Pilates

Wellbeing

Pilates and pregnancy
Exercising during pregnancy is important for maintaining muscle strength and preventing musculoskeletal problems. Adi Balogh presents the evidence that when correctly taught, Pilates may be an ideal form of exercise for achieving this.
Introduction
Pregnancy is associated with a number of musculoskeletal problems (Owens et al, 2002; Berg et al, 1988;Boissonnault and Blaschak, 1988; Wang et al, 2004). The weight and pull of the fetus, the deconditioning that results from lack of exercise and the hormonally-induced ligamentous softening leads to a significant insult to the back and associated joints. Back pain is the most common cause of physical disability in the working age population of the UK with direct healthcare costs in excess of £1.6billion(Clinical Standards Advisory Group, 1994). Even without pregnancy, most of us sit badly, stand awfully in a queue, pick up things without care and toss and twist during the night, all resulting in a lack of engagement of our postural muscles, which then become weak. While many of us think of posture as being the way we stand or hold ourselves, posture is in fact dynamic and is much more about theway we carry out functional daily activities. These postural muscles or lack of them become even more important during pregnancy. The following article is an introduction to the principles of the exercise method known as Pilates and the role that Pilates-based exercises can have on preventing a number of problems associated with pregnancy. the more difficult exercises. Ideally, a Pilates instructorwill combine mat and equipment-based exercises and tailor them to the particular user’s needs. The most commonly used piece of equipment is the reformer – a moveable carriage for pushing and pulling against spring resistance.

Adi Balogh is director of the Swiss Cottage Pilates Studio, London

Problems associated with pregnancy
A recent study suggested the incidence of back pain in pregnancyis over 68%, and more likely in the younger woman and those with a history of back pain. Interestingly, only 32% of the respondents in this study informed their prenatal care-providers of their back symptoms and only 25% of prenatal care-providers recommended a treatment (Wang et al, 2004). During pregnancy, certain biomechanical changes take place (see Box 1), resulting in poor posture andincreased shear forces through the joints of the lower back. Because of the rise in levels of hormones such as relaxin, ligaments begin to soften, leading to loss of stability of certain joints and symphysis pubis dysfunction (Owens et al, 2002) – sacroiliac joint problems (Berg et al, 1988) are also common. In addition, many women develop symptoms of urinary incontinence (Holroyd-Leduc and Straus,2004) during pregnancy.

Breast and chest What is Pilates?
Pilates is a ‘mind-body’ conditioning exercise programme that targets the muscles stabilising the trunk (Anderson and Spector, 2000). The method was the brainchild of Joseph Hubertus Pilates. Born in Germany in 1880, Pilates was a rather sickly child and said to have asthma, rickets and rheumatic fever. However, by the age of 14 he hadovercome his illnesses and chose to dedicate his life to physical fitness. He studied a variety of techniques from gymnastics, zen meditation, martial arts and yoga to the Greek and Roman regimes of exercise. These were the inspiration for his method that he called ‘contrology’. After the first World War, he emigrated to the US and opened the first Pilates studio in New York City. Dancers and otherperforming artists took a liking to his techniques and it gained an almost cult-like status among these groups. Following a great deal of research to understand the science behind the art (Hodges and Richardson, 1997; Richardson et al, 2002), the Pilates method has now become a mainstream form of exercise used by doctors, physiotherapists and physical therapists all over the world. Pilates first...