PILATES AFTER PREGNANCY: BRINGING BACK AWARNESS TO THE BODY ALIGNEMENT

Transcription

1 PILATES AFTER PREGNANCY: BRINGING BACK AWARNESS TO THE BODY ALIGNEMENT Bucurescu Sara Alexandra Comprehensive Course july-november 2015 Paris

2 Abstract This student paper is a continuance and a completion to the final paper that I did for my Master degree in the National University of Physical Education and Sports in Romania. My paper was about weight loss after pregnancy, bringing back the body to its previous physical condition using classic cardiovascular and strength exercises. In the student paper that I have prepared for the Comprehensive Teacher Training Course I chose to use Pilates as main tool to remodel the body by improving the postural alignment and increasing the general strength by using the Pilates machines. In my opinion Pilates should be the first to turn to after pregnancy rather than the gym. The Pilates method is in essence the most functional workout system making the body ready for its daily tasks. The other workout methods should be used complementary to Pilates depending on each person objectives.

3 TABLE OF CONTENTS 1. Women after pregnancy : physical changes and postural alignment changes Case of study Conditioning program and motivation for the program Conclusion Bibliography... 10

4 1. Women after pregnancy : physical changes and postural alignment changes The postural changes that occur during pregnancy have profound effects on all the parts of the body. During pregnancy as the baby grows in the uterus the pelvis tilts forward to counterbalance the load. The pubic bone and tailbone move backward, thereby increasing the arch in your lumbar spine. Because the spine is a dynamic structure, alignment changes in the pelvis have a ripple effect on the rest of the spine. The upper back increases its curve, which rounds the shoulders forward. In response to the increased thoracic curve, the head slides forward. At lower limbs level due to the forward tilt of the pelvis the hips internally rotate and the knees drop inward referred as Knee Valgum.

5 Higher up, the body sees a rounding and elevation of the shoulders caused by an increased flexion of the thoracic spine. This increased upper spine curvature weakens the muscles at the back of the shoulders and between the shoulder-blades. This position of the shoulders will also cause the head to push forward, inevitably leading to muscle tension, pain and movement restriction in the neck and shoulders. The increasing size and weight of the fetus causes an exaggerated forward pelvic tilt, affecting the woman s centre of gravity and balance. This results in an increased extension of the lumbar spine as the lower back works harder to hold her upright. This will cause shortening and tightening of the surrounding lower back muscles which restricts movement. The forward pelvis tilt and tight lower back muscles will also cause lengthening and weakening of the abdominal muscles which are responsible for alignment of the pelvis and protection of the spine together with the back muscles. Lower down the body, the forward pelvic tilt causes a weakening of the hip, glutes and shin muscles. This results in the internal rotation of the hip bones. Inability of these muscles to fully activate and align the hips and lower limbs will place excessive stress upon the hip, knee and ankle joints during static posture and dynamic postural movements, bringing the knees in Valgum. So during pregnancy, women experience a compound alignment problem. These postural misalignments have a series of adverse effects especially on the muscles that support the body. To compensate for the postural deviations, some muscle groups must work harder to support the body in the upright position. Over time, these muscles shorten and become hypertonic and too tight. Opposing muscle groups need to work less to support the body, and weaken and atrophy, or become hypotonic. These postural and muscular changes tend to develop in time. As the belly expands, the postural deviations worsen, which in turn, further augment muscular imbalances. Muscles tighten during pregnancy: hip flexors (iliopsoas and rectus femoris), muscles of the lower back (quadratus lumborum), the pectoral muscles, the internal rotators and elevators of the shoulders (rhomboids, levator scapulae, and the upper fibers of trapezius).

6 Muscles that weaken or are over-stretched during pregnancy: gluteals or hip extensors, Hamstring muscles, Abdominal muscles, Mid and lower fibers of the trapezius, external rotators of the shoulder, Serratus anterior, neck flexors, Pelvic floor muscles, Intercostals. These postural deviation and muscles unbalances don t just go away after birth. The body has been used for 9 months to assume a certain position in order to carry the baby, so in order to recover a good posture the post-partum body has to be trained in order to do so. 2. Case of study My client is Marina a 41 years old mother of 3 years old twins and 1 year old baby. She is in good clinical health but her posture is destroyed. She gained more than 20kg during each pregnancies and she undertook C section surgery for both deliveries. Since she gave birth the first time she has not been training her CORE muscles accusing pain after she first attempted to do some chest lift on her own at home. After her first pregnancy she worked with a personal trainer in the gym to lose the extra weight she gained. This second time she wanted to change her strategy giving Pilates a try. Using the plumb line and observing her from the side, front and back to assess her posture I conclude that her body kept the same alignment as during pregnancy: head pushed forward, shoulders protracted, very big kyphosis, hyperextension in the lumbar spine, pelvis tilted forward, and knees in Valgum.

7 Looking at herself in the mirror Marina is not aware of her body alignment, for example she was not aware that her knees are knocking. While moving her body she can t dissociate her lower and upper limbs from the trunk and pelvis. She has no control over her abdominal wall and pelvic floor while performing different spinal flexion exercises such as chest lift and therefore she can t control the position of her pelvis while moving her body. 3. Conditioning program and motivation for the program Muscles in the body are designed to work in pairs, such as the lower back and abdominal wall. To ensure correct body posture and functioning, there should be equal length, strength and tension in both. If one tightens considerably, the opposite will lengthen and weaken, becoming passive and inactive. As muscles attach to bones, increased tightness and tension in one will cause weakness and lengthening of the opposite muscle, affecting the alignment and positioning of the bones to which these muscles attach. This in turn creates postural instability, increasing the workload on other muscles which otherwise have to compensate for the weakened, passive, inactive ones. Muscles are also meant to activate in specific sequences or patterns to provide optimal body function. These patterns often become corrupted by the postural changes associated with pregnancy, further worsened by unsuitable pre or post-natal exercise, or lack of effort to correct and reverse the unfavorable postural, musculoskeletal and biomechanical effects of pregnancy. At our first meeting, Marina and me have agreed on following a program of 30 sessions, 2 sessions per week. «In 10 sessions you'll feel the difference, in 20 you'll see the difference, and in 30 you'll have a new body» (Joseph Pilates). During 15 weeks I have used the BASI Block system to organize her workout program putting more emphasis on extension of the thoracic spine and stabilizing the pelvis in neutral position. The biggest challenge for Marina was to be aware of the different parts of her body, how they are placed and how to move and correct them in static positions and dynamic movements.

8 Conditioning program: Block Exercises Warm up Foot work Abdominal work Hip work Spinal articulation Stretches Full body integration 1 Arm work Pelvic curl, spine twist supine, chest lift, chest lift with rotation Foot work Series on Reformer: putting emphasis on the knee alignment and pelvis stability during the movement Chest lift on the Foam Roller, Short box Series on Reformer (flat back, tilt, twist): emphasizing the extension of the thoracic spine into a flat back position Hip work Series on Cadillac: emphasizing the pelvis stability in neutral Pelvic curl on Wunda Chair: emphasis put not only on the movement of the spine but also on the activation of the hamstring muscles Shoulder stretch on Cadillac, Pole Series (shoulder stretch, overhead stretch): stretching of the shoulder and pectoral muscles to help the extension of the spine Front Support and Back Support on mat: finding the correct alignment using the full body Arm work Series on the Ped-a-pul: using the pole of the Peda-pul to align properly the spine on it Full body integration 2 Leg work Lateral flexion and rotation Back extension Hamstring curl and Hip Opener on Wunda chair: work the hamstrings and glutes to help the knees align correctly Side stretch on Wunda chair: emphasis on the thoracic spine extension in flat back Breaststroke prep on the Reformer: extension of the thoracic spine while holding the pelvis in neutral position

9 4. Conclusion After 15 weeks of work Marina s body has significantly changed: She has a better awareness of her body alignment She is able to move and dissociate the different parts of her body She has decreased her thoracic kyphosis and opened her chest She has been able to feel her Pelvic Floor muscles and is using them actively with her Power house muscles to hold her pelvis in neutral She has gained tonus and strengthen in her whole body Pilates helps women to reconnect with their body. During and after pregnancy the body goes true big physical changes and the connection of body and mind disappears. The awareness on the placement of the different body parts can vanish or can be wrongly perceived. Pilates can be used to build up the body once again and to create the connection body and mind. «Pilates is gaining the mastery of your mind over the complete control over your body.» (Joseph Pilates)

10 5. Bibliography Books: Pilates, Rael Isacowitz Study Guide, Body Arts and Science International, Rael Isacowitz Pilates for Injuries and Pathologies, Body Arts and Science International, Samantha Wood Website Natal-Postural-Effects.pdf