Pilatesforlowerbackpain

AmandaQin

January18,2018

Comprehensiveprogram2017-2018

BodyInMotion,CA

Faculty:DominiqueLesperance

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Abstract

Pilatesisagreatwaytohelpwomenprotectedandstrengthentheirbody

whiletheyarepregnant。Pilatesfocusesonposturalalignment,core

strength,andoverallmusclebalance.InthispaperI’mgoingtotalkabout

theinfluenceandchangeofpregnancyonthebody,andchangesinbody

posture.Next,I’mtalkingaboutthecauseofthelowerbackpainafterbirth

andIwillalsoincludeaconditioningprogramutilizingtheBlockSystem

fromBASI.

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Table of Contents

Abstract page2

AnatomicalDescription page4-9

Discussion page9

ConditioningProgram page10-12

Conclusion page13

Bibliography page14

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AnatomicalDescription

Pregnancy is a wonderful and wonderful experience for women. Women's bodies are

pregnant, childbirth and lactation. During pregnancy, the body of a woman is affected

by a hormone, with some major physiological changes. The most obvious change is

the growing number of babies in the womb, the increase in weight and the change in

body posture.ThefollowingtenitemsisimportantthatthePilatesinstructorand

clientareawareofthechangesoccurring.

1 musculoskeletal and changes in body posture

The spine continues to realign to maintain balance. This produces a shift in posture

with exaggerated lumbar lordosis towards late pregnancy. Increased laxity in the

ligaments, caused by an increase in relaxin, contribute to back pain and pubic

symphysis dysfunction. The pelvic bones loosen to prepare the body for labour and

birth.

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2 The Respiratory System

The respiratory rate rises to compensate for increased maternal oxygen consumption,

which is needed for the uterus, the placenta and the fetus. As a result the client may

feel out of breath.

3 cardiovascular system

As the uterus enlarges, it rises up and out of the pelvic cavity. The action displaces the

stomach, intestines, and other adjacent organs. Progesterone causes relaxation of the

lower esophageal sphincter. As a result the client may experience constipation, reflux

and heartburn.

4 changes in the breasts

Breasts may become larger and tender due to the increased levels of hormones,

estrogen and progesterone. The nipples may stick out and by the third trimester,

colostrum may start to leak.

5 urinary system

The growing uterus puts pressure on the bladder, urethra and pelvic floor muscles

which may result in the client needing to frequently urinate.

6 gastrointestinal system

As the uterus enlarges, it rises up and out of the pelvic cavity. The action displaces the

stomach, intestines, and other adjacent organs. Progesterone causes relaxation of the

lower esophageal sphincter. As a result the client may experience constipation, reflux

and heartburn.

7 endocrine system

Hormonal changes readjust the entire body system. The placenta acts as a temporary

endocrine gland during pregnancy, it produces large amounts of estrogen and

progesterone. It serves to maintain the growth of the uterus, helps to control uterine

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activity, and is responsible for many of the maternal changes in the body. Pregnant

women may feel warmer due to increased hormonal level and basal metabolic rate.

8abdomen system

During the second trimester the abdomen starts to expand and the uterus will be close

to the ribcage by the end of this trimester. The client may ache on either side as the

abdominal wall and ligaments stretch.

9 leg cramps

Caused by carrying extra weight, compression of blood vessels, excess in

phosphorous, a shortage of calcium or magnesium and an increase in pregnancy

hormones.

10 swelling

Feet and ankles may swell due to an increase in fluid.

Manyofthephysicalchangesthatcancauselowbackpainduringpregnancy,

childbirthandpostpartumperiod.Duringpregnancy,expandinguterusstretches

andweakensabdominalmusclesandaltersbodyposture,puttingstrainonthe

back.Plus,extraweightmeansmoreworkformusclesandcreasedstressedon

thejoints.Whatmore,hormonalchangesinpregnancycanloosenthejointsand

theligamentsthatattachpelvicbonestospine,whichcanmakefeellessstable

andcausepainwhenwalk,standorsitforlongperiods,rolloverinbed,getout

ofalowchairorthetub,bendorliftthings.Inadditiontothis,thereisalsothe

causeofhyperlordoticspine,diastasisrectiandimbalancemuscles（lower

crossedsyndrome）

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Hyperlordotic

Hyperlordosisofthelumbarspineisaconditionthatoccurswhenthelumbar

regionorlowerbackdramaticallycurvesinwardtothepointofcausingexcess

painorspasms.Itisacommonposturalpositioninpostpartumperiod。This

faultypostureispelvis in a fixed anterior tilt.causedbyweakabdominals,tight

hipflexors,andtightbackextensors.Tocorrecthyperlordosistheabdominals

needtobestrengthened,andthehipflexorsandlowbackextensorsneedtobe

stretched.Specificallythetransverseabdominalsandmultifidusneedtobe

strengthened.Thisposturecreatesexcesspressureonthelumbarspineandcan

causelowerbackpain.

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Diastatis Recti

DiastatisRecti,bydefinitionisphysicalseparationoftherectusabdominis

muscles.Thisisverycommonamongpregnantwomanaspregnancyapplies

pressureonthebellywhichpreventstheabdominalsfrommaintainingtheir

shape.Themainsymptomsofdiastatisrectiisprimarilytheinstabilityofthe

abdominalsalongwithbackpain,poorpostureandconstipation.bythe

occursbetweentheLineaAlbaandLineaSemilunarisintheAbdominalRaphe,

whichisthemidlinecollagenousconnectivetissue.Themainsymptomsof

diastatisrectiisprimarilytheinstabilityoftheabdominalsalongwithbackpain,

poorpostureandconstipation.

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TransverseabdominalsandMultifidu

Thetransverseabdominalsarethemusclessurroundingeithersideoftheback

belowtheobliquemuscles.Thetransverseabdominalsmusclesplayakeyrolein

stabilizationspecificallyinstabilizingthelowerbackandpelvis.TheMultifidusis

abackextensormusclerunningalongthespinethatplaysakeyrollinstabilizing

thejointswithinthespine.TogetherthetransverseabdominalsandMultifidus

helpstabilizeusthrougheverydayactivityandhelpprotectthespine.

CaseStudy:

Clientname: Susan 30yearsold

Sheisathreemonthsbaby’snewmother,becauseshetookherchildallday

alone,andsherecentlyfoundherlowerbackpain,especiallywhenshewas

holdingachild.Atthreemonthspostpartumherabdominalsarestillveryweak

andthereisanoticeableseparationoftheabdominalsandrelaxationofthe

stomachmuscles.Soherweakabdominalsarecausinglumbarhyperlordosis,her

lowerbackextensorstooverusing,leadtolowerbackpain.Shesuffered

constipationtoo,whichIthinkwascausedbytheseparationoftherectus

abdominis,andthedecreaseinabdominalpressurecouldalsoproduce

constipation.Shedoesn’thaveanytrainingbase.Hermainobjectiveistolosethe

weightthatshehasgainedfromherpregnancywhilefocusingonregainingher

abdominalstrengthandincreasinghermobility. 9

ConditioningProgram-BASIBlockSystemforSusan

BASIBLOCK Sessions 1-10 Sessions 11-20 Sessions 21+

WARMUP

RollDown

PelvicCurl

SpineTwist

Supine

RollDown

PelvicCurl

SpineTwist

Supine

ChestLift

ChestLiftw/

Rotation

RollDown

PelvicCurl

SpineTwistSupine

ChestLift

ChestLiftw/

Rotation

FOOTWORK

Reformer

ParallelHeels

ParallelToes

VPositionToes

OpenV-Heels

OpenV-Toes

CalfRaises

Prances

Reformer

ParallelHeels

ParallelToes

VPositionToes

OpenV-Heels

OpenV-Toes

CalfRaises

Prances

SingleLegHeels

SingleLegToes

Cadillac

ParallelHeels

ParallelToes

VPositionToes

OpenV-Heels

OpenV-Toes

CalfRaises

Prances

SingleLegHeels

SingleLegToes

Abdominal

work

Reformer

Hundred（heaton

themat）

WunderChair

StandingPike

SittingPike

Cadillac

BreathingWith

PushThroughtBar

Reformer

Hundred

Teaser1

HipWork

Reformer

Frog

Circles(Down,

Up)

Openings

Reformer

Circles(Down,

Up)

Extendedfrog

Extended

frog/reverse

Cadillac

Frog

Circles(Down,Up)

Walking

Bicycles

Spinal

Articulation

N/A

Reformer

BottomLift

BottomLiftw/

Extensions

Cadillac

Monkeyoriginal

Stretches

Mat

Catstretch

Reformer

StandingLunge

Reformer

kneelingLunge

Cadillac

ShoulderStretch

Fullbody

Integration

N/A

Reformer

Scooter

Cadillac

Sittingforward

ArmWork

Reformer

Armssupine

series

Reformer

Armssitting

series

Cadillac

Armsstandingseries

Chestexpansion

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ArmWork Reformer

Armssupine

series

Extension

Adduction

Circles(upand

down)

Triceps

Reformer

Armssitting

series

Chestexpansion

Biceps

Rhombids

Hug-a-tree

Salute

Cadillac

Armsstandingseries

Chestexpansion

Hug-a-tree

Circles(upand

down)

Punches

Biceps

LEGWORK

Reformer

HamstringCurl

(nostraps)

Reforfmer

SingleLeg

Skating

Cadillac

Squats

LATERAL

FLEXON/

ROTATION

Mat

Sidelift

Reformer

Mermaid

Cadillac

Butterfly

BACK

EXTENSION

Mat

Backextension

Reformer

BreastrokePrep

Reformer

PullingStraps1

PullingStraps2

Final

Assessment RollDown RollDown RollDown

Conclusion

Mothers are prone to developing muscles imbalances due to new repetitive movement

patterns and routines. Daily activities such has picking up and holding a child,

breastfeeding, and carrying a diaper bag can overload unconditioned muscles causing

stress and fatigue. There is a strong emphasis in Pilates to strive to achieve overall

balance. In doing so muscles imbalances need to be addressed, and the appropriate

muscles need to be stretched, strengthened, and conditioned. At the same time, it

needs to be established ideal posture，to reduce the pressure of the joints and bones.

Susanupon evaluation after completing her tenth session, the exaggerated curvature

of lumbar spine had slightly decreased while her pelvis appeared to be closer to a

neutral position than it had been at the beginning of the program. Her abdominal

strength was also improved. After twenty session the symptoms of the rectus

abdominis were also improved. During the training period, I paid special attention to

her rectus abdominis separation, so I did not do the chest lifting and rotation in the

first ten sessions. No trunk flexion but strengthen transverseabdominals and

multifidusco contraction and awareness , to establish trunk stabilization. Mobility in

Susan’s lumbar spine has also improved, the lower back pain is better than started.

She is motivated to continue her Pilates conditioning program, striving for ideal

alignment and a healthy spine.

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Bibliography

Pilates in Pregnancy

http://www.babycentre.co.uk/a563313/pilates-in-pregnancy

Rosecrams,Tracy.BodyChangesThroughPregnancy.WebHealthline.com,

http://www.healthline.com/health/pregnancy/body-changes-infographic

BASI.Studyguide–comprehensivecourse.CostaMesa,CA;2000-2014.

BASI.Reformer–movementanalysisworkbook.CostaMesa,CA;2000-2012.

BASI.Mat–movementanalysisworkbook.CostaMesa,CA.2000-2012.

BASI.Cadillac–movementanalysisworkbook.CostaMesa,CA.2000-2012.

BASI.WunderChair–movementanalysisworkbook.CostaMesa,CA.2000-2012.

IsacowitzR.Pilates.Champaign,IL.HumanKinetics;2006.

IsacowitzR,ClippingerK.PilatesAnatomy.Champaign,IL.HumanKinetics;2011.

PilatesJH.Returntolifethroughcontrology.Miami,FL.PilatesMethodAlliance:

Reprinted;2003.

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