Pilates in Pregnancy

Image from webmd.boots.com

Can you still practice Pilates with a baby on board? Absolutely, but we do have to make a few modifications to adapt to the changes in a pregnant woman’s body. Many of our clients continue to practice right up to their due date, much to the admiration of their fellow class members! This blog will look at the many benefits of continuing Pilates practice during pregnancy as well as giving some ideas for exercising safely during pregnancy.

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There are some reasons not to exercise during pregnancy and it is always a good idea to check with your physiotherapist or midwife if you have any concerns. See the full list of signs to stop exercising at the bottom of this article.

Exercising during pregnancy is known to benefit both mother and baby – and can have long lasting health effects for the baby long after it is born. Studies have shown that if the mother’s heart rate is raised, the fetus’s heart rate also goes up. So by keeping yourself fit, you are giving your baby a wee workout!

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In general, it is advised to keep the intensity you exercise at to a moderate level. Make sure you can still speak in sentences while working out. You are recommended to continue an exercise programme from before pregnancy and stop any exercise where there is a risk of impact. If you were totally inactive before pregnancy, then it is advised to start some form of gentle exercise. Pilates is a great gentle exercise and can be adapted to any level, even if you have not done it before pregnancy, to exercise the muscles effectively and safely.

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Antenatal Pilates helps to maintain posture, strength and flexibility to reduce/prevent pregnancy-related discomfort and a class taught by a specialist antenatal Pilates instructor will teach awareness of correct body biomechanics and postural alignment while adjusting to the changes in the body – increased weight and the change in centre of gravity with a growing bump.

The pelvic floor has additional pressure placed on it from early in pregnancy. It is a good idea to start pelvic floor exercises before you even get pregnant, but if you’ve missed that opportunity, it’s definitely better to start before the birth than after the birth. Pilates during pregnancy can help you get best function from your pelvic floor while performing the exercises.

Image from pregnancyyogadublin.ie

There is a fairly common misconception that a strong pelvic floor is also tight and can cause problems during the birth. Actually, problems of tightness in the pelvic floor, as in any other muscle, tend to arise when there is weakness in some areas of the muscle – the weak muscle fibres build up tension to compensate. A well functioning pelvic floor which is both strong and mobile can actually aid the delivery by encouraging the baby to turn effectively as it is being born. If the pelvic floor is in good condition prior to the birth, it can really speed recovery and limit effects of continence problems after the birth.

An antenatal Pilates class will also focus on the upper back and arms to help prepare the body for caring for your baby. Good control around the shoulder blades will be essential when you spend hours leaning over and carrying baby. When you go to a pregnancy Pilates class you might wonder why you do so many squats! Think ahead, how many times a day will you be picking up baby and getting on and off the floor? If you train this movement prior to the birth, you will be able to maintain better leg and spine alignment when this is probably not at the forefront of your mind!

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It is important to know that you shouldn’t do sit up type exercises after the first trimester of pregnancy. This is because the long stomach muscles which run from the sternum down to the pubic bone stretch to almost double their original length in pregnancy and will split apart in two thirds of women. This split (rectus diastasis) is not a problem in itself – it is a natural part of pregnancy. But any sit-up type movements that strengthens the muscle in the split position can make it more difficult to rehab postnatally. You still want to maintain the control of the deep abdominal muscles and obliques, but this can be done in sitting and standing positions as well as on hands and knees (4 point kneeling) and will not create an intense pull on the muscles.

Image from http://www.persilandcomfort.co.uk

The antenatal classes will also give the added benefits of allowing you time to focus on yourself and your developing baby in a relaxed class which is small enough to allow you personal attention when required. You will meet like-minded mums-to-be and get to exercise in a supportive environment where everyone in the class is experiencing similar changes to their bodies and benefiting from the instructor’s expert advice and experience.

As an antenatal class is suitable for all stages of pregnancy, please be aware there might be people in your class in their first trimester. If you know someone in the class who is in the early stages of pregnancy, please help them keep their big secret until they have made their pregnancy public!

All images from darrochphotography.com unless otherwise stated.

Stop exercising and seek advice if you experience any of the following:

  • Ligament pain
  • Pubic/sacroiliac/pelvic girdle pain
  • Low back pain
  • Leg pain or cramps
  • Varicose veins
  • Swelling in hands and feet
  • Carpal tunnel syndrome
  • Vaginal bleeding
  • Abdominal cramping
  • Feeling faint/short of breath
  • Decreased fetal movement

Pilates homework

I can hear a collective spluttering out of your healthy new year smoothie as you open this message. Homework?! But I come to a class, I don’t need to do that as well!

I’m hoping I can show you a few ways you can make Pilates work for you outside of your classes and hopefully see benefits in other areas of your life too.

You know the feeling you get after your Pilates class? Being stretched out, better aligned and walking tall, and all seemingly effortlessly… This is something that could be achieved more regularly by continuing your practice through the week. Just two or three extra sessions at home can make a huge difference to your progress.

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Nobody practices Pilates to be really good at Pilates (except instructors, but then we have to be obsessed!). It is usually done to benefit another area of your life. You might have a demanding job where you spend a long time in static postures and use pilates to stretch out and destress at the end of the day. You might be planning a skiing or sailing holiday and need to build up a strong foundation and endurance required for the trip. Or maybe you’re training for a new sporting challenge like a triathlon or the moonwalk and recognise the benefits of good posture on improving your performance. Whatever it is, you will find that the benefits of Pilates will go so much further if you incorporate the principles of what you do in class into your everyday activities.

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Your practice at home doesn’t have to be an intensive session, the much used phrase ‘little and often’ can be very appropriate in building on and maintaining the benefits you get from your classes. And you don’t necessarily need a mat or even to lie down. Pilates can be done in standing, sitting or lying. It can also be done in secret! As well as being a series of exercises, Pilates is about how you move your body and also how you rest between activities.

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Equipment such as magic circles or foam rollers can be a great incentive to do some work at home, taking exercises from your classes and doing them while you watch your favourite television show. Equipment can make a workout more fun, but again it’s not essential to your practice.

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If you find you stiffen up between Pilates sessions, you could be doing two or three exercises daily focusing on your problem areas and you should find that you maintain your flexibility and are more comfortable between sessions. For example, we regularly incorporate roll downs into our classes because they are great exercises for spinal mobility, core activation and coordination, and waking up the nervous system. Also, while the first one can feel stiff, by the third it already feels looser. Try doing 3 in the morning for a couple of days.  It will take you two minutes -see if you notice a difference during your day. If you struggle with getting the mobility through your back as you roll down, try the exercise against the wall and focus on peeling one vertebra at a time away from the wall, pause and work into any areas of stiffness or tightness as you need to.

PilatesPlus2013IMG_9081 PilatesPlus2013IMG_9083 PilatesPlus2013IMG_9085 PilatesPlus2013IMG_9087Tess demonstrates a roll down

So, how do you do Pilates in secret?! Notice your posture as you go through your day and focus on the watchpoints you work on in your class. If you keep your low back in neutral, gently work your shoulderblades back and down and lengthen lightly through the back of the neck you will be helping to keep good muscle balance, work your core muscles at a low level and encourage the muscles to stay switched on and work at the right moment. It is unlikely anyone will notice you making these subtle changes, but they may well remark on how well you look!

Please see your instructor if you have any questions regarding the exercises mentioned in this post. Your instructor can give you a handout of home exercises and can help give you ideas of exercises to do with the equipment you have at home.

Let us know how you get on with doing your Pilates at home!

Keeping up your Pilates practice over the holidays

It’s that time of year again – across the country cries can be heard: ‘It can’t be December already!’ Yes, that’s right,’tis the season to stay indoors, eat a lot and move very little. Which is wonderful, until a few days in where you start feeling a bit ropey. All the hard work you’ve done through the year seems to evaporate as the old aches and pains start to make their presence known. That is, until you had ‘the handy Pilates Plus Guide to surviving Christmas and maintain your mobility and fitness’. Bit of a mouthful, but we’re working on it!

So, we started off by thinking of ways you could incorporate Pilates into your Christmas routine. Firstly, you could roll down as you wind the tinsel round the tree!

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Then how about getting your toes in on the act and putting up the decorations with your feet, introducing: the Christmas shoulder bridge!

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And to get the decorations a bit higher up the tree, the Christmas side bend!

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Doing a ‘Pilates demonstration’ in your front room not your thing? Then we maybe have some slightly sensible options to help prevent stiffening up as you watch ‘It’s a Wonderful Life’ for the 37th time. Your Pilates instructor can issue you with our handout of home exercises. We also recommend the APPI DVDs available from their website: http://www.ausphysio.com

Are you somebody who has beautiful posture in your Pilates class and then slouches out the door? If so, make this Christmas the time that you remember all the postural points your instructor tells you about during your classes. Your little black dress or kilt outfit will thank you for it at the Christmas parties – you don’t see A-listers slouching down the red carpet! Good posture can make a nice outfit look amazing, and yes, you have to work extra hard at it in heels!

   Image from www.bennettclinic.net

Even five minutes a day can help maintain mobility, the next few exercises have been chosen as they give you a good mobility workout and can be done in a small space. If you are not comfortable on your wrists you can do these exercises on a clenched fist, keeping the wrist straight or come down onto your elbows. Stop if any of the exercises are uncomfortable and see your Physio/Pilates instructor for an alternative.

Cat – Camel. In 4-point kneeling, start by inhaling and engaging your centre, exhale and arch your back into a deep C-curve, dropping your head between your arms. Inhale and hold then slowly unravel the other way as you exhale, just lifting your head far enough to look at the floor in front of your hands. Repeat 8-10 times.

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Thead the Needle. In 4-point kneeling, exhale as you thread one hand through to twist your spine. Inhale and hold. Exhale and draw the arm back through, lifting it up to the ceiling to rotate the spine the other way. Inhale and hold, then repeat 6-8 times each side.

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Spine Twist. With or without an elastic band. Sit cross legged, or in a position you find comfortable. Inhale and grow tall, exhale rotate to the side, inhale and hold, rotate a little deeper if you can. Exhale back to the centre. Repeat to the other side. Repeat 8-10 times to each side.

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Spine flexion stretch. Start sitting with your legs to the sides. Sit tall as you inhale, exhale reach forward and curve your spine forwards. Inhale and hold, stretch a little further if you can. Exhale and return to the start. Repeat 8-10 times.

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Think about all the cues you hear in your Pilates class each week. Checking the turkey in the oven? Engage your centre as you bend down! Reaching out to fix a decoration on the tree? Keep your shoulders melted down your back! Christmas carolling? Find neutral pelvis! Pouring mulled wine? Lengthen through the back of your neck! Before you know it, the entire festive season will be filled with Pilates…

If you do any festive Pilates moves, please post on the Pilates Plus Facebook page or tweet us @PilatesPlusPhys, we’d love to see how you keep yourself fit over the holidays!

xmas Laura and Tess

Wishing you all a wonderful festive season and best wishes for the new year from Laura and Tess and all the Pilates Plus team. We look forward to seeing you rested and ready for some new challenges in 2014!

Pilates for Triathletes

Triathlon training is time consuming as it is, so why spend time doing Pilates?

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Triathlon is considered one of the most challenging endurance sports. Triathletes require mental and physical stamina, postural control and kinaesthetic integrity.  It is not only about the mileage…

Pilates works on your powerhouse, the CORE of the body by enhancing strength, flexibility and control, key aspects for aspiring triathletes. Specifically Pilates works on your transverse abdominus, rectus abdominus, erector spinae, obliques and gluteals.

Pilates allows you to simultaneously improve your core without gaining undesirable bulk and weight yet tones pure muscle.  Increasing core strength results in better posture, increased power efficiency and output and potentially reduces your risk of injury.  Pilates isolates and integrates muscles groups which assist functional movement patterns improving alignment of the pelvis giving you a stable base of support.  Consequently postural awareness and balance control reduce the risk of low back pain and other potential injuries.

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Swimming: Similar to swimming, Pilates is performed at a deliberate pace and utilises specific breathing patterns therefore translates well into the pool environment.  Neck flexibility and spinal positioning are also key to a good swimming technique, in addition streamlining is paramount to speed and reduced drag.  Specific Pilates exercises can improve streamlining leading to an effortless and efficient stroke pattern.

Cycling: Often leads to dominant leg development and less core and upper body muscular development.  Core strength is key to reducing the levels of fatigue and getting through those long rides.  Pilates improves muscular imbalances, alignment, core and upper limb strength enhancing pedal stroke and power output.

The kyphotic (hunched) posture that is required for cycling is less than desirable, prolonged periods in this position can potentially lead to injury if preventative corrective measures are not utilised.  The posture allows for excessive forward flexion of the lumbar spine, forward rotation of the hips and pelvis and often there is a shortening of the neck muscles too due to looking forward during riding.  This posture is one of the leading causes of low back pain in cyclists.  Shortened hamstrings and neural issues along with Itb/gluteal/piriformis injuries are often seen in both cyclists and runners. However, there is evidence to suggest that Pilates can improve and prevent low back and other common injuries by improving core, restoring postural alignment and muscle imbalances.

Running: It’s all about economy and efficiency – it should be smooth and effortless.  The repetitive movement of specific muscle groups during running can result in muscular imbalances.  Pilates can improve muscle flexibility which can not only prevent injury but lead to improved stride length potentially giving you the ability to run faster and longer!  Pilates also works on your breathing which is integral to a good running technique.

Tri Specific Exercises

Clam

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Focus: hips, thighs, buttocks (side-lying feet either on the ground or slightly lifted). Open hips to 45 degrees, slowly return together.

Repeat: 3×10 each side

(to increase difficulty add a resistance band around the knees)

Swim with Resistance Band

 swimmingFocus: spinal position and alignment/balance, buttocks, hamstrings, upper limbs. Start in four point kneeling slowly take opposite arm/leg away from body in a straight line (watch spinal position do not allow your back to arch).

Repeat 3×8 each side (to increase difficulty add a resistance band)

 

Leg Pull in Prone

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Focus: spinal aligment, transverse abdominus, upper limb strength, scapula control. Assume a plank position slowly lengthen one leg back and lift a few inches off the floor without losing spinal alignment (do not allow you back to arch).

Repeat: 2×10 (alternating sides)

One Leg Stretch

 one leg stretchFocus: spinal position (including deep neck flexors), transverse abdominus, pelvic floor, thighs, hips. Spine should not be too arched or too flat on the floor, legs start up at a 90degree angle, extend single leg away from the body making sure the back does not arch

Repeat: 2×10 (alternating sides)

Triathlon photos © http://www.darrochphotography.com

Pilates photos © http://www.pilatesplusphysio.co.uk

Pilates – why bother?

Apart from allowing you to do silly things at the top of mountains, what can Pilates offer you?

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Welcome to the first of three posts introducing you to Pilates from the view of a physio and Pilates instructor. You may find you can motivate yourself by just wanting to do something positive for your health and fitness and I applaud you. Many of us need a little more to get us going – having to fit into an outfit for your daughter’s wedding, performing at a  high level in your sport, dreading getting into swimwear on holiday this summer… It may simply be having paid upfront for a block of classes and wanting to get your money’s worth. Whatever it is that drives you to get to a class, hopefully this blog can add new reasons to get enthusiastic.

You may be here because you are already a super-fit person looking for something more, or you may just be dabbling in the reasons to get active. Before we even get started on Pilates, here is an excellent video on the need for physical activity as a starter:

Now, Pilates isn’t for everyone – people have their own preferences and will choose alternatives – but, in my humble opinion – it is for a huge number of people from different backgrounds. You may prefer yoga for the spiritual element, you may find the whole thing too slow and (yawn) boring and stick to your high intensity classes. In my experience, if people only do one activity, it needs to address alignment of the body, support of the joints, stability of the muscular system, flexibility of the muscles and mobility of the joints. Pilates does all of these (I’m not claiming nothing else does – but a lot of activities will only address a few aspects of fitness and if that is all you do, leave you with an imbalance which could lead to problems). So, if you’re only going to do one activity, you could go for Pilates. If you’re only going to do something which only works muscles repeatedly in a specific range like cycling, walking, running, swimming and so on, I would strongly suggest you get in another activity that will help maintain muscle strength and length and prevent muscle imbalances.

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Anecdotally, I met a rower at a  Pilates course who was training six days a week on various torturous training programmes (I know, I’ve done them all – six days a week is the minimum you have to put in to remain competitive in rowing). When she started training in Pilates she added in a Pilates session on the seventh day and quickly saw her rowing results improve dramatically.

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Every week in my classes I have a client say ‘I feel so much better for that’, or ‘I feel inches taller’. I feel it myself as well, the healthy feeling of alignment in the body and knowing you’ve done something good for yourself stays with you. My argument for ‘why bother?’ is that Pilates is exercise which supports you in your life and improves quality of life. Coming out of a class, you feel you have the energy to get on with things and have a feeling of having treated yourself well. How many people can say that after a gruelling spinning class? Although spinning has its place, I know myself  I’d rather lie down in a darkened room afterwards.

Enough anecdotal evidence, what do the experts say? Ferreira et al (2006) conducted a systematic review of specific stabilisation exercises (such as those used in Pilates) and found that for the low back and neck, the exercises were beneficial for treating chronic (lasting 6 weeks or longer) pain, reducing cervicogenic headaches (headaches arising from neck problems) and preventing recurrence of pain.

Up next: Pilates – What is it good for? Let’s hope the answer isn’t ‘absolutely nuthin’!’

Reference: Ferreira PH, Ferreira ML, Maher CG, Herber t RD and Refshaug e K (2006): Specific stabilisation exercise for spinal and pelvic pain: A systematic review. Australian Journal of Physiotherapy 52: 79–88