From the very beginning of pregnancy your body experiences many fascinating changes, all designed to prepare your body for both the carrying of your baby and the eventual delivery. With these changes however, your body will physically adapt and excess pressure can be placed upon certain areas. Some areas can become stretched, strained, weakened and/or overused. These strains generally increase as you progress through the trimesters, so anything you can do from the start to maintain good body posture and strength will hopefully ease aches later on.
Pilates is the perfect accompaniment for this. Pilates is a type of exercise that involves using your core (the abdominals, pelvic floor, back muscles, and diaphragm) to move more efficiently and it promotes restoring correct posture and alignment, whilst strengthening each muscle group. Pilates is fantastic for enhancing this in anyone, but it can be a real life saver during pregnancy, and also postnatally when your body is placed in new postures as you carry, feed, and care for your baby.
What physical changes may occur during pregnancy?
- Weakened abdominals
- Weak pelvic floor muscles
- Increased lumbar lordosis
- Forward tilted pelvis
- Weakened gluteals
- Thoracic stiffness
- Tight adductor muscles & pubic pain
Hormonal changes kick in from as early as 8 weeks in pregnancy, with the hormone Relaxin. This relaxes your ligaments throughout your body, but is most commonly experienced with pelvic pains as your pelvis is normally a rigid structure, but this ligament laxity allows minor movements to occur. With the growing bump and increased weight gain (on average approximately 12kg) this can affect your pelvis further as the joints move more than normal, disrupting pelvic muscles and occasionally the nerves too.
This weight gain of the expanding bump stretches the abdominal muscles and causes separation (called diastasis recti) as well as weakening from as early as 14 weeks antenatally, and in 66-100% of women in the third trimester (Spitzangle et al. 2007).
As the pelvis tilts forwards with the bump expanding, the gluteal (buttock) muscles become inhibited, and excess pressure is placed upon the groin (adductor) muscles at the front. This can lead to groin tightness and occasionally pain in the pubic bone region. These changes later in pregnancy can display as a “waddling” gait pattern as your body tries to compensate.
The upper body often curves forwards at the thoracic spine with rounding of the shoulders to try counteract the lower body curve changes. This can place tension on the upper shoulder muscles and around your shoulder blade. This is further enhanced postnatally when holding your baby for long and frequent periods.
The pelvic floor
As the baby grows and places greater pressure within the pelvis, this pressure creates a downward force on to the pelvic floor. In combination with ligament laxity here, the pelvic floor muscles can become weakened. This laxity can last up until 5 months postpartum, and longer if breastfeeding (Gabbe 2012). These muscles are responsible for supporting the bladder, rectum and uterus. They ensure correct functioning of these organs by assisting the closing force of the bladder and bowel passages to prevent leakage, and allowing relaxation for effective emptiness.
Dysfunction here can leak to urine or faeces incontinence, organ prolapse, localised pain, and painful sex. It has also been related to lower back pain and pelvic pain postnatally (Pool-Goudzwaard et al. 2004). Pilates ensures exercise to the pelvic floor muscles to maintain and strengthen this support network with the aim of minimising any dysfunction postnatally. A strong efficient pelvic floor can also assist in a vaginal delivery as these muscles are contracted to push during labour contractions and relax in between to allow muscle recovery before the next big push!
Pilates exercises will:
- Strengthen the abdominal, pelvic floor, gluteal, and scapular (shoulder blade) muscles
- Provide pelvic stability and strength to minimise any ligament laxity
- Mobilise the thoracic spine and reduce stiffness around the shoulders
- Stretch the chest muscles and open up the front of your body
- Restore correct posture
- Strengthen all major muscle groups in the upper and lower body to ensure strength is maintained for pregnancy, labour, and postnatally.
- Pilates is a mind-body form of exercise. This means that the exercises are more effective if you focus your mind on engaging your core muscles. Research demonstrates that the core muscles are controlled by a separate area of your brain, therefore to strengthen this connection you need to think about what you are doing at the time of doing it (Hodges 2008).
- This concentration directs your thoughts to what you are doing, reducing distractions and clearing your mind. You will feel mentally and emotionally eased and exercising during pregnancy has been shown to reduce insomnia, stress, anxiety and mild depression (Price et al. 2012).
- Pilates exercises can be completed with a specific breathing pattern too. This focuses on exhaling on the more challenging part of the exercise, and inhaling on the easier part. This is because your core muscles are activated earlier on the exhalation, therefore providing your spine with the greatest local muscle stability and support you need for the exercise (Hodges et al., 1997).
- This breathing pattern can also be a great focus for your attention and ensure you stay focused on what you are doing. These breathing principles can also be used during times of anxiety when pregnancy may feel overwhelming, when pain becomes more uncomfortable, or even during labour. Staying calm and relaxed can help your body and mind prepare for birth and promote a more positive labour experience for both you and your baby.
References: Gabbe D.G. 2012. Obstetrics: normal and problem pregnancies. 6th edition. Saunders. Hodges P.W., et al. 1997. J Appl Physiol. 83:3; 753-760. Hodges P. 2008. Sports Med. 42, 941-944. Pool Goudzwaard A., et al. 2004. Clin Biomechanics. 19: 564-571. Price B.B., et al. 2012. Med Sci Sports Exerc. 44: 12; 2263-2269. Spitzangle T.M., et al. 2007. Int Urogynecol J 18; 321-328.