Julie: So people always ask me, why do children have a diastasis?

>> Dr. Laura: Can we back that up? Uh, can you describe what a diastasis recti is? For somebody who’s never heard that term.

>> Julie: The word diastasis means separation. And recti is the rectus abdominis, which is the outermost abdominal muscle. So it is a separation of the abdominal muscles. And the. Those outermost abdominal muscles are your support system for your back. In between those abdominal muscles is a piece of connective tissue called the linea alba. And right in the middle of it is your belly button. So your belly button is a weak spot in the connective tissue. So any type of force on that weak spot stretches that, uh, connective tissue and weakens it, and then the muscles separate. So everybody is born with a diastasis with their muscles separated. And usually around three years old, after the nervous system develops, the muscles come closer together, but they’re never totally close together because there’s that piece of connective tissue. Now, as an infant, if they have any kind of genetic issue with their connective tissue, if they crying a lot, uh, if they’re constipated, this is the force on the connective tissue during the birth process. If that umbilical cord is pulled too much, that’s a problem as well. All right. Because it’s connected to the belly button or umbilicus.

>> Dr. Laura: So, yeah, I mean, I see infants, uh, with umbilical hernias, right? And those are typically, they’re straining to poop, to pass gas. There’s a lot of intra abdominal pressure happening, and their belly buttons are popping out. And that’s not even normal for an infant. To have that, it’s indicative that there’s stress on their digestive tract. Right. Which needs to be addressed.

>> Julie: Or during birth, there was, like, too much pressure on that.

>> Dr. Laura: Well, I see like the belly button popping out with all the gas bubbles. Like there’s that digestive component that, uh, we’re addressing. So. Yeah, but to your point, an average developed child, their diastasis essentially closes around three years old.

>> Julie: It doesn’t close, it comes closer together.

>> Dr. Laura: Okay. That’s a normal development, depending upon what.

>> Julie: Happens during their infancy, then when they’re older and they start doing things like gymnastics, where they’re continuously arching the back, which flares the ribs and stretch. And continuously is stretching that connective tissue. If they have them doing crunches, uh, during school, I went to the gym teacher, my daughter’s school, and said she’s not to do crunches. Sometimes swimming, where you’re arching the back, you know, certain, uh, activities like tennis, um, these type of things stretch that connective tissue and weaken it. So then they get pregnant and the relaxin hits that connective tissue and the growing uterus puts pressure on it and the. And the pushing puts pressure on it and. And it’s a large diastasis after the first birth. Then they have a second birth. They haven’t brought it together, and that’s why they show faster. So.

>> Dr. Laura: Right. Or third pregnancy, fourth pregnancy, and puts.

>> Julie: Them at risk for a C section. Because if, uh, this is my uterus and this is my cervix, and this is my vaginal canal, the cervix needs to be lined up with the vaginal canal. When the muscles separate and the connective tissue is supporting the organs and uterus, the uterus tilts forward. So now the cervix is pointing sideways instead of downwards. And that’s a C section. And the other thing, the separated muscles makes pushing very difficult because when the muscles are separated four fingers apart or more, they move side to side. They need to be close together to move front to back and put pressure on that uterus during pushing.

>> Dr. Laura: Yeah. And then, as you’ve taught me, it’s harder to engage our abdominal muscles when we’re back lying versus upright. And so if a woman is pushing on her back, that’s also going to be harder to engage the muscles. And certainly we’re not utilizing gravity to help that baby move down the birth canal either. It’s like the worst position to give birth in, Right?

>> Julie: Exactly.

>> Dr. Laura: Yeah. So we talked about why a child might have a persistent diastasis with different activities. Or if They’re a low tone child, maybe with some special needs. Their stomach’s more open. So these children will potentially. Will they present more with postural issues or even back pain?

>> Julie: Postural issues, back pain, low energy, you know, all the same side effects that affect the adults.

>> Dr. Laura: Constipation.

>> Julie: Constipation, huh? Uh-huh. And it, and it does affect their growth and development because if they’re rounded like that, that’s going to affect how. Just how they do everything.

>> Dr. Laura: Right.

>> Julie: Energy level and it’s.

>> Speaker C: Yeah.

>> Dr. Laura: And as a chiropractor, their energy level is impacted because their nervous system is stressed. Right. If we’re, if we’re not in a good spinal alignment, our nervous system is not going to work as well. So that impacts every. How we breathe and eliminate and digest and. Yeah. So this is important. And I think also with. I see more kids on screen time, screens are contributing to postural issues as well. So I’m also wondering if that’s happening and you’re in a slouch position that’s also going to potentially stretch that connective tissue. Right. I mean, is that.

>> Speaker C: Exactly.

>> Dr. Laura: Yeah, yeah. So we really want to talk to our kids about being upright, bringing the screen and, or the books up.

>> Speaker C: Right.

>> Julie: Because when the back is rounded, you can’t engage the abdominal muscles.

>> Speaker C: Okay. So, you know, when you round the back, the abdominals go forward in a, uh, forceful manner. So it’s not a good position for sure.

>> Dr. Laura: Right. So if we see a child appears to have a weaker core, has been checked for diastasis, and it’s there. But what can a family do to help that child heal and engage their core?

>> Speaker C: Well, my program, whether it’s for an adult or for a child, it’s all about, uh, strengthening that stretched out and weakened connective tissue between the separated muscles, all right. Until it’s strong enough to hold the muscles in a close together position. And with the big picture of it, it’s number one, repositioning. So if these were my muscles, my hands, and this is the connective tissue that’s stretched out, all right. We want to reposition the muscles, putting them close together so that when you do the exercises, they move in the right direction, front to back. We also want to take the stretch off the connective tissue and continuously keep it in this narrow position. Now, you use your abdominal muscles with every move you make and with every breath you take. So, um, what that means is you want the muscles and the connective tissue in this position. When you sneeze and cough and stand up and sit down and go to the bath. And when you do the exercise, it’s when you work out. Okay. You continuously want. It’s sort of like a cast. If you put a cast on and continuously keep the two bones together. Fuses. Unlike, um, a cast, you can strengthen the muscles while you have the splint. And that’s the whole point of wearing the splint, is so that the muscles and connective tissue are in the right position so that they move front to back. Because a lot of times people say, oh, don’t wear a splint. It’s going to weaken your muscles. No, it just puts them in the correct position to, to do the exercises and to use them with activities of daily living. And when you’re working out.

>> Dr. Laura: Right.

>> Julie: Repositioning, doing the exercises and preventing any type of stretching of the connective tissue. Because if our goal is to strengthen it and you keep stretching it and how do you keep stretching it? Well, if I stand up and I don’t engage my abdominals, I’m stretching it because the muscles are going forward and. And it brings the connective tissue with it. Right. So if I sneeze and don’t engage, if I cough, if I stand up, if I go to the bathroom. So with activities of daily living, we always have to have our innermost muscle, called the transverse muscle, be our best friend. Because again, we use our muscles with every move we make and with every breath we take. So not only do we have to use it, but we have to breathe correctly, doing what’s called a belly breath. Because if you breathe in opposition, where you inhale and your abdominals go back and then you exhale, they’re going forward forcefully. With a belly breath, you expand the belly with air. The belly goes forward passively, and then you exhale, the belly goes back to the spine. So that’s basically how you should be breathing to protect your connective tissue as well.

>> Dr. Laura: Right. And I think you talked about that family wellness approach. So if, uh, a, uh, if parents are concerned about their child having this, then they would do the Tepler technique together as the belly buddy. Everybody, at least, or mom and kid are both. They’re wearing their splints, they’re doing their exercises together, they’re learning to get up and down correctly and also helping to support each other with that and then awareness of their activities of daily living. Right. So really owning those four steps.

>> Julie: Right. And the other thing that I think is important that I have seen that has helped anybody, whether it’s an adult or a child, is Number one, falling in love with wearing the split. Oh, look at this. My belly looks better. Instead of saying, oh, I don’t like it. Having that positive attitude. And then when you do the exercise, have it be a muscle meditation where you see in your mind’s eye, you see your connective tissue going from a piece of Saran Wrap to a piece of rope, all right? That you have that intention, that that’s what’s happening with this program. So, uh, those are the two things that I recommend. Also, when you do the exercises that you have it be a muscle meditation. Everybody sits at the family, sits around, plays some relaxing music, close their eyes, and does the little exercises. Now, these little isometric exercises, what they do, according to Helene Langevan, a neurologist out of Vermont, basically what they do is they create this microcurrent. This mechanical backward movement creates this microcurrent in the connective tissue, and that’s what remodels and heals it. So that’s why it’s so important to. To do the exercises as well and also engage the transverse with activities of daily living.

>> Dr. Laura: Right?

>> Julie: Yeah.

>> Dr. Laura: The four steps all work together. And I think what I find with anything where you’re learning, like a new habit, it’s nice to have, um, even for adults, to have a buddy or a team, you know, somebody at home to do it with when you’re doing a cleanse or you’re eating differently, whatever. New lifestyle. So this is a new lifestyle, right, that they’re creating in their home. It’s nice to do together. So for an average child, how long are they doing this program for? Is it 18 weeks for them as well?

>> Julie: Yeah, it’s in the little guidebook. It’s just six weeks, but they can do it longer. Absolutely.

>> Dr. Laura: Got it. Six weeks seems maybe more manageable for a child.

>> Julie: And getting your child started with a strong core early in their life is only beneficial for everything. You know, when they get older, going into their. They’re having a baby or, uh, they’re involved in sports of any kind, having that strong core and be able to have the muscles close together, which is the only way you can have a strong core is when the muscles are close together. But having that will make a big difference in terms of their posture, their energy level, and. And with everything. So getting them started early with knowing what the transverse muscle is and how to use it will be very helpful to the parents as well as the child.

>> Dr. Laura: And what age would you recommend this for kids?

>> Julie: Um, as soon as they’re able to bring their Belly button to their spine. I did a class with my daughter.

>> Speaker C: She was six years old with all.

>> Julie: Her friends, and they were all able to do that.

>> Speaker C: So six years old, they’re pretty much able. When you say bring your belly button.

>> Julie: All the way back, touch your spine, they’re able to do that. They can start the program.

>> Dr. Laura: Got it.

>> Speaker C: Before that, I’ve had many physical therapists and moms ask me, is there anything I can do before they can do that? And just keeping the muscles and the connective tissue in a closer together position does help a little bit.

>> Julie: So before they’re able to engage it.

>> Speaker C: Just wearing the splint would be helpful.

>> Dr. Laura: Yeah, wearing the splints and it is going to take some of that pressure off as well. Right, got it. So also, I think, you know, we talk about that better posture helps with the nervous system, but it also helps with the lungs and breathing. So if there’s a history perhaps of asthma. Right. This could impact your child’s airway by having that better posture as well.

>> Speaker C: Being able to breathe better is very important because we all know that oxygen is what we need for life. But getting more oxygen, so if they’re.

>> Julie: Rounded, they’re not going to be able.

>> Speaker C: To expand their lungs fully. So being able to be in a correct position, you know, with their spine in what’s called neutral spine, which is not rounded and not arched. And to know how to belly breathe correctly is just going to be able to help them with giving them more energy with, uh, doing any of their aerobic exercises to get more oxygen into their body.

>> Dr. Laura: So I know you had a book for kids in the past, and you essentially rewrote it, right? You revamped your book.

>> Speaker C: I have the video Belly Button Boogie, and I have the little guidebook for children.

>> Dr. Laura: Okay.

>> Speaker C: And this book is just a new book that just came out.

>> Dr. Laura: Got it. So tell us about this book and the QR code. Is that different from the video that you have?

>> Speaker C: Yes. So in this book, I have little QR codes. And when you put your phone, you know, your camera on, brings up little sections in the Belly Button Boogie video. So it’s kind of a fun thing for them to do this.

>> Julie: And all of a sudden, see this.

>> Speaker C: This video come up with these kids singing and doing rap songs and. And they’re all in costumes and stuff, so it’s really kind of fun.

>> Dr. Laura: Got it. And it’s like segments from the full video is what you’re saying. Yes.

>> Julie: And we spend time, you know, talking about their belly button, you know, because it’s Basically, you know, we focus on that in the book and in the video.

>> Dr. Laura: Okay, so for parents that want to learn more about this and get the book or also get the video, I guess if they get the book, they are getting parts of the video.

>> Julie: They are getting parts of it. But, you know, you recommend both. Well, I. I do recommend both because it’s easier to see how to do the exercises on a video than read about it in the book.

>> Dr. Laura: Okay, so how can parents find out more about this?

>> Julie: Well, they can go to my website and anybody watching this show can get a 50% discount on the book or the video. And the code is all small letters. Kids book 50 and then a percent and then kids video 50 and then a, uh, percent sign. And that discount is good until December.

>> Dr. Laura: 31St, which is awesome. Thank you. And where is your website?

>> Julie: And the website is diastasisrehab.com or tupler technique.com.

>> Dr. Laura: Uh, got it. So they can go there. They’ll see your entire inventory of products.

>> Julie: Right. So if they go to shop and they go to individual products, they can just scroll down to the. The children’s stuff.

>> Dr. Laura: And then. What about a splint for a kid?

>> Julie: Yeah, the splinter. We have small and extra small, and we have regular torso, which is a little bit taller, and then we have a short torso one. And if anybody, you know, wants to buy the splint for their child or my diastasis coach will help you get the right size and teach you how to measure, um, your child so that you get the right size.

>> Dr. Laura: Right.

>> Julie: My final note is about checking for diastasis. So if your child has an outie belly button, then you know for sure they have a diastasis because an outie belly button is a side effect of a diastasis. If when they sit up, you see this little ridge between there, like a little doming, then you know they have a diastasis. There is a video on my website. There’s a video how to check for a diastasis. Certainly if they have any questions about checking or anything. You know, my dream is that before I leave this planet is that every belly gets checked for a diastasis as part of any medical or fitness evaluation. Because people have the side effects of diastasis, like back pain, bloating, poor posture, and it goes on and on. And they’re never checked for diastasis. They’re just never checked. The medical community has not connected the dots that back pain is a major side effect of diastasis, and they’re never checked for It. And the other thing is, if they do get checked, sometimes professionals don’t check correctly. So when we check for diastasis, we do not have them lift the head. We have them just bring the belly button to the spine, and we feel the muscles moving side to side. And we check out the belly button above the belly button, halfway between the belly button and the sternum, and below the belly button, halfway between the belly button and the pubic bone. Um, and we check for two things. We check the distance between the muscles, and we check the condition of the connective tissue. The deeper my fingers go, the weaker the connective tissue. The weaker the connective tissue, the longer it takes to strengthen it. So if, uh, somebody’s checking and they ask the child to lift their head and shoulders, the muscles come together, so you’re checking it at its smallest instead of at its largest. So I just wanted to mention that because they might say, well, how do I know if my child has a diaspora?

>> Dr. Laura: Yes, you want to know how to check. And I think also what you just added there is really separating how that is different than how potentially a PT might check for a diastasis. And I have a lot of that, you know, misinformation that, you know, people are confused about whether they have one or they’re a new mom, let’s say, will get checked. And, um, we’ll be told it’s small because her head is lifted and it’s measured, let’s say, at its smallest. But when she’s relaxed, it’s not small. And so if you think something small and you don’t have to address it, then you don’t. Right. It gets ignored.

>> Julie: Exactly. And it’s interesting because many professionals will say, it’s not a problem, it’ll resolve itself. And it doesn’t resolve itself. A diastasis only gets larger with age and improper exercise. And with seniors, you see the seniors that are rounded over and their spine is permanently rounded. I cannot help them. Once their spine is permanently rounded, they’re not able to engage the transverse. They’re not able to wear the splints. So that’s where it’s headed. So we don’t ever want to get there.

>> Speaker C: Okay.

>> Dr. Laura: Yeah, we don’t. And, um, started early.

>> Julie: With children, it’ll make a big difference in their energy and just everything.

>> Dr. Laura: Even their athletics. Right?

>> Julie: Athletics, everything. When they understand how to have all the power coming from their strength. And transverse muscle. All right. The most important muscle, my feeling, it’s the most important muscle in the body because it affects the upper the lower, the front and the back. All right. So once they understand this muscle and how to use it, it’s going to just give them more power, more confidence.

>> Dr. Laura: Yeah, I love it. Well, Julie, I’m so grateful that you took time to come on the show today. You are so passionate about this topic and such an advocate for getting this information out because it’s not really being acknowledged by the medical community like you mentioned. And so as parents and as, you know, people ourselves, we need to know how to care for our bodies and the children’s bodies.

>> Julie: And thank you so much for teaching the Tepler technique and having me on again for the program to share this.

>> Dr. Laura: Awesome. It’s always a pleasure. Thank you. Well, it’s always a pleasure having Julie on the show. She’s a close friend and a comedian, so it’s always fun to be with somebody funny. But she is so passionate about healing Diastas Recti. And previous episodes that we’ve done, we really focused on talking about diastasis recti as well as specifically using it during pregnancy and postpartum. But it is important to know that men can have a diastasis recti as well as children. And she really wanted to share her newest book called Will youl Be My Belly Buddy? Which is written for children that have Diastas Recti. And if a child is going through the Tepler program, she always recommends that the mom does the program with the child. So the mom and the child both get the benefits of a stronger core, improved digestion, less back pain and strain, and then an optimized nervous system when the spine is in its proper alignment. And she also has a video specifically for children as well called the Belly Button Boogie. So it’s kid friendly for them to learn the program and get excited to do the exercises, wear the splint and commit to the steps to in order to get the results right. So between now and December 31st of, um, 2025, Julie is offering a special discount for listeners of well Adjusted Mama. If you’re interested in purchasing either the kids book or the kids video on her website diastasrehab. In the code you’re going to put in kids book, 50%. If you’re purchasing the book or kids video, 50% for the video to get that 50% off code from listening to well Adjusted Mama. And then it allows you to help support your child and having that stronger, healthier core.