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Understanding Pre & Post Natal Fitness
Recently, we had a question from one of our fitness professionals asking if it was safe for a pregnant participant to sit on a noodle - specifically to sit astride a noodle. (We generally call this position a bicycle as many people have used a bicycle in their lifetime.) The lady was concerned about the sanitary conditions for a pre & post partum client. She had suggested that using a buoyancy belt might be safer. 
Truthfully, we were amazed that this individual was not aware of the benefits, pleasures and regulated safety of the water. (Most public pools have very well scrutinized sanitary conditions because of health and safety inspections, trained pool operators as well as superior chemicals as compared to 20 years ago). It should not need to be pointed out that customers would be getting infections or become sick on a regular basis if pools were unsanitary. What needs to be said is that any exercise modality may have apparent risks and pre and post natal fitness may, in fact, be the most challenging clientele to program both in and out of the water.
The good news is that expectant mothers “feel really good” in the water. There are many things to consider when designing a program for pre & post natal groups, such as skill and physical levels, healthy histories, body types and goals, but water fitness may be the place where a mother is most protected and feel refreshed and rejuvenated (especially in the hot days of summer!) Also, a person may bring their own noodle – if they prefer their own equipment.
When we referred this question to WaterART Grand Master Trainer, Diana Griffin, an expert in the pre-post natal field, she responded:

“I have been teaching at an aquatic therapy hospital for many years with pre natal programs as my specialty. This is what I recommend, it has been proven and it works! Water exercise using the noodle is the most supportive piece of equipment for the growing uterus, as it provides the mom-to-be improved circulation with out any restriction that can be experienced when using a tight buoyancy belt! Buoyancy with a noodle allows exercise with improved oxygen flow to Mom and baby, the water surrounds the belly to caress the baby and adds support. The compression of the water is soothing on their core as well as the joints and muscles that are stressed by the added bulk of pregnancy.

An aquatic belt adds bulk in the wrong areas of an already growing body; in fact, a Mom-to-be could tip over and sustain abdominal muscle strain. When used with correct technique a noodle can be positioned to ride astride, placed behind the back, or in the front for support. Location depends on the core strength and balance skill of each individual woman, as well as their body shape and term time of the pregnancy.
For example, breast growth and abdominal expansion shifts a woman's center of gravity forward, making back pain and sciatica (pressure on the long nerve passing down the back of the thigh) common during pregnancy. Hormonal changes initiated by pregnancy also result in greater laxity and mobility in joints, thereby increasing the risk of injury, especially to hips, knees, and ankles. The zero-impact nature of exercising in water alleviates both conditions, and I know the noodle used correctly is of minimal risk.”
          First Trimester           
     Second Trimester                    
Third Trimester
As the body changes during pregnancy (0-44 weeks) the program design must be adapted to each individual. Working on a strong core is important from the early stages through the third trimester.
A strong core may help alleviate back pain and will facilitate better posture and balance. A strong core is invaluable when it comes time to push during delivery. Just sitting on the noodle (whether bicycling or sitting on a swing) will enhance core musculature.  
The noodle may be utilized to adjust to the changing centre of balance. Generally, in the first stage of pregnancy the mother has a little belly and may sit comfortably on the noodle like a bicycle.
During the second trimester, her uterus grows so it may be more comfortable to wrap the noodle in front of the body (being careful not to let the shoulders ride up). Finally, in the third trimester it may be easier to wrap the noodle behind the back to better balance the “larger belly”.
The process of pregnancy and the natural weight gain puts a lot of strain on the body particularly the low back. The spine naturally sways into an over exaggerated or hyper extended lordotic spine since most of the weight gain is essentially carried in the middle of the body. However, using a noodle correctly in a balanced program will support the additional body weight, alleviate low back pressure and stabilize the core – all simultaneously.
Obviously everyone balances differently based on skill, and body fat distribution, however, this is easy to monitor and correct just by hanging vertical in the water. A forward tilt indicates the noodle should be placed at the back whereas, a backward tilt indicates more buoyancy is required in the front. If the participant can maintain a vertical posture she may prefer sitting on the noodle in either the “horse” or “swing” position. .
Throughout pregnancy, the hormone relaxin results in greater laxity and increased mobility in the joints which is necessary for delivery. However, the increased risk of injury, especially to hips, knees, and ankles needs to be minimized. Therefore an exercise program should be low to non impact or vertical stress.
The zero-impact nature of exercising in deep water alleviates stress and wear on the joints. Caution must be given to prevent overstretching or allowing buoyancy to take the joint beyond the preconception range. Assume that this clientele may need more modifications than other for other classes. The instructor should be constantly providing positive coaching tips to help the participant balance and stay balanced in good posture throughout a program.
• Avoid fatigue and over-exertion and overheating,
• Activity should be limited to start with 20-30 minutes
• Abdominal exercises performed on the back are contraindicated (on land) because of restricts blood flow (and hence deprivation of oxygen to the fetus) after the fourth month of pregnancy. Although this may not be the case in the water because of the massage effects of water – laying on the water requires the mother to sit up and engage the abdominals powerfully.
• Any advanced abdominal work is contraindicated as the rectus abdominis muscle may split with excessive work which may cause diastasis recti. Splitting of the abdominals more than 3 inches will result in surgery to knit the muscles together
• Avoid exercising in heat for fear of dehydration, and damage to the growing fetus, especially in the first trimester.
• Avoid high impact activities, particularly as the pregnancy progresses (and weight increases), because of excess stress on joints and soft tissue.
• Begin and end all exercise sessions with a proper and gradual warm-up, cool down, and stretching.
• Monitor heart rate to keep it within the recommended guidelines. Generally the max heart rate should not go about 140 bpm; however, with older mothers, this may need to be lowered considerable.
Whether or not Mom exercised regularly before she got pregnant, making fitness gains during this time might cause harm to Mom or the baby. Exercise may be vigorous, but not extreme. Mom should never feel winded, dehydrated, or exhausted during or after a workout. If a particular exercise produces pain or discomfort, it should be discontinued and an alternative exercise should be performed.
Don't let Mom get dehydrated. Pregnant women who are maintaining an exercise regimen should be drinking about 3 liters of water a day. In exceedingly hot and humid weather more liquid may be required and exercise should be less strenuous. Exercise that requires bouncing around is also discouraged - like rebounding, high-impact water aerobics and any extreme sport, which may cause harm to the developing fetus. Avoid moves such as opposition JAX, excessive Hip extension & hyperextension of the Lumbar Spine and multi-directional movements such as a pendulum. Avoid too much side movement as the belly grows, cycling in a circle or any moves that may place too much resistance stress on the belly.
NOTE: Check out DVD022 Pre-Post Natal DVD or the Pre & Post Natal Instructor Certification program. Completing this certification will upgrades and renews your WaterART qualifications as well as provide you with many safety guidelines and adaptations using a noodle.
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