It is becoming common knowledge for fitness professionals to account for the physiological and anatomical changes of pregnancy and childbirth when designing a postnatal workout. But unless you’re a mom, you might not be aware of the movements of motherhood.
Motherhood in itself can place great strain on the body. Ask any physical therapist or chiropractor, and they are likely to say that new moms are some of their most frequent patients. Their ligaments are instable, the spine is more vulnerable to injury, and moms are not likely to spend a lot of time thinking about their bodily mechanics. It’s ironic that when a woman is at her weakest and most out of alignment, she has to take on her most challenging physical role. Workouts for new moms should take into account the changes that took place during pregnancy and labor, but they should also consider “maternal movement patterns.” As a trainer, you need to teach your pregnant clients good lifting, carrying and holding techniques. If you’re not a mom, you’ll get an inside look at their day and how to train them for optimum function!
New moms will feed their babies every 1–3 hours for the first months of the baby’s life. Some of the biggest postural strains come from poor feeding positions. Some moms sit down any place, anywhere to feed their babies. Encourage your clients to use a good chair with back support. A footrest can take strain off the back and increase blood flow. The most common feeding position is for mom to lay baby on her lap and literally hunch down to reach baby. The upper back rounds over, and the shoulders roll forward. Instead, suggest that your client use a nursing pillow, which brings baby up toward her. Depending on her size, she may even need additional pillows to raise baby so she can feed in a neutral spine position. She is going to be in this position a lot, so it’s important that she use good posture whenever she can. If she talks on the phone while feeding/nursing, she will undoubtedly crook her neck to hold the phone. Instead, she can use a headset to maintain her neck in neutral alignment.
Holding Your Baby
Babies like to be held, and moms do a lot of it! It seems natural to always hold baby on the same side of body. Just think about the muscular imbalance that will be created if you hold a weight on one side of your body every day, not to mention mom usually juts her hip out as a baby rest. Muscles, ligaments and discs will all be strained by this asymmetrical posture. Mom should do her best to hold baby equally on both sides. It will feel awkward at first (kind of like writing with your non dominant hand!), but it is possible, and she will get used to it. When possible, she should hold baby in the center of her body using both arms. She will naturally hold baby with an excessively abducted scapula and stretched rhomboids and trapezius. This is a primary reason for the spasms that many moms experience in their shoulder girdle. Mom needs to do her best to keep shoulders down and back and abdominals strong while holding baby. Hip holders are available to distribute the weight of baby so mom does not have to push hip out as baby rests. Carpal tunnel is a common condition during and after pregnancy due to edema around the median nerve. Moms will often crook their wrists around baby to give baby more support as she moves about her day. This repeated wrist position can exacerbate or create pain in the wrist area. If a mom experiences carpal tunnel syndrome, she must be hyper aware of the repetitive motions of baby care and adjust her wrists accordingly.
Baby carriers have been around for thousands of years. They used to be simple pieces of fabric that literally strapped baby to mom. Now, there are countless models available. There are slings, backpacks, frontpacks and wraps. All are wonderful at soothing baby and freeing mom’s hands. They also have some advantage in terms of dispersing the load on the body. However, all can be very tough on the back! It is almost impossible to keep the chest from collapsing and the spine in neutral alignment. Consider that mom is moving about her day, often sleep deprived with this weight load on her spine. Teach clients to be very careful about their posture and their movements when using a baby carrier, particularly when doing twisting motions. Focus on lifting the chest and bracing the core when using a baby carrier and always adducting the shoulders. The weight of baby can actually be very effective when doing scapular retractions, lunges or squats. Always make sure that baby is secure first and foremost! Look for baby carriers that have ergonomic design in mind and offer padded and adjustable straps to make the fit as good as possible.
Pushing a Stroller
Strollers are an excellent way of getting baby around so mom doesn’t have to carry him everywhere. However, most moms don’t think often enough about posture when pushing a stroller. One size does not fit all. The stroller should be tall enough that mom can walk with good form. She shouldn’t need to bend down to hold handles, and she should be able to take natural strides, even when running. If you look at common posture when pushing the stroller, you will see the head jutting forward, shoulders protracted and wrists in extension. Work on some postural awareness with your clients, and teach a chin tuck to keep head evenly balanced over spine. Teach clients how to retract shoulders when pushing and lead with the chest. Show your clients how to push stroller with wrist in neutral alignment. If you have clients who push a double stroller, suggest that they alternate the children’s seats regularly. Otherwise, she will always be pushing a weight that is heavier on one side, again leading to further muscular imbalance.
Car Seat Carrier
I’m not sure when they were invented, but many moms were grateful at the invention of the car seat that was also a baby carrier. Yes, it’s convenient. However, even the lightest baby becomes a heavy unbalanced weight when in a car seat carrier. You see women all the time with their diaper bags on one shoulder and the car seat carrier dangling along side her laterally bent frame. Your clients are not going to like these suggestions, but their bodies will thank you. First, insist that if she carries it on one side, she should switch sides regularly. Second, the BEST way for her to carry it is like a laundry basket in the center of her body with both hands. Why won’t she like that? Because she won’t have her hands free to carry other items! Teach moms proper lifting technique. For instance, have her center herself in front of the car seat (if it’s on the ground), bend at her legs and brace her core when she lifts. When baby is in the car, she should climb in to the car and, with knees bent, lift baby out of the car. Most moms try to do it from standing along side the car and carry the sheer and awkward weight of the car seat in their backs. It’s easier to lift the car seat from an already elevated position than from the grounds so she should place the seat on a table or chair rather than the floor.
Believe it or not, babies can sleep an average of 14-15 hours per day in the first year of life. Unfortunately for the parents, it’s not in large sums of time. That means a lot of putting baby in and taking baby out of the crib. Think about the weight load on the spine when mom (or dad, for that matter) holds baby away from the body and then lowers baby in the crib. And to make matters worse, mom probably just nursed baby to sleep and will contort in any way so as not to wake baby up. There’s really no easy way to do it, but there are better ways! First, mom should lower the rail on the crib. Almost all cribs have rails that lower for this purpose, but most parents don’t do it as it is one more step. Then, mom aligns her body next to the crib so she won’t have to twist to lower baby or pick up baby. She should brace her core and try to keep her spine in alignment as she lowers or picks up baby.
Moms pick up a lot of toys and other baby paraphernalia. It’s essential that you truly teach them how to pick an object up. Most people in general stoop down to pick an item up. You need to teach them to bend at the hips, knees and ankles and actually squat down to pick up the object. Spine should be in alignment throughout entire movement. Mom should square herself right in front of the object and firmly pull in the abdominal muscles to protect the spine. Lift the object straight in to the body and use the legs to elevate. Remember, the further an object is away from the body, the heavier and harder it is as well! Getting strollers and baby carriers out of the car can be awkward. Mom should bring object close to her body before lifting it. It’s the repetitive motions done incorrectly and seemingly harmlessly that end up wreaking havoc on the body.
Recommendations for the post-natal client are becoming less stringent, which is a good thing. Doctors and researchers are recognizing the benefits of exercise both during and after pregnancy. Be cautious that your interpretation of these guidelines is not to put your client right back in her previous exercise routine. Much has changed in your client’s body, and just as much as changed in her life. My recommendation is that you design workouts for your clients that recognize the specific needs of this population. Your post-natal exercise program should consider the recovery from pregnancy, childbirth and the new role of motherhood. Functional fitness is all about training movement and not muscles. If the anatomical and environmental changes are not taken into account, her imbalance will last far past childbirth. Teach her sound movement patterns like you would for any other sport, and she too will be a winner!