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Pilates For The Mother Runner

Emma Wagenvelt

July 2018

Comprehensive Teacher Training Certification

The Woodlands, TX.

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Abstract

Running as a form of exercise has numerous health benefits, including

cardiovascular endurance, increased bone density, weight management and

mental wellbeing.

New mothers are often eager to resume their running routine quickly to

regain a sense of “self” and manage the stress of early motherhood. However,

pregnancy and delivery place a heavy demand on the body, and returning

running too quickly can leave postpartum women susceptible to injury and

fatigue. This paper will examine the ways in which a Pilates program can help a

new mother restore optimal physical condition, so that she may find joy in

running once more.

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Table of Contents

Title Page…………………………………………………………......1

Abstract………………………………………………………………..2

Table of Contents…………………………………………………….3

Anatomical Description…………………………………………..….4-7

Case Study…………………………………………………………....8-9

Program & Discussion…………………………………………….....10-15

Conclusion…………………………………………………………….16

Bibliography…………………………………………………………...17

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Anatomical Description

Figure 1

Image from drlib.info

As a pregnancy progresses, a woman's body will undergo significant

postural change. The weight of the growing baby will cause her center of gravity

to shift and pull the pelvis out of neutral alignment (figure 1a), which will have

compensatory effects on spinal alignment. Loss of strength in the abdominal

muscles can pull the pelvis into an anterior tilt (figure 1b), resulting in increased

lumbar lordosis. Alternatively, the pelvis may be pulled into a posterior tilt (figure

1c), resulting in a flat lumbar spine and a fatigued or “sway back” posture. The

first year of motherhood places further demand on the thoracic spine, as most

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new mothers spend hours in a rounded or “hunched” position nursing, rocking,

and cradling their new infant. As a result, many new mothers present with

thoracic kyphosis- rounded thoracic spine and shoulders, weak pectoral muscles,

and cervical lordosis (DiFiore 2010). In a high-impact sport such as running, the

spine acts as a shock absorber, so correct alignment is key for injury prevention.

Therefore, identifying and working in a neutral pelvis and spine will not only be

beneficial to posture, it will encourage correct muscle recruitment, and improve

efficiency in breathing.

The hormone relaxin specifically targets the ligaments of the pelvis to prepare a

mother's body for birth, but all joints in the body are affected to some degree.

Increased joint laxity during pregnancy (and beyond, if breastfeeding), can

compromise joint stability and support, making joints susceptible to injury. The

stress on the joints is exacerbated by pregnancy weight gain, and the weight of

the growing baby (DiFiore 2010). As running places strain on the ankles, knees,

pelvis and spine, lumbar-pelvic stability should be restored before a running

program is resumed.

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Figure 2

Image from mutusystem.com

The four muscles of the abdomen (transverse abdominals, rectus abdominals,

internal oblique, external oblique) work together in conjunction to form a

“muscular corset” that provides support for the abdominal and pelvic organs, and

stabilizes and supports the pelvis and lumbar spine. During pregnancy the

abdominal muscles stretch to accommodate the growing baby. Relaxin increases

the elasticity of connective tissue which allows the linea alba to stretch, and the

rectus abdominals to separate. Muscle length will reduce naturally following birth,

but this process can be enhanced with Pilates exercises (DiFiore 2010). Strength

in the abdominals is important for a runners posture, balance, endurance, and

stability.

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Figure 3

Image from www.goread.com

The pelvic floor muscles at the base of the pelvis work in conjunction with the

transverse abdominals, obliques, and multifidus to maintain intra-abdominal

pressure, and stabilize the pelvis and lumbar spine. During pregnancy the

increasing weight of the baby, coupled with lax ligaments can cause the pelvic

floor to weaken. As running increases intra-abdominal pressure, a weak pelvic

floor could lead to a number of issues including lower back pain, incontinence, or

even pelvic organ prolapse.

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Case Study My case study client is a 32-year-old mother of two. She practiced Pilates,

running, walking, and yoga consistently throughout pregnancy. We started our

sessions when she was 5 months postpartum, and she had been practicing mat

Pilates for two months prior to that. She is in good physical health, but still

presents with some common postpartum conditions that she would like to

address before resuming her regular running program.

• Anterior Pelvic Tilt- identifying and working from a neutral pelvis will be

crucial to remedy other postural imbalances

• Lumbar Hyperlordosis- tight lower back extensors causing some lower

back pain, tight hip flexors and hamstrings. Working in a neutral spine and

pelvis, plus improving lumbar pelvic stability and abdominal strength, and

stretching the hip flexors, hamstrings, and lower back extensors will help

to correct

• Thoracic Kyphosis- tight pectorals and weaker upper back extensors.

Focus on strengthening the thoracic extensors, and the pectoral muscles.

Teach good body awareness whilst nursing and caring for infant.

• Weakened Abdominals- a lack of abdominal strength causing a lack of

support in the internal organs and spine, and contributing to lower back

pain. Focus on activating the TA, and strengthening the rectus abdominals

and obliques

• Joint Instability- She is still breastfeeding, so joint instability caused by the

hormone relaxin is a concern. Special care that exercises are performed

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within the appropriate range of motion for the joint, with correct alignment,

and close attention to technical detail to prevent injury

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Program & Discussion

Block Sessions 1-10 Sessions 10-20

Sessions 20+ Notes

Warm Up (Fundamental Mat) Roll Down Pelvic Curl Supine Spine Twist Chest Lift Chest Lift with Rotation

(Fundamental Mat) Roll Down Pelvic Curl Supine Spine Twist Chest Lift Chest Lift with Rotation

(Fundamental Mat) Roll Down Pelvic Curl Supine Spine Twist Chest Lift Chest Lift with Rotation

Footwork Cadillac Cadillac Cadillac Performing footwork on the Cadillac provides a beneficial stretch through the hamstrings as well as building strength through the legs. The limited range of knee flexion means we are training in the “power range”, a more functional range of motion, and reducing stress on the knee. Another benefit of footwork on the Cadillac is pelvic-lumbar stabilization.

Abdominals Cadillac Bottom Lift with Roll Up

Reformer Hundred Prep Hundred

Reformer Hundred Prep Hundred

Bottom Lift with the Roll Up Bar was initially

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Bar Coordination Coordination selected to regain pelvic-lumbar stability. After ten sessions the client was ready to progress onto The Hundred Prep, The Hundred, and Coordination on the Reformer

Hip work Cadillac Basic Leg Springs Frog Circles (Down/Up) Walking Bicycles Single Leg Supine Frog Circles (Down/up) Hip Extension Bicycle

The benefits of performing hip work on the Cadillac include hip adductor strength and control, hip extensor strength and control, and pelvic-lumbar stabilization. The Single Leg supine exercises provide the opportunity to address imbalances between the two sides of the body.

Spinal Articulation

Reformer Bottom Lift Bottom Lift with Extensions (after 5 sessions)

Cadillac Tower Prep Tower

Cadillac Tower Prep Tower

In the first 10 sessions, the client was still building abdominal strength and regaining confidence with the Pilates repertoire.

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Bottom Lift on the reformer was selected to facilitate hamstring control, pelvic stabilization, and abdominal strength. After 5 sessions, extensions were added to increase the challenge. From session 10, the client was ready to progress to a more advanced exercise. Tower prep and tower were selected, which had the added benefit of a hamstring stretch.

Stretch Reformer Standing Lunge

Reformer Kneeling Lunge

Reformer Kneeling Lunge

Performing the standing lunge provided an excellent stretch for the hip flexors and hamstrings. Progressing to the Kneeling Lunge after 10 sessions increased the intensity of the stretch.

Full Body Integration

Reformer Reverse Knee Stretch

Reformer Reverse Knee Stretch

Reformer Up stretch 1 Up stretch 2

Reverse Knee Stretch was selected to develop abdominals and

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hip flexors strength, and trunk stabilization. After 20 sessions Up Stretch 1, 2, and 3 were selected to stretch hamstrings and shoulders while still developing strength and stabilization through the core.

Arm Work Reformer Arms Sitting Series

Reformer Arms Sitting Series

Reformer Arms Kneeling Series

The Arms Sitting Series was selected to challenge trunk stability. After 20 sessions, the client had sufficient trunk stability to progress to Arms Kneeling series on the Reformer.

Leg Work Wunda Chair Hamstring Curl Hip Opener

Wunda Chair Hamstring Curl Hip Opener

Wunda Chair Forward Lunge Backwards Step Down

The hamstring curl was selected so that the leg strength could be developed in a very safe and stable position. Hip Opener on the chair was selected to improve pelvic-lumbar stabilization, hamstring

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control, and so that the client could benefit from stretching and opening up her tight hips. After 20 sessions the client was ready to progress onto the advanced exercises Forward Lunge and Backwards Step Down to increase leg strength, power, control, and also add a balance challenge.

Full Body A/M

N/A N/A Reformer Balance Control Front

For the first twenty sessions we didn’t include an exercise in this block. After session 20 Balance control front was selected to further develop core strength.

Lateral Flexion

Wunda Chair Side Stretch

Wunda Chair Side Stretch

Reformer Side Over On Box

Side Stretch on the Wunda chair was selected to regain oblique strength in a safe and stable position. After session 20 the client had sufficient oblique stretch to do the Side Over on the

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Reformer

Back Extension

Wunda Chair Swan Basic

Wunda Chair Swan Basic

Reformer Pulling Straps 1 Pulling Straps 2

Swan Basic on the Wunda Chair was selected to practice back extension from a safe and supported position. After 20 sessions Pulling Straps 1 & 2 were selected to strengthen the back and shoulder extensors

Additional Stretches

Pole Series

Pole Series

Pole Series

The Pole Series was added at the end of sessions or for “Homework” to stretch the shoulders and chest, and ultimately improve posture

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Conclusion

My client began running 3-4 miles, 2-3 times per week after about ten Pilates

sessions. By twenty sessions, she was up to 4-5 miles, 3-4 times a week. She

reports a noticeable difference in her endurance, and a sense of “lightness and

freedom” during her runs, as well as quicker recovery time between runs. I feel

that her stronger core and improved posture have improved the quality of her

running form and her efficiency as a runner. She also reports increased body

awareness in her everyday activities when caring for her infant daughter, and she

is no longer suffering from lower back pain. In our sessions, her strength has

developed quickly, and her flexibility continues to improve. She plans to continue

with Pilates as a form of cross training as she trains for her next marathon.

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Bibliography

Books

Angell, H. (2017) Pilates for Runners, Bloomsbury, UK.

DiFiore, J. (2010) The Complete Guide to Postnatal Fitness, A & C Black,

London.

Isacowitz, R. (2013) BASI Comprehensive Course Study Guide, Body Arts and

Science International, CA, USA.

Isacowitz, R. (2006) Pilates. Your Guide to Mat and Apparatus Exercises, Human

Kinetics. USA.

Isacowitz, R. Clippinger, K. (2011) Pilates Anatomy, Human Kinetics, USA.

Puleo, J. Milroy, P. (2010) Running Anatomy, Human Kinetics, USA.

Websites

Pelvic Floor Tutorial with Leah Stewart www.pilatesanytime.com

Pelvic Organ Prolapse https://www.nafc.org/pelvic-organ-prolapse/

Pilates Running Mojo with Myriam Kane www.pilatesanytime.com