- Samara Nanayakkara
Safe Exercise in Pregnancy
THE BENEFITS OF EXERICSE IN PREGNANCY
Reduced back pain, easing of constipation and a decreased risk of gestational diabetes, preeclampsia, and cesarean delivery? Yes please! Correct and safe exercise through your pregnancy promotes healthy weight gain during pregnancy, improves your overall general fitness and mood, and strengthens your heart and blood vessels.
How much and what type of exercise?
Diabetes Australia do not have specific parameters or a target amount of exercise to aim for each week. However, the American College of Obstetricians and Gynaecologists (ACOG) guidelines recommend at least 150 minutes of moderate-intensity aerobic activity every week (30 minutes / day, 5 days / week).
Exercise program guidelines:
· An aerobic activity is one in which you move large muscles of the body (like those in the legs and arms) in a rhythmic way.
· Moderate intensity means you are moving enough to raise your heart rate and start sweating. You still can talk normally, but you cannot sing.
· Wear light & breathable clothing, to ensure you don’t overheat
· Exercise at a safe intensity- start lightly and progress gradually if you have been sedentary or after prolonged periods of rest
· Choose low impact exercise to protect vulnerable pelvic joints, lower back and your pelvic floor
· Use your core abdominal muscles and pelvic floor muscles throughout your exercise program
· Do strength training, and choose lower weights and high repetitions
· Ensure you are well hydrated and have a healthy diet
· If exercise is a new activity for you, have a review by your physiotherapist before starting an exercise program
What changes to the body occur during pregnancy that affect exercise?
· Joints — progesterone rises during pregnancy, cause the ligaments that support your joints to become relaxed. This makes the joints more mobile and at risk of injury. Avoid jerky, bouncy, or high - impact motions that can increase your risk of being hurt.
· Balance — the extra weight in the front of your body shifts your center of gravity forwards during pregnancy. This places stress on joints and muscles, especially those in your pelvis and low back. You are at greater risk of falling as you are less stable.
· Breathing — When you exercise, oxygen and blood flow are directed to your muscles and away from other areas of your body, especially your uterus if you are working too hard. While you are pregnant, your need for oxygen increases. As your belly grows, you may become short of breath more easily because of increased pressure of the uterus on the diaphragm (a muscle that aids in breathing). These changes may affect your ability to do strenuous exercise, especially if you are overweight or obese.
Safe exercises to do during pregnancy
You can enjoy physical activity by incorporating activity into your daily routine. Start with 10 minutes a day of the following:
· Walking — brisk walking gives a total body workout and is easy on the joints and muscles.
· Swimming and water workouts — the water supports your weight so you avoid injury and muscle strain. If you find brisk walking difficult because of low back pain, water exercise is a good way to stay active.
· Stationary bicycling — riding a standard bicycle during pregnancy can be risky. Cycling on a stationary bike is a better choice.
· Prenatal Yoga & Pilates —Yoga reduces stress, improves flexibility, and encourages stretching and focused breathing. These classes often teach modified poses that accommodate a pregnant woman’s shifting balance. You also should avoid poses that require you to be still or lie on your back for long periods.
Exercises to avoid during pregnancy
· Contact sports - and sports that put you at risk of getting hit in the abdomen, i.e. ice hockey, boxing, soccer, and basketball
· Activities that may result in a fall - I.e. downhill snow skiing, water skiing, surfing, off-road cycling, gymnastics, and horseback riding
· “Hot yoga” or “Hot Pilates” - which may cause you to become overheated
· Scuba diving
· Activities performed above 6,000 feet - if you do not already live at a high altitude
· Heavy weights
· Bouncing – especially star jumps or similar activities
· Sit ups or curl ups
· Excessive twisting and turning activities
· Exercises that require you to hold your breath
· Exercises that involve standing on one leg for a period of time
· Pushing off with one leg at a time when swimming – try to push off with both feet when you turn at the end of the pool
· Excessive breaststroke at the end of your pregnancy - this puts stress on your pelvis
· Prolonged standing static exercises - i.e. standing still and doing arm weights for a long period of time
· High – impact, jerky exercises - or those that involve sudden changes in direction or intensity
· Exercises that increase the curve in your lower back
· Prolonged bouncing - this can overstretch the pelvic floor muscles
· If you have any medical conditions that is affecting your pregnancy, get assessed by your medical practitioner or physiotherapist prior to starting exercise
· Drink plenty of water before, during, and after your workout. Signs of dehydration include dizziness, a racing or pounding heart, and urinating only small amounts or having urine that is dark yellow.
· Wear a sports bra that gives lots of support to help protect your breasts. Later in pregnancy, a belly support belt may reduce discomfort while walking or running.
· Avoid becoming overheated, especially in the first trimester.
· Drink plenty of water, wear loose-fitting clothing, and exercise in a temperature-controlled room. Do not exercise outside when it is very hot or humid.
· Avoid standing still or lying flat on your back (after 16 weeks) as much as possible. When you lie on your back, your uterus presses on a large vein that returns blood to the heart. Standing motionless can cause blood to pool in your legs and feet. Both of these positions can decrease the amount of blood returning to your heart and may cause your blood pressure to decrease for a short time.
· Avoid single leg or split leg exercises, as this can cause pelvic girdle pain When possible, sit up for upper body exercises.
· Pain in your joints or difficulty with mobility such as walking or getting in & out of bed
· Bladder or bowel problems
Stop exercising & call your doctor if you feel:
· Bleeding from the vagina
· Dizzy or faint
· Shortness of breath before starting exercise
· Chest pain
· Muscle weakness
· Calf pain or swelling Regular, painful contractions of the uterus
· Fluid leaking from the vagina
Do not exercise through your pregnancy if you have:
· Certain types of heart and lung diseases
· Cervical insufficiency or cerclage
· A pregnancy with twins or triplets (or more) with risk factors for preterm labour
· Placenta previa after 26 weeks of pregnancy
· Preterm labour or ruptured membranes (your water has broken) during this pregnancy
· Preeclampsia or pregnancy-induced high blood pressure
· Severe anemia
For a personalized exercise program - speak to your physiotherapist Samara about tailoring an exercise program for your body and goals.