Fitness In Pregnancy
By Jocelyn Hacker, Chartered Physiotherapist
Exercise is good for you and your developing baby, but deciding how much and what, is dependent on what your pre-pregnancy levels of activity were. If you have had a desk-based lifestyle with very little activity, it is advised that now is not the time to take up training for the marathon and starting zumba.
Brisk walking and swimming are excellent for all; pilates and yoga can provide specialist exercises to help as your pregnancy progresses.
Most importantly any activity which causes pain should be avoided (see pelvic pain).
Advice for exercise
- Avoid high impact or contact sports during pregnancy.
- Listen to your body, stop exercising if you feel unwell, tired or uncomfortable
- Slow down – work within your limits – its normal to slow down as the pregnancy progresses
- Drink plenty of water to avoid dehydration
Hormonal changes at different points during your pregnancy can soften ligaments which lead to joints becoming more flexible and for some, more unstable. Such instability can lead to symptoms such as aching lower back or pelvic pain. In addition, as the weight of the baby increases, your posture can change adding to pressure on the lower back
What can you do?
- Reduce time spent standing
- Ensure that when sitting, you support your lower back and your desk and computer monitor are at the correct height for you
- Reduce the amount you carry and try to divide it evenly to carry on both sides.
- Sleeping with a pillow between the legs helps reduce the pressure on the pelvis
- Take care on all movements that require twisting such as getting in and out of the car, or getting up from bed – there is less force put through the pelvis if the knees are kept together.
How Can IGophysio help you?
If the advice isn’t helping and your Gp/midwife has checked that everything is well, early intervention by seeing a physiotherapist can prevent things getting worse and keep you as active as possible for as long as possible.
The physiotherapist will be able to identify and assess the problem. They may recommend the use of a support belt which can reduce the pressure on your pelvis and back and use a variety of techniques to reduce your pain.
The pelvic floor muscles
These are the muscles that lie across the bottom of the pelvis and support your lower organs such as your bladder. They control both the bladder and bowel – and keep you continent.
During pregnancy these muscles are put under considerable strain which is then further affected by giving birth. It is therefore important to exercise the pelvic floor as regularly as possible during pregnancy and then as soon as possible after delivery.
How to tighten your pelvic floor
It is normal that after you have given birth you may have occasional problems with leaking, whether when coughing, laughing or running.
The following exercises help to build endurance with the pelvic floor. Initially, you may find it very hard to do them but over a number of weeks you should notice that it gets easier.
- Imagine you are trying to prevent yourself peeing mid-stream, combined with trying to stop yourself passing wind. Many people find the image of ‘lift doors closing and then the elevator rising ‘ is similar to the cue of ‘squeeze and lift’ to help identify the correct muscles to activate.
- Try to contract for as long as you can – 10 seconds is a good goal. Rest for a couple of seconds and repeat up to 10 times. Try to repeat throughout the day, start in an easy position such as sitting but as this progresses, try to incorporate into more challenging positions such as standing and then walking.
- Be mindful that you are not holding your breath, squeezing your buttocks or thighs.
Source: POGP: (Pelvic, Obstetric, Gynaecological Physiotherapy)
Getting fit after having a baby
Everyone can agree that you are not going to get fit on pelvic floor exercises alone, but when are you ready to get back to exercise?
There is a great temptation to dive into gym classes that offer high impact with a high adrenaline approach. Even post-natal yoga and pilates now offer get fit quick promises but without an assessment to check that you are ready.
Because birth equals trauma! Like any other trauma in the body, after giving birth you need a period of rehab to recover appropriately. Some muscles get torn, others get stretched and putting further strain though these ‘core’ structures (pelvic floor, abdominals, your back muscles and diaphragm) can cause harm.
First signs may be doming in your abdominal area when trying to activate your tummy muscles, or you may notice an increased gapping in these muscles – known as diastasis recti. You may find you start to leak when you try and run. Alternatively you may put yourself at risk of prolapse – the first signs of this may be a dragging sensation or heaviness in your vagina during exercise.
So if you feel ready (having had your 6 week check up by your Gp), and you don’t have any pain to your hips or back, and no problems as described above you are most likely ready for a paced return to activity, but watch out.
If your local class starts getting you to do high impact movements with abdominal ‘bracing’ such as planks, sit ups, crunches, or burpees, you may well find that the increased pressure such exercises puts on the pelvic floor and ‘core muscles’ is enough to start to cause you problems.
A physiotherapy post-natal assessment can help correct pregnancy posture, assess the pelvic floor and deep abdominal muscles are functioning correctly and help with the key exercises that you should focus on to begin rebuilding that core.