Remember! Our guides are to be used following an assessment with a qualified medical professional. Do not attempt these exercises if you have not been given a formal diagnosis, or given consent to complete these exercises by a Physiotherapist.

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Exercise During Pregnancy Physical Therapy Guide

Exercise And Pregnancy

The use of exercise throughout pregnancy is an extremely effective tool for improving general emotional well-being, maintaining optimal weight management, and controlling blood glucose levels. The majority of women are able to perform exercises during their pregnancy to benefit their health and well-being. In most cases, providing the pregnancy is progressing normally, women are able to maintain a reasonably high level of exercise until discomfort levels force them to reduce their training, this typically occurs around the sixth month. There is a good body of evidence that suggests regular low impact exercises in a low risk pregnancy is highly beneficial. There are many guidelines listed below that should be noted prior to performing an exercise or competing in a sport in you are pregnant.

  • Prior to participating in any exercise programme, it is imperative that women first meet with their midwife, consultant or other healthcare provider to complete a risk assessment for any possible contraindications to exercise.
  • Slowly build up your exercise tolerance levels. If a woman has been sedentary for a long period prior to the pregnancy, new exercise programmes should be avoided initially and then gradually introduced and self-paced.
  • Avoid prolonged periods of exercise whilst lying on your back after the first trimester.
  • Avoiding exercising in hot weather.
  • Make sure to see a nutritionist as you will be required to consume more calories if regularly exercising.
  • Perform a good warm up and cool down.
  • Cease activity immediately if any abnormal symptoms develop.

Advantages Of Exercising During Pregnancy

The advantages of exercising relate more to the general physical and psychological well-being of the mother rather than the fetus. Women who exercised prior to pregnancy and continue to do so during their pregnancy tend to weigh less, gain less weight, and deliver slightly smaller babies that sedentary women. Women who have an increased level of fitness may also be better equipped to be able to deal with labor. It has been noted that even overweight pregnant women who commence a low impact aerobic exercise programme can vastly improve their fitness levels throughout their pregnancy. Active women also have approximately 40% reduction in pre-eclampsia risk.

Exercising during pregnancy is also extremely valuable for the mother in the prevention and treatment of conditions such as gestational diabetes. Women who engage in recreational physical activity during their pregnancy have approximately 50% reduction in the risk of developing diabetes compared to inactive women. This is because exercise causes activation of large groups of muscle which allows for an improved glucose utilization while simultaneously increasing insulin sensitivity.

Risks Of Exercising During Pregnancy

While exercise has been proven to be an extremely safe practice for women who are pregnant, there are some risks to the mother and fetus which should be noted.

  • Changes in fetal heart rate may occur in response to exercise, however the clinical significance of this is uncertain.
  • The average birth weight of babies whose mothers have exercise intensively and very frequently during pregnancy is lower than that of babies born to sedentary mothers. However, there do not appear to be any long term effects as a result of this.
  • There is also a risk of hyperthermia (overheating). Animal data suggests that a core temperature  in excess of 39° may result in neural tube deficits in the fetus. Although this has not been confirmed in humans.
  • The pregnant woman shows an increased susceptibility to musculoskeletal pain, especially in the lower back, sacroiliac region or the pubic synthesis.
  • Another possible problem affecting the pregnant woman is hypotension. When lying flat, the uterus can compress the major blood vessels in the area, resulting in reduced blood return to the heart which results in hypotension.

Warning Signs To Stop Exercising While Pregnant

  • Vaginal bleeding
  • Regular painful contractions
  • Amniotic fluid leakage
  • Dizziness
  • Headaches
  • Chest pain
  • Muscle weakness affecting balance
  • Calf pain or swelling

Lower Back Pain And Pregnancy

Pregnant women are very susceptible to musculoskeletal pain, especially the development of lower back pain. The mechanism of the development pelvic and lower back pain often relates to a combination of factors, including a chance in the centre of gravity upwards and forwards which is associated with forward tilting of the pelvis. This causes an increase in lumbar lordosis, and loosening of ligaments associated with increased levels of the hormone "relaxin". Lower back pain can be reduced during pregnancy by paying careful attention to posture and avoid sudden movements through advice, exercise and Physical Therapy.

Contraindications To Exercise During Pregnancy

Exercise is contraindicated in women with any serious or potentially serious complication of pregnancy. A list of these contraindications is shown below. It is imperative that you meet with your midwife or healthcare provider before starting an exercise programme to ensure your babies health is not at risk.

  • Significant heart disease
  • Lung disease
  • Incompetent cervix/cerclage
  • Risk of premature labor
  • Persistent 2nd or 3rd trimester bleeding
  • Placenta previa after 26 weeks of gestation
  • Ruptured membranes
  • Pre-eclampsia/pregnancy-induced hypertension.
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Exercise During Pregnancy

There is no "perfect" type of exercise during pregnancy. The pregnant woman should continue performing the exercise she enjoys most unless discomfort forces her to stop. The more active and fit you are during pregnancy, the easier it will be for you to adapt to your changing shape and weight gain. It will also help you to cope with labour and get back into shape after the birth. Keep up your normal daily physical activity or exercise (sport, running, yoga, dancing, or even walking to the shops and back) for as long as you feel comfortable. If you are pregnant, try to fit the exercises listed below into your daily routine. They will strengthen your muscles so that you can carry the extra weight of pregnancy. They'll also make your joints stronger, improve circulation, ease backache, and generally help you feel well.

1) Brisk Walking

Brisk walking keeps you fit putting added pressure on your knees and ankles, and gives your heart a much needed cariovascular workout. It is extremely safe throughout pregnancy, and can be built into your daily routine. Aim to walk for at least 30 minutes a day, five times a week. So walk to the shops rather than drive, take the bus only part of the way, or do a brisk few laps of the park or pavements in your lunch hour.

2) Swimming

Swimming is a fantastic form of exercise to utilize during pregnancy. It activates your arms and legs, whilst working your heart and lungs. The bigger your baby bump gets, the more you’ll enjoy feeling weightless in the water. If you enjoy group activity, you could aso join an aquanatal class or aqua aerobics class and make friends whilst doing so. Exercising while standing in water is gentle on your joints and supports your bump. It can help to ease back pain and swelling in your legs in late pregnancy.

3) Pilates

Pregnancy pilates helps you to maintain muscle tone and flexibility whilst improving your posture. It’s kinder to your joints than more vigorous types of exercise. However, you should also aim to do some aerobic activity, such as brisk walking, a few times a week, to give your heart a workout. Stretching helps to keep you supple whilst core stability exercise will ensure everything stays tight. Make sure that your yoga teacher is experienced in providing advice for pregnant women. It’s best to go along to a pregnancy yoga class, rather than start with a DVD.

4) Pelvic Floor Exercises

It is imperative that exercise your pelvic floor before, during and after pregnancy! If you have weak pelvic floor muscles, you may experience small amounts of wee leaking when you exercise, cough or sneeze (stress incontinence). You can prevent this from happening by doing pelvic floor exercises every day. Check out this pelvic floor training video guide by Oh Baby! Fitness. The aim of pelvic floor training is to improve muscle tone by strengthening the muscles of the pelvic floor. Kegel is a popular prescribed exercise for pregnant women to prepare the pelvic floor for physiological stresses of the later stages of pregnancy and childbirth. Kegel exercises are said to be good for treating vaginal prolapse and preventing uterine prolapse in women. The many actions performed by the pelvic floor muscles include holding in urine and avoiding defecation. Reproducing this type of muscle action can strengthen these muscles. The action of slowing or stopping the flow of urine may be used as a test of correct pelvic floor exercise technique but should not be practiced as a regular exercise to avoid urinary retention.

5) Aerobic Exercises

Low impact aerobic exercise is the easiest, most enjoyable and most beneficial exercise to complete throughout pregnancy, and is often completed through various forms of physical activity and non-contact sport. Low-impact exercises don't involve high kicks, jumps or leaps. You keep one foot on the ground at all times, so that your joints and baby bump don’t come under stress. This type of aerobic exercise also protects your pelvic floor muscles. General aerobic exercises include going for long walks, hiking at low altitude, aerobics and steps classes, and dancing! There is no pre-defined level or intensity you need to be aiming for, just working up a gentle sweat and enjoying yourself is the most important aspect of aerobic exercise. You will, however, probably need to gradually taper off your exercise regime towards the end of your pregnancy as you experience more and more discomfort preforming physical activity.

6) Pelvic Tilts

Another way to strengthen your pelvis and reduce lower back pain is to complete pelvic tilt exercises regularly. These easy movements strengthen your abs, soothe backaches during pregnancy and labor, improve posture, and ease delivery on the big day. Most importantly, they're extemely easy to do anywhere — like on a short break at work. If you're experiencing pelvic girdle pain or symphysis pubic dysfunction, strengthening those pelvic muscles is key in helping you cope. Not to mention that as you approach nine months, your increasingly heavy baby will start putting even more pressure on your pelvis (and hips and bladder), so pelvic tilts during pregnancy will be all the more crucial in relieving that stress. Once past the fourth month of pregnancy, pelvic tilts should be done in a standing position only.

How to do it:

  • Stand straight with your back to the wall and relax your spine.
  • Breathing in deeply, press the small of your back against the wall.
  • Exhale and repeat. Continue the exercise for about five minutes.
  • Do pelvic tilt exercises several times throughout the day.

Running When Pregnant 

Jogging is an extremely popular form of exercise for women and may be continued but not commenced during pregnancy. Most pregnant women reduce the distant run, particularly in the later stages. Particular care must be taken to avoid exercising in extreme hot and humid conditions, and close attention must be paid to ensure adequate fluid intake.  Running on softer surfaces and wearing running shoes with adequate arch support will reduce the impact of jogging and may prevent musculoskeletal injuries, particularly sacro-iliac joint strain.

2017-08-26T22:33:31+00:00