Why the belly bulge?
57 Male Client with 13% body fat (athletic). Why does his stomach bulge outwards? We work abs, he does cardio, eats really clean and healthy, yet his stomach sticks out past his ribs. If he makes an abdominal muscle it seems to be all muscle and toned, yet he says its way larger than when he was younger. I am stuck on what to do. I have considered a dairy allergy, conflict with his medication, etc. but it's outside of my scope of practice at that point... I doubt there is a magical exercise to help with this, but he is looking to me for answers and so now I look to YOU!!! Thanks!
I would suggest a nutritionist and also a complete medical work up to rule out any abnormalities.
Many times clients aren't totally aware or honest with food intake.
You can ask him to track for a few weeks.
It is good to rule out any condition or abnormality. This is not just because it is important if something seems not as you would expect it to make sure there is nothing going on that would impact his health, but also it is important for your own liability in training him, it could give you insight on how to progress, and it is great for you to be and to present yourself as the kind of trainer who is able to refer to other professionals when something is out of your scope of practice.
If his physical comes back completely clean, and the physician or other health care provider does not have some suggestion on what might be causing the symptom you are noticing, the nutritionist can be a good second step.
Another thing to do is to look at past fitness testing you did with him and look for patterns“. are his gains in the strength and shape of other areas what you would expect, and is the abdominal area the only thing that stands out? Particularly also look at standing form“ did you notice postural deviations when he started with you, or do you notice them now?
Once you (or rather those who have the scope of practice to do so) rule out abnormalities of musculature, underlying pathology, nutritional issues, and so on, at that point you might also start trying some different ways of going into the core area. Personally I teach a lot of core work and I really like the Pilates type work for core. I feel it allows a deeper activation, and focus on more than just the outer 'washboard' area. I do a yoga series called 'fire series' that targets stabilizers from the entire area: not just the front, but lateral muscles, and low back.
Dr. Pamela Peeke was a keynote speaker at an IDEA event a few years ago. She has done research into the correlation between intra abdominal fat and stress, and her articles may well explain your client's situation. Check this article http://blogs.webmd.com/pamela-peeke-md/2010/04/the-toxic-stress-fat-conn.... There are others like it.
This does not mean that your client should not check with a doctor but it may provide additional input.
To continue the reach for an answer on the "belly bulge," I am going to add an anterior tilt to the list.
It is common for us to associate an anterior tilt with lumber flexion. We cant forget that the forward and downward tilt of the pelvis can push the abdominals forward creating a "pooch," belly.
I agree with Jeremy, could be a lower cross syndrome that needs correcting and or insulin resistance, blood sugar issue. If you haven't already, have him do a very detailed food log that states not only the times he eats but his energy levels an hour afterwards. I also have my clients dictate how their bowel movements are. I know it sounds nasty but that is how to tell if he's digesting everything appropriately and is healthy. It all comes from the digestive system.
Hope that's a little bit helpful and good luck!