Transcript Structural changes during pregnancy

Presentation Title
Structural
changes during
pregnancy
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Lesson objective
• Explain correct posture and how to transfer
safely and effectively between different postural
positions and during different daily activities
• Explain the structure and detail the structural
changes that occur in the spine and pelvis
• Explain the muscle, ligament and bone density
implications of the ante state
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Weight Gain
• Average total gain: 12-13 kg / 27-30 lbs
Activity 1
• In small groups label the weight distribution
diagram given to you by your tutor
• 5 minutes
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Activity 1
• Group 1 - Explain what is meant by correct
posture and consider the effect pregnancy
may have on correct posture?
• Group 2 - What effect does pregnancy have
on the pelvis and what effect does gravity
have on pregnancy?
• Group 3 - What effect does pregnancy have
on muscles, which lengthen, which shorten?
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Posture
• Feet approx hip distance apart
• Feet comfortably placed, distributing weight
evenly between feet
• Knees slightly bent
• Locate a neutral pelvic position
• Bring shoulder blades down and closer
together, lifting rib cage away from hips
• Lengthen back of neck, chin at right angles to
shoulders & looking straight ahead
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Effects of Pregnancy on the Spine
• Centre of gravity changes
• Abdonimal muscles
Lengthen & weaken
• Reduced support for the
spine
• Increased ligament &
intervertebral disc elasticity
• Increased lordosis
• Increased kyphosis
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Effects of Pregnancy on Posture
• Centre of gravity shifts downwards & outwards
• Lumbar lordosis increases
• Thoracic kyphosis increases
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Correct Posture
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Dependent on:
– Flexibility in:
hip flexors
hamstrings
pectorals
lower back
– Strength in:
gluteals
abdominals
upper back
The Pelvis
• 4 bones:
2 hip bones
sacrum
coccyx
• Each hip bone
consists of 3 fused
bones:
ilium
ischium
pubis
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Joints of the Pelvis
• All fixed (fibrous) joints
• Front - symphysis pubis (pain)
• gap 4mm pre-pregnancy (up to9mm during
pregnancy)
• Back - sacroiliac
allows for slight forwards, backwards &
sideways movements when spine flexes or
extends
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Muscle, Ligament & Bone Adaptations
to Exercise (non pregnant population)
• Muscle mass increases
• Force & velocity of contraction
increases
• Improved muscle co-ordination
• Increased ligament strength
• Increased bone density
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Muscle Adaptation when Pregnant
• No research to suggest force or speed of muscle
contraction is any different throughout
pregnancy.
• Muscle mass & strength increase in response to
weight gain. Specific increase to lower body
muscles
• Abdominal muscles become stretched, thinned
and weaker as a result.
• Other postural muscles may become shortened
as a result of poor postural adaptation.
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Effects of Pregnancy on the Rectus
Abdominus
• Muscle lengthens width ways & separates
• Muscles ability to contract weakens
• Can separate at the linea alba (diastasis recti)
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Ligament Adaptation to Pregnancy
• Centre of gravity changes stretches ligaments
supporting pelvis, hips and lower back leading to
decreased mobility & increased mechanical
stress.
• Release of relaxin loosens ligaments throughout
pregnancy & up to 6 months postnatal.
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Bone Adaptations when Pregnant
• Maternal bone mineral density is maintained
• Maternal bone turnover increases
• Calcium absorption through intestinal walls
increases
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Muscle, ligament & bone adaptations to
exercise during pregnancy
Results do not appear to be additive with respect
to:
•lean muscle mass
•remodeling
•bone density
• Regular weight bearing exercise should have
positive effect on:
•muscle strength & tone
•improve posture, abs & back strength
•mechanical stress from centre of gravity
changes & back pain
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Summary
• Postural awareness and correction can be the
single most important skill a pregnant woman
can learn.
• Discomfort and pain around the pelvis should be
addressed through alternative positions,
exercises and referral to health professionals
when persistent
• Muscle function and bone density remains
unaltered, whilst ligaments loosen during
pregnancy
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