Pilates and Pregnancy: Michelle J

 

I would highly recommend Pilates to anyone, but it’s particularly important leading up to, during, and after pregnancy for the following reasons:

1) Less pain and discomfort because skeletal imbalances. Pilates emphasizes working your body in the correct align meant, or working towards bringing you into alignment. This definitely helps prevent common pregnancy aches and pains. I was constantly conscious of trying to work against the lordosis that usually occurs in the lower back during my pregnancy and engage my core to bring myself back to a more neutral alignment.

2) Less chance of diastasis recti because of the focus on strengthening transversus abdominis. This is a common side effect of pregnancy when the two halves of the rectus abdominis separate as a result of over stretching. When this deepest layer of your core (like an internal corset)  is strong and you are mentally connected to how it works, you are better protected from having diastasis recti because you know how to move and use these muscles properly.

3) Pelvic floor, pelvic floor, pelvic floor!  These muscles are SO important during pregnancy, labour, and recovery.  Pilates teaches you how to use these muscles, and they are important in two ways during this time. You need strong pelvic floor muscles to support the growing weight of your baby during pregnancy. Equally important is the ability to relax these muscles during delivery ….trust me! Pilates teaches you an awareness of the pelvic floor that is invaluable.

- Special considerations for the pregnant client:

Again, strengthening and awareness of the pelvic floor muscles and transversus is key. By the time the client reaches the 5th or 6th month, it’s important to avoid exercises that put too much emphasis on flexion or where the torso or specifically abdominals have to work against gravity to prevent diastasis recti. So - traditional ab crunches or roll ups, or rollbacks are out, as are planks and regular push-ups. Push ups can be modified to be done against a wall or slightly elevated. Another concern is the possibility of supine hypotensive syndrome in some pregnant women - where the weight of the baby can compress the inferior vena cava when the mother is lying on her back. This can potentially slow blood flow back to the mother’s heart, which in turn will reduce blood and oxygen flow to the fetus. Because this is potentially dangerous, it is best to avoid working in a supine position by the end of the second trimester. But in both cases, it does depend on the individual.

- Other resources (websites)/best studios in Toronto to train at:

I did my Pilates teacher training at Stott Pilates and also a specialized Prenatal Reformer workshop there - luckily just before I found out I was pregnant.  I find the Instructor Trainers at Stott to be very knowledgeable when it comes to a variety of specialized cases such as pregnancy or injuries. I teach at Misfit Studio on Queen St. West and the owner, Amber Joliat, is a Pilates and yoga instructor who has a great understanding of movement and anatomy, and she is a wonderful teacher.  We also offer Eccentrics at Misfit Studio and I found that to be a great workout during my pregnancy, as much of it is done standing and provides a great amount of stretch and release for muscles and joints that are a little overburdened during that time.

'Nutrition and Pregnancy' by Nathalie Niddam

If you are reading this and you are thinking about getting pregnant then there is a lot you can do to make sure that your body is best prepared to grow a new human!  If you are already pregnant, there is no time like the present to improve your nutrition.  

For the most part, growing babies will get what they need from Mom both during the pregnancy and while nursing - the tricky bit is that in the case of deficiencies on Mom’s part this can leave her open to issues of her own when trying to meet her body’s needs. 

Your body’s needs for virtually all nutrients, vitamins and minerals will increase during pregnancy - on average, women will need to consume in the neighborhood of 300 calories more per day.  It is critical that these calories come from nutrient dense foods that help to shore up nutrient stores and availability for the baby and Mom.  In particular:

•   Protein needs can increase by up to 50%, 

•   calcium (for bones, teeth, muscle and heart function, blood clotting and nerve transmission),

•   iron (your blood volume increases by 50% during pregnancy - iron is critical for red blood cell formation for mom and baby!) (target is around 27mg/day from food and supplement sources)

•   zinc for the normal development of the foetus’s immune system,

•   Folic Acid again to help form red blood cells but also to support the development of the baby’s nervous system and to stimulate Mom’s appetite (!).  Consider taking 800-1000 mcg per day as folate or 5-MTFH as some people have trouble converting folic acid to it’s active form.

•   Vitamins A. C, E, B6 and minerals Iodine, magnesium and sodium are all also needed in greater quantities….in terms of sodium this is not a licence to eat bags of chips and pretzels….use grey or pink sea salt in moderation, consume raw unpasteurized fermented foods like sauerkraut and pickles and try not to overdo it to avoid issues with blood pressure or water retention.

So, what are you to do?  Basically two things -  start with a high quality pre natal vitamin along with vitamin D3 and a good omega 3 supplement.  And then, eat the best diet you can possibly manage - as we are told time and time again there is no better way to give your body what it needs than from food, in the way that nature intended. 

Get your house in order - Ideally before you get pregnant

1.     have a full physical and get your doctor to check on your Vitamin D3, Iron, and B12 status.  If any of these are anywhere other than in the healthy range then you may need to consider taking supplements (in addition to adopting a solid diet plan) to bring up your stores more quickly. 

2.     If you suffer from digestive issues (bloating, gas, constipation, diarrhea) try to finally take the time to try and understand what could be driving these issues.  It could be as simple as improving your diet or you may need to address some underlying cause - whatever it is, it will be easier to deal with now and could well set you up for an easier pregnancy overall.  If necessary, consult with a health practitioner to help you pinpoint what the issue may be.

3.     Pay special attention to constipation - if this is an issue you need to resolve it sooner than later, make sure that you are consuming between 25-45 grams of fibre daily and drinking plenty of water - if that still doesn’t work, get some help pinpointing the cause and an appropriate remedy.

4.     Now is the time to clean up your diet - out with the junk and in with the real, whole food.   Eat organic whenever you are able to minimize the load on your liver and drink the cleanest water that you can get your hands on.

Let’s expand on the principles of a “nutrient dense whole food diet:

1.     Hydrate:  Drink 6-8 glasses of water a day - every day.  Avoid caffeine, pop, fruit juices and alcohol.

2.     Eat loads of vegetables - cooked, raw, steamed, any way you like ‘em (other than deep fried in bad fats) and eat as many different kinds as you can find.  Try to have the most colourful meals ever - orange (carrots, butternut squash, sweet potato, pumpkin), green (avocado, collards, Kale, rapini, arugula, broccoli, asparagus, artichokes), red (beets, peppers, tomatoes, radishes), blue/purple (blueberries, purple potatoes, red cabbage, radicchio) even white and yellow (spaghetti squash, summer squash, lemons, cauliflower).

3.     Consume healthy amounts of the best protein you can afford - grass fed beef, pastured chicken & their eggs, pastured  pork, wild caught fish.  Anytime is a bad time to pick up an unwelcome guest (ie parasite) but before and during pregnancy is especially bad so make sure that your pork and fish are properly cooked and from impeccable sources - you may have to park the sushi habit for now to avoid exposing yourself and your little one to unnecessary risk.

4.     Healthy fat is needed to absorb fat soluble vitamins, for energy, to help you feel satiated and to avoid excessive cravings.  Use extra virgin coconut oil, extra virgin olive oil, avocado oil, butter from grass fed cows, ghee, nut butters, nuts and seeds and whole eggs.  About 1-2 thumb size portions per meal is a rough guide to how much.

5.     Grains:  If you eat grains pick whole organic grains and ideally sprouted to make them most nutritious and digestible.  Try not to eat grains at the expense of your daily needs for protein, vegetables and healthy fats - they will be important to meet your calorie needs but they simply do not measure up on the nutrition scale compared to these other food groups.

6.     Pre and probiotic foods:  the gut microbiome - that colony of bacteria living in your gut is one of the most active areas of research in all areas of medicine these days and there is increasing evidence that Mom’s micro biome status plays an important role in establishing baby’s immunity both immediately after birth and into childhood.  There is some evidence that indicates it may be wise to take probiotics during pregnancy but it’s a good idea to consult a health practitioner to determine if this is right for you and what type to buy.  Having said that, there are foods you can eat that will support that micro biome including:

•   organic, plain, whole milk yogurt and kefir (assuming dairy agrees with you) either from cow, sheep or goats milk - if dairy doesn’t work for you there are also options made from coconut milk

•   raw and unpasteurized sauerkraut and kimchi

•   kombucha (always choose naturally lower sugar varieties like ginger)

•   eat prebiotic foods like raw asparagus, jicama, jerusalem artichokes, raw and cooked onions, raw garlic (in small amounts), green plantain chips, cooked and cooled potato and white rice.

•   and of course, the foods to avoid:  excess sugar, processed foods, bad fats (trans and hydrogenated fats, vegetable oils, corn oil, soybean oil…almost anything that is not on the “good fat” list above).

** Certainly nausea in the first trimester can complicate matters somewhat and this is one of the many reasons why a good prenatal vitamin is always a good idea.  You can also drink ginger tea to try and manage the nausea, and eat smaller, more frequent meals.  This last point will also come into play in the third trimester when your growing baby starts to take up more space and leave less room for your own organs.   Do your best to choose the most nutritious foods you can manage - for some people this means going bland, for others it means more flavour - try to understand what tastes appeal to you most and make the best choices you are able to in that spectrum.  There is some evidence that morning sickness could be associated with the extra stress placed on the liver at this time - supplementing with vitamin B6 in its active form (P5P) can sometimes be helpful at a dose of 25-50mg 3x a day.  And water, drink water….

With all this talk of food and eating more many women wonder just how much weight they should gain during pregnancy.  Like all questions surrounding weight gain, this is a complicated one to answer.  For a woman who is underweight the target is anywhere from 28-40 lbs, women at a healthy weight should aim for 25-35 lbs and for women who are significantly overweight the target is a bit lower, between 15-25 lbs.  Before you run off and decide what category you fall in (us girls are notoriously challenged in this area), do yourself a favour and consult with a health professional to decide what is right for you.  One thing that is almost never the right idea is to decide to go on a diet during pregnancy unless you are being closely monitored by your doctor or health professional - and even then, there’s a reasonable chance that improving your diet will get the job done without restricting calories or major food groups. 

Aside from all this….enjoy your pregnancy, take this time to take care of yourself, get extra rest, appropriate exercise, get lots of fresh air and, if you have other little ones around try to get some help from friends and family when you need a break. 


Training During Pregnancy: A Personal Trainer's Perspective by Freya .R.

I love training pregnant women. It’s so rewarding to be a part of that important time in their lives; to help them embrace their changing bodies, instill confidence in them, and empower them to become great mothers.  In my experience, is it women who feel strong and capable during pregnancy that tend to be the women who not only recover well from the physical effects of pregnancy, but also encourage self confidence and athleticism in the next generation through their children.

Labour is likely the biggest and longest workout of any mother’s life…why wouldn’t you want to train for childbirth just as you would for that next 10km run or competition! Every woman and every pregnancy is very different depending on how active they were before pregnancy and if they have any medical conditions or concerns that need to be considered. Therefore, communication and goal setting between trainer and client is extremely important.  Some women just want to ‘stay fit’, others want to be able to ‘bounce back to pre baby bodies’, and others (typically the already very fit athletes I train) fear loosing their current performance measures and want to maintain strength so they can get back to ‘where they were’ as soon as possible. Though the programming for each of these clients will be different, I think it important to make each woman choose at least one specific, measurable, non-body composition related goal. I find that this allows them to maintain a certain level of ‘self’ and not get too wrapped up in the physical stuff that they will more often than not loose control over.

Becoming a mother can be challenging. Motherhood temporarily requires extreme selflessness as new moms often loose their bodies, their time, their career, and arguably their mind!  I think it important that they do not also loose their sense of self. I find that having that one personal, non-image related goal helps keep them grounded and reminds them of who they were before the baby and who they will continue to be on top of being ‘mom’. I tend to encourage setting a skill or mobility goal that keeps them focused and accountable. It doesn't have to be epic in any way, just something that makes them feel like they are working on and towards something for themselves and so that they don't feel like their training gets ‘paused’, or that they will need to start from scratch post partum. Some simple examples I have used with women would be improving pulling or pushing strength (using the slow weight gain to their advantage), improving mobility in areas they struggle with, or working on any imbalances so that strength and skill progress can be faster after childbirth.

As a trainer, my goal is to instill a feeling of safety, confidence and strength in each person I train, no matter what level they were at pre-pregnancy. If a woman is already training, and she has no underlying medical conditions, she can generally continue to do her usual workout throughout the 1st trimester (week 1- aprox week 12). Of course, if a movement or activity makes her nervous or concerned about safety, I encourage modifying it right away. Typically however, women feel comfortable and enjoy doing the same activities they did beforehand. As a trainer, I value helping women tune in to their bodies and really listen to how each exercise makes them feel. This promotes heightened body awareness from the very start, which will help them be aware of their changing bodies as the pregnancy progresses.

From the very beginning, for each client, no matter their goal, the main things I focus on are abdominal and pelvic floor strength, posterior chain development, joint stability and, of course, body awareness in all movements.

Abdominal and pelvic floor strength may be the obvious targets of programming as these are the muscles that support the baby’s growth, and they will be your main allies during labour.  As Julie Tupler, the co-author of Lose Your Mummy Tummy, states: “If you go into pregnancy with strong abdominals, you’re going to prevent back problems, have an easier time pushing during labor, and recovery is going to be better”. Just visualize the muscles being stretched around your belly. Strong muscles will stretch easier, help you push better, and bounce back faster!

A strong back, glutes and hamstrings are also crucial, as the extra weight of the baby will pull the body increasingly forward as the baby grows.  Your posterior chain will no only support the extra weight, but also help minimize common back pain caused by weight gain.

Joint stability is also very important, as during pregnancy the production of the horone relaxing increases, which has a ‘loosening’ effect on muscles.1 Flexibility and mobility frequently increases (which is awesome) due to this hormone, but control in those new found positions isn’t always there…so should therefore be treated with caution. Another reason why stability should become a focus in training is the obvious: feeling stable and balanced will help minimize slips, falls and accidents as your body grows and changes.

As the woman enters into the 2nd trimester (approx week 12), her body position can affect her cardiovascular system. After the first trimester, when laying on their back, the weight of the pregnant uterus slows the return of blood to their heart, which reduces blood flow to the fetus. This means the baby will get less oxygen and fewer nutrients and therefore supine positions (exercises done laying on their back) should be avoided.2 Women often start to feel uncomfortable laying on their backs at this point anyways, so this is when I start removing any supine positions (sit ups, hollow body work, supine leg raises etc…)

In many ‘training during pregnancy’ articles, you will be told that it is not safe to squat below parallel as you enter your 2nd trimester, due to the effects the relaxing hormone has on the joints. Though it is true that hormones released during pregnancy relax ligaments, muscles and joints which can cause instability, I am of the belief that if done slowly, with control and awareness, squats below 90 degrees are no more dangerous than any other movement taken to full range of motion.3 I continue to program these in a one-on-one setting at sub maximal weights, often with a tempo.  That being said, in a written program where I cannot see and monitor how closely the client is following my instructions, I will usually remove weighted full depth squats in the 2nd trimester and have them squat full depth with no weight or with weight to a box placed under them. This will not only prevent them from moving too quickly and ‘loosing control’ at the bottom of a squat, but it will also strengthen different bottom positions of the squat which will end up improving the structure and stability of the squat overall: Win-win!

Once the woman enters the 3rd trimester (approx week 29), most movements will need to be modified, simply because of the belly getting in the way! As long as there is a safe and technical pathway for equipment, things like balls, dumbbells and barbells can still be used. If, however, the bar pathway is inhibited by the belly (In Olympic lifting, the snatch and clean movements for example) then they need to be removed from the programming. Not only are you putting your baby at risk of contact with equipment, you are also altering your muscle patterning in these movements which will interfere with your technique and slow down your progress after the bump is no longer in the way. My rule of thumb is if it’s uncomfortable or if it alters a technical movement’s pathway: modify it.

Some basic examples of modifications I use with people are:

-       Sumo deadlift in lieu of traditional narrow stance Deadlift which can squeeze the belly as it gets bigger into an uncomfortable hinged box and can force bar path and beginning position to change.

-       One handed Kettlebell/Dumbell Cleans and Snatches instead of barbell snatches once the bar path is impeded by the belly and you can no longer keep the bar close.

-       Burpees/push ups on or between two boxes so belly doesn’t hit the floor.

The third trimester is also when things like hanging, skipping and jumping tend to become uncomfortable. If the client is still happy and feels safe, I let them continue until that changes. It’s important to remember that each pregnancy is different! If something doesn’t feel good or right, I tell them to avoid it.  Some women find jumping uncomfortable quite early on, while others feel safe and good about box jumps and skipping until the very end. Some women don’t feel safe hanging from the bar as soon as they start to get heavier, and it’s important that they feel safe and in control of any training that they do. Their training with me is there to help them feel confident about their body changing, not to make them anxious.

The last element I like to play with, especially as they near their due date, is breathing techniques and patterns. I’m no Lamaze breathing coach but I do believe in the power of patterning breath to movement and I coach women through different patterns and techniques while they move so they can familiarize themselves with linking strenuous activity to their breath. I also like to ‘simulate’ labour by programming intervals of hard work with Tabatas4 and 30 - 120 second working sets with short rests between sets. I have had several clients tell me that they thought about and visualized these work sets during labour and that it helped them manage contractions and feel in control of the process knowing that like a workout, each contraction was temporary.

Training during pregnancy doesn’t have to be complicated. As long as you listen to your body and train with a coach that you trust, you can reap all the benefits of training throughout pregnancy: you can sleep better, boost your energy and self confidence, reduce pregnancy discomfort and stress, prepare yourself for the workout of labour and get your strength and body back faster after childbirth!  I hope that all expecting moms reading this can find ways of staying active and strong in mind and body as they prepare for childbirth and motherhood. And please come find me if you aren’t sure where to start, I’m happy to introduce you to your inner baddass!

Freya

The Freya Experience!

FREYA'S TESTIMONIALS

I started training with Freya after my first pregnancy and before my second, so I had the opportunity to compare the two. It's not really a fair comparison; pregnancy was so much better the second time around after I had a strong, functional baseline. I kept on training through my pregnancy right up until I delivered. Freya researched pregnancy and exercise before adjusting my program, and I always felt challenged but safe. Most importantly, my ability to manage labor was changed. I kept hearing Freya's voice in my head, with each contraction, saying 'you're in control, breathe and calm your heart rate.' It was like the most intense tabata ever, and after I gave birth to a healthy baby girl, my midwife exclaimed, "that was the most efficient birth I've ever seen!"

-Mei-ling Wiedmeyer (delivered her daughter in August 2013)

Freya is really perceptive in knowing when to push you further (which can be surprisingly far!) and when you really just have to stop. She can also spot frustration and lack of focus a mile away and knows exactly what to do and say to help you restore it - I find that to be such an important part of training! At first it was disappointing in early pregnancy to not be able to push myself quite as hard but she's still made me feel like I accomplish a lot at the end of each session. Freya is an empowering trainer and I'm so grateful that she's busting my butt while I'm pregnant to keep up my posture/balance while my body changes and to prepare me for the physical challenges of labour.

-Sarah Maynard (15 weeks pregnant)

I'm 29 years old, 28 weeks pregnant and have been crossfitting for 4 years now. Freya has been my coach since the beginning, though I've only started working with her one on one since becoming pregnant. I'm pretty independent in the gym and Freya respected this by putting together a flexible once per week program with some additional modules that I could use on my own, or to help modify the WOD. This program has been instrumental in guiding me to workout safely and still train hard during pregnancy - both to maintain my strength and train for delivery. My first meeting with Freya was also very significant for me. Before we even got into specifics, we spent some time exploring my goals and validating the transition that I am experiencing going from athlete, to athlete mom. This helped me to appreciate the mental importance of ongoing training in pregnancy since being an athlete is an important part of my identity that I plan to continue into motherhood. I'm very much looking forward to more private sessions with Freya as I get bigger in the later stages of pregnancy and during the 4th trimester! I can't say it's always been a piece of cake so it's great to have someone like Freya there for support and to answer my questions along the way.  

-Laura Lachance (28 weeks pregnant)

During my pregnancy I felt safe working out with Freya as my trainer. I was able to stay active and safe while pregnant and for that I thank Freya. She rocks!

-Karla Bravo (delivered her daughter April 2015)