a case study on healing diastasis during pregnancy

Closing a four-finger width Diastasis Recti (DR) separation during pregnancy once seemed like an impossibility in my practice, but one case proved me wrong.  Closing a separation at the same time that the belly is growing just wasn’t in my realm of thought.  But using a technique that I often use with my postpartum clients healed my client’s separation at 28 weeks pregnant, eliminated all back pain and ultimately showed only a one finger separation at one-week post-birth.

Kerry began working with The Bloom Method knowing that she would soon be pregnant again. When she came to me, she was very clear about wanting to create a deeper awareness in her core while healing a DR that she had gained from her previous pregnancy three years prior. I started her with my preconception core exercises. Within only three weeks of working with her to heal separation, she became pregnant with her second child sooner than expected. We kept to this TA-strengthening core program with slight modifications now that she was pregnant.

At about 28 weeks pregnant, Kerry came into one of our sessions in a lot of pain. She complained that her low back was bothering her and even keeping her up at night. I assessed her core and realized that her four finger width separation from her previous child had reappeared. The news wasn’t a huge shock because I knew that we hadn’t had the time needed to truly repair the connective tissue before she became pregnant this time around. The already-weakened connective tissue and the rapid growth of the belly seemed a perfect scenario for reawakening a diastasis recti.  Her separation showed to be consistent from her belly button all the way up to her ribcage.

I was concerned —  I knew we needed to get this under control and protect it from worsening.  Kerry was up for anything but I wanted to keep it simple. I gave her one exercise that I always use with postpartum clients. I call the exercise Ab wraps.

How to Do Ab Wraps

• Have your client lay supine, placing their hands on the lower abdomen, above the hipbones

• Have them take a deep belly inhale followed with a deep core engaging exhale

• Lifting through the Pelvic Floor to begin, have them then imagine that the TA muscle draws their hip bones in towards each other as if to kiss one another

• Once they feel a tightening sensation in the lower abdomen, have them hold that connection as they take a small inhale in the chest (allowing the chest to rise with the inhale )

• On the second exhale, have them bring their hands up to their mid-torso and add to the deep core connection by wrapping the midsection with the TA muscle (lower abdomen and mid-abdomen should now both be engaged)

• Follow with another chest inhale as they bring hands to the outsides of the ribcage

• Exhale and wrap the top section

• Once they feel the entire length of the torso engaged, have them keep that full torso engagement as they begin to move back down the torso wrapping each section again, from top to bottom and back up, allowing the engagement to be a little deeper with each “wrap + exhale”

• Continue moving up & down the torso for a full 45s | Have them take a deep expansive, belly inhale and go right back into another round of TA binds starting from the beginning for one more 45-second hold. {2 / 45 second holds is 1 set of TA binds}

I taught this exercise to Kerry and made sure she could feel the TA activating with each wrap while most importantly keeping the engagement for the duration of the exercise. Once we determined that she could, in fact, perform the Ab wraps correctly, I recommend that she do them three to five times every day for one week. As she left our session, I remember hoping that at the very least this would improve her current back pain.

One week later I was prepping for my session with Kerry when she came bounding in with incredible new energy.   She said, “I closed my separation and I haven’t had any back pain in days”.  I smiled in affirmation but knew that it would be impossible for her to close her separation in one week, while pregnant.  I told her, “I don’t think you’ve closed your separation but lie down and let me take a look.”

I set Kerry up to test her separation and was astonished. While she hadn’t completely closed her DR, she had gone from a four-finger width separation to a two. I was already amazed, but then she told me something that blew me away:  “I also went through a growth spurt last week and my midwife says that my belly is measuring bigger than it was when you taught me this exercise”. It was in that moment that I realized the power and importance of correcting and protecting a separation during pregnancy.  I suddenly felt the power of core activation exercises. They were effective in addressing separation postnatally as well as prenatally.

Kerry continued doing the Ab wraps along with a few other core exercises that I recommended for the remainder of her pregnancy and never complained of back pain again. In fact, it was quite the opposite. Kerry beamed about how she was able to decrease the size of her DR during pregnancy and happened to feel better the last 12 weeks of pregnancy than she had at the beginning.

Kerry welcomed her little guy, Cedar in April.  At only one-week post-birth, I assessed her at a mere one finger separation.  Kerry no longer had diastasis by common medical standards.  She tells everyone about how connected to her core she feels post-birth now and how it has empowered her far beyond the way she felt after her first pregnancy. DR needs to be prevented, protected and eventually healed. Knowing if your client has DR during pregnancy is crucial, along with having the right exercises for recovery.  You can set your clients on a great path for a more comfortable pregnancy and quicker healing post-birth. 

Brooke Cates is a Fit For Birth Master Instructor and founder of The Bloom Method, (www.thebloommethod.com, @thebloommethod).  She is known for her strong desire to empower women through movement before, during & after their pregnancies.  Her passion for empowering pregnant women through body awareness and movement techniques has earned her an international following from both perinatal women who are seeking her services and fitness professionals who desire to be trained in her methods.  Her work with prenatal and postpartum women is pushing the fitness industry’s boundaries, and leading the way for the expansion that is so desperately needed.

To learn more about her continuing education course, Pre & Post Natal Diastasis and Core Consultant, please visit GetFitForBirth.com/diastasis