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When working with prenatal or postpartum clients, perhaps you begin by considering which exercises you’ll include in their programs. However, how they move is even more important. This holds true for how they move during their workouts, and throughout the rest of their day, because good alignment leads to fewer pregnancy pains and a faster postpartum recovery.
Therefore, one of the most critical coaching tips when working with pregnant or postpartum clients is neutral alignment.
While it may not seem like the sexiest topic, helping your clients find (and move and live) in neutral alignment is the FIRST thing you should address with them. Neutral alignment is important for any individual, but it’s especially important for your pre and postnatal clients. This is because when the body is in proper neutral alignment (which we will define below), it eliminates excess tension from being placed on the muscles and soft tissues of the body – especially the core muscles. This is very important during pregnancy (when your muscles have enough tension on them already) and postpartum recovery (when your muscles are trying to heal).
Let’s discuss a bit more about what neutral alignment is, and how you can help your clients improve their alignment.
What is Neutral Alignment?
There are essentially two criteria for being in neutral alignment:
- Vertical stacking: The first goal is to have vertical stacking of 5 landmarks: ears, shoulders, hips, knees, and ankles, as demonstrated by the yellow dotted line on the far-left photo below.
- Neutral pelvis: Just because your client may be able to vertically stack those 5 landmarks does not necessarily mean that she is in neutral. The other qualification is to ensure a neutral pelvis, with the ribs and pelvis parallel to each other, as noted by the yellow horizontal lines in the far-left image. To find this, locate the ASISs (bony prominences in front of pelvis) and imagine they are flashlights. These “flashlights” should point straight ahead (left picture). If the lights point to the ground, the individual is in an anterior tilt (middle photo) and if they point to the sky, the individual is in a posterior tilt (right photo).
As mentioned above, when your body is in neutral alignment, it reduces stress on the muscles and soft tissues because your bony structures are keeping you upright. However, if your body is out of neutral alignment, this increases stress on the soft tissues as now they must help support your body. So, more of your muscles’ capacity must be diverted to simply managing the increased stress placed on them.
Common Pregnancy-Induced Alignment Shifts
Unfortunately, the physical changes of pregnancy tend to shift an individual’s alignment. We typically see the following changes:
- Lumbar lordosis: As the belly grows, it often tips the pelvis anteriorly resulting in lumbar lordosis (or the excessive lower back arch). This is one of the reasons that low back pain is the #1 most common pain during pregnancy.
- Thoracic spine kyphosis: A consequence of the lumbar lordosis is that the other curves in the spine will accommodate, often leading to exaggerated kyphosis of the thoracic spine. This can be exaggerated by the weight of the growing breasts.
- Wider Pelvis: During pregnancy, the pelvis also widens a bit. This results in an increase in foot width, which means that gait and movement patterns will likely be altered, resulting in movement compensations (and more aches and pains).
- Shift in Center of Gravity (COG): The COG for a non-pregnant individual is a few inches below the navel. During pregnancy, the growing belly shifts this COG out and up. In the photo below, you can see this woman trying to counterbalance this shift in COG by leaning backwards (further exaggerating the pressure on her low back).
It’s important to note that the movement compensations – and resulting pains and injuries – discussed above do NOT have to be an inevitable part of pregnancy. Therefore, coaching your client into neutral alignment will be a critical component of your prenatal training.
How to Assess Your Client’s Alignment
This can be a tricky one because if you say to your client “OK now I’m going to analyze your alignment,” most likely she will NOT stand the way she normally would (of course). So, instead we teach this March In Place assessment below. Your client thinks you are observing her marching skills, but instead you are observing her stance when she stops marching.
How to Coach Your Clients into Neutral Alignment
The first step is to find neutral in a standing position. After that, we must help our clients learn to move and live in neutral. We cover this in detail in our Pre/Postnatal Performance Training Specialist Course. For group fitness instructors, we also cover simple ways you can help your participants move in better alignment (something that benefits ALL your participants) via your cues, corrections, and even movement choices in our mini course: Pre/Postnatal Education for Group Fitness Instructors.
For a few tips that you can immediately apply with your clients, watch the video below. It is targeted to clients and shows them first how to find neutral alignment on their own bodies, then how to move in neutral during common daily activities. This can play a significant role in improving your clients’ alignment, as our muscles and bones conform to the way we move. So, addressing poor movement mechanics is the first step to improving alignment.