There have been numerous questions lately about this “bulge” located on the belly while exercising or straining.
Do you have a bulge above your belly button? No, I am not talking about the “padding” that might be located there; I am talking about a bulge, especially when you do a sit up and/or contract your abdominal muscles.
If you do experience that “bulge” it would be wise to have a doctor diagnose it first.
There are two common possibilities for what it can be:
One, it could be an epigastric hernia. An epigastric hernia can develop in the mid upper abdomen in a part of the abdomen that is called the linea alba. The linea alba is the fascia or tendon that is between the two rectus abdominal muscles commonly called the “six pack.” Believe it or not, everyone has a “six pack” and linea alba. Some may be covered by some extra padding. This particular hernia is not uncommon. It arises in a defect of the linea alba. They are generally small in size and localized, rarely larger than the size of a golf ball. Due to the fact that it is small, the contents are easily pinched and can cause a great deal of pain. This particular hernia is well suited for repair.
Two, it can be diastsis recti. This is not a hernia. Although often confused and at times misdiagnosed as an epigastric hernia, these abdominal wall protrusions happen to the widening of the linea alba. There is no defect or true hernia present in normal diastsis recti. The linea alba does not contract like the muscles do. When people with diastsis recti do a sit up, a bulge in the upper abdomen will appear. This non- tender bulge extends from just below the breast bone down to the naval. I remember when I was pregnant and would do a sit up I would have a slight bulge come up too. There is no pain associated with this and when standing the bulge is not noticeable. Surgery is not recommended for this condition. Typically during and/or after pregnancy or a big weight loss, people can experience diastsis recti.
So what kind of exercises can you do? First you have to make sure that your doctor is in agreement with your exercise program. At any time when performing a crunch or sit up your belly should stay down. Right? Bring belly button down to the inner spine while contracting. Some doctors recommend putting a back brace on backwards or will order a diastsis splint to assist the abdominal muscles and keep the bulge down. That would be one possibility. Another one is to hold your hand over your “bulge.” When doing any kind of abdominal exercise press hard enough that the bulge stays down. This way you can still do the exercises. Any time when you are carrying weight in your mid section you have pressure pushing your bulge out. Try to lose weight and get a flat stomach. (I know, not an easy task and everyone’s dream!)
Be aware of your posture, keep your stomach tight, talk to your doctor, and if it hurts, don’t do it!

Ester H Marsh is health and fitness director at the JF Hurley Family YMCA.