Prenatal Pilates

Pregnancy can be a very exciting, exhausting and sometimes stressful time. During the prenatal period you will be going through many changes on both a physical and emotional level. I love teaching Pilates to pregnant clients as its so rewarding being able to help during this often challenging time.

There are certain pre-existing medical conditions or complications of pregnancy that prohibit exercise. However, unless these situations present themselves there are many benefits to expectant mums to practice Pilates.

Pilates does need to be adapted to suit the pregnant client and as a general rule these adaptions will vary according to the stages of pregnancy, or trimesters. However, we are dealing with the safety of two clients at once so general rules may be overruled by individual considerations.

You should always be comfortable, extra padding may be necessary, especially as the bump gets bigger. The room should not be too hot or cold as expectant mums may find it more difficult to regulate their temperature. It’s advisable to have a small snack an hour before the session in order to avoid low blood sugar and to drink plenty of water to stay hydrated. Which leads to my next point, ready access to a toilet as the uterus may put more pressure on your bladder!

Before any sessions commence I always find out how the pregnancy is progressing so if there are any complications I can adapt or halt the session as appropriate.

During pregnancy blood volume can increase by up to 30-50%. This can then also increase blood pressure so care must be taken not to over exert yourself as increased heat rate may increase blood pressure further. Most of the guidelines recommended by the American College of Obstetricians and Gynaecologists relate to aerobic exercise but it is prudent to apply them to Pilates as well. From the second trimester it is not advisable for the expectant mother to lay on her back as the pressure of her uterus on one of the major  blood vessels can cause a drop in blood pressure and blood supply to the foetus. From the second trimester supports should be used so you can recline on a slight angle. For my home visits I have an inflatable wedge cushion, also very useful for the client to have one at home as it can also help to prop your feet up if you suffer from swollen ankles or varicose veins. It’s worth bearing in mind that the foetus will feel the effects drop in blood pressure before the mother experiences any symptoms such as dizzy-ness, so support should be given even if the client does not report any discomfort.

Hormonal changes during pregnancy can lead to some common complications. Relaxin is a hormone typically released from the second trimester. It’s the body’s way of accommodating a growing foetus and relaxing the pelvic ligaments and joints ready for the delivery. The action of the hormone is non specific and will affect all of the ligaments, muscles and joints in your body, which presents us with several considerations:

Do not over-stretch. You may get very excited that you can now achieve stretches that were difficult before! This may be taking your ligaments beyond the range when they can effectively protect your joints.
Certain abdominal exercises need to modified in the first trimester and eliminated from the second onwards. This is to avoid diastasis recti, or separation of the stomach muscles as the ligaments binding them are relaxing.
The ligaments lending stability to the front of the pelvis can also be compromised. This can lead to pubic symphysis disorder, pain and discomfort in the pubic area. Many Pilates exercises need to be modified in order to avoid this condition or to prevent exacerbation if a client is already experiencing it.

However, it’s not all bad news. Though these conditions are not unusual many women do not experience them and the adaptions to the exercises are a precaution. I will be returning to some of these conditions in more detail in later blogs.

In the last few weeks leading up to delivery I tend to wear my osteopath hat as well and start to check that the joints around the pelvis are functioning well. If the sacro-iliac joints that join the sacrum to the pelvis are not mobile it could compromise the opening of the pelvis during delivery and mums need all the help they can get here! Many mums I have reported back to me that they felt Pilates really helped them to both cope with the changes that occurred to their bodies during their pregnancy and really helped them feel strong and ready for labour