Two physiotherapists. One passion for Pilates. Join us as we blend science and studio know-how to help instructors teach with confidence, precision and purpose. From anatomy deep-dives to real-world client tips, we share the tools you need to deliver your best classes yet.
Welcome to The Pilates Physios, where anatomy meets abs and science meets sweat.
I’m Tanya Winter, physiotherapist and co-founder of Studio Pilates International. I’m super passionate about making Pilates education better, and training world-class Pilates instructors with real-world skills.
And I’m James Mangahas, a physiotherapist, course facilitator, and veteran Pilates instructor.
Together, we’re diving into the world of Pilates from a physio’s point of view, breaking down movement science, busting myths, sharing instructing tips, and helping you become the Pilates instructor everyone wants teaching their class.
James: So Tan, I just finished a course recently, actually yesterday. And we were talking about exercise programming, as we always do. And a big question that came up, and it always comes up during courses, is pregnancy guidelines.
And with Studio Pilates we do have some specific pregnancy guidelines, and why do you think we have that? Some people think that the guidelines are a little bit restrictive and/or might be a little bit “back in the olden days” sort of way of thinking.
Tanya: Yeah. I mean, you know, if you do the wrong thing exercise-wise when you’re pregnant, it can have some really bad outcomes for you, as you know, from a physio background.
And we’ve had lots of clients with this over the years. Doing the wrong abdominal exercises can be really dangerous, and it can have long-lasting impacts on the woman.
You know, you can end up with the abdominals separating, maybe even need surgery to fix it down the track. And also, you’re trying to keep the baby safe and mum safe whilst you’re exercising too.
So there are a lot of people out there who have no pregnancy guidelines whatsoever – quite scary.
There’s lots of courses that don’t really cover any science-based pregnancy guidelines either, which means instructors are not learning how to take people through their pregnancy safely, which to me I find crazy, and very concerning actually, and alarming.
So, you know, those guidelines do need to be there to keep both the mother and the baby safe, and to make sure that the mother’s body, you know, can recover afterwards as well, and she’s not causing herself any harm throughout the pregnancy.
James: And what do you think about, let’s say for example, someone says to us that – to give people more information, like we do start to have some relatively rigid guidelines from second trimester onwards.
You know, we wanna limit things like no sustained supine, direct abdominal exercises, inner thigh stuff. Some people might think that’s a bit too rigid.
Let’s take, for example, a person who’s like a high-level athlete. They’ve, you know, still been training quite a lot, they’re still an active athlete, and they’re stronger than the regular person.
What should we think about when we start dealing with someone who’s of that level but is getting pregnant or, you know, progressing through their pregnancy?
Tanya: Sure. I think it depends on the issues that you’re talking about.
You know, everybody’s going to be different.
Like, you know, I guess with the guidelines, usually somewhere around after the first trimester-ish, a lot of women don’t find it super comfortable laying on their back.
And regardless of how fit you are or not, that often makes no difference because it’s more about where the baby’s sitting in your tummy, where your blood vessels lie in your tummy.
You know, if you’re on your back for long periods of time, depending on where the baby’s sitting, it can really squash those blood vessels and mum can get dizzy and lack oxygen, and the baby can have the same, like the blood flow’s not there.
And irrespective of how fit you are, it’s kind of just anatomy, and each pregnancy might be different for each person.
So generally we’ll say, you know, somewhere at the end of first trimester, beginning of second trimester, just generally it’s best to not lie on your back.
Now, in saying that, some women feel amazing on their back through the whole pregnancy.
So, you know, if someone’s like, “I sleep on my back for eight hours every night,” well, good luck if you’re sleeping eight hours when you’re pregnant.
But you know what I mean. If they’re lying on their back all night and they’re not having any symptoms and no dizziness, no shortness of breath, they’re probably gonna be okay to lie on their back for short periods of time in their Pilates class.
James: Those types of things you can definitely have some leeway with. You know, it’s probably a bit crazy to say, “No, you can’t lie on your back,” when you’re doing it for eight hours a night.
Tanya: But then I think there’s other things.
Obviously the other risk during pregnancy is, you know, like overheating, overworking. Now someone that’s super fit, they’re gonna have way less risk of that. So they can probably work harder in general than someone who’s not super fit.
But then if you think about the other restrictions that you have, you know, generally it’s like, be very careful on your back after that first trimester.
And then also lying on the stomach. Well, I mean, that’s gonna impact everyone, you know, once your baby shows. It’s not gonna be comfortable to lie on your stomach or probably good for the baby.
James: And in terms of working the abdominals, this is one of the things I think that there’s most contention about.
Tanya: Yeah, absolutely, in the kind of Pilates and just fitness space in general.
The risk of working your abs is obviously if you’re doing too much of your Rectus Abdominus or six-pack muscles, once your baby starts to show, those muscles are kinda really stretching out over your baby, and they’re already on length.
And if you really work those muscles too hard, obviously sometimes it doesn’t feel good, having a baby in there and doing that.
But some people actually go, “Oh, it feels okay,” and they want to keep working their abs ‘cause they’re very fit. They don’t wanna stop exercising.
But you do run the risk of those muscles separating if you’re working them too hard.
Particularly if you’re someone that’s not super tall, because your abs are gonna stretch out further.
Often the women that have, you know, Victoria’s Secret model height might be able to have less risk of that.
But, you know, the more your belly stretches out, the more your abs have to stretch.
Working your abdominals, doing crunches or even, like, planks and hardcore abs over the top of, you know, a belly that’s protruding, you really increase that risk of those muscles separating.
And it’s long-term. Sometimes they don’t come back together. Sometimes you need surgery. You know, you end up with all sorts of back problems.
So in general, you know, when you’re training people to be instructors, you want people to err on the side of caution rather than, you know, hurting people.
You don’t want to be the person that is giving someone an issue.
James: And also we gotta think about it too, you know. Like if we’re doing reformer classes, for example, and it’s a pregnancy-based reformer class, if there’s going to be several people in that class, you wanna definitely be erring on the side of caution.
You know, you might want to be able to take care of someone who is a bit of a higher level, higher sort of physical capacity in that class, but maybe you could probably just do that for that particular person.
It’s always best, from my opinion, to start off on the lower end of the spectrum so that everyone can do the exercises and do the exercises safely, and then modify based on how the person’s feeling on that day or the people that you have actually in the class.
Tanya: Absolutely.
And I think that’s a really good point. When you’re taking a group class, it is also harder to individualize at times, as opposed to when you’re taking a one-on-one, because you can probably communicate with that woman on how she’s feeling in that moment.
So it probably also depends on the setting too.
James: We’ve talked about lying on the back and the stomach. We’ve talked about not overworking those six-pack muscles.
In saying that, you can still do some Pilates basic abdominal exercises. You can still do some of the side-lying exercises that work more your Obliques and obviously your Pelvic Floor and Transversus, as opposed to working that Rectus Abdominus six-pack.
But what are your thoughts on restrictions or modifications, and what issues do you see people come in with musculoskeletally – like with backs and hips and whatever?
James: Look, ah, I mean, this anecdotally of course.
We’re not really gonna have a full systematic review of anything like that.
But like most of the time we’ll see things like lower backs and groins are the big ones that you’ll see as pregnancy starts to progress and mature.
And that kinda makes sense. The belly’s starting to get bigger, postural changes, and in terms of joint instability, things are gonna happen more so at the pelvis.
You’ll commonly see a lot of people start decreasing in terms of their mobility as they get to the later stages of pregnancy.
Tanya: Oh, I know. I was a prime example of that.
I was so fit and strong before, and yeah, I had epic pelvic instability and pubic symphysis and sacroiliac joint issues.
I was someone that thought I would be able to really exercise quite hard the whole way through, and that’s not always the case.
But in saying that, doing the right type of exercises can really help those pregnancy issues.
If you strengthen your buttock muscles, that’s gonna really help stabilize your pelvis.
If you’re strengthening your Transversus and Pelvic Floor, same thing.
But there are certain movements that might exacerbate it, and that’s why those are in our guidelines to be very careful with.
As you said before, those groin and hip issues. Being careful with inner thigh exercises for that reason.
A lot of the asymmetrical glute exercises aren’t good, ones where the legs are separating.
I think that’s really important.
They’re such common things that people have that we need to be teaching that to instructors.
Because a lot of people do Pilates courses, become instructors because they want to take pregnant people.
So it’s crazy to me that you don’t learn all the ins and outs of how to help someone that’s pregnant and keep them safe.
James: The last point that we were talking about with some of the students yesterday was, you know, when it comes to exercising whilst pregnant…
Generally speaking, you’re not gonna get to the point where the person’s physical condition’s gonna drastically improve.
You’re not gonna get someone who’s gonna start training and all of a sudden they get massively stronger.
So even in terms of people talking about exercise intensity or just maintaining or doing whatever they used to do, I’m not necessarily sure if that’s the best way to go about it.
You wanna think about trying to do exercise whilst pregnant to help maintain your body, but also keep you in a good position so that when you are not pregnant anymore and you wanna return to sport or do all the other things that you like to do in life, that you’re in a good position to do that.
That you haven’t beaten your body up just because you like training.
You wanna get to the point where your stomach, your hips and everything like that are strong enough so that you can start to rebuild yourself after pregnancy and get back to all those things that you like, faster than if you just kind of crush yourself the whole time.
Tanya: Yeah, agree.
I mean, you’re not going to get epic amounts of gains in pregnancy.
So it is trying to maintain whatever exercise you can do.
Some women feel amazing and can do a lot of exercise, obviously within the guidelines of avoiding all of the positions that they shouldn’t be doing, and other people really can’t.
So it’s important to try and do what you can to keep as good as you can.
Then afterwards, if you’ve done Pilates and done the right thing through your pregnancy, it should be easier afterwards to get back that strength and stability.
Tanya: The interesting thing I found when I was a new mum too, is just how much arm strength you need.
You’re lugging your prams in and out of cars, holding babies.
You really need a lot of upper back strength.
Your posture ends up being so forward and rounded and you get a lot of upper back and neck pain.
Probably more so after having the baby, whereas during the pregnancy it’s more lower back, hips, pelvis.
So I think doing a lot of those arm strengthening, upper back strengthening – they’re safe to do when you’re pregnant – and I think that they really help afterwards.
James: Look, I mean, when I play with my nephews I have to pick them up and everything like that, and they wriggle around.
They’re definitely hard to hold and keep in place.
You have this entire pregnancy where you do lose a bit of strength because you can’t do as much.
One thing you can work on is your arms though, and probably some of your leg muscles too.
I think it’s invaluable to be able to have that strength because you just don’t realize, and they do get quite heavy, and they are quite wriggly.
Tanya: And of course afterwards as well, getting the abdominals back and Pelvic Floor is a priority.
Post-pregnancy, and we learn about and teach this in our courses too, you want global strength obviously to help you be strong enough to deal with all the things it requires you to do when you’re carrying a baby around.
But you really need those abdominals back.
They have generally been very stretched, and Pelvic Floor impacted too.
So Pilates is literally the perfect exercise to do post-pregnancy because the main focus, as you know, is Pelvic Floor and abs.
They’re on with every movement that you do.
And really getting people stretching and getting them to stretch all those muscles that were quite tight through pregnancy.
I honestly think it should be mandatory for everyone to do Pilates after having a baby.
James: Nice. If not while they’re pregnant too.
Tanya: Just Pilates for everyone.
James: Yeah.
