Master Class: Pre- and Postnatal Strategies

Ellie’s no-nonsense prenatal and postnatal protocol will help you give your clients a safe and rewarding workout.

Pregnancy

Do’s and Dont’s

• DO: Limb Strengthening

  • Assuming a healthy pregnancy, it is safe to perform all the leg and arm strengthening exercises in this book (squats, lunges, barre work, arm springs, etc).

• DO: Side Lying and Side Planks

  • You can do anything at all in the side lying position while pregnant. Of course, you may need to modify as you get bigger because, hey, pregnancy makes things harder!

• DON’T: Prone Exercises

  • Lying on your belly will not feel good for most of your pregnancy. Use your judgement in the first trimester; if it feels ok, then proceed.

• DON’T: Supine Exercises in the Third Trimester

  • Lying on your back can be dangerous to you and your baby once the baby gets to a certain size because it can put pressure on the vena cava and stop blood from flowing. Modify supine exercises by propping the torso up onto a big pillow or Pilates Arc, or just skip them completely.

• DON’T: Spinal Flexion Abdominal Exercises

  • During pregnancy, the abdominal wall is continuously stretching. There is no need to try to shorten or strengthen it during this time. Wait until you have the baby to resume abdominal strengthening!

• DON’T: Planks or Push-Ups In the Second and Third Trimester

  • Once the baby gets heavy, the abdominal wall will become stressed when in a plank position. You can modify and do push-ups in a standing position using the Barre or against the wall.

Sample Class: Prenatal

• Warm-up: Cat focusing on lumbar flexion

• Side Leg Series (with a blanket under the waist or Pilates Arc)

• Side Planks add Side Bending. Can modify by putting the top leg in front or do on knees.

• Knee Mermaid into Thread the Needle

• Seated Series with Theraband (can progress to Second Position Squat if pelvic floor is intact)

  • Around the World Pectoral Stretch

  • Rotator Cuff

  • Rhomboids

• Lunging Series with Theraband

  • Lunging Triceps

  • Lunging Biceps

  • Squats with Tricep Stand to Biceps

• Second Position Squats with Theraband

  • Around the World, Angel Pulls into Pectoral Stretch

  • Bent Arms Around the World

• Theraband around outer thigh

  • Squats

  • Side Walking Squat

• Wall Push-Ups

  • Wall Squats with ball or yoga blocks between knees

• Beginning Balance Combo (with a small ball between ankles): bend knees, stand and come up on toes

• Advanced Balance combo (holding small ball or circle or yoga block)

  • Arms reaching out: Lift one knee (hip flexion), alternate sides

  • Add Rotation with hip flexion

  • Add Forward Fold with back leg in arabesque or warrior 3

• Mild cardio

  • High knees, allowing arms to swing spine into rotation

  • Hip/spine Extension walks, kicking leg behind and reaching opposite arm overhead

  • Standing abdominal oblique curl; hands behind head rotate elbow to opposite high knee, allowing the lumbar spine to flex, pulling tail between legs.

• Modified Jumping Jacks

Post Natal: General Principles

Blown-Out Core. After giving birth women have stretched out abdominals and pelvic floor (with vaginal birth). Be gentle with any exercises that require core stability. But the core must be addressed and strengthened in a safe way to avoid injury to the new mother.

Focus on Transversus Abdominis. Seated wrap, neutral spine work, cueing ASIS drawing together

Strengthen/stretch the inner thighs and pelvic floor. Give precise anatomical cues to engage pelvic floor (i.e. Diamond image: pubic bone coccyx, sit bones). Research has shown that if you tell a woman to engage her pelvic floor 50% do it wrong. Pelvic Floor needs to be stressed at least as much as it needs to be strengthened.

Side Lying and Side Planks Are Safe for Post-natal (and Pre-Natal)- be careful with Diastisis Recti.

Focus on Postural Muscles. Seated Standing Exercises are wonderful to get upright posture back. Caring for an infant and breastfeeding puts the body into poor posture and weakens the back extensors.

Things to be careful about:

• Inversions require pelvic floor strength so wait a while after vaginal birth before introducing anything where you have to lift your hips up from a supine position (hip ups, short spine stretch, etc)

• Overstretching: because the body is still full of elastin, the tissues are lengthened and the body tends to be hypermobile. Keep movements in a functional range of motion.

Postnatal: Do’s and Dont’s

• DO: Wear a postnatal support girdle for six weeks after birth

  • This will ensure that the abdominal wall doesn’t undergo further stress. This is especially important to wear while exercising and if you have a diastasis recti, a separation of the rectus abdominis.

• DO: Lots of Extra Pelvic Floor and Tranversus Abdominis Strengthening

  • Start by simply holding a posterior pelvic tilt while lying supine and doing Kegels, drawing the belly in. This can do wonders as soon as 10 minutes after delivery. You can also do Kegels and transversus abdominis engagement in neutral spine, once you feel those muscles connecting. Its easier to feel in posterior pelvic tilt at first.

Special Do’s and Dont’s for Diastasis Recti

If you don’t know whether or not you have this condition—separation of the rectus abdominis muscle—find a Pilates Instructor, physical therapist or personal trainer versed in postnatal rehabilitation. Don’t expect an ob/gyn to know anything about this.

• DO: Transversus Abdominis Bracing use yoga strap or belt

• DO: Eccentric Abdominal Curls

  • Use a ball, blanket, or rolled-up towel under your upper-mid back and lie supine over it, so you’re starting with your spine in extension. Then come up to neutral spine, drawing your belly in.

• DON’T: Spinal Flexion Abdominal Exercises

  • See above. Instead of going into spinal flexion, do extension to neutral abdominal work or neutral spine stabilization instead.

• DON’T: Planks and Push-Ups

  • Because the plank position is a vulnerable position
for your now weakened abdominal wall, skip these exercises until your diastasis recti is healed (yes it can get better!). If you are dying to do push-ups, wear an abdominal brace. Otherwise, you can modify on knees and/or do push-ups in a standing position using the Barre or against the wall.

Sample Class: Postnatal

• Diastasis Recti Strategy. Start with releasing the back muscles. Follow with transversus abdominis strengthening.

• Stretch and Release Back Muscles & Oblique Abdominals

  • Side lying on Arc, Reach arm above head and carve a sphere

  • Roll out spine with roller (or myofascial release ball)

  • Cat focusing on lumbar articulation, hunting cat, sexy cat

  • Mermaid- Side Bend into Rotation

  • Reverse knees Stretches on Reformer

  • Supported Roll Downs on Reformer or Cadillac/Tower/Springboard with heavy springs.

• Seated Transversus Wrap- Wrap a Theraband around waist and draw belly and hold for 30 seconds, counting aloud, pulling the skin away from the Theraband each exhale.

• Pelvic Tilts (with small ball or yoga block between knees)- engage pelvic floor and low abdominals. Can be done immediately after birth.

• Bridges (with small ball or yoga block between knees)

  • Progress to single leg bridge

  • Yoga Block single leg bridge sequence

• On Roller

  • Breathing engaging pelvic floor and Transversus Abdominis

  • Pelvic Tilts

  • Shoulder Slaps

  • Arm Reaches

  • Chicken Wings

  • Dying Bug

  • Heel slides

  • Tiny Steps

• Eccentric Abdominal Curls on Ball: extension to neutral

• Side Kicks Series- on Pilates Arc is ideal, or you can pad the under waist with a blanket to encourage side lying neutral.

  • Leg Lifts

  • Gentle Circles

  • Gentle front/back Side Kicks

  • With both knees in tabletop: Clam, Around the World with Bent Knees, end with 4’s stretch. Can put Theraband around thighs. Add Inner thigh lift.

• Quadruped Series (contraindicated for Diastasis)

  • Thread the Needle thoracic stretch

  • Start with Cat/Cow and find Neutral Spine. Transversus Lift.

  • One Leg Off

  • One Leg and opposite arm Off, bring to the side

  • Knees Off (with ball or yoga block between thighs). First, hold for 2-3 breathes then add 10 pulses in Neutral Spine and C-curve

• Side Forearm Planks (contraindicated for Diastasis) add Side Bending. Can modify by putting top leg in front or do on knees.

• Knee Mermaid into Thread the Needle

• Wall Push Ups

• Wall Squats with ball or yoga blocks between knees

• Seated Series with Theraband (can progress to Second Position Squat if the pelvic floor is intact)

  • Transversus Wrap

  • Around the World Pectoral Stretch

  • Rotator Cuff

  • Rhomboids

• Lunging Series with Theraband

  • Lunging Triceps

  • Lunging Biceps

  • Squats with Tricep Stand to Biceps

• Second Position Squats with Theraband

  • Around the World, Angel Pulls into Pectoral Stretch

  • Bent Arms Around the World

• Theraband around outer thigh

  • Squats

  • Side Walking Squat

• Beginning Balance Combo (with small ball between ankles): bend knees, stand and come up on toes

• Advanced Balance combo (holding small ball or circle or yoga block)

  • Arms reaching out: Lift one knee (hip flexion), alternate sides

  • Add Rotation with hip flexion

  • Add Forward Fold with back leg in arabesque or warrior 3

• Mild cardio

  • High knees, allowing arms to swing spine into rotation

  • Hip/spine Extension walks, kicking leg behind and reaching opposite arm overhead

  • Standing abdominal oblique curl; hands behind head rotate elbow to opposite high knee, allowing the lumbar spine to flex, pulling tail between legs.

  • Modified Jumping Jacks