antenatal pilates - certification programs...pilates exercises for pregnant women in the 2nd...

BASI Study Paper:

Antenatal Pilates –

Focussing on the 2nd & 3rd Trimesters

Mike Smith

Jan 2012 (BASI CTTC)

Hobart , Tasmania

2 | P a g e P A P E R B a s i F i n a l 1

Abstract

This paper considers a case study of a pregnant client in the 3rd trimester and includes a pilates

conditioning program based on the BASI block system.

It includes an anatomical description and notes changes away from ideal posture. It also includes

details of contraindications and specific issues associated with pregnant clients.

The paper considers: “should a new client start pilates when pregnant if they have never done pilates

before?”

The paper concludes that:

As clients bodies will tend away from ideal alignment maintaining good posture should be a

primary goal.

Exercises should be modified as bodies alter during pregnancy.

Clients and instructors should be aware of conditions specific to pregnancy.

If pregnant clients are starting pilates for the first time routines should safe and very

controlled, and clients should probably get the “all clear” from a doctor first.

The BASI “whole body” approach to pilates should work well for pregnant clients, especially

with strong emphasis on individual needs and changes.


Contents Abstract ............................................................................................................................................... 2

1. Anatomical description of area of body and focus of the paper ................................................ 4

2. Contraindications, recommendations and specific issues associated with pregnant clients

exercising. ........................................................................................................................................... 7

3. Case study ................................................................................................................................. 11

4. Conditioning program ............................................................................................................... 12

2nd Trimester Routine Using BASI Block system: ............................................................................. 13

3rd Trimester Routine Using BASI Block system: .............................................................................. 14

5. Discussion .................................................................................................................................. 16

6. Conclusion ................................................................................................................................. 18

7. Bibliography/References ........................................................................................................... 19

Table of Figures Figure 1 - Diagram showing typical pregnant posture (Anthony 2005) .................................................. 4

Figure 2 – Pregnant client: deviation from good and bad alignment (Sullivan 2009) ............................ 5

Figure 3 - Good posture for a pregnant client (Robinson 2006) ............................................................ 6

Figure 4 - Diagram of Diastasis Recti (Powell 2013) .............................................................................. 7

Appendices Appendix A – Studio photos showing some of the different modifications which can be used to ensure the pregnant client is exercising in a safe position.

Appendix B – Alexander Technique Photos showing some transitional movements.


1. Anatomical description of area of body and focus of the paper The topic of pilates for pregnancy is a very large topic area with many possible combinations of

factors, such as; Trimesters: 1, 2, and 3 (this also then leads onto post partum), and different fitness

levels of the clients ,for example:

1. Very unfit, overweight or a rehabilitation client.

2. Relatively fit, some pilates practice.

3. Fit and regular pilates practice.

4. Very fit/athlete with high level pilates practice.

To limit the scope of the paper to a manageable focus, I have chosen the main topic of the paper to

be Trimester 2 leading to Trimester 3, and a client noted in the list above as “type 2” i.e. Relatively

fit, with some pilates practice.

The BASI approach to pilates is a whole of body approach however, after researching the subject

area, the main topic and area of focus for this paper is posture. Secondary topics are stabilization

(specific strengthening and toning exercises) and lastly (but not least) breathing as a focus for

preparation for labour in the 3rd trimester.

Below in Fig 1 and 2 are two diagrams of a “typical pregnant posture”, noting the deviations away

from the ideal posture.

Figure 1 - Diagram showing typical pregnant posture (Anthony 2005)


Figure 2 – Pregnant client: deviation from good and bad alignment (Sullivan 2009)


Ideal posture and typical Pregnant Posture

In the pregnant client we are expecting changes to occur which will tend to “force” the clients

posture towards the “typical pregnant posture”, because of this we need to emphasise those

exercises that will help maintain, and strengthen the parts of the body to avoid this change towards

a “bad” posture, or at least ensure that this postural deviation is minimised. The diagram below

shows landmarks of the body and highlights good postural alignment for a pregnant client.

Figure 3 - Good posture for a pregnant client (Robinson 2006)


2. Contraindications, recommendations and specific issues associated with

pregnant clients exercising.

Diastasis Recti (sometimes also known as Divarication [UK])

Due to muscle tonal changes in pregnancy and to allow the uterus to grow the superficial abdominal

muscle, the rectus abdominis, will need to expand. This can lead to the separation of these muscles

(called diastasis). Diastasis recti is the separation of the linea alba, the connective tissue joining both

sides of the rectus abdominis together. Prior to starting any conditioning program for pregnant

women it is essential to check for this condition. If left unchecked the problem will increase the

likelihood of spinal problems (Anthony 2008). Pilates exercises for pregnant women in the 2nd

trimester1 should exercise abdominal muscles avoiding abdominal flexion of the torso. Abdominal

flexion of the torso puts the most strain on the rectus abdominus. I.e. avoid chest lift, roll up,

hundreds and similar exercises (Anthony 2008). Checking for this condition is usually done by

manual palpation and any disastasis measured by finger widths, e.g. one or two fingers of

separation.

Figure 4 - Diagram of Diastasis Recti (Powell 2013)

Advice for new clients starting pilates for the first time, a selection of quotes from

different sources

“It is not advised that you begin a pilates program or any form of exercise for the first time

after becoming pregnant” Pilates Anytime website (Stewart 2012).

1 And also in the first trimester to allow the rectus muscles to lose tone and be able to expand.


This same view (not to start pilates if not done it before) was taken during an entirely

separate discussion with Joleen Watson (BASI faculty, Qld , Australia) 29 Jan 2012.

If you are new to pilates we advise you to wait until you are at least 16 weeks pregnant

before you start the program (Robinson 2006).

If woman are at a higher risk of miscarriage2 it may be safer to begin classes after the 14th

week of pregnancy (weeks 8-14 are when miscarriage is most likely to occur - Teaching

Prenatal Dru Yoga: Teacher Training Notes 2012).

Unless already practicing yoga, do not begin during the first 3 months of pregnancy (Dru

Yoga: Teacher Training Notes 2012).

“A review of the evidence suggests that, in most cases, exercise is safe for both mother and

foetus during pregnancy and women should therefore be encouraged to initiate or continue

exercise to derive the heath benefits associated with such activities.” (RCOG 2006.)

All movement is good. It should be considered that for a client wishing to start pilates for the first

time when pregnant, this may be the only form exercise that she does, or will, do during her

pregnancy.

Contraindications

Exercise in the supine position should be avoided after 16 weeks of gestation.

Avoid magic circle between legs (use a ball of cushion instead).

Don’t over stretch or bounce during pregnancy.

Avoid exercises that might force air into the vagina (such as exercises where you bring your

knee to your chest while on all fours).

Avoid exercises that cause the small of your back to curve inward (when loaded).

Avoid exercises that require “bridging” (bending over backwards).

Avoid exercises that involve deep flexion or extension of the joints (such as deep knee

bends), jumping, sudden changes of direction or jerky motions.

No loaded abdominal work (e.g. no chest lifts, hundreds etc.).

Extension of the torso is also not recommended if there is separation/diastisis.

Single legged work is contra indicated if any pain in pubic symphasis or hips.

No strong twisting.

No double leg float.

Nothing loaded on belly (not over ball, no rocking prep, swan dive etc.).

Because of instability around the pelvis, continue to avoid exercises with a wide range of

movements and/or long levers.

Do not use leg weights.

Specific recommendations and modifications:

Learn to release and control pelvic floor (PF) , have awareness.

Use active controlled stretching, not held, not pushing, with control.

Prone work is OK if still comfortable. Do not put load on belly, i.e. use props: c-cushion,

towel/mat supporting belly over an arc, triangular cushion, or in quadruped position.

Use ball or cushion for adductor gentle controlled squeezing - to replace MC between knees.

Can use arc on Reformer (fat end to lie against) to prop up clients for foot work.

2 You should also refer to medical practitioner if this is the case in order to confirm it is OK to start or continue

pilates.


In supine position do a 1/2pelvic curl (just the pelvis to full ROM and back) not lifting off.

Footwork on wunda chair (good for posture).

Squatting on ped-a-pole or against wall using fit ball.

Include exercises for scapulae stability.

Include exercises that work the calf pump to improve circulation.

Include calf stretches to help prevent leg cramps.

Keep you limbs close to your bodyline and bend your knees when necessary.

Consider using a wedge or a rolled-up towel under sitting bones during sitting exercises.

Try to include some back extensions at each workout.

Encourage flexibility in hips, knees, ankles and shoulders.

Strengthen postural muscles (especially legs abdomen and lower back).

For relaxation adapt a side lying position on their left side, a cushion supporting the head,

and in later pregnancy a cushion supporting their belly.

Legs raised and supported (e.g. on fit ball) can be good for circulation.

For reformer footwork and hip work you can use a jump board resting on the shoulder rests

to elevate the head and torso of clients (to help avoid the supine position).

Pregnant cat good exercise to allow abdomen to release and stretch in a safe position and

take weight off the pelvic floor.

When Pregnant Women should avoid exercise:

Any vaginal bleeding.

Unexplained back pain.

Extreme nausea or headache.

Pubic pain (in class avoid exercise which causes the pain).

Sharp pain in abdomen or chest.

Uterine contractions.

Blurred vision.

Fainting.

Decrease in foetal movement.

Difficulty in walking.

Gush of fluid from vagina.

Placenta previa3.

Multiples (twins, triplets etc.).

History of 3 or more miscarriages.

Incompetent cervix4.

Intrauterine growth retardation.

Pregnancy induced hypertension.

Dizziness,, or Palpitations, very hot and clammy (fever).

Severe breathlessness or shortness of breath (Dyspnoea) before exercise.

Excessive swelling in hands, feet, calf, ankles and face.

Excessive fatigue.

Muscle weakness.

3 Where the placenta is attached to the lower half of the uterus, covering or partially covering the opening of

the cervix – because exercise may exacerbate bleeding. 4 Where the neck of the womb opens prematurely due to the pressure on it of the uterus and the baby.


Calf pain.

Some problems to watch for during pregnancy:

Varicose veins – legs and vulva area (use ball for mat work).

Carpal tunnel syndrome.

Sciatica.

Swelling in hands and feet.

Round ligament pain5.

Leg cramps.

The above information in section (2) has been précised and collated from a number of different

sources including: Anthony 2008, RCOG 2006, Isacowitz 2008, Cook 2009, Eisenberg et al 2000,

Teaching Prenatal Dru Yoga 2012, Donahue et al 2013, Robinson 2006, Stewart 2012, and Watson

2012.

5 The round ligament connects the front part of the womb to the groin. Symptoms, typically in the second

trimester due to the growing uterus, include a sharp spasm in the belly. The pain only lasts a few seconds.


3. Case study

Client choice.

The client is my partner who went through pregnancy approximately 1 year ago. This made the

client choice very easy for me as I had a vested interest in establishing a good, healthy and safe

pilates practice for pregnant women in the 2nd and 3rd trimesters. This paper has been progressively

updated throughout the second and third trimesters as my client progressed through pregnancy, I

also taught pregnancy classes to the client (and 2 other pregnant friends) over several months

during the 2nd and 3rd trimesters.

Client particulars

Female, age 33, fairly fit, some pilates experience and some yoga experience, regular walking and

moderate exercise, very healthy diet, non-excessive caffeine intake, non-smoker and low alcohol

intake prior to pregnancy (negligible alcohol and caffeine intake during pregnancy). Weight gain in

the pregnancy was normal and well within recommended guidelines.

Pilates/yoga history

Some pilates practice over the last 2-3years. Some group sessions and some individual sessions with

BASI instructors. Started regular weekly pregnancy equipment pilates practice (group sessions of 3-

people) at end of 1st trimester. Yoga practice over a number of years (under instruction), started

regular twice weekly pregnancy yoga practice (group sessions) at end of 1st trimester. More regular

yoga practice than pilates practice over past 2 years until pregnant.

Physio/pilates physio assessment (and areas to focus on)

Slightly Kyphotic, focus on thoracic extension and work towards ideal neck position, Tendency

towards flat back – needs to focus and trigger multifidous (especially in sitting). Some history of hip

misalignment prior to pregnancy (treated well with osteopathy and physiotherapy) long periods of

problem free movement, especially when practicing pilates and yoga under instruction.

Pilates Client Goals

Short-term

Posture (improve and maintain through pregnancy)

Pelvic floor (improve and maintain through pregnancy)

Keep current high fitness level as much as possible Medium term

Improve specific fitness for pregnancy

Preparation for birth

Improve hip alignment Long term

Improve chances of a swift recovery from birth (whether vaginal or caesarean)

Strength for the pregnancy (and post partum, e.g. holding baby, lifting baby etc.).

Prevention of future hip misalignment episodes.


4. Conditioning program Utilizing the block system two exercise routines are included below, one for the 2nd Trimester, the

other for the 3rd Trimester. The reasons for selecting the particular routines are based on taking into

account the contraindications, modifications and recommendations noted above. Some of the

exercises have specific notes next to them or refer to photos later in the text to explain the

modification.

First Trimester – As noted earlier the main focus of this paper is the 2nd and 3rd trimesters.

Exercises in the first trimester should be based around establishing a routine, usually based around

exercises which the client is used to doing. Focus on: Neutral spine, extension of thoracic spine,

flexion on lumbar spine, transverse abdominus and oblique strengthening and stabilization (to

counteract loss of tone in the rectus), and pelvic floor toning. Breathing, practice learning different

breathing techniques.

Second Trimester – Exercises in the 2nd trimester should be based around modifying a routine,

Neutral spine, lateral flexion, extension of thoracic spine, flexion on lumbar spine, transverse

abdominus strengthening and stabilization (to counteract loss of tone in the rectus). Gentle and

oblique exercises (as they will be getting more stretched now) pelvic floor toning and breathing to

stretch intercostals muscles.

Third Trimester – Exercises in the 3rd trimester should be based around decreasing a routine.

Essential exercises include: Pelvic tilts, hip circles, stretching, pelvic floor work, squatting, breathing,

stability of the spine and pelvis. This is a good time to start the process of “bulging” (Anthony 2008)

of the pelvic floor (approx 3 weeks before due date).

Notes on Appendices

Appendix A includes a number of photos of modified exercises as identified in the pilates routines

described below. Some of these are to adjust the client so as to not be in a full supine position or

turn an exercise into a closed chain exercise.

Appendix B includes some pictures of transition movements during pregnancy using the Alexander

Technique movement principles (Machover et al 1993), it is suggested that these are very good for

the 3rd Trimester and post natal.


2nd Trimester Routine Using BASI Block system:

Block Exercise (& equipment) Notes

Warm up

Roll down (Mat) Press up against the wall# (Fit ball) Pelvic tilts (Fit ball) Small hip circles (Fit ball) single leg lifts# (Fit ball) Breathing (Mat)

This is a great closed chain (and safe position) warm up exercise which can be made easier or harder by altering the height of the Fit ball. Hands on HIPS (front/back) sides These warm up exercises are done sitting on the fit ball as they are great warm up exercises and the supine position can be avoided. Awareness of the breath and body. A great way to give feedback is to tie a thera-band around the chest/ribs and feel the expansion and contraction of each breath.

FBI 1 Assisted Squats# (easy ones - Cadillac) or Flat Back (knee stretch series - reformer)

This exercise is performed using the RUB (springs set high up) to make the exercise easier and also makes the exercise closed chain for safety and added support. Good, safe core work without over working the rectus abdominus.

Foot Work foot work + Single leg (Reformer) # Calf raises (Wunda Chair)

Sitting Footwork on box#, feet on bed, keeping clients in a non-supine position

Abdominal Work

short box series (Reformer) Flat Back Tilt Twist

Closed chain, standard exercise, with care.

Hip Work Clams (Cadillac) Circles (Cadillac) Leg lower then lift (Cadillac) Side kicks (Cadillac)

All side lying short lever # Straps up at thigh level. Long yellow.

Additional legs

Leg press standing (Wunda chair) or Side lying hip work Reformer

Use pole for extra balance. Strap # or footbar # Client can be propped up if required for comfort.

Stretches Pole stretches or Standing lunge (Reformer)

Sitting on box or fit ball. 1-spring, gentle. Due to postural changes hip flexors can get tight, nice stretch do not hold too long, move into stretch then out of stretch within one breath, do not force stretch.

FBI 1 Scooter (Reformer) Good, safe, closed chain.

Lat flex/rot Mermaid (Reformer) Good, safe, closed chain, controlled stretch.

FBI 2 Thigh Stretch with RUB (Cadillac) Good for stretching and strengthening thighs, abdominal control, closed chain, safe position.

Arm work Shoulder Adduction Sitting (Cadillac) Circles Forward (Wunda chair) Shrugs (Wunda chair) Side kneeling arm (Wunda chair)

Good, safe, closed chain, great for shoulder stability and alignment. All good, safe, closed chain non-supine upper body work.


Triceps (Wunda chair)

Back Extension

Cat Stretch (Mat) or Standing Cat stretch (Cadillac) Then REST position (Mat)

Great back extension exercise, do not emphasise lordosis. Modified with PTB # Cushions or blankets may assist comfort.

Spinal Articulation

Pelvic Curl (Wunda chair)

With care, do not need to go too high, e.g. half way/pelvis full ROM, only if client OK with supine position.

Finish Roll down leaning against wall (Mat) # Having your back against the wall (in addition to providing good feedback) makes the exercise closed chain for safety and added support if required.

# See Appendix B for photos of modified exercise.

3rd Trimester Routine Using BASI Block system:

Block Exercise Equip/Notes

Warm up

sitting sitting sitting

Roll down (Mat) Press up – Fit ball against the wall (Mat) Pelvic tilts Hands on HIPS (Mat) Small hip circles (Mat) single leg lifts (Mat) Breathing awareness (Mat)

leaning against wall for support/balance#

Fit Ball# Sitting on Fit Ball Sitting on Fit Ball Sitting on Fit Ball Awareness of the breath and body, e.g. with thera-band tied around chest/ribs.

FBI 1 Side Reach (Cadillac) or Flat back Knee stretch series6 (Reformer)

Without anterior tilt. Closed chain, controlled, small ROM.

Foot Work foot work + Single leg (Wunda Chair) + calf raises (Wunda Chair)

Very light weight for single leg, to reduce unilateral pressure on pelvis and Pubic Symphasis.

Abdominal Work

Thigh stretch with RUB (Cadillac)

Good for stretching and strengthening thighs, abdominal control, closed chain, safe position.

Hip Work (strap work) & Additional legs

Hip Opener straddling (Wunda Chair) Single Leg Side Series

Changes Scissors Circles (forward and back)

Light springs# This will also count for hip work, as clients cannot lie supine.

Stretches Pole stretches sitting on ball (Mat) Standing lunge (Reformer)

Fit Ball or Box, promote focus on breathing through these exercises. Ref (1-spring) Due to postural changes hip flexors can get tight, nice stretch do not hold too long

Lat flex/rot Side Stretch (Wunda Chair) With bottom foot pushing against wall/floor junction to make it closed chain. Good, safe, closed chain, controlled stretch.

6 Due to the fact that there is no rectus abdominus work in this routine, FBI exercises which work the core

have been used instead.


FBI 2 Scooter (Reformer) Note this can also be done standing inside the reformer, with active foot against the edge of the bed. Once in position this is more stable and less twisted than normal set up.

Arm work Arm series: (PED A POLE) Extension Adduction Up/Down Circles Triceps

Good, safe, all movement below shoulder level. Good for scapular stability.

Back Extension Cat Stretch (Cadillac) then REST position (Mat)

Standing with PTB#

Spinal Articulation

Cat Stretch (Mat) Emphasize pregnant cat relaxation, and discourage arching of the lower back, aim to keep in neutral.

finish Roll down (Mat) Leaning against wall for support/feedback.

# See Appendix B for photo of modified exercise.


5. Discussion It is probably not ideal to start new comprehensive pilates repertoire (or any new exercise) during

pregnancy if not experienced it before, however, the client could do a limited and safe routine (e.g.

‘a basic and simple routine focussing on breathing, stabilization and gentle stretching’ [Anthony

2008]). However it is worth noting that due to the many changes going throughout the pregnant

body it would be difficult to know what is normal/not normal for new exercises.

It is interesting to note that during pregnancy the fitness, mobility and endurance of clients will

reduce! This is different and opposite to the teaching of most other clients who, on the whole,

improve with a regular routine. This phenomenon needs to be considered and included within the

planned routines, the routines will need to be catered for each individual and progressively reduced

in difficulty, and the number of safe exercises as the pregnancy progresses.

In addition we should be looking for certain (potential) conditions, such as diastisis recti and

separation of the pubic symphasis, on a regular basis.

It is also worth noting that from week to week, day to day and even hour to hour, the way a

women’s body can change is significant during pregnancy, much more so than expected fluctuations

in other clients. It is important for clients and instructors to be aware of this and make allowances.

A final observation of note was passed onto me be my osteopath who noted that structural changes

in the body can occur during pregnancy due to relaxin and the movement of bones, because of this

certain structural abnormalities or imbalances have the potential to be corrected during pregnancy

and soon after birth before the body changes back to “normal”. For example for the client in my case

study there is a chance that with good posture and some osteopathy/pilates treatment her hip

asymmetrical issues may be permanently resolved after pregnancy. It should be noted that the

bodies will be different than before pregnancy, so a new assessment and notes, and an approach to

pilates should be considered necessary for post partum sessions, almost treating them as a new

client.

Due to the possible problems that can occur during pregnancy it is prudent to seek assurance from

the client that they have seen their GP/Dr and have been given the all clear to start/continue a

pilates exercise routine during their pregnancy. This ensures that the client has been checked for

medical conditions, and would also cover you in the event that some problem did occur later during

the pregnancy which may be unrelated to pilates. Also it may highlight any areas you need to be

more aware of about your client, and help to ensure that the client has been told of certain physical

conditions that they should be aware of during any exercise routine especially with their changing

bodies.

Clients will lose their rectus abdominus tone! Do not focus on trying to keep or improve rectus

abdominus, in fact intentionally let it go. Focus on PF and other core muscles as they will need to do

more work than normal due to loss of muscles and the extra weight due to the baby, and the fact

that relaxin means that the hip/pelvic girdle complex can no longer be relied on to take all the

weight (it may separate) so other buttock muscles and hip muscles need to be able to help “carry

the load”. Fitter clients may be at more risk of diastisis due to tight abdominals, and may also have

more difficulty in learning to allow these to relax.


As noted in the paper there are conditions which clients (and pilates instructors) need to be aware

of. Also the fact that these can change literally on a day to day basis, e.g. diastisis recti, issues with

pubic symphasis, blood pressure, and energy levels. Both clients and instructors should “check in” on

a regular basis for such conditions to allow exercise to continue in a safe and pain free zone at all

times.

At the Natural Balance Studio in Hobart, Tasmania, a detailed review of guidelines for instructing

pregnant clients was conducted during the course of the research for this paper. Pregnant clients are

only taught in specific pregnant classes. These guidelines (based on the research carried out for this

paper and professional development sessions at the centre including input for BASI instructors who

are also qualified physiotherapists and osteopaths) were amended so as to be safe for all trimesters

(i.e. if a client is pregnant it doesn’t matter if in the 1st, 2nd or 3rd trimester). This approach does

mean that for fit clients in the earlier trimesters that the class may be a bit slower and easier that

could be conducted. However, interestingly, the feedback from these clients has been very positive,

in that they say it is enjoyable to slow down and focus on their pregnant bodies, rather than always

pushing to do the hardest exercise.


6. Conclusion 6.1. During pregnancy changes will occur to the client’s body which will tend to affect their

posture detrimentally, and tend to move it away from good alignment. A primary aim of

pilates exercises should be maintaining good posture.

6.2. Additional client goals include: pelvic floor conditioning, fitness for pregnancy (and

recovery from birth), and to improve hip alignment

6.3. During pregnancy there may be an opportunity to permanently alter alignment issues in a

positive way, due to relaxin flowing through the body.

6.4. Pilates routines can and should be modified, including assists, for pregnant clients as

suggested in the two routines included in this paper.

6.5. Should a new client start pilates when pregnant? the conclusion is that movement is good,

so yes, but to ensure that routines are safe and controlled. Also it is prudent to get the all

clear for exercise from their doctor.

6.6. Pregnant clients should recognise that they will (and need to) lose tone and definition of

their rectus abdominus.

6.7. There are a number of specific conditions that pregnant clients may encounter, clients and

pilates instructors should make themselves aware of them.

6.8. As the pregnancy progresses clients will become less able and need more control in their

movements (unlike most clients who you expect to improve in their performance week to

week).

6.9. The BASI “whole body” approach to pilates should work very well for pregnant clients in

maintaining pregnant bodies, preparing for birth and assisting in post birth recovery.

Especially when used with a strong emphasis on clients individual and changes to their

bodies, week to week.


7. Bibliography/References Anthony, C (2005), “Pre/Post Natal Specialist Pilates Certification”, Notes from pilates certification

course, The Centre For Women’s Fitness, LCC, MI, USA.

Anthony, C (2008), The Pilates Way To Birth, Exercises for Mat, Cadillac, and Reformer, The Centre

For Women’s Fitness, LCC, MI, USA.

Cook, K, (2009), “Exercising in pregnancy”, Up The Duff, Viking, Australia.

Donahue, C et al. (2013), Natural Balance Professional Development workshops (5/2/13, 29/2/13),

Hobart, Tasmania

Eisenberg A, Murkoff H, Hathaway S, (2000), “The Fifth Month”, What To Expect When You’re

Expecting, Angus & Robertson, NSW, Australia

Isacowitz, R (2008), “Specific Populations, Module 12”, BASI Comprehensive Course Study Guide

[Pilates Teacher Training notes], Body Arts and Science International, CA, USA.

Machover, I, Drake, a, Drake, J (1993), “A guide to better pregnancy, natural birth and parenthood”,

The Alexander Technique Birth Book, Frankfurt Germany

Noble, E (1988), “Essential exercises for the childbearing year”, Houghton Miffin, Boston, USA.

(NOTE- this book was referenced and recommended in the book “Spiritual Midwifery” by Inna May)

Pilates Anytime website ref: www. : Leah Stewart Prenatal & Postnatal weblink (8 Feb 2012)

RCOG (2006), “Exercise in pregnancy”, Summary of recommendations from a detailed literary review

of peer reviewed reliable database, Royal College of Obstetricians and Gynaecologists, Statement No

4, Jan 2006 , UK, http://www.rcog.org.uk/womens-health/clinical-guidance/exercise-

pregnancy

Robinson, L, (2006), “Optimum Health and Fitness for Every stage of Pregnancy”, Pilates Pregnancy

Guide, Firefly Books, NY, USA.

Stewart, L, (2012), “Pilates Anytime Reformer prenatal video”, BASI Faculty (pre and post natal

instruction) Feb 2012 on-line resource, www.pilatesanytime.com

Sullivan, K (2009) “Introduction”, Pregnancy and Birth, DK Publishing, Australia.

Teaching Prenatal Dru Yoga (an introduction, Book 12 Prenatal yoga), Teacher Training Notes 2012,

USA.

Watson, J (2012), “Discussions/Q&A session” during final module of BASI Pilates Comprehensive

Teacher Training, Hobart, Australia 29 Jan 2012.

Wood, S, (2012), “Repertoire photos and examples“, Pilates for Pathologies and Injuries [Notes],

BASI advanced education course 8-10 June 2012, Hobart, Tasmania, Australia.

Powell, W (2013), Google web search,5/11/13, http://www.google.com.au/imgres?imgurl=http://mutusystem.com/wp-

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avoid.html&h=538&w=800&sz=170&tbnid=23iqhfpX2utQQM:&tbnh=105&tbnw=156&zoom=1&usg=__jMfOuNtAQ1_9ti0Mz128aF_aKn0=

&docid=lHDnnVOHrJKN-M&sa=X&ei=xrF4Us6DHoTHkQXizYGoAg&sqi=2&ved=0CEQQ9QEwAg

http://www.rcog.org.uk/womens-health/clinical-guidance/exercise-pregnancy

http://www.rcog.org.uk/womens-health/clinical-guidance/exercise-pregnancy

http://www.pilatesanytime.com/

http://www.google.com.au/imgres?imgurl=http://mutusystem.com/wp-content/uploads/2012/06/Diastasis-Recti-V3.jpg&imgrefurl=http://mutusystem.com/diastasis-recti-test-what-works-and-what-to%20avoid.html&h=538&w=800&sz=170&tbnid=23iqhfpX2utQQM:&tbnh=105&tbnw=156&zoom=1&usg=__jMfOuNtAQ1_9ti0Mz128aF_aKn0=&docid=lHDnnVOHrJKN-M&sa=X&ei=xrF4Us6DHoTHkQXizYGoAg&sqi=2&ved=0CEQQ9QEwAg





Appendix A

“Book openings” Elevated hip work - cadillac

Push ups with fit ball

Sitting foot work

reformer

Side lying hip work

(strap) reformer

Side lying hip work

(footbar)

Single leg lift from

quradruped WC single leg raises fit ball

Squats against the wall Fit ball


The monkey (with theraband)

Hip opener

straddling WC

Assisted Squats

cadillac

Side lying short

lever cadillac

Standing cat stretch with PTB + leg raise


Appendix B

antenatal pilates - certification programs...pilates exercises for pregnant women in the 2nd...

Documents