The aim of Pilates is to improve balance, strength, flexibility and posture. Like yoga, it uses breathing techniques as part of the exercises.

What is Pilates?

Pilates is a low-impact (no jumping around) way of being active that aims to improve your posture and movement.

It is usually done on a mat, but you can also use special equipment that has been designed to work on different muscles.

What are the benefits of Pilates during pregnancy?

There is little research on the benefits of pregnancy Pilates – but it could help prevent aches and pains while you’re expecting.

It strengthens and stretches your core muscles and could help your body cope with carrying the extra weight of your growing baby, as well as preparing you for childbirth and recovery afterwards.

Pilates often focusses on strengthening your pelvic floor, which is important for labour and recovery after birth. A strong pelvic floor can also help you avoid wetting yourself by accident when you cough, sneeze or exercise. Try these pelvic floor exercises.

How can I make sure Pilates is safe for me in pregnancy?

Be careful not to over-exert yourself or stretch too much. And once you get to 16 weeks pregnant, avoid exercises where you lie on your back.

As there’s not a lot of research on pregnancy Pilates, make sure you look for a specific pregnancy class or a one-to-one teacher who is trained to work with pregnant women.

When choosing a class, make sure the teacher is qualified and tell them how many weeks pregnant you are.

A teacher who is qualified to work with pregnant women should be able to adapt the exercises to suit your changing body at each stage of your pregnancy.

If you already do non-pregnancy Pilates classes, tell your teacher you’re pregnant. Your teacher may be trained to work with women during pregnancy or might suggest a pregnancy class that would be better for you.

As with all exercise during pregnancy, if you feel any pain it’s important to stop straight away.

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Pilates in pregnancy

Pilates trains your body to be strong, flexible and balanced (Tommy’s 2018). It involves a series of movements and positions that help to improve your strength and coordination (Tommy’s 2018). Deep breathing and relaxation are important in controlling how you do the exercises (POGP 2015, Tommy’s 2018).
The movements focus on your tummy, pelvic floor muscles and back muscles, which are all key to good posture, balance and strength (Tommy’s 2018). They also help your back and pelvis to be supported (Tommy’s 2018).
If you strengthen your muscles, you’ll develop a stable core (POGP 2013, Tommy’s 2018). Pilates builds on this strength through a series of controlled movements that won’t put your body under strain.

How can Pilates help me in pregnancy?

Pilates strengthens your tummy, back and pelvic floor muscles, which are the areas that can cause problems during pregnancy and after the birth (Tommy’s 2018). So it’s a great exercise to do when you’re pregnant, although some of the exercises will need to be modified as you get nearer your due date (Tommy’s 2018).

Check that your Pilates instructor is experienced and trained in teaching pregnant women, or try to find a Pilates class that’s just for pregnant women (Tommy’s 2018).
Doing regular Pilates will help to:

  • Strengthen your tummy muscles, which equips your body better to cope with the strains caused by the weight of your growing baby. Hormones make the tissues (ligaments) that connect your bones more pliable in pregnancy, making you more prone to injury (POGP 2013).
  • Reduce back pain, by exercising the tummy muscles that stabilise your back and pelvis (Endleman et al 2008). Strengthening these muscles can help to reduce back or pelvic pain (Aladro-Gonzalvo et al 2013, Tlapáková et al 2011).
  • Strengthen your pelvic floor, which will help to support your bowel, bladder and womb as your baby grows and moves down. This may prevent you from leaking small amounts of wee when you cough or sneeze (Tommy’s 2018). It will also help you to push your baby out when you give birth (Tommy’s 2018).
  • Improve balance, as you may feel a little more clumsy, or that your balance isn’t as good as usual (POGP 2013), in pregnancy. Pilates exercises strengthen your core (Tommy’s 2018) and may make you more stable when you walk as your bump grows.
  • Take the strain off your back and pelvis, by using positions such as going on your hands and knees, which is a great position for easing pregnancy back pain (Tommy’s 2016). Some experts say it may also help to get your baby into the right position for birth, although there’s not a lot of evidence to support this (Tommy’s 2016).
  • Relax and control your breathing, which is important for pregnancy and labour (NCCWCH 2014, RCM 2012).

Exercise is good for you during pregnancy. You should aim to do a combination of aerobic exercise, such as brisk walking or swimming, and muscle-strengthening exercise, such as Pilates or yoga (Wright 2017, Zavorsky 2011).

What if I haven’t done Pilates before?

Before trying Pilates, make sure that you can find your pelvic floor muscles. If you can do a good pelvic floor contraction, you’ll get more from your Pilates sessions. If you can’t find or feel them, ask to see a physiotherapist before starting Pilates.
Try the following exercise to see how good your core stability is. You may have to try it a few times before you get the hang of it:

  • Get on to your hands and knees. Align your hands under your shoulders, and your knees under your hips. Keep your back flat. Try to do it next to a mirror, so you can check your position.
  • Breathe in, and then as you breathe out, squeeze your pelvic floor muscles. At the same time, pull your belly button in and up.
  • Try to hold this for 10 seconds. Continue breathing normally throughout the squeeze, and keep your back still.
  • Relax your muscles slowly at the end of the exercise.

If you can perform this exercise easily, and repeat it 10 times, your pelvic floor and core tummy muscles are working well. This exercise is safe to perform at any stage of your pregnancy.

Can I attend any Pilates classes?

Look for a class that is for pregnant women. If your instructor isn’t a health professional, check that she has a qualification in teaching exercise to pregnant women (POGP 2013).
If there isn’t an antenatal Pilates class in your area, make sure your instructor knows that you’re pregnant, and how many weeks you are (Tommy’s 2018). She’ll need to adapt some of the exercises for you (Tommy’s 2018).
If you’re in any pain or discomfort at any time, stop what you are doing and let your midwife or doctor know before returning to your classes.
Be cautious about the following:

  • Positions that involve lying on your tummy or back, or standing on one leg, in mid-pregnancy and beyond. A good instructor will suggest alternative, safe postures. For example, instead of lying flat, you can prop up your upper body with pillows. And many of the exercises which involve lying on your tummy can be done on all fours instead (POGP 2015).
  • Don’t stretch any joint to its full range, especially in an unsupported position. This is because your joints will be looser because of hormone changes, which makes you more prone to injury (POGP 2013)..
  • Supporting your weight on your hands and knees may make your wrists ache. This can be particularly uncomfortable if you have carpal tunnel syndrome. Your instructor should show you how to lean forward on an exercise ball, if this is the case.

More on exercising in pregnancy

  • Exercising safely during pregnancy
  • How to prevent overheating during exercise
  • Find out when it’s not safe to exercise during pregnancy

Last reviewed: April 2019 Aladro-Gonzalvo AR, Araya-Vargas, GA, Machado-Diaz, M. et al. 2013. Pilates-based exercise for persistent, non-specific low back pain and associated functional disability: a meta-analysis with meta-regression. Journal of Bodywork and Movement Therapies 17(1), 125-136
Endleman I, Critchley D. 2008. Transversus Abdominis and Obliquus Internus Activity During Pilates Exercises: Measurement With Ultrasound Scanning. Archives of Physical Medicine and Rehabilitation 89(11):2205-2212
NCCWCH. 2014. Intrapartum care: care of healthy women and their babies during childbirth. National Collaborating Centre for Women’s and Children’s Health, Clinical guideline, 190. www.nice.org.uk
POGP. 2013. Fit and Safe to exercise in the child-bearing year. Pelvic Obstetric and Gynaecological Physiotherapists group. https://pogp.csp.org.uk
POGP. 2015.Pilates in Women’s health physiotherapy. pogp.csp.org.uk
RCM. 2012. Second stage of labour. Royal College of Midwives, Evidence based guidelines for midwifery-led care in labour. London: RCM www.rcm.org.uk
Tlapáková E, Jelen K, Minaříková M. 2011. The relationship between pelvis inclination, exercise and low back pain (LBP) during pregnancy. Acta Universitatis Palackianae Olomucensis. Gymnica. 41(3), 15-21
Tommy’s. 2016. Pregnancy information from our midwives. Getting your baby into the best birth position. www.tommys.org
Tommy’s. 2018. Pregnancy information from our midwives. Pilates and pregnancy. www.tommys.org

Wright M. 2017. Pregnancy and physical activity. Patient UK. www.patient.co.uk
Zavorsky GS and LD. 2011. Adding Strength Training, Exercise Intensity, and Caloric Expenditure to Exercise Guidelines in Pregnancy. Obstet Gynecol: 117:1399–1402

Can I do pilates during pregnancy?

Pilates is really popular right now, but is this type of exercise safe to do while pregnant? Pilates is more of a toning technique than an exercise regimen, however anything you can do to keep your body fit and healthy is a plus during pregnancy. But are pilates safe for your unborn baby?
Yes, pilates is perfectly safe during pregnancy. However, you will find that some pilates moves are great and others pose a higher risk, the same for those who are doing yoga in pregnancy.
Pilates works to increase strength and muscle tone in the belly, back and pelvic muscles – all important parts of the body for pregnancy and childbirth. Its benefits include improved balance, increased flexibility and the promotion of muscular endurance.
Once you hit your second trimester, it is time to stop doing any exercises that require you to lay flat on your back. This is because laying on your back decreases blood flow to both you and your baby. Be certain you do not hold your breath and if you feel lightheaded or sick it is time to stop.
During late pregnancy, it is possible that your abs will separate. This is called diastasis and if this happens you need to stop doing pilates.

How to Modify Group Fitness Classes When You’re Pregnant

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A lot has changed when it comes to the science of exercising during pregnancy. And while you should always consult with your ob-gyn to get the okay before jumping into a new routine or continuing your usual workouts with a baby on the way, pregnant women have fewer limitations for safe exercise than before, according to the American Congress of Obstetricians and Gynecologists (ACOG).

That’s good news for anyone who is religious about barre classes and strength training. Just know: Some moves call for necessary safety modifications and swaps. One overall guideline? “In general, I always tell my mamas to avoid any exercise that puts stress on her pelvic floor, causes incontinence, and/or creates ‘coning’ of the belly,” says Erica Ziel, a mom of three and creator of Knocked-Up Fitness and the Core Athletica rehab program. (Coning is when abdominal muscles bulge during an exercise that’s causing too much stress on the abs.) This can be a good indicator for determining whether or not to continue a certain type of exercise.

Otherwise, check out how to change up some of the go-to moves in your favorite classes with these pro swaps.

TRX

TRX master instructor Ami McMullen says when you’re pregnant you should always avoid “any exercise that might increase your likelihood of falling.” Your center of gravity will change as your belly grows and you progress through pregnancy, making balancing more of a challenge.

Avoid: TRX Lunge

This lower-body exercise has you facing away from the anchor with your back foot suspended in the foot cradle as you balance with your front leg and drop your back knee into a lunge. This “creates more demand for balance and stability in the standing leg’s knee, ankle, and hip joints,” says McMullen.

Pregnancy modification: TRX Balance Lunge

Instead of just one foot in the TRX foot cradles, you actually hold onto the handles with both hands for more balance stability. Face the anchor point in a standing position and step back into a reverse lunge, keeping back toes hovered above the floor. “This option still works your lower body and core, but keeps you much more stable by allowing your arms to help unload the weight. It also gives you the option to touch the back foot on the ground quickly if you begin to feel wobbly.”

Barre

Barre can be a wonderful prenatal option because it’s naturally low-impact, but some of the moves can be uncomfortable and, at worst, dangerous. Most core work can easily be modified (but always avoid crunches) and you’ll want to use the barre more for balance support, but your foot position and range of motion are two commonly overlooked factors pregnant women should be mindful of.

Avoid: Deep First Position Plié

Levels of the hormone relaxin increase during pregnancy, which can cause ligamentous laxity-or instability in the joints. That means movements where the knee drives out past the toes, such as in this first position plié where toes are turned out to 45-degree angles and you bend at the knee, should be avoided, says Farel B. Hruska, an ACE-certified trainer and FIT4MOM pre/postnatal fitness expert. For expectant moms, these moves can be dangerous as they place the knees in a less stable position, potentially causing stress on the joints throughout the leg, says Hruska.

Pregnancy modification: Second Position Plié

To make knees more stable, stand in second position (toes still turned out but feet approximately 3 feet apart) instead of a narrow first position with heels together. And yes, you’ll still get the thigh-and-booty benefits. (Learn more about the best and worst barre exercises.)

Cycling

Cycling, like barre, is a crazy-awesome low-impact workout. If you’re a runner but your joints ache or your bladder leaks during runs (a common and obviously annoying side effect of pregnancy thanks to pressure on your bladder from your expanding uterus), cycling can be a great go-to for cardio and strength training, too.

Avoid: Too-low handlebars and too-intense interval work

A growing belly and larger breasts mean most pregnant women are already battling poor posture. Too-low handlebars can further the problem. Also, with added blood volume, expecting mothers can get winded much more quickly than they did pre-pregnancy. Your overall effort should decrease, says Alexandra Sweeney, lead instructor for Flywheel’s Pacific Northwest region.

Pregnancy modification: Ride upright and work up to a 6 out of 10 exertion level

Lifting the handlebars prevents your knees from hitting your belly during every rotation and helps encourage better posture. Not to mention, riding upright can simply be more comfortable, says Sweeney. As for intensity level: “On a 1 to 10 scale, if you usually aim for an 8, 9, or 10, you’ll want to drop your highest effort level closer to a 6. Give yourself the permission to do what you can.” Bottom line: There’s no shame in going at your own speed and intensity. You’re already the badass pregnant woman who showed up to work out. (Don’t know the difference between a 6 and an 8? Learn more about how to judge your rate of perceived exertion more accurately.)

CrossFit

CrossFit has probably seen the most polarizing reaction when it comes to prenatal fitness. But whether you’re an experienced CrossFit athlete or a more casual enthusiast, you can still enjoy your WOD safely while expecting.

What to avoid: Box Jumps

While ACOG no longer rules out jumping while pregnant, most women will find that finding air can mean a leaky bladder and joint pain. Ziel says that beyond incontinence, intense jumps can also cause more intense pelvic floor dysfunction in the future. That can mean anything from sexual dysfunction to pelvic organ prolapse, which can cause your bladder to literally drop from where it’s supposed to be-yikes!

What to do instead: Squats

“Squats are great! Even without weight, they are extremely effective during pregnancy,” says Ziel, “Squatting is a great way to strengthen legs and deep core, open hips, and even prepare for safely picking up baby.” As long as you practice good squat form, they are also perfectly safe for the knees. (Related: The Top 5 Exercises You Should Do to Prepare Your Body for Childbirth)

Mat Pilates

Much like core-focused TRX, you might be pleasantly surprised to learn that you don’t have to throw in the towel on your Pilates mat class. (More proof: 7 Prenatal Pilates Exercises to Safely Strengthen Your Core During Pregnancy) If you are a dedicated Pilates student, schedule a private session with your instructor to review modification options, suggests Heather Lawson, a lead instructor trainer for STOTT Pilates at John Garey Fitness and Pilates. You’ll also want to avoid being on your back for extended periods, according to ACOG. Extended time spent lying supine (or on your back) can decrease blood flow to your heart and temporarily decrease blood pressure.

What to avoid: The Hundred

The Hundred is basically an abdominal crunch in which you lie on your back, hover your torso and legs above the ground, and pump your arms up and down 100 times. It is a very common Pilates exercise but Lawson says it can be harmful to prenatal women because they are on their back for an extended time, and crunches increase the risk of diastasis recti (a separation of the rectus abdominous muscle wall).

What to do instead: Pilates Bridge

Bridge is a great substitute because you can just lift the hips from your supine position. Holding the torso at an angle is safe (as opposed to staying flat on your back). Bridge is a great way to strengthen the legs and back and encourages good posture. It’s also not uncommon for you to feel like your baby is interfering with your full lung capacity, and this position can help you feel like you can finally take a few deep breaths.

Zumba

Studies show that movement and music are both soothing to your baby, so don’t put away your dancing shoes just yet. And good news: “Modifying impact in any class does not mean you will not get an intense workout,” says Madalene Aponte, Strong by Zumba master trainer.

What to avoid: Thrusting and popping

Most Zumba moves are low-impact but fast, says Aponte. She recommends minimizing trust movements (such as Samba crossovers or Merengue fast twists) and anything that causes hyperextension in your back (think: booty pops). The speed of these movements and the combination of relaxed joints and compromised posture can mean a higher risk of throwing out your back. Also, super-fast movements can increase your risk of falling when balance is already compromised.

What to do instead: Dance at half tempo

Rather than completely eliminating these moves, Aponte says you can simply perform them at half tempo to lessen risk of back injury and falling.

Yoga

Yoga might get a lot of credit as a great prenatal exercise but that doesn’t mean every single pose is safe. You’ll want to pay attention and listen to your body (even in prenatal-specific classes but especially in an all-levels class).

What to avoid: Standing Splits

Because this is a balance pose, there’s an increased risk of falling. Holding the head below the heart can also lead to dizziness and, if you lift your leg too high, you risk overstretching. “In prenatal yoga or other yoga classes, be careful to avoid overstretching due to the hormone relaxin that is present in the prenatal body,” says Ziel. One sign you’re overstretching: All of a sudden it seems as if you can stretch far beyond what you did pre-pregnancy. Or you might even have to force your body into the stretch. Avoid both of these sensations since overstretching joints during pregnancy can mean discomfort, pain, and instability for years postpartum.

What to do instead: Warrior II

Warrior II is more stable since you’re on two feet. You’re also upright so you don’t have to worry about dizziness. This pose allows you to open the hips in a safe range of motion while also strengthening the low body and arms at the same time.

  • By By Andrea Blair Cirignano

Pregnancy Pilates is becoming increasingly popular all across the world. This article discusses in detail everything a pregnant woman needs to know about the safe practice of Pilates during pregnancy. This also provides useful links to the guidance from recognised relevant medical organisations on exercise during pregnancy.

What is Pilates?

Pilates is of a group of exercises (‘low impact’) and breathing techniques which aim to improve the strength of the abdominal, pelvic floor and back muscles to develop a stable central core (trunk muscles).

The six basic principles (Ref 1) of the practice of Pilates are as follows:

– Concentration

– Control

– Precision

– Flow

– Breathing

– Centre of force or Centering

The ‘centre of force’ or ‘Centering’ or Core is the primary focus of the Pilates and is this includes flexor and extensor muscles of the spine and hip and the pelvic floor muscles. Joseph Pilates described this as the ‘Powerhouse of the body’.

The aim of the Pilates is to develop a stable and strong central core first. Pilates is a known practice to help to strengthen the core trunk muscles. (Ref 2 )

Subsequently, the instructor introduces more difficult/ powerful movements and exercises of the extremities to avoid strain to the body.

One could do Pilates exercises either on a mat or with the help of special equipment, which could be used to support a specific posture or create resistance to strengthen the muscles, depending on the individual needs and exercise plan.

Usually, a standard Pilate training regime consists of both mat and equipment-based exercises. (Ref 3)

Pilate is now a quite popular form of exercises and could help in the following:

1. Posture improvement

2. Better balance, body strength and muscle tone

3. The mobility of joints and flexibility

4. Stress relief and wellbeing

Myth and reality:

Many people believe that a stable central core is synonymous with toned ‘abs’ (abdominal muscles) or a ‘six-pack’. It is important to remember that in reality, these abdominal muscles contribute very little to the core strength of the trunk for a good posture and balance.

The important contributors to the core strength are the back and pelvic floor and specific breathing techniques.

Strengthening of these muscles and appropriate breathing techniques are the key principles of Pilates.

Is Pregnancy Pilates safe during the first, second and third trimester?

There is very limited research on the pregnancy pilates. However, due to the gentle nature of the exercises, pilates during pregnancy is usually considered safe both at the early (first trimester) and late stages (second and third trimesters) of pregnancy and post-childbirth period.

The injury from prenatal pilates exercises is rare due to the low-impact nature of the Pilates training.

However, it is always advisable that Pregnancy Pilates should be done under supervision and guidance of a Pilate Instructor/ Trainer with experience of prenatal pilates training. If someone is already doing Pilates before pregnancy, she should inform the Trainer once she is pregnant as necessary modifications of the exercise regime could be necessary.

Please find what a Midwife and Prenatal Pilate Instructor, Nikki Williams-Quamina has to say.

What precautions do I need to take for prenatal Pilates?

During the pregnancy Pilates sessions (and other forms of exercises during pregnancy), it is advisable to wear appropriate supportive bra and clothing which are comfortable and safe and also drink plenty of fluid to avoid dehydration.

It is also advisable to avoid the following during pregnancy:

1. ‘Hot’ Pilates (Ref 4)

2. Exercises on the supine position (lying flat on the back): you should avoid this position after the first trimester (first twelve weeks) to avoid obstruction to the blood flow to the baby.

This is one of the reasons why Pilates is becoming an increasingly popular form of exercise during pregnancy as many of them can be done lying on the sides and sitting positions. (Ref 3)

3. Over-stretching of muscles/ joints and over-exhaustion.

I have a medical condition. Can I do Pilates during pregnancy?

If she has any medical condition or develops pregnancy complication, she must get a medical advice from a doctor before continuing Pilates (also applicable to any exercise during pregnancy).

I have never done Pilates in the past. Can I start Pilates for the first time during pregnancy?

Of course, you can do so. However please join pregnancy specific Pilates class or get a personal trainer who is experienced and trained in Pregnancy Pilates.

What are the benefits of Pilates during the pregnancy and perinatal period?

It is generally thought that Pilates helps women to adapt better to the changes of pregnancy by strengthening and stabilising pelvic floor, back, and abdominal muscles.

Recent studies have indicated that Pregnancy Pilates is an effective way to reduce aches and pain during pregnancy.

Studies also have shown that a well-structured prenatal Pilates programme also have shown to result in ‘significant improvements in blood pressure, hand grip strength, hamstring flexibility and spinal curvature, in addition to improvements during labour, decreasing the number of Caesareans and obstructed labour, episiotomies, analgesia and the weight of the newborns were found at the end of the intervention.’

Although such results are encouraging, we have to remember that these findings are based on small studies. Further research is needed to better understand and ascertain the benefits of Pilates during pregnancy and post-childbirth period.

How soon can I start postnatal pilates after the childbirth?

Mothers are encouraged to commence Pilates after childbirth, as soon as practicable to ensure ongoing benefits of physical and mental wellbeing.

How is Pilates different from yoga?

Both the Pregnancy Pilates and pregnancy yoga are safe and good forms of exercises during the pregnancy and post-childbirth period and choosing one over the other is usually a personal choice. It is important to carry out both practices correctly with appropriate instruction, supervision, and training. Some people even combine them both to stay active during pregnancy and post-childbirth period.

They are similar in many different ways including the involvement of specific position and postures to improve balance, strength, and stability of the body for physical and mental wellbeing.

Both are low-impact (no jumping involved) types of exercises.

Some of the differences are:

1. The origin:

Yoga is often described as a way of life and it originated almost 5000 years ago in India as a philosophy to connect the body, mind, and spirit and to have better understanding and awareness of the inner self.

Pilates was created by Joseph Pilates in early 20th Century with the aim of rehabilitation (from physical injuries) of World War 1 soldiers. The primary aim of the Pilates is stabilising the inner core muscle strength.

2. The main focus:

Yoga often involves meditation and quiet contemplation. Some people want to learn and practice yoga with a view to relieving stress. Therefore, a large part of the yoga focuses on the mind.

Pilates, on the other hand, aims to improve the muscle tone and strength by exercises and breathing techniques Although Pilates also helps to improve emotional and mental wellbeing, this is not it’s primary goal.

3. Types of movement and joint flexibility:

Yoga mainly focuses on stretching of the body and holding this in a static posture to improve the flexibility of the different joints.

Pilates is more dynamic and the focus is mainly on the strengthening of the central core (trunk muscles). Although Pilates helps to improve joint flexibility but this is not the primary focus.

4. Breathing techniques:

Yoga focuses on breathing based on the stomach (abdominal) muscles, whereas, Pilates training involves lateral chest breathing techniques aiming to improve the core strength

5. Need for equipment:

Yoga is a mat-based exercise and does not involve equipment.

Pilates training usually combines both mat and equipment-based exercises.

Conclusion

Pregnancy Pilates is usually considered a safe form of exercise during pregnancy and post-childbirth period but it is recommended that it is done under the supervision and guidance of a Pilates instructor who is experienced and appropriately trained in Pilates during pregnancy and perinatal period. The Pilate instructor should be informed by the woman when she gets pregnant so that appropriate changes are made depending on the stage of pregnancy.

If you have a medical condition and planning to commence Pilates for the first time or develop any pregnancy or birth complication, then medical advice must be sought from your Obstetrician, GP or another healthcare provider.

Please find further information on exercise during pregnancy:

1. The American College of Obstetricians and Gynaecologists (USA)

2. The Royal College of Obstetricians and Gynaecologists (UK)

3. The UK Department of Health information and infographic (UK)

1. Muscolino JE, Cipriani S. Pilates and the “powerhouse”—I. J Bodyw Mov Ther. 2004;8: 15–24

2. Finatto P, Silva ESD, Okamura AB, Almada BP, Oliveira HB, Peyré-Tartaruga LA (2018) Pilates training improves 5-km run performance by changing metabolic cost and muscle activity in trained runners.

3. Pilates and pregnancy. Balogh A. RCM Midwives (2005)

4. Exercise during pregnancy: The American College of Obstetricians and Gynaecologists (July 2017)

5. Pilates and pregnancy. Tommy’s

Photo credit

Jessica Monte via www.pexels.com

Declaimer

    • Resources Library

      // Pilates during pregnancy

      Pregnancy is a wonderful time in a woman’s life, but one which can be subject to uncertainty regarding exercise and what is safe and eff ective. Pregnant women will often turn to classes such as yoga, low impact group fitness and Pilates. As we know, sensible exercise during pregnancy can provide a range of physical and psychological benefits, but it is important that the exercise prescription is appropriate to the individual.

      No two women’s bodies are the same, and this is especially true during pregnancy. Keeping this in mind we need to modify exercise based on each stage of pregnancy and the client’s personal conditions. Over the course of pregnancy the demand on the core increases significantly, creating a need to strengthen the deep stabilising muscles and decrease the load on the global muscles. With the uterus enlarging over 1,000 times we need to reduce the load on the rectus abdominus, especially after week 12.

      During the second trimester, the abdominal muscles become stretched, and some women experience diastasis recti (separation of the abdominal muscles). With reduced abdominal support, there is a greater risk of injury to the lower back and pelvis. Further, due to hormonal changes during pregnancy, the ligaments surrounding the joints become lax, leaving them loose and vulnerable.

      Low impact exercise that focuses on alignment, core stability, mobility, strength, postural awareness and breathing is the ideal option for prenatal exercise. Pilates offers fantastic exercise options which focus on developing strength within the deep stabilising muscles; maintaining alignment while challenging the core against movement. However, not all Pilates exercises are suitable during pregnancy – being aware of each stage and what the guidelines are will assist in safe and effective programming.

      THE EXERCISES

      Pelvic Floor

      The pelvic floor (PF) is stretched and weakened during pregnancy; therefore it is necessary to include PF activation within your sessions. Ideally this is done in a variety of positions. Focusing on the quality of the movement, gently lift the PF on the expiration. Use visualisations such as a sliding door coming together, a plane taking off or a lift ascending. Use a combination of slow and controlled, plus short and fast contractions to activate both fast and slow twitch fibres. Leading up to the birth, include some PF relaxation in the class as this is important during the birthing process.

      SCAPULA DRAW (Photos 1 & 2)

      Benefits: This exercise strengthens the shoulder-stabilising muscles and helps prevent postnatal upper back pain.

      Exercise: Seated on a ball, a chair, the fl oor or against a wall. Arms out at a 90º angle, elbows in line with the shoulders. Breathe in to prepare, engage the PF, extend the arms overhead keeping them in the same alignment, then draw the rhomboids together to bring them back to the starting position. Repeat 3 to 5 times.

      LATERAL RELEASE WITH BALL (Photos 3 & 4)

      Benefits: Develops spinal mobility while focusing on lateral flexion and releases the lateral muscles of the torso.

      Exercise: Start in kneeling position with the ball close to the body. Place one hand on the ball and roll on the diagonal in the opposite direction of the hand. Come back to the start then swap hands, repeat other side keeping the movement flowing. Repeat 5 to 8 times each side.

      SWIMMING (Photos 5 & 6)

      Benefits: This exercise helps develop scapular and shoulder stability while challenging core control with particular focus on multifi dus recruitment. This also helps to develop neck, shoulder, arm and gluteal strength.

      Exercise: Position in four point kneeling, hands in line with shoulders, knees directly beneath hips, feet in alignment with knees. Focus on gentle drawing in of the corset, lifting the pelvic floor while maintaining a neutral pelvis, breathe in to prepare, breathe out, slide one leg up to 90 degree angle. For progression, add the opposite arm to leg. Trying to keep the pelvis as stable as possible, avoid rocking side to side. If there is any movement, regress to leg only, or if the position proves problematic, move to the wall as an alternative. Perform three reps, then swap sides.

      THREAD THE NEEDLE (Photos 10 & 11)

      Benefit: Another fantastic exercise for spinal release and mobility. This exercise gives a great release through the thoracic region without causing issues in the lumbar pelvic area.

      Exercise: Commence in a four point kneeling position, neutral alignment. Breathe in to prepare engagement of the deep abdominal muscles. Breathe out, extend one arm up focusing on releasing through the chest muscles. Breathe in, slide one arm under the other across the fl oor feeling the lateral rotation and release. Repeat 3 to 5 times each side.

      CLAM (Photo 12)

      Benefit: This exercise focuses on strengthening the gluteals which assist in increasing the force closure of the lumbar pelvic region. Ideally include this exercise in all pre and postnatal programs.

      Exercise: Start side-lying with both knees bent, legs and feet in alignment away from bottom leg, keeping the feet on the ground at all times. Inhale, set deep abdominals, breathe out, lift the top knee away. Breathe in, return to the start position. Avoid any rocking of the pelvis. Focus on the alignment at all times. Repeat 5 to 8 times each side.

      As with any exercise during pregnancy, you need to constantly assess your client’s progress, remaining aware of the stages of pregnancy and the appropriate modifications for each. Pregnancy is a constantly changing state, so pregnant clients must have their state of health and musculoskeletal symptoms assessed prior to each session.

      Pilates exercises provide many wonderful benefi ts that can help women achieve safe healthy pregnancies, assist their birth process and hasten recovery in the postnatal period.

      Liz Dene, BHMS
      Liz’s expertise relates to exercise and pregnancy issues. She is a master trainer for Network Pilates and is actively involved in developing and delivering courses both nationally and internationally. With a degree in human movement, Liz has over 15 years experience in all areas of training and fi tness. She merges traditional fi tness practices with a holistic approach to wellbeing. For more information visit www.lizdene.com

      NETWORK MAGAZINE • SUMMER 2007 • PP40-46

      Exercise is an integral part of a healthy lifestyle. It helps prevent disease, is important for healthy bones and can help reduce stress, manage fatigue and lead to a better overall quality of life. All of which are very important when there is a newborn to care for.

      Pregnancy and childbirth have a major impact on a woman’s body, both internally and externally. During pregnancy, every system is affected, including respiratory, cardiac/circulatory, hormonal, biomechanical and musculoskeletal. This can lead to shortness of breath, tiredness, swelling, varicose veins, postural changes and issues such as lower back pain, pelvic joint pain, carpal tunnel symptoms, rectus diastasis (separation of the abdominal muscles) and urinary incontinence.

      In this article, we will revise the pregnancy guidelines and the implications for Pilates.

      First Trimester (1-12 weeks)

      The mother-to-be may be experiencing morning sickness or be feeling tired. This initial stage of pregnancy is where there is the most risk of miscarriage. Pilates is a safe exercise to perform, but the intensity needs to be lighter to avoid the body temperature and heart rate elevating too high, as this can increase the risk of miscarriage. Even in the first trimester, the amount of “sit up” abdominal exercises need to be reduced. Instead, focus more on T-zone activation and the pelvic floor muscles. Exercises like Bent Knee Fallouts and Lift Foot are great for this pelvic floor activation.

      Second Trimester (13-26 weeks)

      Throughout the second trimester, there are a series of positions and exercises which need to be avoided.

      1. Avoid all abdominal work (except Double Leg Lift)
      During pregnancy, we want to avoid strengthening the Rectus Abdominus. As the belly gets bigger, we don’t want the rectus to be tighter as it will stretch and can cause a rectus diastasis. For more on rectus diastasis, click here.

      2. Avoid inner thigh work
      We want to avoid inner thigh work because your adductors attach to your pubic symphysis (your pubic bone). When someone is in the advanced stages of pregnancy, their ligaments and joints become more lax. Many pregnant women experience some groin pain as the pubic bone starts to separate. Working the inner thighs when the pubic symphysis is already unstable can cause the pubic bone to separate even more.

      3. Avoid prone positions (lying on the stomach)
      At this stage of pregnancy, lying on the stomach becomes very uncomfortable as the baby is showing.

      4. Avoid supine positions (lying on the back)
      Supine positions are avoided at this stage as many women feel nauseous or dizzy lying in this position. This is because the baby can sit right on top of the main blood vessels as they exit the spine and cause less blood to pump through. This can not only make the mother feel dizzy, but can also be dangerous as less oxygen is passed to the baby.

      Third Trimester (27 weeks to birth)

      During the third trimester, the mother’s posture changes dramatically due to the baby’s increased growth. A lordosis-kyphosis posture becomes more evident. For Pilates, the second trimester guidelines continue; however now avoiding ALL abdominal exercises including avoiding Double Leg Lift, as well as inner thigh work, supine and prone positions.

      Other recommendations for exercising when pregnant include:

      • Maintain a moderate intensity due to the cardiac changes the body is already in an exercised state, therefore don’t want to increase heart rate too much
      • Keep cool avoid hot, humid conditions, wear loose clothing, stand near fan or air-conditioner if in gym. As the baby is not able to regulate temperature.
      • Stay hydrated drink lots of water even if swimming.
      • Warm-up and cool-down well – due to circulatory changes the mother will need to warm-up and cool-down to avoid blood pooling and leg cramps.
      • Avoid breastroke, unilateral exercises, wide lunge/stance positions as this can put extra stress on pelvis.
      • Activate pelvic floor muscles during all exercises to keep as strong as possible, during the later stages may be harder to feel.
      • Stop if feeling dizzy, nauseous, if vaginal bleeding or leakage of amniotic fluid.

      Is Pilates safe to do during Pregnancy?

      Exercise during pregnancy is a worry for many women as they fear they might harm their unborn child. Pilates is a gentle form of exercise which focuses specifically on the muscles most affected during pregnancy. As a low impact exercise method, it allows the practitioner to perform the exercises without putting strain on either the joints of the back. As such it is viewed as one of the safest forms of exercise for a pregnant woman. It is felt that the strengthening of the core and pelvis floor muscles allows for an easier pregnancy, delivery, and post birth recovery.

      Pilates and your pregnancy, step by step.

      • During the first trimester;

      Many women feel fatigued and nauseous and need a gentler, flowing form of exercise. Pilates concentrates on improving breathing techniques, improving flexibility, and strengthening your body while give your mind space to concentrate and relax. Many women find Pilates invigorating and a way to connect with their changing body.

      • The second trimester;

      Brings a change in hormones which leaves many women feeling energize. At this stage your Pilates routine concentrates on the pelvis floor, back and abdominal, preparing the muscles in preparation for the third trimester and the delivery.

      • The third trimester;

      Can be physically tiring for many women and hormones are released to loosen the pelvic joints can cause back pain. The additional weight can lead to a lack of balance, poor posture, swollen legs and varicose veins are common . Pilates helps all of these conditions by strengthening the central or “core” muscles which in turn leads to improved posture and circulation.

      • At delivery:

      Women claim Pilates has helped their delivery because of their improved muscle tone, circulation (more oxygen to the womb which is less distressing for the baby) and breathing techniques

      • Resuming Pilates after Childbirth

      Women can generally return to Pilates four to six weeks after delivery, or eight to twelve weeks after a Caesarean section. Your doctor will advise you on when your body is ready. Pilates will help your body regain its shape and tone and strengthen muscles that have been weakened during your pregnancy. Exercises can be adapted to individual needs, so whether you have had a vaginal or caesarian delivery, a safe workout can be developed to target particular muscle groups.

      SimplyBePilates strongly recommend private or semi private classes for pre and post natal.

      We have great instructors full trained at international level with over 10 years experience – you will be in safe hands with SimplyBePilates … but …Dont believe us ask us for our clients opinions, see how the classes are from our mums to be!

      For more information please feel free to contact us.

      Enjoy Pilates in Barcelona!

      Topic: Trimester by Trimester : Is Pilates safe to do during Pregnancy?

      Tag: Pilates Pregnancy

      Pilates in Pregnancy

      • What is Pilates?
      • How does pregnancy affect the abdominal muscles, back and pelvic floor?
      • Is Pilates useful in pregnancy?
      • Is Pilates safe in pregnancy?
      • How do I modify Pilates during pregnancy?
        • Food and water intake
        • Monitoring your energy levels
        • Take care not to fall
        • Don’t overstretch your joints
        • Avoid abdominal crunches and curls
        • First trimester
        • Second trimester
        • Third trimester
      • Where can I do Pilates during pregnancy?
      • What are some examples of Pilates exercises during pregnancy?
        • Pelvic floor exercises
        • Basic deep abdominal contraction
      • Top tips for Pilates in pregnancy

      What is Pilates?

      Pilates is an increasingly popular form of exercise for people of all ages and fitness levels. It is a low impact, versatile, and effective option for people wanting to improve their strength, posture, balance, flexibility and muscle tone. Pilates exercises focus on strengthening the lower abdominal muscles and pelvic floor, providing a ‘stable core’ that supports the back and allows efficient movement. Exercise programs can be extensively modified to focus on different body parts and accommodate individual needs. Resistance is provided through ‘studio’ Pilates equipment known as ‘reformers’ and ‘trapeze tables’, gravity, and other smaller equipment such as exercise balls and resistance bands.

      How does pregnancy affect the abdominal muscles, back and pelvic floor?

      During pregnancy, the abdominal (tummy) muscles are stretched to make room for the growing baby. This may weaken the muscles, particularly the deep abdominal muscles. Deep abdominal muscles are responsible for providing support to the back (working like a corset). Lack of support makes the back vulnerable to injury. This is made worse by the hormone relaxin, which is released in pregnant women to soften the ligaments and allow the pelvis to stretch during delivery. All ligaments are softened by relaxin, including the ones in the back. With reduced support from ligaments and abdominal muscles, many pregnant women experience back pain. Relaxin remains in the body for some time after the baby is born. It is therefore important to protect the back not only during pregnancy, but also after birth, particularly when lifting, bending, breastfeeding, etc.

      The pelvic floor muscles are responsible for controlling the bladder and bowel. They are weakened as they stretch and hold the weight of the growing baby. Weak pelvic floor muscles can result in difficulty controlling the bladder or bowel (incontinence) and can impact on sexual function. For example, some women find they leak urine when they cough or sneeze (stress incontinence). Around 46% of pregnant women in Australia experience urinary incontinence, and 30% have ongoing problems after delivery.

      Is Pilates useful in pregnancy?

      Pilates is an ideal exercise during pregnancy as it is designed to strengthen the deep abdominal and pelvic floor muscles. Strength in these areas is known as ‘core stability’. These exercises can be performed in positions that are suitable for women at all stages of pregnancy, such as on hands and knees. Such exercises may take the stress off the back and pelvic floor, and help position the baby for delivery. Pelvic floor exercises have been shown to reduce urine leakage in women with stress incontinence and women who have to rush to get to the toilet on time.

      Pelvic floor exercises are an important part of Pilates, but may be carried out on their own (i.e. not as part of a Pilates program).

      Is Pilates safe in pregnancy?

      It is important to check with your doctor or midwife before starting any new exercise program during pregnancy. If you have not done Pilates before pregnancy, it is essential to receive input from a Pilates instructor or physiotherapist in a setting where you can receive individual attention. Do not attempt exercises on your own until a professional has assessed your performance.

      To exercise safely in pregnancy, you should be able to perform an effective pelvic floor and deep abdominal contraction. Very basic Pilates exercises are designed to achieve this. If you cannot contract your pelvic floor or deep abdominals muscles effectively, more advanced exercises may place too much strain on your joints. This is why you need to be assessed by a Pilates instructor or physiotherapist before continuing with exercises.

      Certain exercises are no longer appropriate from mid pregnancy onwards due to the positions they require (e.g. lying on your tummy or flat on your back). However, exercises on hands and knees, in sitting, and in kneeling positions are all likely to be safe. As your pregnancy progresses the muscles become more stretched, and it may become more difficult to achieve good contractions.

      General Pilates classes may not be suitable for pregnant women because they may involve positions that are not appropriate or may progress too quickly. Clinical Pilates (in small groups of about four people, with a physiotherapist), or studio Pilates (in small groups) are generally more appropriate. These classes tend to be based on equipment, which will provide more variety in exercises, and will still be safe. Alternatively, some ‘Pregnancy Pilates’ classes are available, and are designed specifically to suit the needs of pregnant women.

      How do I modify Pilates during pregnancy?

      Food and water intake

      As with all exercise, it is important to stay well hydrated. You may need to increase your intake of calories to make up for the energy and water you have lost while exercising. This may mean eating a small healthy snack (e.g. low fat yoghurt or a piece of fruit) and drinking an extra glass of water.

      Monitor your energy levels

      Pilates is a ‘low impact’ form of exercise, which means it is kind to your joints,. It can be modified so it is not too strenuous during pregnancy. However, you must monitor your energy levels. Don’t ‘overdo it’ during class, or in general. Signs that you need to slow down include:

      • Being too winded to talk in a relaxed tone and rate
      • Dizziness
      • Uterine contractions
      • Bleeding or leaking fluid
      • Headache
      • Nausea
      • Feeling faint
      • Racing heartbeat

      If you experience any of these symptoms during or after a Pilates session, stop exercise, inform your instructor and, if they feel it is necessary, seek medical advice.

      Take care not to fall

      As you get larger during pregnancy, your centre of gravity shifts forward, affecting your balance. Be cautious with activities such as getting on and off equipment, balancing exercises, and getting up and down from the floor.

      Don’t overstretch your joints

      Due to the hormone relaxin, your joints are more flexible during pregnancy. It is important you do not overstretch, as this may cause injury. Working in a small range of movement, working on control and core strength is more appropriate.

      As your tummy gets larger and the muscles stretch, it will become more difficult to achieve a good contraction. Continue to focus on achieving a sense of activating your abdominals and pelvic floor, and don’t compensate by ‘squeezing harder’ and activating other muscle groups.

      Avoid abdominal crunches and curls

      Avoid abdominal crunches and curls throughout pregnancy. Using the rectus abdominis muscle (the ‘six pack’ muscle that runs down the front of the tummy), particularly as you grow larger with pregnancy, may increase the chance abdominal diastasis, where the connecting tissue that holds the two sides of the rectus abdominis muscle together is separated. Some degree of diastasis is common during pregnancy. If abdominal diastasis is present, have it assessed by your doctor or physiotherapist. They will check the way you are using your muscles to make sure it is not worsening the diastasis. Abdominal crunches also increase strain on the lower back, and may cause injury there.

      First trimester

      Don’t overdo it, particularly if you are feeling exhausted or nauseous. These sensations often improve later in pregnancy, allowing you to do more.

      Second trimester

      Focus on:

      • Arm strengthening
      • Pelvic floor exercises
      • Squatting exercises
      • Pelvis and lower back stability
      • Spinal stretches (gentle)
      • Postural exercises

      Avoid:

      • Exercises with legs wide apart (e.g. side stretches on the reformer). These may place strain on the joint at the front of your pelvis (symphysis pubis).
      • Lying flat. This may reduce the blood supply to you and your baby. If this occurs, you may feel dizzy or lightheaded.
      • Abdominal crunches
      • Extreme stretches
      • Unstable balance exercises
      • Unsupported back bends
      • Inversions (where your feet are higher than your heart, with your hips up too)
      • Sharp percussive movements
      • Jumping

      Third trimester

      Focus on:

      • Gentle stretches (these should feel good!)
      • Arm exercises
      • Supported back bends (such as over a bolster)
      • Stability exercises for your lower back and pelvis
      • Pelvic floor exercises
      • Breathing exercises
      • Thigh strengthening exercises (though not a deep squat in the last 4-6 weeks of pregnancy, as this may induce labour)

      Avoid:

      • As per second trimester; also
      • Deep squats during the last 4-6 weeks of pregnancy (increases pressure on the cervix and may induce labour)
      • Exercises on one leg or with legs apart (lunges, splits)

      Where can I do Pilates during pregnancy?

      Check with your doctor or midwife before commencing Pilates.

      Pilates in Pregnancy classes are available, and are ideally suited to the needs of pregnant women. If you have not done Pilates before, you need to go to a Pilates in Pregnancy class, studio Pilates session, or clinical Pilates with a physiotherapist, where you can receive individual attention. This is also the best environment if you have done Pilates in the past.

      There are Pregnancy Pilates books, videos and DVDs available, but you should not start Pilates on your own with these resources if you have not received feedback from an instructor to ensure that you are performing the basics correctly.

      What are some examples of Pilates exercises during pregnancy?

      These exercises can cause harm if performed incorrectly. You should be supervised by a physiotherapist, Pilates instructor or midwife to make sure you are doing them properly before carrying them out on your own, particularly during pregnancy.

      Pelvic floor exercises

      These exercises can be performed in any position. To start, perform these exercises in a sitting position, or on hands and knees.

      The pelvic floor muscles are those around the vagina and back passage. To contract them, you should draw the muscles ‘up and in’. To practice, imagine the muscles you would tighten to prevent passing wind from your back passage, or to stop the flow of urine. Do not practice these exercises by stopping urine flow when you are on the toilet. Practice tightening these muscles around the back passage, then try the same contracting movement further forward around the vagina. You should not be tightening your buttock or leg muscles. The most serious mistake people make when carrying out these exercises is to ‘bear down’ or push down rather than ‘lifting up’. This ‘straining’ actually stretches the pelvic floor and makes it weaker.

      Some programs suggest a series of ‘quick flicks’ of 2 second pelvic floor contractions, followed by sustained 5 second contractions, aiming to build up to 10 second contractions.

      Relax your pelvic floor completely for 10 seconds between each contraction. Do not hold your breath during contractions. It is important to concentrate and focus on each separate contraction.

      Basic deep abdominal contraction

      Lie on your back with your knees bent (crook lying) or, if in the second half of your pregnancy, kneel on your hands and knees (four point kneeling). Check that your back is almost flat (don’t tilt your pelvis too far forward or ‘arch’ your back).

      Breathe in. On the breath out, contract your pelvic floor, and gently draw your belly button down towards your spine (crook lying) or lift your belly button up towards your spine (4 point kneeling). Do not ‘suck in your stomach’. The contraction should be gentle (about 30% of maximum effort).

      Try to maintain this pelvic floor and abdominal contraction for 10 seconds. Do not hold your breath or move your back during this time. Gently relax after 10 seconds. Repeat this exercise 10 times.

      Top tips for Pilates in pregnancy

      1. Before starting Pilates classes, consult your doctor.
      2. Have an assessment of your posture by a qualified instructor before starting to make sure the program is appropriate. Have an assessment of your pelvic floor and abdominal strength by a qualified instructor to make sure you are carrying out the exercises correctly.
      3. Wear a properly fitted bra and comfortable, nonrestrictive clothing.
      4. Continue classes with an instructor so the program can be modified appropriately as your pregnancy progresses.
      5. Monitor your energy levels during Pilates so you don’t overdo it. Watch out for ‘warning signs’ as listed above, and consult your doctor if they occur. Don’t get overheated.
      6. Don’t overstretch your joints. Don’t do abdominal crunches or curls.
      7. Don’t lie flat or with your feet over your head in the second half of your pregnancy.
      8. Take care with your balance. Don’t get up from the floor too quickly.
      9. Keep up your fluids and eat a small healthy snack.
      10. Good quality deep abdominal contractions will be difficult once the muscles are stretched during the later stages of pregnancy. Focus on gentle contraction, posture, and pelvic floor work.

      More information

      For more information about pregnancy and exercise, including pre-pregnancy exercise, suitable types of exercise, risks and benefits of exercise and exercise myths, see Pregnancy and Exercise.
      For more information about pregnancy, including preconception advice, stages of pregnancy, investigations, complications, living with pregnancy and birth, see Pregnancy.
      For more information on fitness and exercise, including stretches, types of exercise, exercise recovery and exercise with health conditions, as well as some useful videos, see Fitness

      Is pilates safe during pregnancy?

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