Jasmine Jafferali, MPH, ACE-CPT, is a fitness and wellness manager at a major health club in Chicago. She has a diverse fitness background having worked in corporate wellness and the commercial health club setting. Her practical experience in wellness programming gives her a distinctive opportunity to teach wellness to other fitness professionals. She also advocates bringing the fitness and medical community together through wellness and preventative programming. Jafferali specializes in women’s health and wellness, focusing on pre- and postnatal fitness, and is a Master Trainer for Healthy Moms® Fitness and Resist-a-ball®.
Below is a list of general prenatal exercise modifications you can give your trainers that will help them when working with prenatal clients. Remember to also have them take a course that specializes in perinatal training so that they can familiarize themselves on how to adapt their training to the physiological changes that are occurring with their clients.
Strength Training Modifications:
Higher repetitions of 15-20, one to three sets of each exercise.
- Avoid large range of motion, overextension and over flexion.
- Focus on the smaller muscle groups such as shoulder and pelvic stabilizers and mobilizers.
- Adjust for changes in postural alignment and the lumbopelvic region.
- Use shorter levers to minimize joint stress.
- Watch joint laxity. The hormone relaxin, while essential to help a mom’s body prepare for delivery, can also increase their flexibility
- Due to the increased demands of uterine and baby growth, stretch tight muscles such as chest, low back, hip flexors, gluteus, hamstrings and calves
First Trimester Training (Weeks 1-12)
Training throughout each trimester provides its challenges. The first trimester client can do the same activity as they did pre-pregnancy. They may find that they are more fatigued or feel nausea. Up to 75 percent of women experience nausea in their first trimester, and half of those women will experience vomiting. If you find that your client is vomiting, it may be wise to send them home to rest instead of having them get sick in the middle of the weight room. While no one knows the exact reason for morning sickness, some say that the extreme rise in hCG and estrogen hormones may be the culprit, along with a list of other reasons. Keep the training light and easy.
Second Trimester Training (Weeks 13-26)
This is when the fun begins. Many women are feeling better, have more energy and are ready to train. However, you may have to make weekly exercise modifications to their changing bodies. Discontinue any supine exercises; even incline work puts added pressure on the vena cava. Also, although squatting is a great exercise, avoid plie squats due to extra stress on the low back and greater trochanter. Using stability balls are an added benefit because the client can sit on the ball and do their arm work while working the core.
Keep a good eye on their postural alignment, watching for kyphosis and lordorsis. Balance activities are great in the beginning, but shifts in the center of gravity may cause your client to be less aware of their surroundings. When in doubt, ask your client how they are feeling throughout the training session. If they are apprehensive about a certain exercise, it’s best to move onto something that makes them feel comfortable.
Third Trimester Training (Weeks 27-40)
Your client is beginning to feel uncomfortable and will gradually become more tired again. She may be experiencing heartburn, more frequent trips to the bathroom and sciatica. Exercises that strengthen her adductors may help alleviate sciatica nerve pain. Be sure to stretch the piriformis and hamstring muscles as well.
Also, watch for diastatis recti, which is an abdominal separation of the rectus abdominis. If you see any type of “peaks” forming on her torso, she may have diastatis recti, and any type of oblique or rotational work should be avoided. Working the low back by doing cat/cow stretches will help open the spine and allow for needed circulation.
Taking some time for relaxation at the end of your session will be greatly appreciated. Promote belly breathing to strengthen the abs and engage in some prenatal yoga stretches to help relax the muscles.
Many moms will be eager to begin the postpartum routine. It is not advisable that they try and lose their baby weight quickly, especially if they are nursing. And, it is important that you receive medical clearance before they come back to train. Two out of three moms will have diastatis recti after delivery and will not be able to do any type of core work.
One out of three moms will experience some type of stress or urinary incontinence and may not be able to do high impact activities or core work. While this is an embarrassing topic for women to discuss, it is important that you are aware of this condition, for it will alter the way you train their entire body. Strengthening key muscles such as the Transverses Abdominis (TVA), Multifidus and pelvic floor will help improve the integrity of the entire core.
Be patient, supportive and kind with your postpartum clients. They still may be sensitive to the changes that their bodies are undergoing. Remind them that their bodies went through nine months of changes, and it is going to take some time to get their bodies back to where they are most comfortable.