Physio: Things you should know about exercising during pregnancy

Sometimes fitness during pregnancy is at the expense of the woman's health, or worse—the health their baby.

Most women know that it is important to stay physically fit and healthy during pregnancy, however, there is more and more pressure these days for women to maintain a certain level of activity and fitness throughout their pregnancy and sometimes it is at the expense of their own health or pain, or even worse—the health their baby.

Pregnancy results in many physical changes of a woman’s body and consequently can cause issues such as low back pain, pelvic pain, incontinence, postural changes and balance problems just to name a few.  In fact, over 70 per cent of pregnant women experience low back and pelvic pain.

One may think that continuing with their regular strengthening, stretching and core strengthening routine, or enrolling in a fitness class may help their current pre-natal aches, pains and other issues. Unfortunately, simply attending a regular fitness class, yoga or pilates class isn’t always safe and appropriate when you are pregnant.

The good news is that there is a great deal of evidence showing that specific exercise programs designed and delivered by physiotherapists can relieve low back pain, pelvic pain and urinary incontinence in pregnant women.

A physiotherapist assessment followed by an individual treatment program can help you safely and effectively participate in a home program or class setting in order to gain the specific strength, stability, flexibility, balance, postural control and pain management required to maintain a healthy pregnancy.

Here are some general tips to keep in mind if you are already participating in a pre-natal exercise program of any kind:

• Do not overheat. Keep body temperature within comfortable limits.

• Keep heart rate from elevating to a high, rapid, uncomfortable rate and always maintain your breath. You should always have the ability to talk while exercising.

• Do not overstretch muscles. Your relaxin hormone is high, therefore decreasing the ligaments’ abilities to stabilize your joints. Overstretching muscles around unprotected or unstable joints can lead to injury.

• Avoid prolonged supine (lying on back) postures after around 20 weeks or first trimester. This position can potentially occlude the inferior vena cava and consequently compress the subrenal aorta. This compression can then reduce maternal cardiac output (resulting in decrease oxygen to tissues, including to your fetus).

• Caution with standing balance exercises. Your center of body mass will change dramatically, causing your balance to become altered. Walls and sturdy chairs can be used for extra support.

• Avoid aggressive forward bends or twists.

• For those who practise yoga: do not perform any pranayama (breath work) that involves retaining the breath or overheating the body.  Yoga inversions, such as headstands, are controversial. The main danger during inversions is the risk of falling and injuring yourself or your baby during the fall. As a general rule, if you practised inversions prior to your pregnancy, it is safe to continue if you are tolerating the pose with great ease. Currently there is no evidence supporting the fact that inversions are dangerous during pregnancy.

• Exercises in the prone (lying on stomach) position are not dangerous, however, they tend to become very uncomfortable and physically impossible, therefore, inappropriate.

• Pay attention to any warning signs such as light headedness, unusual nausea or vomiting, increased low back pain, or any pain in general, decreased fetal movement, spotting or fluid leakage, or any other symptoms that you are unsure about. Exercise will not cause these symptoms, but if you have pregnancy related conditions, you may need to avoid exertion or certain activities.

• Please always inform your doctor before you participate in any pre-natal exercise class or activity, including classes such as pre-natal yoga.

It is important that you let your therapist or instructor know when you are in pain or feel uncomfortable in any way. As always, know and respect your own limits and ‘listen to your body’.

This column is not intended to diagnose or treat. Please consult with your physician prior to participating in an exercise program.

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