Ten tips on working with your pregnant clients
- At about 20 weeks the abdominal muscles start to separate so avoid strong abdominal work and open kinetic chain work, which puts strain on the abdominal muscles, so no curl up, no legs 90/90. This separation is called Diastasis Recti meaning a split of the liner alba, this allows for uterus to grow. This happens in 95% of pregnancies and can cause back problems. Rather than cueing “pull the tummy in”, cue a “gentle huge of the baby towards you.” This also means: no open kinetic chain, no lumbar flexion.
- Relaxin – relaxes all the joints and makes the pelvis unstable and vulnerable to Sacro Iliac Dysfunction, ligaments painfully stretch; this all allows the uterus to grow. You need to avoid anything that may compromise pelvic stability – anything standing on one leg is out.
- As soon as you know a client is pregnant or trying to fall pregnant and thereafter avoid ball, seal, rocker and other rolling exercises as well as short and long spine on the reformer, tower series on the caddie, and roll over on the Mat, as well as jumping on the reformer, and horseback on the ladder barrel. In fact, as soon as I know someone is pregnant I start the antenatal program!
- Pubic Symphysis Separation is caused by relaxin…. Relaxin is useful as it softens and prepares the pelvis for birth, but it can also have the delightful affect of becoming inflamed…. avoid working the adductors. You also need to avoid any exercises that have a shearing force on the pubic symphysis such as lunges, and side lying pendulum. Generally avoid over stretching the muscles around the pelvic girdle especially avoid the ballet stretches on the Ladder Barrel and on the Caddie- this is a recipe for disaster as you are combining standing on one leg with pelvic girdle stretching…..
- Blood Pressure can go up during Pregnancy at around 4 – 5 months. Keep the program easy, no lying on the back, no torso higher than head, no upside down work. Keep them cool and hydrated– keep their heart rate below 140 BPM. When the heart rate goes up the body temperature goes up also. So if you use an exercise bike in your studio monitor their heart rate and keep in under 140BPM.
- Each pregnancy is unique and client should be encouraged to speak out if they feel uncomfortable during an exercise. Eg. Dizziness. This may happen with taking the arms up over the head with some blood pressure conditions brought on by pregnancy.
- During Pregnancy the posture changes – the Lower back becomes more lordotic and thoracic more kyphotic. Try exercises such as imprinting on the wall, and the push through on the Caddie on haunches into child pose to stretch out the lower back.
- Lying flat on the back can cause the weight of the uterus to restrict blood flow to the Vena Cava – The superior vena cava is the large vein which returns blood to the heart from the head, neck and both upper limbs. The inferior vena cava returns blood to the heart from the lower part of the body. If the woman’s blood flow to her heart is reduced, then her unborn baby may also receive less blood flow for a short period of time. This may occasionally be enough to cause the baby to be temporarily stressed and open their bowels inside the uterus before the birth. Knowing this, clients should not be worked in a supine position after 18 weeks. If the client is feeling light headed than the Vena Cava may be affected, get them to change positions.
- Carpel Tunnel is another fun change that can occur during pregnancy, symptoms my stem from neck or swelling in the wrist. Find a comfortable positions for the wrists in four point kneeling work such as using a half roller under the wrists, or even better, work on forearms on a box or on the foot bar with a think mat under the forearms.
- Most importantly remember to work the pelvic floor! The pressure of the weight of the pregnancy can cause stress incontinence, and no one likes the feeling of that little dribble as you cough of sneeze!
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