"Closing the GAP" is OUT ❌ | Here's what's IN ✅ when it comes to helping clients heal pregnancy-related diastasis recti! 

When it comes to healing diastasis recti, 👉 “closing the gap" USED to be a popular metric of measurement, and can be described as the bio-medical way of healing - solely focused on the physical. 

Over the years, as more research on intra-abdominal pressure management and fascia healing came out, experts determined that using inter-rectus distance as a healing metric was limiting, and just plain incorrect, as far as function was concerned. 

• Many women have a visible 'gap' several years postpartum, and are considered healed, feeling strong, stable, and completely functional - and is what we call 'functional DRA'

Now, if a woman is functional, but doesn't like the gap, THAT's where surgery comes in. (In severe cases, women need surgery to help with function.)

It's REALLY important that women go through a healing movement protocol, and wait at least 2 years postpartum before even considering surgery. 
This is because it’s about the system — breath, posture, movement, mindset — working together - not just the superficial muscles you can see. 

This is where the bio-psycho-social approach changes everything.

Research shows that teaching from a bio-psycho-social approach creates the best outcomes.

And there's TONS of research to back it up! 

💡 What is the Bio-Psycho-Social Approach to Teaching?

It’s a way of looking at the client in front of you (just like in Pilates) as a whole person; not just looking at her abdominal muscles. 

It means that healing doesn’t just happen through core exercises 
…it happens through nervous system regulation, language that empowers, and small wins that rebuild identity.

Trying to explain each element on it's own is difficult because the elements are affected by each other, 

and it can get tricky trying to categorize a process that involves nature 🌱& the miracle of the human body as it's own self-healing, self-sustaining creation. 💫

BUT, I'll do my best.

So here we go...

🧬 Biological – You're already teaching the biological part - which is the physical. You teach breathing strategies and movement patterns that manage pressure and promote healthy tissue loading.

Nutrition and sleep are also a part of the biological aspect. 

   ✅ How to Apply it with DRA Clients & Pilates

• Movement-based rehab: cueing breath, core, PF; progressive loading; posture and coordination.
• Also, education on healthy everyday movement vs. just focusing on the perfectly executed Pilates exercise. 

The biological is STRONGLY influenced by the psychological.

🧠 Psychological is the mental and emotional aspect - what the client feels, and believes about the condition. 

    ✅ How to Apply it with DRA Clients & Pilates

• Reframe body image issues, reduce fear, build self-trust in movement again.
• Function-focused, helpful language vs. Aesthetic-focused, unhelpful language.

The psychological aspects are STRONGLY influenced by the sociological aspects. 

🗣️ Sociological is the social aspect - the relationships your client has with important people in her life (spouses, family, friends, you,) the environment she lives in, and the studio environment you provide. This includes cultural beliefs, and is where the pressure of 'bouncing-back' stems from. 

     ✅ How to Apply it with DRA Clients & Pilates

• Provide a supportive, uplifting, and judgment-free studio environment.
• Resolution-based conversations - vs. complaining.

The psycho-social is JUST as important (and might actually be MORE important)

🌈 WHY the Psycho-Social Aspect is Crucial:

Research consistently shows a STRONG connection between psychological well-being and physical healing.

• Positive emotions, social support, and a strong sense of purpose can lower stress hormones, improve immune function, and promote healthier behaviors, ultimately leading to faster and more effective physical recovery. 
• Negative emotions like anxiety and depression can hinder healing by increasing stress hormones and impairing immune responses. 

📄 There's a list of sources at the end of this email if you're interested in reading more about the psycho-social aspects of healing.

A GREAT book to read about the power of a positive outlook & healing is called Anatomy of an Illness by Norman Cousins

🔷 🔷 🔷

To sum it up, bio-psycho-social is simply treating your client as human, not just a body. 

Involve her WHOLE life! 

While it's awesome, and common, for women to do Pilates for the physical, aesthetic aspect, the secret to getting them that 'Pilates body' is to light 💡 them up from the inside out! 

Your Turn: 

With your next client, see how you can apply the bio-psycho-social elements. 

To Your Perinatal Teaching Success,

Alison Marsh - Pregnancy Pilates Impact 💫

P.S. I LOVE hearing from you! 💌 Reply to this email letting me know what your struggling with when it comes to teaching clients with diastasis recti! 

Follow me on Instagram for thought-provoking, educational content (mixed in with some personal stuff) @pregancy.pilates.impact

Sources on Bio-Psycho-Social Model of Healing

[1] Why Physical and Mental Health Are Interconnected in the Recovery Process
Source: St. James Rehabilitation & Healthcare Center
URL: https://www.stjamesrehab.com/blog/why-physical-and-mental-health-are-interconnected-in-the-recovery-process

[2] How Your Mental Health Impacts Your Ability to Heal and Recover
Source: St. James Rehabilitation & Healthcare Center
URL: https://www.stjamesrehab.com/blog/how-your-mental-health-impacts-your-ability-to-heal-and-recover

[3] Health care providers should harness power of mindsets, researchers say
Source: Stanford Medicine News Center
URL: https://med.stanford.edu/news/all-news/2017/03/health-care-providers-should-harness-power-of-mindsets.html

[4] Biopsychosocial Model of Illness: Why We Still Need It
Source: National Center for Biotechnology Information (NCBI), PMC
URL: https://pmc.ncbi.nlm.nih.gov/articles/PMC11426302/