Presentation title (Date) Presentation Title Presentation title (Date) Structural changes during pregnancy
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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
Dependent on:– Flexibility in:
hip flexors
hamstrings
pectorals
lower back– Strength in:
gluteals
abdominals
upper back
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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