Professionals who have taken our Pre/Postnatal Performance Training Specialist Education know that functional training for “ADLs” (Activities of Daily Living) is a key component of our prenatal and postpartum program design because we want to help our clients move better in their daily lives to minimize stress to their bodies and maximize day-to-day function. However, we recently had a trainer run into the following scenario:
I was writing to confirm an appointment with a postpartum client and she responded by saying that she had thrown her back out several days prior and was unable to even straighten up without pain. When I probed about the cause of the incident, she mentioned that it happened when trying to get her 18-month old into his car seat. This client also has a 3 month-old, and has just been getting back into more structured exercise. While she had a history of low back pain prior to pregnancy, she did not have any major back problems during our prenatal training. She tolerated the stresses well and was able to lift at higher intensities throughout both pregnancies.
So what happened? This trainer spent so much time working on ADLs during prenatal training specifically to avoid situations like this. This client’s story, like many others, begs an inquiry into how we train our clients for ADLs. Practicing those perfect ADL-Based Movement Patterns is a great first step. But often when clients perform these activities in real life, their patterns are a bit more varied. So, it’s important that we increase tissue tolerance in a variety of positions, especially as the “loads” increase (and get much wigglier and unwieldly). Let’s illustrate this with a few examples.
Adding “Creativity” to ADLs
After you teach your client the standard ADLs, begin expanding the range of motion, planes, and vectors in which your client performs them. For example, teaching clients to squat with feet and thighs parallel is a great fundamental pattern, but most of the time their squat needs will be more varied than this one pattern. Therefore, after teaching that initial squat strategy, get creative and experiment with different positions, like you see below. Teach this unloaded first, but then — as your client’s joints and connective tissues get more accustomed to these new ranges — start to add load.
Another important pattern to vary is the Crib Reach. This is the version of a hinge that involves an anterior reach (and the basis for that car seat movement that likely overloaded this postpartum client’s tissue tolerance). After mastering the basic Crib Reach, start adding different heights, angles, and planes of motion to the reach. It is very important for the trunk to get strong when not vertically aligned over the feet. Note, the video demonstration below is done with a 25lb sandbag (because the average 2-year old is 25 – 30 lbs). However, start with a lighter weight first before progressing.
Depending on where you are training your clients, you can play around with different modalities like VIPRs, sandbags, weighted bars, even back packs or heavy pots. In general, the further the distance of the load is from your center of gravity, the more challenging of an anti-core movement it becomes.
Have fun with these ADLs and use your real-life observations to get creative!