Tag: pregnancy

Pregnancy Massage

A woman’s body undergoes profound physical and metabolic changes over the course of pregnancy and massage can be a powerful tool for supporting these changes by soothing and balancing the nervous system and improving many of the symptoms that may develop as the fetus grows.

Many women experience headaches, muscle pain, fatigue, or swelling, and an experienced therapist can reduce and sometimes alleviate any or all of these. Touch is an effective tool for balancing the sympathetic(fight or flight) and parasympathetic(rest and digest) branches of the autonomic nervous system. When in balance, our bodies function better; this is especially important during pregnancy. Massage also increases levels of serotonin, dopamine, and endorphins in the bloodstream, which decrease pain and increase restful sleep and feelings of well being along with other benefits.

There are special considerations for massage and pregnancy, and it is good to consult with your healthcare provider to rule out any complications that could be contraindicated for receiving massage. It is also important to be properly positioned on the table to protect and support the health of the child, either side-lying or with specialized body cushions. Which we do have here at the club and can use upon request. A licensed practitioner will have received basic education in pregnancy massage, and many of us have gone on for more advanced training. Let us know if we can help, we are always available to assist with your  bodywork needs.

Postpartum Exercises

Pregnancy can be tough on the body; an individualized experience that can leave you stronger in many ways, yet weaker in others. Each unique experience will require a different approach to your exercise routine. Isometric core exercises and stabilization are viable with every case. Speak to your doctor or a fitness professional for details concerning where you should start.

Isometrics involving a static hold position where you are finding proper core activation in different planes is a good place to start from. One useful isometric is lying down on your back; feet flat against the ground perform a few pelvic bowls by tucking the hips under and rounding the lower back and then performing the opposite with the lower back in an arched position. Find the neutral, center for the spine, or if you feel excessive lower back tension remain in the scoop, rounded position. With your hands at the front part of your hip bones tense the inner pelvic floor muscles and directly between your hands, below the line of the belly button. One way to rediscover these muscles is to say “hut” with forceful breath and you will notice a contraction that tightens the muscles inward and up. Once you have engaged those muscles you can perform a plank working from the wall, to a bench, to the ground on your knees, and last on the feet.

Stabilization is where you have more integration of stabilizer muscles performed in an unstable exercise. A single leg balance should be performed with the same muscle contraction. A good progression to strengthen the psoas is doing a standing hip hike with a towel against the wall, then a floor leg march, then an alternating leg lift, and lastly a pilates roll up exercise. Nothing should be progressed upon until you feel confident you have full control of the motion. Once these basic are accomplished with good form exercises in other planes of motion should be performed.

Every exercise variance should be based on if your doctor has cleared you for exercise and if it is appropriate considering circumstances such as cesarean or abdominal separation. If the exercises are performed correctly, you will create more strength and proper length in the most impacted area of the body. For further details, additional exercises and questions please contact personal fitness trainer Amber Walz.

Get This Thing Out of Me!

At the end of May in 2011 I found out I was pregnant (finally!) and boy were my husband and I so excited! I was really unsure about pregnancy and how much I would like it. Well, I LOVED it… until 8 months and then I wouldn’t have wished it on my worst enemy. In the beginning I continued to do my normal workouts for the most part. My husband said NO jumping, however, the doctor said I could do whatever I wanted, even handstands, I asked. But as time went on and I got bigger my workouts changed. I couldn’t run (too many trips to the bathroom to make it worth it), at a certain point my deep front squats stopped happening, and my every 3 steps stair running wasn’t working because my thighs kept hitting my baby. But I did what I wanted for the most part. I lifted a little less heavy, my cardio was slightly less intense because I was breathing so much harder as my baby pressed into my lungs, and I may have taken a few more breaks than normal but other than that the workout world was my oyster. Kettlebells were my favorite, it still felt good, I could do swings without having to work around my big stomach, and I felt powerful. Towards the end I started doing a lot more stair running (and stepmill), jump roping (the husband may or may not have known about that), and a lot more lunging. By 35-40 weeks I was just ready to have my little guest come into the world so I could feel normal again.

The day before I gave birth, my workout was the following:

  • 10 kettlebell snatches (each arm)
  • 10 kettlebell crush push-ups
  • 10 kettlebell lockout lunges (each leg)
  • 1 minute jump rope
  • potty break 😉

I repeated that 5 or 6 times, I don’t remember.

The moral of this story?
When pregnant you should do what YOU are comfortable with. Had I never workout out before and gotten pregnant then decided to get in shape I would NOT have done these workouts. I know my body, I know what I’m capable of, I know how to lift properly. I didn’t do anything that made me work too hard (at least not without adequate breaks), I didn’t try new things, I stayed away from the exercises I knew I couldn’t do correctly (goodbye clean and jerks). But I made it my goal to continue to workout 6 days a week. I didn’t always feel up to it but I had a goal and i stuck to it. I strongly believe that because I was so active I had a relatively easy birth (as easy as a natural birth can be I suppose) and a super fast recovery time.

Post baby
After my 15 days of doctor recommended, no exercise, I began doing body weight workouts in my living room while my adorable baby girl slept. I started pretty basic and it was quite a shock at how hard the basics were. I moved from there into workouts wearing my baby, I swear she liked it. It kept us close and bonding, she loved the movement, and it usually put her to sleep. We did squats, lunges, “ran” the stairs in our house, did one legged squats, step ups on the coffee table, etc etc. From there I moved back into kettlebells. Granted I was using a lighter bell than I usually do but I felt pretty good doing them none the less. Again, I did what I felt I was capable of, what didn’t cause me pain, and what made me feel good.

Now
5 months later I’m doing everything I want to do. I’m slowly working my way back to the weights I was using before pregnancy and my fitness level is getting close to where I left off. I feel better about my health every day and I’m excited to be close to my goal weight. It’s taken longer than I thought which is a little frustrating and my post pregnancy body may never be the same but I’m okay with that. In total I gained 38 lbs. during my pregnancy, and at the time of posting this blog I have lost all but 1/2 lbs. (back to “normal”). Its been a long hard journey but I’m happy to be healthy again!

But it’s not all exercise. A member (a male member at that) asked me the other day, “Adriana, how did you lose all your baby weight so quickly?” Well, I was thinking in my head, “not all” but I was happy to hear he thought so : ) My answer… Paleo. Paleo has been something I’ve been doing for the past year and a half before I got pregnant. I’ve never felt so good, felt so strong, recovered faster from workouts, felt healthier, moved better, or kept off those 5 pounds that I gain and lose all the time. When I got pregnant after about 4 months and my cravings set in and I was getting “fat” I said, screw it. When in my life will I ever get to be “fat” and not care? I didn’t get nuts but I did eat oatmeal on the weekends, enjoyed gluten free cupcakes, and maybe had some cheese and gluten free crackers! But about a month after having my baby I got back to Paleo. That is the real reason I dropped weight. The working out helps and has definitely helped tighten my body parts back up but it’s really the clean healthy eating that got me back close to where I want to be. If you don’t know what Paleo is, the basics are; I eat meat, poultry, seafood, all veggies (except basic potatoes), fruits (except I stay away from the tropical fruits), natural fats like avocados, coconut/oil, and animal fat, and nuts and seeds (except no peanuts, those are a legume in which I do not eat). It seems really restrictive and it is but in a good way. I chose to live my life this way, it’s NOT A DIET, this is really how I live. I don’t buy packaged food, I don’t eat may if any processed foods, and I drink nothing but water, flavored mineral water, black coffee, and wine (wine by the way is not exactly Paleo, a girls gotta live!). If you would like to know more about Paleo, just ask me, I’ll talk your ear off about it. I think it’s the best thing ever and I wish more people would believe they can do it because, without sounding too corny, it will change your life and they way you look at food.

So if you were wondering how to have a good (ish) and healthy pregnancy/post pregnancy this is what I found worked for me. Whatever you do, don’t stop working out! Modify, take it easy, rest more, stay hydrated, but whatever you do keep exercising! You’ll thank me in the long run!

How Pilates May Be Able to Help in Pregnancy

Amy B. is no stranger to Pilates, but was still amazed at how her Pilates sessions helped her through pregnancy, delivery, and being a busy, working mom of 2 lively kids. In San Francisco and Seattle, Amy took Pilates Mat classes for 7 years before the birth of her first child. After Amy’s baby was born, she felt strained in her back and shoulders due to lugging around a car seat with a growing baby. She wanted an efficient workout; something that combined strength and flexibility, because with a new baby she no longer had time to separately do strength conditioning and yoga — she needed to cram it all into an hour if possible. Lastly, she wanted her pre-pregnancy body back and to fit into her clothes again. She contacted Jocelyn and decided to start private sessions once a week.

Fast-forward two years; Amy is expecting her second baby. Amy says, “I felt very strong this pregnancy, which I attribute to consistently running and doing Pilates for the two years prior. For the first several months, I kept with the same exercises, but as my belly started to grow there were obviously some exercises we had to cut out or adjust to not lay on my belly or put unnecessary strain on my back”.

Amy was elated to learn that she could be tired during the day, but a Pilates session with Jocelyn after work would energize her and she’d feel great! She did Pilates right up until the end of her pregnancy, 10 days before she gave birth to Emilia.

According to Amy, delivery was “easy”! It took 5 minutes for her daughter to join the world with no medical interventions. Recovery was much easier this time too. She was pushing a stroller around Green Lake a week later, and resumed Pilates sessions with Jocelyn about a month later.

Pilates During Pregnancy Leads to a Successful Labor for One Member

Ashley started Pilates mat classes about 5 years ago at the Seattle Athletic Club. She was in physical therapy for hip problems and her therapist recommended starting Pilates for core stability. It helped her enough that she was able to stop doing PT.

During her first pregnancy three years ago her doctor was uncomfortable with stressing her abs while pregnant so she stopped at about 3 months and ended up with hip problems during her pregnancy. During delivery she pushed for 2 1/2 hours and her doctor was really close to moving towards a c-section as they were hitting 24 hours of labor. Luckily, she was able to convince them to let her go a little while longer and was able to delivery naturally.

When Ashley got pregnant again 2 years later, she did her research on Pilates and pregnancy. She found information both on-line and on a Pilates videotape. Plus, she talked with me about the modifications necessary for her pregnant self.

She went to her same doctor armed with information and was able to get her comfortable that she could continue Pilates with the modifications. Ashley stacked 5 Yoga blankets behind her back and used this as support during the stomach series, the roll-ups, & neck pulls. Since she was unable to do any exercises on her stomach, I suggested some alternate exercises she could do to keep moving. During rolling exercises she practiced balance instead of rolling. Once she reached her 3rd trimester I made sure that she was only lifting one foot off the ground at a time during any exercise.

By doing Pilates during her pregnancy (up until 3 weeks before delivery), she avoided the hip problems she encountered with her first pregnancy. While most of her labor was similar with her second child (totaling 22 hours!), the major difference was that she pushed for just 12 minutes – 3 pushes total. Her doctor was amazed.

Ashley says, “Since labor requires you to be in a curled up position (just like Pilates), I believe that all the Pilates exercises combined with a deep concentration on pushing were the key to my easy delivery. I owe a big thanks to Jocelyn for all her support and creativity during my pregnancy. She was incredibly helpful along with members of my Monday night class who were always checking up on me.”

Congratulations Ashley!

What is Sciatica?

Sciatica is a set of symptoms including pain that may be caused by general compression and/or irritation of one of five nerve roots that give rise to the sciatic nerve or by compression or irritation of the sciatic nerve itself.

Generally speaking it is pain in the lower back, glutes, leg and foot. The pain may be in one of those places or all of them and can be mild or very severe. Someone with Sciatica may also feel numbness, and may experience muscular weakness causing difficulty moving or controlling the leg. Typically the symptoms are on one side of the body.

Although sciatica is a relatively common form of low back pain and leg pain, the true meaning of the term is often misunderstood. Sciatica is a set of symptoms rather than a diagnosis for what is irritating the root of the nerve, causing the pain. This point is important, because treatment for sciatica or sciatic symptoms will often be different, depending upon the underlying cause of the symptoms.

What are the causes of Sciatica?
The number one cause of Sciatica is a disc herniation – A condition where two vertebrae’s are compressed together forcing the jelly like cushioning to bulge out from in between the vertebrae’s. There are others causes though, such as:

  • Spinal Stenosis – A condition due to narrowing of the spinal cord causing nerve pinching which leads to persistent pain in the buttocks, limping, lack of feeling in the lower extremities, and decreased physical activity.
  • Spondylolisthesis refers to the forward slip of a vertebra over the one beneath. There is different grades of this, which explains why some people don’t have pain with this condition.
  • Pregnancy – Weight gain, uterus growth, ligaments and joints relaxing due to hormonal changes, cause shift in the pelvis, which can in turn cause compression on the sciatic nerve.
  • Sacroiliac (SI) Joint Dysfunction – SI Joint becomes inflamed; the portion of the sciatic nerve running in front of the joint will become irritated.
  • Piriformis Syndrome – is a condition due to an over active Piriformis causing compression on the Sciatic nerve.
  • Daily Habits and Activity – Daily activities can cause overuse of the Piriformis muscle or place more stress on the joints, which can cause added compression or irritation to the sciatic nerve.

Can sciatica be cured?
There is no cure for sciatica. You can relieve the symptoms to the point you don’t have any more pain or discomfort though a series of stretching and exercises. However, these symptoms may come back depending on the cause of sciatica. The best thing to do is, once the symptoms are relieved continue with the stretching exercises prescribed by your doctor or physical therapist. This will help in future prevention of the symptoms of sciatica to come back.

What can I do to relieve the symptoms?
Depending on what is causing sciatica depends on the treatment. There are many different forms of treatment that your doctor will prescribe to you depending on the cause of sciatica. Below are different approaches that may help to relieve symptoms. In most cases many of these will help. Always ask your doctor before beginning any form of treatment though.

Below is a list of treatments and description of each, try the least evasive forms of treatment first.

  • Stretching Exercises – Though a series of stretches for the hips and back you may relieve the symptoms of sciatica. This will help to relax the over active muscles compressing on the sciatic nerve.
  • Physical Therapy – Will rehabilitate the herniated disc or the over active muscles as well as give you a program to follow to prevent recurrent flare-ups and compression on the sciatic nerve. This program will help you to strengthen the muscles supporting your back, stretch the over active muscles, and improve the posture, which can cause the compression on the nerve roots.
  • Massage Therapy – Massage therapy along with trigger point therapy is a great way to help alleviate the symptoms of sciatica by getting the muscles around the area to relax releasing the compression on the nerves.

If these forms of treatment do not relieve the sciatica symptoms, then trying these more aggressive forms of treatment.

  • Non-Surgical spinal decompression – this technique is great for those with herniated or bulging disc that are causing the sciatic symptoms. It gently separates the vertebrae from each other, creating a vacuum inside the discs that we are targeting. This moves the herniated or bulging disc into the inside of the disc, off the nerve root. Eliminating the symptoms of sciatica.
  • Medications – you may be prescribed anti-inflammatory medicine to reduce the inflammation of the muscles that are creating sciatica along with a muscle relaxer to allow the muscle to relax. If you have a lot of pain a pain killer (narcotic) may be used for short term relief. In some instances your doctor may inject a corticosteroid medication into the affected area to help relieve pain.
  • Surgery – in some severe cases, this is an option when the compression is causing excessive weakness, loss of bowel or bladder control, and when the pain is progressively getting worse, even following all other treatment options.

What are some Exercises and Stretches I can do at home?

  • Low Back Stretch – Start by lying on your back pulling one or both knees to your chest holding for 30 seconds
  • Lumbar Rotation – Lie on your back with both knees bent, hands and arms making a “T” shape, drop your knees to the side, keeping your feet flat on the ground the whole time. Hold for 30 seconds and repeat on the other side.
  • Kneeling Hip Flexor Stretch – Start by kneeling on the floor, place left foot in front creating a 90degree angle. Press hips forward while engaging the left glute to help the left hip flexor relax. Hold 30 seconds and repeat on the right side.
  • Piriformis Stretch – Lie on your back cross the left knee over the right, raising the knees and pulling across the midline of the body. Hold for 30 seconds and repeat on the other side.
  • Lat Stretch – Start by sitting on your heels. Keeping the hips on the heels, walk the hands out in front stretching though the back only as far as out as you can go while maintaining hips on heels. Hold for 30 seconds.
  • Marching – Start by lying on your back, placing your heels on the floor at a 90degree angle from your hips. Holding that angle as if in a cast, raise your knee up slightly past perpendicular to your hips maintaining that 90degree angle, lower and repeat 10-15 reps.
  • Clam Shells – Start by lying on your side in a fetal position, knees bent to almost 90degrees. Roll your hips forward so that the top hip and knee is slightly in front of your bottom hip and knee. With out rocking your hips backward and keeping your heels together, raise your top knee only as far up as you can with out changing the position of your hips.
  • Quadruped – Start out on your hands and knees by placing your hands directly below your shoulders and your knees directly below your hips. Raise your left leg straight back pushing your heel toward the wall, while raising your right arm straight out keeping it as close to the ear as possible. Hold this for 5 seconds, lower and repeat on the other side, 8-12 reps on each side.
  • Swimming – Start by lying on your stomach placing hands out in front of you. Raise your left leg and right arm, and lifting chest off the ground, keeping the neck in neutral position, hold for 3 seconds, lower and repeat on the other side, 8-12 reps on each side. REMEMBER do not jerk your body into position only as far as you can controllably raise your chest, arm, and leg.
  • Bridge – Start by lying on your back, knees bent at a 90degree angle, feet flat on the ground. Squeeze the glute muscles, keeping the abs engaged, lift the hips up off the ground. Hold for 5 seconds, lower and repeat for 10-15 reps.
  • Pelvic Tilts – Start by lying on your back, knees bent at a 90 degree angle, feet flat on the ground. Place your hands on your hips and tilt hips forward, (think about taking your hip bones and moving them to touch your leg bones). It is important to remember to not use your back muscles to create an arch in your bag, but instead using your deep core muscles to move your hips. Then tilt your hips backward (think about taking your hip bones and moving them to touch your rib cage.) It is important again to remember to use your deep core muscles to move your hips rather then squeezing your glutes to move your hips.

For a more detailed view of the Sciatic Nerve see the below pictures.

Pathophysiology

Testimonial:
A couple of years ago I injured my back while training for a marathon. Initially I thought rest and ice would take care of it – it didn’t. I tried going to a chiropractor with no relief. Eventually, my doctor sent me to physical therapy where I received ultrasound treatments and was taught various stretching and strengthening exercises. The PT provided some relief, but I was still frustrated at my lack of progress as I had a nearly constant nagging pain, especially when I sat for long periods.

I spent a lot of time self-diagnosing. An article in a running magazine suggested that one common cause of lower back pain in runners was an injury to the piriformus muscle in the lower back and buttocks. It quite literally is described as a “pain in the butt.” I decided this must be it. At the end of 2009, I started working with Katrina Yniguez at SAC. I explained to her my desire to get back to running, and my belief that my piriformus was causing my back pain.

Katrina conducted an assessment of my biomechanics and immediately prescribed some corrective exercises for my leg and back muscles. She also started me foam-rolling (deep tissue massage) my piriformus muscle and other muscle groups. At first I thought she was crazy as the exercises she had me doing were very easy and seemingly unrelated to my back. Katrina explained, however, that strengthening these muscle groups would improve my biomechanics and ultimately reduce the risk for future injury. I persisted.

Eventually, Katrina stopped being crazy and started being just plain mean. Although always pleasant and upbeat, she had obviously decided at some point that the corrective exercises were not needed anymore, and it was time to start the hard stuff. Now, twice a week, she puts me through my paces with core-focused exercises that primarily work my back, legs and chest. I never look forward to the tough workouts, but I always am glad that I did them after they are through. The good news? My back pain is almost completely gone and, when it occasionally returns, I know exactly what to do to get rid of it. I’m now back to regular running, pain-free.

I appreciate Katrina’s ability to listen to what I thought was happening to my body and to design a program that would target the needed areas. It has been great working with her. She is great to work with an always has a positive attitude, and I’ve discovered she’s not really that mean (well, she kind of is).

Matthew D. Latimer

If you would like to begin developing a training program to assist with your specific situation, please contact Katrina Yniguez.

Pilates and Pregnancy

Most women wonder if Pilates is recommended during a pregnancy, and fortunately the answer in most situations is yes! Pilates is a great way to tone abdominal and pelvic floor muscles, which can support an ever-changing pregnant body. Also, Pilates is very adaptable. Most Pilates exercises can be modified as your body and abilities change. The modifications keep the original goal of the exercise, while altering the form to work for your body. Exercise during pregnancy may support an easier labor, a speedy recovery postpartum, a quicker return to your pre-pregnancy weight, not to mention a comfortable pregnancy.

Sounds great, right? Well, there are a few basic guidelines to follow before you jump right in.

First, and most importantly, if you have never done Pilates before and just found out you are pregnant; this is not the time to start. Wait until the birth, and then find a qualified Pilates instructor to lead you through the exercises. Generally this will be about four to six weeks postpartum for a vaginal birth and six to eight weeks for a surgical birth.

Second, as with any exercise routine, check with your doctor. Inquire about your limitations during pregnancy, especially during unique circumstances.

Third, exercise moderately. Most experts recommend not letting your heart rate get above 140 beats per minute. If you do not own a heart rate monitor, use the “talk test”. If you are too winded to talk in a normal fashion, it is time to slow down. Other signs that you need to take a break are dizziness, feeling faint, and nausea. Headache, shortness of breath, a racing heart, uterine contractions, and bleeding or leaking fluid are also signs to stop and see your physician.

Fourth, do not over stretch. Hormones, like relaxin, soften the ligaments in your body to allow your joints to spread for the birth of your baby. Consequently, women do experience more strains in their bodies during this time. You will want to be sure not to overstretch. Working in a smaller range of motion, avoiding bouncing exercises, and strengthening the muscles around your hips and spine will help you avoid the pain of strains.

Fifth, stay off your back. In the second trimester it is time to stop doing exercises while lying flat on your back. Your uterus has grown out of your pelvis and can press down on the major vein in your torso. This reduces the amount of oxygenated blood flow to your baby, and causes most women to be dizzy or light-headed.

All in all, pregnancy could be a very rewarding time to tune inward and connect with the principles of Pilates: centering, concentration, control, precision, breath and flow. Consistently working with these philosophies may enhance your workout experience and offer skills to bring to the birth and care of your baby.

If you are an expecting mother and would like to begin a Pilates program during your pregnancy, please contact Danielle.