Pilates and Pregnancy

Exercise is an integral part of a healthy lifestyle. It helps prevent disease, is important for healthy bones and can help reduce stress, manage fatigue and lead to a better overall quality of life. All of which are very important when there is a newborn to care for.

Pregnancy and childbirth have a major impact on the body, both internally and externally. During pregnancy, every system is affected, including respiratory, cardiac/circulatory, hormonal, biomechanical and musculoskeletal. This can lead to shortness of breath, tiredness, swelling, varicose veins, postural changes and issues such as lower back pain, pelvic joint pain, carpal tunnel symptoms, Rectus Diastasis (separation of the abdominal muscles) and urinary incontinence.

Prenatal Pilates can really assist the pregnant client in so many ways!

Here are just a few:

• Assist with fitness for pregnancy, labor and early motherhood

• Improve self-esteem and feelings of wellbeing

• Aid in the prevention of excessive weight gain

• Improve mental health and reduced symptoms of depression

• Heighten body awareness

• Give a greater awareness of the pelvic floor muscles. Clients will feel the encouraging sensation of being able to lift through the pelvic floor as well as slowly relax pelvic floor. Practiced daily, the pelvic floor will become more elastic, which is a bonus during labor, and supportive – to assist in bladder control and prevent future weakening

• Assist with stress relief

• Enable a quicker return to fitness after giving birth

• Improve posture and condition muscles to protect from backache

• Strengthen the arms ready for the all the lifting demands of Motherhood. Pilates equipment allows your client to strengthen and tone safely

FIRST TRIMESTER (1-12 WEEKS)

The parent-to-be may be experiencing morning sickness or be feeling tired. This initial stage of pregnancy is where there is the most risk of miscarriage. Pilates is a safe exercise to perform, but the intensity needs to be lighter to avoid the body temperature and heart rate elevating too high, as this can increase the risk of miscarriage. Even in the first trimester, the amount of “sit up” abdominal exercises need to be reduced. Instead, focus more on T-zone activation and the pelvic floor muscles. Exercises like Bent Knee Fallouts and Lift Foot are great for this pelvic floor activation.

SECOND TRIMESTER (13-26 WEEKS)

Throughout the second trimester, there are a series of positions and exercises which need to be avoided.

1.     AVOID ALL ABDOMINAL WORK (EXCEPT DOUBLE LEG LIFT)During pregnancy, we want to avoid strengthening the Rectus Abdominus. As the belly gets bigger, we don’t want the rectus to be tighter as it can cause a Rectus Diastasis. 

2.     AVOID INNER THIGH WORK

We want to avoid inner thigh work because your adductors attach to your pubic symphysis (your pubic bone). When someone is in the advanced stages of pregnancy, their ligaments and joints become more lax. Many pregnant people experience some groin pain as the pubic bone starts to separate. Working the inner thighs when the pubic symphysis is already unstable can cause the pubic bone to separate even more.

3.     AVOID PRONE POSITIONS (LYING ON THE STOMACH)

At this stage of pregnancy, lying on the stomach becomes very uncomfortable as the baby is showing.

4.     AVOID SUPINE POSITIONS (LYING ON THE BACK)

Supine positions are avoided at this stage of pregnancy as many people feel nauseous or dizzy lying in this position. This is because the baby can sit right on top of the main blood vessels as they exit the spine and cause less blood to pump through. This can not only make the parent feel dizzy but can also be dangerous as less oxygen is passed to the baby.

THIRD TRIMESTER (27 WEEKS TO BIRTH)

During the third trimester, the parent’s posture changes dramatically due to the baby’s increased growth. A lordosis-kyphosis posture becomes more evident. For Pilates, the second trimester guidelines continue; however now avoiding ALL abdominal exercises including avoiding Double Leg Lift, as well as inner thigh work, supine and prone positions.

OTHER RECOMMENDATIONS FOR EXERCISING WHEN PREGNANT INCLUDE:

• Maintain a moderate intensity due to the cardiac changes the body is already in an exercised state, therefore don’t want to increase heart rate too much

• Keep cool and avoid hot, humid conditions, wear loose clothing, stand near fan or air-conditioner if in gym. As the baby is not able to regulate temperature.

• Stay hydrated. Drink lots of water.

• Warm-up and cool-down well – due to circulatory changes, the parent will need to warm-up and cool-down to avoid blood pooling and leg cramps.

• Avoid breaststroke, unilateral exercises, wide lunge/stance positions, as this can put extra stress on pelvis.

• Activate pelvic floor muscles during all exercises to keep as strong as possible, during the later stages may be harder to feel.

• Stop if feeling dizzy, nauseous, if vaginal bleeding or leakage of amniotic fluid occur.

• Avoid high intensity exercise (such as jumping on the reformer) that can increase the heart rate potentially causing fetal distress as well as create musculoskeletal issues for the mother to be such as SIJ dysfunction and SP dysfunction. Hypoglycemia and overheating can also occur through an intense exercise program

• No supine exercise after 16 weeks due to the weight of the placenta on the vena cava reducing the return of blood flow to the mother and baby

• No excessive intra-abdominal pressure exercises after 20 weeks when there may be separation of the rectus abdominis and a more vulnerable pelvic floor due to the increasing weight of the pregnancy and the hormone relaxing. It is wise to avoid any exercise that places significant load on the abdominals and pelvic floor including abdominal curls, sit ups, planks and hovers

• Avoid exercise that stand on one leg or that are asymmetrical. Any lunge type activities are best avoided to prevent injury to pelvic connective tissue including Standing Leg Press, Lunges and Going Up Front on the Chair, Scooter and Russian splits on the Reformer, Ballet stretches on the Cadillac and Ladder Barrel