Pilates for the postpartum body
Postpartum is a period that begins after a woman gives birth and ends with the body's complete recovery. During this time, the body undergoes various changes, and women can experience a range of physical and emotional challenges. While some women may return to their pre-pregnancy state within a few weeks, many may take longer to recover. In this blog post, we will discuss the benefits of Pilates for postpartum bodies, including how it can aid in recovery, serve as a preventive measure, and cue modifications for various Pilates exercises.
Before we dive into a postpartum body, it's essential to understand what happens to the body during pregnancy.
The anatomical differences between a pregnant and a non-pregnant body are numerous and significant. One of the most noticeable changes during pregnancy is the increase in abdominal size. The uterus expands 500 - 1,000 times, and the belly protrudes, which can cause posture and center of gravity changes, leading to discomfort and pain in the back and hips.
The hormonal changes that occur during pregnancy can also impact the body. For example, the hormone relaxin increases the elasticity of ligaments and joints, which can cause increased mobility and flexibility, but also an increased risk of injury.
Additionally, the circulatory system undergoes significant changes during pregnancy. The body's blood volume increases by up to 50%, which can cause swelling in the extremities and a decreased ability to tolerate physical activity. Other changes include increased breast size, changes in the pelvis, and weight gain. These changes can significantly impact a woman's physical health and well-being during and after pregnancy.
It is essential for women to be aware of these anatomical differences and to take steps to support their physical health during pregnancy. Regular Pilates exercises can support the musculoskeletal system and promote overall health and well-being.
Postpartum Description
Postpartum is a period that begins after a woman gives birth and lasts for weeks or months. During this time, the body undergoes significant changes. The uterus contracts and shrinks back to its pre-pregnancy size, and the body expels lochia, which is the discharge of blood, mucus, and uterine tissue that occurs after childbirth. Additionally, women may experience other physical and emotional challenges, such as fatigue, mood swings, and difficulty sleeping. Postpartum can affect all women who have given birth, regardless of their age, health status, or number of previous pregnancies.
Preventive Measure
Women who practice Pilates during pregnancy may experience more manageable labor and delivery and quicker postpartum recovery. Additionally, Pilates can help prevent diastasis recti (a significant separation of the abdominal muscles that can occur during pregnancy). DR occurs in about 67% of women during pregnancy.
Pilates can also improve posture and reduce the risk of back pain.
Surgery and Recovery
Sometimes, a woman may need surgery during delivery, such as a cesarean section or an episiotomy. A C-section is major surgery, and the client should adhere to their physician's recommendations for recovery.
This is no mean feat, especially with a newborn and no sleep. Static TVA and pelvic floor contractions are a great beginning and will help strengthen the core and prepare for further activity. New moms will spend time sitting in various positions feeding their baby/babies. If they are aware of their posture and can use this time for TVA and pelvic floor contractions, this can only help.
Episiotomy recovery can take around two to three weeks, during which women should keep the area clean and dry to prevent infection.
Pilates for Postpartum Recovery
Pilates can be a great form of exercise for postpartum recovery. Keep in mind that physicians' clearance for training typically takes six weeks, during which time women should avoid heavy lifting and strenuous activity. Return to physical activity after pregnancy is associated with decreased postpartum depression, but only if the exercise is stress relieving and not stress provoking. Pilates is a low-impact exercise that develops core strength, flexibility, and balance. After childbirth, women may experience weakened abdominal and pelvic floor muscles, leading to back pain, urinary incontinence, and other health issues. Pilates can help women regain strength in these areas and improve their overall fitness.
Contraindications
While Pilates can benefit postpartum women, instructors should be mindful of specific contraindications. Women who have had a cesarean section or an episiotomy should wait until their doctor clears them for exercise. Additionally, women experiencing postpartum bleeding or having a pelvic prolapse should avoid Pilates until they have recovered. Instructors should also avoid exercises that put pressure on the pelvic floor, such as the hundred or teasers.
Women who have experienced diastasis recti, pelvic organ prolapse, or hernias should avoid Plank and Balance Challenges or work with a qualified instructor who can provide modifications.
During a c-section, the surgeon cuts through some nerve endings meaning the new mom may be unable to feel or activate her transverse abdominal muscle voluntarily (TVA). This is your starting point. Making that mind-body connection can take time (especially with a non-Pilates person) as the nerve endings have to heal. If this is a non-Pilates person, they will have to learn how to activate their TVA and pelvic floor muscles.
Cue Modifications for Pilates Exercises
Pilates instructors should be mindful of cue modifications for specific exercises when working with postpartum clients. The following modifications are recommended for some common Pilates exercises:
Footwork: Women who have had a cesarean section should avoid exercises that require a lot of bending or twisting, such as the single-leg circle.
Modifications include keeping the legs straight or using a small range of motion. Instructors should cue clients to keep their feet parallel and hip-width apart and avoid turning the feet out to prevent strain on the knees and hips. If pelvic organ prolapse is present, avoid exercises that increase intra-abdominal pressure, such as the frog or heel squeeze.
Footwork
Begin lying on your back on the reformer with feet in straps.
Do a few pelvic tilts to find your neutral spine.
Inhale to engage the core
Press the carriage away with both feet
Exhale to bring it back in.
Repeat for 8-10 repetitions, keeping the core engaged and the pelvis stable.
Bridging: Women with pelvic floor weakness should avoid exercises that involve lifting the hips, such as the traditional bridge.
Modifications include keeping the feet on the ground or using a smaller range of motion. Instructors should cue clients to engage their glutes and pelvic floor muscles while lifting the hips off the mat and avoid hyperextending the spine.
Shoulder Bridge
Lie on your back with your feet on the foot bar and hands resting by your sides.
Inhale to prepare, and exhale to lift the hips up towards the ceiling, engaging the glutes and pelvic floor muscles, creating a straight line from shoulders to knees.
Inhale at the top, and exhale to lower back down.
Repeat for 3-5 repetitions, focusing on maintaining stability in the core muscles and avoiding any pressure on the pelvic floor.
Abs: Women with diastasis recti should avoid crunching or twisting exercises, such as the full sit-up.
Modifications include using a smaller range of motion or focusing on exercises that target the transverse abdominal.
Instructors should cue clients to avoid flexing the spine and instead focus on stabilizing the pelvis and engaging the deep abdominal muscles. TVA and pelvic floor muscles can be activated quickly or held for a few breaths in any position.
Cat Cow
Begin on all fours with hands under shoulders and knees under hips.
Let the belly release, allow gravity to do its thing, and feel as if the belly is 'hanging,' then engage the core by drawing the belly button in towards the spine without holding your breath.
Inhale and arch the back, lifting the head and tailbone towards the ceiling.
Hold for a breath
Exhale gently, pushing the ground away from you.
Round the spine, bringing the chin to the chest and tucking the tailbone under.
Hold for a breath
Repeat for 5-8 breaths, emphasizing spinal mobility and stability in the core muscles. When holding, activate the pelvic floor as if trying to prevent yourself from weeing.
This is a great position to reengage the TVA and understand the feeling. Once the mind-body connection is there, these contractions can be done anywhere.
Legs: Women who have had a cesarean section should avoid exercises that require a lot of bending or twisting, such as the side-lying leg series.
Modifications include keeping the legs straight or using a smaller range of motion. Instructors should cue clients to keep the knees in line with the hips and avoid turning the feet out to prevent strain on the knees and hips.
Skating
Begin by getting onto the reformer, one foot on the platform, then one on the reformer, feet hip distance apart.
Split the big toe and second toe of both feet.
Keep more weight on the platform foot.
Inhale to prepare to engage the core.
Exhale, as you extend, then bend the knee of the carriage leg to press the carriage in and out.
Using breath, continue moving the carriage in fluid motion as if on ice skates.
Repeat for 5-8 repetitions, focusing on maintaining stability in the pelvis and avoiding bulging or entering the abdominal area.
Repeat on the opposite side.
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Plank: Full plank should be avoided. Instructors should cue clients to engage their core muscles and avoid letting the lower abdominals.
Instructors should cue. Engage your core muscles by pulling your belly button towards your spine. Keep your shoulders down and away from your ears. Press through your hands or forearms to avoid collapsing in your shoulders. Keep your neck long and in line with your spine.
Swimming prep
Begin lying on your stomach with arms and legs extended.
Inhale to prepare and engage the core by pulling the belly button to the spine.
Lift the arms, legs, and chest off the mat.
Exhale to lower back down.
Repeat for 4-6 repetitions; focus on maintaining stability in the pelvis and avoiding any straining or pressure in the abdominal area.
Balance Challenges: Avoid exercises that require significant balance, such as tree pose or arabesque. Use exercises that provide support from two points.
Instructors should cue clients to: Engage core muscles by pulling the belly button towards the spine. Keep standing leg strong and steady, and their gaze focused on a single fixed point to help with balance. Use a wall or chair for support if needed.
Lunge to kneeling
Begin standing near the footbar, standing with toes and nose facing the center of the class.
Find a spotting point on the other side of the room.
Inhale to prepare and engage the core.
Then step one foot forward into a lunge position. If you need help stabilizing, place one hand on the foot bar next to you but keep your body aligned forward
Lower the back knee down to the mat, coming into a kneeling position.
Hold for a few breaths, and then return to standing. Repeat on the other side. If diastasis recti is present, avoid any twisting or crunching motions and focus on maintaining a neutral spine.
https://www.pilatesanytime.com/mx/postpartum-pilates
https://katiebellphysio.com/how-soon-after-giving-birth-can-you-do-pilates/
https://www.futurefit.co.uk/blog/pilates-in-c-section-recovery/
https://www.pilatesanytime.com/blog/pregnancy/five-pilates-exercises-for-the-fourth-trimester
https://blog.clubpilates.com/5-postpartum-home-pilates-exercises