Exercise in Pregnancy – What you need to know

Exercise in Pregnancy – What you need to know

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I get asked on a regular basis “what exercise is best in pregnancy?” and “can I still continue to play {enter sport} now that I am pregnant?” Despite of (and perhaps because of) the fact that there is so much information online these days, I think there is growing confusion as to what role exercise plays in pregnancy and what is considered “safe”. So let’s run through some of the basics.

Is it good to exercise during pregnancy?

Yes. Research does show that exercise has lots of benefits for the pregnant woman including:

  • Improved psychological well-being. Not to be underestimated, the effects on mood are well documented. I notice a lot of women comment after exercise classes “I really didn’t feel like exercising today, but I feel so much better now that I have!”
  • It can help women adapt to changes to their body in pregnancy, such as helping relieve low back pain, tiredness or swelling in the ankles
  • It may help prevent conditions such as gestational diabetes and high blood pressure
  • It can help get you physically fit for birth and help in your recovery

Ok, I’m convinced. So what is the best exercise to do?

Great question and one that is difficult to answer, as the perfect exercise for you might not be perfect for someone else. Here are some tips for those with an uncomplicated pregnancy:

  • If you were already physically active before you were pregnant, you can continue doing that exercise during your pregnancy as long as you have cleared it with your doctor and you have none of the contraindications (see below). For example, if you are a runner and you love running, you can continue running in pregnancy. Having said that, consider the effect of impact exercise on your pelvic floor.
  • Exercise in water (eg antenatal hydrotherapy) is enjoyed by many women in pregnancy. The buoyancy effect of the water can help with any joint pain and the pressure of the water can help with swelling (oedema).
  • Aerobic exercise can have good health benefits for the mother and has been shown to have no adverse effects on the baby, but low-impact exercise is preferable (because we love our pelvic floor muscles!). Aerobic exercise could be in the form of stationary bike, walking or low-impact aerobics.
  • Strength training can be beneficial in pregnancy and light/moderate exercises are considered safe. You should think about having a physiotherapist or a personal trainer who specialises in pregnancy write you up a program and ensure that your technique is correct. You should never hold your breath or strain when you are exercising (once again, we love our pelvic floor!).
  • Stretching exercises can be wonderful in pregnancy and many women enjoy prenatal yoga classes as it leaves them feeling more mobile and can help relieve stiffness and tension. Due to the effects of a hormone called relaxin on your soft tissues, it is easy to overstretch in pregnancy though, so it is best to be supervised by a trained instructor and to listen to your body.
  • Pilates classes are great in pregnancy (I might be a little bit biased here!) as they include strengthening exercises for the deep abdominal and pelvic floor muscles, as well as postural exercises and stretches. Again I would recommend seeking an instructor who specialises in antenatal exercise, as many of the more traditional pilates exercises are not suitable in pregnancy.
  • Contact sports such as basketball, netball and hockey can result in trauma to both the woman and baby. Similarly, activities with an increased risk of falling such as gymnastics, horseback riding or skiing are considered dangerous and should be avoided. Scuba diving should be avoided at any stage of pregnancy due to the risks to the fetus.

Here is a great link from Sports Medicine Australia with more detail:
http://sma.org.au/wp-content/uploads/2009/10/WIS-ExPreg.pdf

What should I do before I start exercising?

It is important that you talk to your doctor before starting an exercise program in pregnancy to make sure that you are safe to do so. To see a list of some of the contraindications and warning signs related to exercise in pregnancy, please follow this link:
http://www.acog.org/Resources-And-Publications/Committee-Opinions/Committee-on-Obstetric-Practice/Exercise-During-Pregnancy-and-the-Postpartum-Period

Great – I am ready to exercise. Anything else I should know?

At the risk of overwhelming you, I think it would be useful to know about a couple of things:

Look after your tummy muscles. The rectus abdominis muscles (6-pack muscles!) get separated in more than two-thirds of women during pregnancy. While there are some things you can’t avoid (such as the size of your torso, your genetics and how many babies you are carrying), you can choose your exercises wisely in order to not put unnecessary strain on the connective tissue between the two sides of the muscle. So that means making sure you roll onto your side when getting in/out of bed, avoiding planks and abdominal curls, and making sure that you don’t do any activities which cause a bulge to pop out of your belly.

pregnant exerciseTake care of your pelvic floor – if you feel heaviness or have any symptoms of incontinence (ie leaking of urine with cough/sneeze or inability to get to the toilet in time) please seek help sooner rather than later and make sure you avoid impact activities such as running and jumping. There are some fantastic women’s health physiotherapists in Perth who specialise in this area and they can assess you and give you specific exercises to help this issue. Here are a couple of resources:
http://www.pelvicfloorfirst.org.au/
http://www.continence.org.au/pages/wa-continence-advisory-service.html

Watch out for pelvic girdle pain – women with this will often complain of pain in the groin or buttock. Some will describe it as “sciatica”. If you suffer from pain in the low back or pelvis, I encourage you to seek help for it, as it may cause problems with normal activities of daily living and can certainly restrict exercise. There are simple things that you can do such as avoid exercising while standing on one leg, keeping your knees together as you roll over in bed and shortening your step length when walking.

It is a huge topic, so here is a great resource if you think you may have pelvic girdle pain.
http://www.piaaustralia.com/f/Uk_Patients.pdf

If you would like to receive regular information about exercising in pregnancy and in the postnatal period, feel free to join our mailing list. Information received may be in the format of a short video or blog post and will be sent out every 1-3 weeks. You can unsubscribe at any time.
http://bit.ly/dynamicstrengthnewsletter

Marika Hart

APA titled Musculoskeletal Physiotherapist

www.dynamicstrengthphysio.com.au

By Marika Hart (Musculoskeletal Physiotherapist and Pilates Instructor, Dynamic Strength Physiotherapy)

 

 

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