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Pregnancy: Fitness Strategies

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An uncomplicated pregnancy in a healthy active woman does not mean that her keep fit regime must stop. Fiona Jacobsen, principal physiotherapist at Physio2go St. Albans explores the benefits of exercise and provides specialist advice for pregnancy and following childbirth.

The Evidence

There is increasing evidence that many common complaints associated with pregnancy, such as tiredness and minor foot swelling, are reduced by exercise. Strength training and slow controlled weight bearing exercise in moderation and under supervision can be of benefit in labour and delivery. Always check with your GP or midwife when continuing and/or modifying a vigorous exercise regime.

Pregnancy: Benefits of Exercise

There are many benefits to continuing to exercise while pregnant, provided the pregnancy is normal and you are healthy. These include:
• Maintaining cardiovascular and musculoskeletal fitness
• Maintaining a healthy weight
• Improvement of posture, co-ordination and balance
• Maintaining a healthy blood pressure
• Emotional and social interaction with other mothers-to-be
• A quicker post-natal recovery.

What you Need to Know

During pregnancy blood volume increases, as does your heart rate. It is recommended that you avoid lying flat on your back when exercising from 16 weeks as the increased weight of the baby may press on major blood vessels. Normal weight gain and the gradual change in your body shape alter your centre of gravity. The natural curves of your lower spine (the lumbar lordosis) may increase, which can lead to poor posture. It is therefore important to try and maintain a good posture to help prevent or reduce backache.
Increasing hormones from 6 weeks gestation can make the ligaments, which support your joints, ‘more elastic’; that in turn can make the joints less stable. This is particularly significant in the pelvis and hips where joints may become more vulnerable to injury. This fact coupled with normal weight gain and postural changes, may result in low back or pelvic girdle pain. Lifting incorrectly, sitting or standing with a poor posture or exercising with a poor technique can exacerbate this.

What You Can Do

• Reduce the risk of strain on your back by sitting correctly with a good posture.
• When possible, sit rather than stand when doing ironing, peeling vegetables etc.
• Ensure that your work surfaces (desk, counter tops etc.) are the correct height both at home and at work.
• If you have another young child, try to avoid carrying them on one hip; if you really have to, make sure that you alternate hips.
• When shopping try to carry evenly weighted bags in each hand.

Participating in a regime of antenatal exercises for your abdominal, pelvic floor and back muscles will help prevent joint related problems. It is important that you use your abdominal muscles; these support and protect your spine and pelvis. As your pregnancy progresses these muscles become stretched and weakened, so it is important to use them correctly to maintain their strength. Increasing weight during pregnancy and actual delivery may weaken the pelvic floor. Your pelvic floor muscles support your pelvic organs and are essential for controlling your bladder and bowel. Strong pelvic floor muscles also enhance sexual intercourse. Ask your midwife, trainer or physiotherapist for exercises to target this area. There are various classes available either through your hospital antenatal care or NCT (National Childbirth Trust). Many local pools and sports centres run aqua natal classes, these can be very beneficial, good fun and a great way to make new friends. Swimming is excellent but if you suffer from pelvic pain then you need to avoid “breast stroke legs.”

After Delivery

After delivery, continue pelvic floor exercises daily whether you had a natural delivery or a caesarean section. When feeding the baby it is important to make sure that your back is well supported. Ask your midwife to show you comfortable positions to facilitate breast or bottle-feeding. Remain conscious of your posture, particularly when changing your baby. The surface on which you change your baby should be at waist height so that you do not have to bend forward. When bathing your baby avoid bending forwards and straining your back; kneeling at the side of the bath is preferable. Your pelvic joints take at least 3-6 months to return to their pre- pregnancy state, although this can take longer if breastfeeding. Protect your back during this time by using good lifting technique. Always try to bend your knees, pulling in your abdominal muscles and tightening your pelvic floor as you lift. When carrying the car seat to and from the car always try and carry it close, in front of your body, rather than one handed at the side.

Returning to Exercise

A gradual return to exercise following childbirth is recommended. Follow the advice of your Doctor or midwife, starting with the exercises you were given by the physiotherapist in hospital. Always wear a well supported sports or maternity bra, appropriate shoes and loose light clothing. “Listen to your body,” do not exercise when in pain; if you feel tired or unwell remember the need for moderation. Brisk walking whilst pushing the pram is an excellent way to exercise. Swimming can be started once you no longer have any discharge or after your 6-week check if you have had a caesarean. Pilates and yoga are an excellent form of non-aerobic exercise. They will help your flexibility, core muscle stability, posture and relaxation. Above all make sure you do something that you find fun and enjoyable.

When to Seek Additional Help

You should seek help and advice if you have any concerns regarding your posture, whether the exercise you are doing is correct and particularly if you are suffering from low back pain. A Chartered Physiotherapist will be able to give you advice regarding exercise, posture or treatment should you require it. If you should suffer from pelvic girdle pain there is help available. You may need physiotherapy treatment and advice on how to manage your condition. Physio2go offers specialist physiotherapy focusing on woman’s health, pregnancy and childbirth issues.

For further information please contact:
Physio2go Ltd.
York Lodge,
St. Peters St,
St. Albans,
AL 1 3HD

Telephone: 01727 850925

Email: info@physio2go.co.uk