Pregnancy is such a wonderful, exciting and scary time of life. I am so glad it takes about nine months; it gave me time to prepare for our first little bundle of joy. As a new mom, I had no idea how someone so little and adorable could take so much of my time, attention and love. Besides all of the craziness of adjusting to motherhood and baby’s schedule, it was exciting to see human development firsthand. As a trained exercise physiologist, it was very interesting to see how my little one developed motor skills. As a new mother, I made note when baby first rolled over, crawled, sat up and walked.

It was even more exciting when I took my baby to the pediatrician for a well checkup and reported baby’s milestones, such as rolled over at three months, sat upright about five and a half months, and walked unassisted at nine months. The pediatrician noted these are within the normal, but about two to three months early compared to the average baby. Also, seasoned grandparents who told me, “This is the strongest baby I have ever seen!” would fill me with delight and wonder.

As exciting as this story is, I noted that my story was not unique. In speaking with many other moms, their stories were similar. As I continued to listen to the stories, we all noted that we were active exercisers during our pregnancies. Interesting.

As a researcher studying the effects of exercise during pregnancy on offspring heart outcomes, we have seen exposure to maternal exercise seems to benefit heart development. With these mothers’ stories in mind along with my own experiences now with two children and many anecdotal stories of friends and research participants, we wondered if exercise during pregnancy could somehow influence baby’s neuromuscular development, leading to these outcomes that so many women have reported to me.

With this in mind, I decided to enlist the help of an expert in the area of child movement, a pediatric physical therapist (PT). I explained my story and the story of many women to my PT colleague and the idea to test if exercise during pregnancy influences child motor development. She was skeptical but interested enough in child health and development to help me.

With funding from the American Heart Association and East Carolina University, we were able to begin a randomized trial to determine if supervised aerobic exercise during pregnancy had an effect on one-month old motor skills. Much to my PT colleague’s surprise, we found that yes, aerobic exercise during pregnancy is associated with improved motor skills of one-month old infants. This is exciting! Our research was published in the August 2019 issue of Medicine & Science in Sports & Exercise.

If kids are better movers this young, will they continue to be good movers as they develop? Could this help decrease the likelihood of children being obese? These are all exciting questions that we hope to answer in the near future. Undoubtedly, more work needs to be done in this field.

For the moment, women who are considering having children or already pregnant and wanting their children to be “movers” should take note that this influence begins during pregnancy. Staying active or becoming active may help your children to move better after birth. You may be chasing your little one more as they grow up, but that is better for everyone too, right? Happy moving!

Learn more about Dr. May’s research in this article from Gretchen Reynolds in the New York Times.

Linda May, PhD, MS, FACSM, is an associate professor at the East Carolina University School of Dental Medicine, teaches dental students and is adjunct faculty assistant professor of exercise physiology for Health and Human Performance as well as obstetrics and gynecology for the Brody School of Medicine. Dr. May conducts research on topics relating to the influence of maternal exercise during pregnancy on child development before and after birth. Her research is presented in world-wide media outlets, including the New York Times. 

 

Leslie Bonci, MPH, RDN, CSSD reviews current recommendations for nutrition timing, focusing on what and when to eat for energy and recovery. She also provides examples plus practical tips to use with your clients – from recreational athletes to active individuals and everyone in between.

About the course:

This course includes an online video from ACSM’s Health & Fitness Summit and a corresponding online quiz. All course content will be presented to you electronically upon completion of your purchase. This includes all videos, quizzes, and certificates (certificates awarded upon successful completion of the quizzes).

Available ACSM CECs 3.0

Learning objectives for the course - You Are When You Eat | Timing is Everything:

• Educate fitness professionals on proper sports nutrition
• Share the latest nutrition research and science
• Provide applications for translating information into practice with clients at a variety of fitness levels

Purchase and earn CECs

---

View More Popular Nutrition Courses

 
Nutrition Spotlight | CEC Bundle


Nutrition Intuition: Moving Away from Dieting Practices

Integrating Nutrition Into Training

ACSM Download: Exercise for Cancer Prevention and Treatment

3 Key Points:

1. For all adults, exercise is important for cancer prevention and specifically lowers risk of seven common types of cancer: colon, breast, endometrial, kidney, bladder, esophagus and stomach

2. For cancer survivors, incorporate exercise to help improve survival after a diagnosis of breast, colon and prostate cancer

3. Exercising during and after cancer treatment improves fatigue, anxiety, depression, physical function, quality of life and does not exacerbate lymphedema

Download from the Resource Library

---

View More Popular Resource Downloads:

 
Women and Heart Disease


Afib and Exercise - What You Need To Know | Download

How do you stay physically active when you’ve got a full-time job, family and a never-ending to-do list? In the September/October 2019 issue of ACSM’s Health & Fitness Journal® Lisa Ferguson-Stegall, Ph.D., FACSM and Jennifer Dysterheft Robb, Ph.D., describe strategies to increase activity at home and work.

Find creative options on how to incorporate activity breaks into sitting time at work and at home.

 

The other day a student who started her master’s degree (focused in Public Health) expressed excitement about all the courses she was enrolled in despite the overwhelming loads of information she processes daily while trying to balance time to study, work, sleep and remain sane!

We are all faced with daily challenges that keep us from engaging in consistent physical activity whether you’re a student or a director of an organization. Rather than focusing on how to make more time, think about how you can encourage clients/patients you work with to change their approach to activity.

For starters, throw out the idea that to be active you have to go to the gym for an hour or more or that you need a weight room to strength train. In other words, encourage your clients/patients to change their perception of what it means to be active and to stop believing that if they aren’t active for longer than an hour at a gym, it doesn’t count.

Instead, think creatively with your clients about how to find opportunities to move (OTM) at work and at home. Identify times throughout the day to accumulate short bursts of movement to start and if they’re successful add in some more specific goals related to time and intensity. The behavior is what we’re aiming to improve when we’re unintentionally encouraged to be sedentary daily.

Learn more by reading the full article “Effective Strategies to Increase Physical Activity in the Working Years" in the September/October 2019 issue of ACSM’s Health & Fitness Journal®.

Become an Alliance Member or Student Member to access the full ACSM's Health & Fitness Journal® library 

Article based on: Ferguson-Stegall L, Robb JD. Effective strategies to increase physical activity in the working years ACSMs Health Fit J. 2019; 23 (5):26-33

Author:

Vanessa M. Kercher, Ph.D., SSC, M.Ed., BESS, is a Clinical Assistant Professor in the Kinesiology Department for the School of Public Health at Indiana University. Dr. Kercher's research passion focuses on helping individuals optimize their physical activity experiences to promote sustainable, positive health behaviors. She serves as the digital editor of ACSM’s Health & Fitness Journal®.

---

Earn CECs - Take the Quiz

Effective Strategies to Increase Physical Activity | CEC Quiz

---

Read more Fit Features by Dr. Vanessa

Burnout: Thriving or Just Surviving?

4 Lessons from Job Hunting

Identifying Upper Extremity Deficits for the Back Squat

---

3 Key Learning Objectives:

1. Understand how to identify upper extremity deficits.

2. Understand the importance of movement assessment for this exercise.

3. Understand coaching cures related to these deficits.

---

The back squat exercise is one of the most widely utilized exercises to improve lower extremity strength and function and athletic performance. The back squat exercise is a closed kinetic chain exercise that requires triflexion of the hip, knee, and ankle joints. Primary movers of this exercise are the quadriceps, gluteals, and erectors.

It is also a functionally relevant movement pattern as it supports derivative squat maneuvers that translate into many activities of daily living such as picking up a child, getting up from a seated position, and lifting heavy objects from a lowered position. Further, the back squat can serve as an evaluation tool to assess an individual for strength, stability, neuromotor control, and mobility within the kinetic chain.¹

The back squat requires a coordinated neuromuscular effort across many joints and that involves many muscle groups. An appropriate amount of relative mobility, stability, strength, and neuromotor control are required in order to effectively execute a safe movement pattern.¹ Any deficit in one or more of these characteristics may result in aberrant movement patterns and compensatory mechanisms that may put the client at an increased risk of injury when attempting to execute this movement, especially under external load.

Any deficit in one or more of these characteristics may result in aberrant movement patterns and compensatory mechanisms that may put the client at an increased risk of injury when attempting to execute this movement, especially under external load.

 

It is the responsibility of the certified fitness professional to have a thorough understanding of the physiological and biomechanical demands of this exercise to properly assess a client and prescribe an individualized exercise prescription. Here are some identified deficits and coaching cues to look for when assessing a client during the back squat exercise.¹

 

Table 1. Upper Extremity Deficits and Coaching Cues
	Deficit(s)	Coaching Cues
Head Position	Head should be maintained in the neutral position relative to the spine. Slight cervical extension is acceptable. The client should also be coached to look forward or slightly upward. Neuromuscular deficits may include the inability to maintain neutral head position which can be exacerbated with incorrect gazing patterns. Strengthening the neck and upper back muscles may help maintain the head in correct position during the back squat exercise. Proper cervical range of motion should also be present in order to safely and effectively perform this movement pattern.	Fix gaze on focal point at eye height or slightly higher. May provide tactile feedback to enhance posterior next muscular recruitment.
Thoracic Spine	Thoracic spine should be slightly extended with the chest positioned outward and upward. Scapulae should be retracted and depressed which may assist with the chest position. These three cues should be executed simultaneously and during the entirety of the movement execution. Activation of the erectors and periscapular muscles during the movements will also help contribute to spinal stability. Neuromuscular deficits could be impaired scapular retraction and chest in a downward position. Strengthening the periscapular muscles and lengthening the anterior deltoid and pectoralis muscles may help correct this.	Pinch shoulder blades together and pull scapulae down by engaging the latissimus dorsi. Point chest towards ceiling.
Lumbar Spine	Goal is to maintain a slight lordotic curve and engage the posterior and abdominal muscles to optimize spinal stability. To minimize undesirable forces to the spine, the trunk should be held as upright as possible to mitigate forward lean. Neuromuscular deficits could include forward lean and rounding of the back. Inadequate core strength of the abdominals and posterior extensor muscles could be underlying factors. Inadequate lengthening of the hip flexors and lack of lumbar spinal mobility could also contribute to excessive forward lean of the trunk.	Pinch shoulder blades together and pull scapulae down by engaging the latissimus dorsi. Engage abdominals and erector muscles. Maintaining good head posture, retracted and depressed shoulder blades, and a high chest will aid in helping stabilize the spine.

 

As certified fitness professionals, we should be familiar with evaluating movements like the back squat exercise. Given its practical applications to many activities in life, incorporating the back squat exercise into a client’s exercise prescription is viable to promote an active lifestyle, enhance performance, and maintain function.

In order to evaluate and properly prescribe an exercise prescription, it’s critical to understand the demands of the movement and articulate feedback to the client. It’s recommended to begin with the client using his or her own weight against gravity for resistance. Once the movement has been evaluated and properly executed, external load may be slowly added. It’s important that the client have good biomechanics prior to adding external load. If there are aberrant movement patterns, the certified professional should not put external load on the client during the movement.

It is not advised to put strength on top of dysfunction or weakness. This puts the client at an increased risk of injury and doesn’t address the underlying deficit(s). Further, adding external load to a client who is unable to properly execute the movement against gravity under no load may exacerbate the compensatory mechanisms. In other words, the stronger muscles get stronger and the weaker muscles get weaker.

These three upper extremity coaching points are a starting point to properly assess a client’s cervical, thoracic, and lumbar spinal positioning during the back squat exercise. The next article in this series will focus on coaching cues for the lower extremity during the back squat exercise.

Author:

Eddie Davila, MS, ACSM-CEP, ACSM-EP, EIM 3, is co-owner of Urban Fitness (www.urbanfitnessmt.com) in Bozeman, MT. He is also a Certified Clinical Exercise Physiologist in the department of Cardiac and Pulmonary Rehabilitation at Bozeman Health Deaconess Hospital. Eddie is passionate about inspiring people to live active lifestyles and helping them achieve their personal best.

References:

1. Myer GD, Kushner AM, Brent JL, et al. The back squat: a proposed assessment of functional deficits and technical factors that limit performance. Strength Cond J. 2014 Dec 1; 36(6):4-27.

The views expressed are those of the author and do not necessarily reflect those of the ACSM.

---

Watch More Popular Coaching Content

Coach It Up!...Coaching and Cueing Proper Movement


How To Teach the Push Up and Bench Press