Tuesday 8 March 2011

Pilates for Pregnancy ( article for ABC magazine March 2011)


Pilates is fast becoming the exercise program for expectant mums, due to its benefits in terms of strength, flexibility and relaxation.

Pilates entails a series of stretching and resistance exercises with a focus on breathing and body awareness that leads to core stability and leaner muscles. The method has an ‘all gain, no pain’ approach. Joseph Pilates developed the method in the early 1900s as an exercise program for First World War veterans. His original technique has now been enhanced utilizing the improved knowledge we now have about the way the body works.

As well as the general benefits of Pilates such as improved posture, prevention of injury and a reduction in back pain, there are specific pre-natal benefits.

The main focus of a Pilates class during Pregnancy is on the maintenance of muscle tone, strength and endurance. This is not a time to be pushing your body, more a time to gently strengthen. Particular focus is paid to the pelvic floor muscles. A significant 64% of women develop incontinence symptoms due to the weight of the baby on the bladder during pregnancy, and as a result of the pelvic floor being stretched or weakened during labour. The risk of incontinence can be greatly reduced by strengthening the pelvic floor. All Pilates exercises will work to strengthen this important muscle, from swimming in a four point kneeling position to seated exercises such as alternate leg lifts on the Swiss Ball.

Pilates can help to achieve optimal fitness and health for both mother and baby during pregnancy, and for labour. Exercises that will lead to improvements in functional fitness for every day life are practiced. For example, squats leaning against a Swiss ball placed on the wall to mimic standing and sitting movements, or the ‘sidekick’ to lengthen the hip flexors and hamstring muscles, counteracting the forward tilt of the pelvis and therefore reducing back pain.

There is a focus on relaxation both during pregnancy and specifically for labour by an emphasis on deep breathing patterns. The respiratory rate naturally increases in pregnancy. The diaphragm is elevated due to its changes in the rib cage placement, which may increase oxygen consumption by 15-20%. This increase makes the body work harder to deliver appropriate levels of oxygen to the developing foetus, which in turn alters the availability of oxygen to the woman, resulting in a sense of breathlessness. A focus on deep breathing into the thoracic part of the spine and into the lower parts of the lungs helps to improve breathing capacity. This helps to improve circulation, decreasing the risk of blood clots, varicose veins, leg cramping and swelling. It can also assist in regulating fatigue levels, as well as improving sleep.

The focus on breathing, the relaxing pace of a Pilates session and the sense of well being it creates, leads to improvements in mood and body image throughout pregnancy, as well as helping to cope with post partum depression. Postnatal benefits are a quicker recovery of body shape and muscle tone after the birth.

The Pilates repertoire is adapted throughout the three trimesters of pregnancy, as changes in the body occur. In the first trimester, and indeed throughout, hormonal changes, particularly the increase of the hormone Relaxin, can result in injury or weakness in muscles and ligaments. The lower back and sacral area are most affected. Gentle stretching and mobility exercises are still included in a class but the range of movement is limited, stretches are held for shorter periods of time and the focus shifts to stability rather than flexibility.

The greatest increase in pelvic mobility and reduction of pelvic stability occur in the 20-27 week period (the latter part of the second trimester). The centre of gravity is also most altered during this stage. Stability exercises are key; working in a neutral pelvic position and strengthening the pelvic floor not only increases pelvic stability generally but also helps to avoid Symphysis Pubis Diastasis, where the pubis separates due to hormonal changes. Focus is on the support of the abdominals as a corset rather than trying ‘to flatten’. In the second trimester abdominal crunches are removed from a Pilates program because of the separation of the rectus abdominus. This occurs with the increased stretch of the abdominal wall.

Changing exercise positions frequently is encouraged to ensure comfort throughout the session. The Pilates spine supporter is introduced after week 12 of pregnancy so that the mother can exercise lying on her back safely by being propped almost to a sitting position. It is not advisable to exercise lying fully flat due to the possibility of Supine Hypertensive Syndrome, a condition where the uterus compresses the vena cava effecting oxygen flow to both the mother and baby.

To gain all the benefits of Pilates through pregnancy and to feel assured that the possible contraindications of pregnancy are recognised, it is important to find a class with an instructor who is specifically trained in Pregnancy Pilates and where classes are limited to a maximum of eight. A Pregnancy Pilates class will help all new mums enjoy their pregnancy to the fullest, feeling relaxed and strong in both body and mind.

Gemma Wright, Studio Director, Purely Pilates.

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