// Pilates during pregnancy

by Liz Dene

Pregnancy is a wonderful time in a woman’s life, but one which can be subject to uncertainty regarding exercise and what is safe and eff ective. Pregnant women will often turn to classes such as yoga, low impact group fitness and Pilates. As we know, sensible exercise during pregnancy can provide a range of physical and psychological benefits, but it is important that the exercise prescription is appropriate to the individual.

No two women’s bodies are the same, and this is especially true during pregnancy. Keeping this in mind we need to modify exercise based on each stage of pregnancy and the client’s personal conditions. Over the course of pregnancy the demand on the core increases significantly, creating a need to strengthen the deep stabilising muscles and decrease the load on the global muscles. With the uterus enlarging over 1,000 times we need to reduce the load on the rectus abdominus, especially after week 12.

During the second trimester, the abdominal muscles become stretched, and some women experience diastasis recti (separation of the abdominal muscles). With reduced abdominal support, there is a greater risk of injury to the lower back and pelvis. Further, due to hormonal changes during pregnancy, the ligaments surrounding the joints become lax, leaving them loose and vulnerable.

Low impact exercise that focuses on alignment, core stability, mobility, strength, postural awareness and breathing is the ideal option for prenatal exercise. Pilates offers fantastic exercise options which focus on developing strength within the deep stabilising muscles; maintaining alignment while challenging the core against movement. However, not all Pilates exercises are suitable during pregnancy – being aware of each stage and what the guidelines are will assist in safe and effective programming.

THE EXERCISES

Pelvic Floor

The pelvic floor (PF) is stretched and weakened during pregnancy; therefore it is necessary to include PF activation within your sessions. Ideally this is done in a variety of positions. Focusing on the quality of the movement, gently lift the PF on the expiration. Use visualisations such as a sliding door coming together, a plane taking off or a lift ascending. Use a combination of slow and controlled, plus short and fast contractions to activate both fast and slow twitch fibres. Leading up to the birth, include some PF relaxation in the class as this is important during the birthing process.

SCAPULA DRAW (Photos 1 & 2)

Benefits: This exercise strengthens the shoulder-stabilising muscles and helps prevent postnatal upper back pain.

Exercise: Seated on a ball, a chair, the fl oor or against a wall. Arms out at a 90º angle, elbows in line with the shoulders. Breathe in to prepare, engage the PF, extend the arms overhead keeping them in the same alignment, then draw the rhomboids together to bring them back to the starting position. Repeat 3 to 5 times.


LATERAL RELEASE WITH BALL (Photos 3 & 4)

Benefits: Develops spinal mobility while focusing on lateral flexion and releases the lateral muscles of the torso.

Exercise: Start in kneeling position with the ball close to the body. Place one hand on the ball and roll on the diagonal in the opposite direction of the hand. Come back to the start then swap hands, repeat other side keeping the movement flowing. Repeat 5 to 8 times each side.


SWIMMING (Photos 5 & 6)

Benefits: This exercise helps develop scapular and shoulder stability while challenging core control with particular focus on multifi dus recruitment. This also helps to develop neck, shoulder, arm and gluteal strength.

Exercise: Position in four point kneeling, hands in line with shoulders, knees directly beneath hips, feet in alignment with knees. Focus on gentle drawing in of the corset, lifting the pelvic floor while maintaining a neutral pelvis, breathe in to prepare, breathe out, slide one leg up to 90 degree angle. For progression, add the opposite arm to leg. Trying to keep the pelvis as stable as possible, avoid rocking side to side. If there is any movement, regress to leg only, or if the position proves problematic, move to the wall as an alternative. Perform three reps, then swap sides.

THREAD THE NEEDLE (Photos 10 & 11)

Benefit: Another fantastic exercise for spinal release and mobility. This exercise gives a great release through the thoracic region without causing issues in the lumbar pelvic area.

Exercise: Commence in a four point kneeling position, neutral alignment. Breathe in to prepare engagement of the deep abdominal muscles. Breathe out, extend one arm up focusing on releasing through the chest muscles. Breathe in, slide one arm under the other across the fl oor feeling the lateral rotation and release. Repeat 3 to 5 times each side.

CLAM (Photo 12)

Benefit: This exercise focuses on strengthening the gluteals which assist in increasing the force closure of the lumbar pelvic region. Ideally include this exercise in all pre and postnatal programs.

Exercise: Start side-lying with both knees bent, legs and feet in alignment away from bottom leg, keeping the feet on the ground at all times. Inhale, set deep abdominals, breathe out, lift the top knee away. Breathe in, return to the start position. Avoid any rocking of the pelvis. Focus on the alignment at all times. Repeat 5 to 8 times each side.

As with any exercise during pregnancy, you need to constantly assess your client’s progress, remaining aware of the stages of pregnancy and the appropriate modifications for each. Pregnancy is a constantly changing state, so pregnant clients must have their state of health and musculoskeletal symptoms assessed prior to each session.

Pilates exercises provide many wonderful benefi ts that can help women achieve safe healthy pregnancies, assist their birth process and hasten recovery in the postnatal period.

 

Liz Dene, BHMS
Liz’s expertise relates to exercise and pregnancy issues. She is a master trainer for Network Pilates and is actively involved in developing and delivering courses both nationally and internationally. With a degree in human movement, Liz has over 15 years experience in all areas of training and fi tness. She merges traditional fi tness practices with a holistic approach to wellbeing. For more information visit www.lizdene.com


NETWORK MAGAZINE • SUMMER 2007 • PP40-46