How to Modify Exercise During PREGNANCY When Half of Your Class Are IN PAIN

When it comes to teaching pre and postnatal, and for me in particular Pilates instruction for these populations, I find things both simple and scary.

Why simple?

Well, once you know the limitations or boundaries of what’s safe and what’s not for the pre/postnatal client, it’s like there’s a simple line that you just don’t cross.

There are exercises you’ll feel comfortable teaching to your prenatal groups and other movements you’ll find are more appropriate for 1-2-1 situations.

Why scary?

Well, let me tell you a little story of one particular pregnancy Pilates course I instructed recently which had 12 participants booked on the 6-week course.

And, would you believe, 8 clients out of those 12 had these pre-existing injuries/issues:

  • Client 1 – knee surgery – preventing her from being on her hands and knees
  • Client 2 – pelvic girdle pain – affecting the SI joint (sacro-iliac joint)
  • Client 3 – pelvic girdle pain – affecting the pubis symphysis (pubic bone)
  • Client 4 – carpal tunnel syndrome – preventing her wrists to be in flexion
  • Client 5 – sciatica – resulting in shooting pains from the glutes down the back of each leg when seated for long periods and requiring crutches to walk even short distances
  • Client 6 – fourth grade placenta previa – requiring Doctor’s Consent before exercise
  • Client 7 – hypermobility – requiring modifications throughout and the client to wear wrist splints
  • Client 8 – suspected diastasis recti not rehabbed from previous pregnancy causing back pain and a significant lack of ‘core’ strength

As you can see – it was one tough session to teach, but, with a bit of tweaking here and there, I did actually manage it.

Please don’t let me put you off teaching pregnancy Pilates – I’m just giving you a window into my life as a Pre/Postnatal Fitness Expert who has the experience and know-how.

You can see from the list of injuries/medical conditions above, that it wasn’t an easy class to teach, but, I managed it.

Just.

There are some things you truly only learn from experience and dealing with pre-existing and pre/postnatal conditions is one of them.

So, what the heck did I manage to teach for a 6-week Pilates course to this seemingly ‘walking wounded’ set of pregnant clients?

Well, the first thing to do was analyse what EVERYONE present can do, and then start to make modifications around this.

Here’s a breakdown:

  • Standing stuff (not surprisingly) was fine for all participants.
  • Seated (on floor) positions were suitable for everyone in attendance.
  • Side-lying exercises, keeping the range of movement smaller for those with PGP/sciatica was actually fairly simple to modify.
  • Seated (chair-based) exercise was fine for all, with precautions for the client suffering with sciatica, depending on how she was feeling ‘on the day’.
  • Hands and knees positions were possible for all but one client, so when instructed to step down to the floor, she sat on a chair instead and did arms or knee lift exercises. For those with wrist/PGP-type symptoms: 1) arm movements were given to those with PGP, and 2) knee lift movements prescribed for those with wrist problems and 3) wall press ups given to the lady who couldn’t kneel.

And, there you have it.

Not as hard as you think, eh?

All it takes is a bit of planning, preparation, and the realisation that standing work is not only more effective, but pretty much suitable for all pregnant clients.

You’ll notice only one client in the list had suspected diastasis recti (abdominal separation).

I’m happy to report that using my “7 Steps to Fixing Abdominal Separation” method I created myself, the exercise I did with her during pregnancy, really helped lessen her separation considerably AND give her a sense of core strength back.

If you’d like to specialise in abdominal separation rehab, you’ll be pleased to know my NEW ‘Diastasis Detective’ online instructor CPD program will be live again in 2018!

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