Sunday, May 22, 2016

Diastasis Recti Abdominus: Does This Condition Change How We Should Train Pregnant Clients?

During pregnancy one of the changes that occur to allow room for the baby to grow is hormonally induced thinning and widening of the linea alba (the fibrous tissue that connects the recti muscles).  This widening of the interrecti distance is termed a diastasis recti abdominus (DRA).

A DRA occurs in nearly all pregnant women by the third trimester, and remains during the postpartum recovery as well. Although a DRA is a normal adaptation of pregnancy, there is some concern that the increase in interrecti distance may affect the contractile strength of the abdominal muscles and pelvic muscle function. 

The development of DRA can be determined and monitored using a simple test during pregnancy.
Have the pregnant client lie on her back with knees bent and feet resting on the floor. Place three fingers horizontally at the umbilicus and have the client raise her head and shoulders upward until you feel the recti muscles contract. Determine the number of fingers fit within the soft area between the two sides of the recti muscles.  

A distance of two fingers or more is considered a DRA, and it’s suggested that women with this condition avoid curl up type abdominal exercises that put stress on the midline. Traditional curl up type exercises focus on the recti muscles, but when a DRA is present the intraabdominal pressure that occurs when lifting the upper body upward puts tension on the linea alba. In addition, the increased interrecti distances affect the function of the recti muscles, causing recruitment of other muscle groups to rise up.

 It’s important for pregnant women to maintain abdominal muscle strength throughout pregnancy by including exercises that target the transverse abdominus, a key support for the lower abdomen and pelvic floor. One of my favorite group of transverse muscle exercises are the Sahrmann series. I’ve modified these supine exercises for pregnancy, and you can see examples of the exercises at:

Check my blog every Monday for another “maternal exercise pearl” from my Prenatal and Postpartum Exercise Design CE course. For more information on the course please

Wednesday, May 11, 2016

New Release:2016 4th Edition "Prenatal and Postpartum Exercise Design CE Course"

Prenatal and Postpartum Exercise Design CE Course-4th Edition 2016
By Catherine Cram and Gwen Hyatt

Prenatal and Postpartum Exercise Design CE Course-4th Edition

$99 online format, $109 print format

To Order
Call: (877) 582-2227

A continuing education course for personal trainers, group exercise instructors, and health/fitness professionals working with pregnant and postpartum women.

Product Description
Course components can be delivered as printed products or online:
                          -Continuing education exam

Discover what every fitness professional working with pre- and postnatal women should know about designing safe and appropriate exercise routines with the Prenatal and Postpartum Exercise Design, Fourth Edition CE Course. Learn the effect of exercise on maternal and fetal health and how to set intensity levels and modify exercise based on guidelines from the American Congress of Obstetricians and Gynecologists (ACOG), the Royal College of Obstetricians and Gynaecologists (RCOG), and the Society of Obstetricians and Gynaecologists of Canada (SOCG). This course covers the latest research; demonstrates appropriate core strengthening and pelvic floor exercises; and includes suspended body-weight, flexibility, relaxation, and breathing exercises. It also suggests guidelines for strength training, water exercise, and competitive sports during pregnancy.

This self-guided course allows you to work at your own pace and explore the material through a comprehensive text and study guide, finishing with a 55-question exam composed of multiple-choice and true-or-false questions (test may be taken online, or mailed/faxed) and certificate and CEs provided at completion and passing of test. 
About This Course
Chapter 1 Benefits of Exercise During and After Pregnancy
Effect of Prenatal Exercise on Maternal Health
Effect of Exercise on Fetal Health
Effect of Postpartum Exercise on Maternal Health and Infant Growth
Self-Check Quiz
Chapter 2 Anatomy and Physiology of Pregnancy
Cardiovascular and Circulatory Changes During Pregnancy
Respiratory Changes During Pregnancy
Metabolic and Thermal Changes During Pregnancy
Anatomical Changes During Pregnancy
Self-Check Quiz
Chapter 3 Prenatal Exercise Prescription
ACOG Guidelines Reaffirmed 2009
International Guidelines for Exercise During Pregnancy and Postpartum
Prenatal Exercise Design
Prenatal Exercises
The Pregnant Competitive Athlete
Self-Check Quiz
Chapter 4 Postnatal Exercise Prescription
Postnatal Expectations
Vaginal Birth Recovery Program
Cesarean Delivery Recovery Program
Scar Mobilization
Core Strengthening Exercises After Cesarean Delivery
Postpartum Exercise Prescription
Abdominal Rehabilitation
Strength Training
Proper Body Mechanics and Ergonomics
Exercise and Breastfeeding
Check Points
Self-Check Quiz
Chapter 5 Maternal Exercise Program Design
Instructor Responsibilities
Program Goals
Fitness Components
Exercise Session Format
Mainstreaming the Pregnant Student
Self-Check Quiz
Chapter 6 Complications and Common Conditions of Pregnancy and Postpartum
Obstetrical Complications
Common Conditions
Bed Rest
Self-Check Quiz
Chapter 7 Professional Responsibilities
Health Screening for Physical Activity
Monitoring Exercise
Record Keeping
Scope of Practice
Emergency Procedures
Self-Check Quiz
Self-Check Quizzes Answer Key
Client Handouts
Nutritional Needs During Pregnancy
Weight Gain During Pregnancy
Essential Nutrients During Pregnancy
Common Complaints and Problems During Pregnancy
Exercise Dos and Don’ts for Prenatal Women
Nutritional Needs Postpartum and When Breastfeeding
Weight Loss While Breastfeeding
Lifting and Carrying Safely
Proper Body Mechanics When Lifting Your Baby
Health History Questionnaire
Status of Current Pregnancy
Physician Consent Form
Maternal Fitness Class Record


ACE                     0.70
ACSM                  7.00
AEA                     6.00
AFAA                   7.00
AFPA                   7.00
BCRPA                6.00
Canfitpro- FIS      4.00
Canfitpro- PFS    4.00
Canfitpro- PTS    4.00
CDR                     7.00
CFES-PT             6.00
Cooper                7.00
COPSKT             0.60
CPTN                  4.00
ECA                     7.00
FNB                     5.00
ICEA                    8.50
ISSA                    7.00
Lamaze               8.50
NASM                 0.70
NASN                  0.70
NCHEC               7.00
NCSF                  3.50
NETA                  7.00
NFPT                  1.00
NSCA                  0.80
NSPA                  7.00
OFC                    7.00
OSHF                  5.00
PTBC                  0.70
REPS                  3.00
SKESA                5.00