Mums to Be – Prenatal Excercise

So, you have just found out that you are pregnant, are conscious of keeping healthy over the next few months and don’t want to put on too much weight – but you don’t quite know where to start and what exactly you are allowed to do.

Clearly, the more weight you put on whilst pregnant, the more you will have to lose afterwards: but just as importantly the more strain you are placing on your already vulnerable joints, the more you will put yourself at risk to joint pain.

You may be eating for two, but this does not mean double the calories! What it does mean is that you will have to pay special attention to eating a healthy well balanced diet, to ensure that you and your growing baby are receiving all the right nutrients to thrive.

Although you will be hungrier than normal, you actually only need an extra 200-300 calories a day, so make sure these extra calories are healthy ones that will sustain you for longer. A well balanced diet combined with taking regular exercise is the key to a healthy and easier pregnancy.

Participating in regular exercise whilst pregnant is going to be hugely beneficial to both you and your baby. As you exercise, your body’s natural ‘feel good’ hormones called endorphins are released into your blood stream. This is the reason why after exercise your mood is lifted and you feel more content and calm.

In pregnancy, these hormones travel across the placenta to reach the baby, producing the same calming effect. If you can already feel your baby kicking and generally moving, you may have noticed that when you are active your baby appears to be sleeping and vice versa. This is due to the constant movement of your body whilst exercising, essentially rocking the baby to sleep. This sleep is vital for your baby’s growth and development.

Before you start on a pregnancy exercise routine, do ensure you take the necessary precautions:

- Never start a new exercise in your 1st trimester.

- See your GP before embarking on exercise, especially if you did not exercise pre-pregnancy.

- Your heart rate shouldn’t rise higher than 130 beats per minute and you should be able to comfortably hold a conversation whilst exercising.

Good exercises include:

Pilates

As long as you know what you are doing or do it in the presence of a qualified physiotherapist or instructor, pilates can be very beneficial. It works your pelvic floor and core stability muscles, which are the main stabilisers of your pelvis. As your pelvis will be more unstable during pregnancy making you susceptible to pain and dysfunction, pilates can work as an injury prevention exercise. You should not lie on your back to do any exercises beyond 16 weeks. As the uterus grows its weight can compress the blood vessels that lead to your heart, compromising the blood supply to your developing baby.

Swimming

Your body will feel weightless. It is a great way to tone the body, stretch and give your cardiovascular system a gentle work out. It is the only time where you can actually forget about the extra load you are carrying and be comfortable again whilst taking the load off your joints.

Walking

Walking is fine and the easiest activity to do and to build into your daily routine. Make sure that your pelvis is in the neutral position (that means not thrust forwards with your bottom under or the opposite – bottom out and small of back is curved) and your chest should be up as this by default activates your deep abdominals.

Walking may, in the later stages, bring on Braxton Hicks contractions. Know what these are and what to watch out for by speaking to your doctor or midwife.

Static bike

Although safe to do, you may find it more difficult in advanced pregnancy as your bump can get in the way as you lean forwards towards the handlebars.

Elliptical runner (cross trainer)

This is the low impact alternative to running and as long as you can get on and off easily enough, you are perfectly ok to do this.

Yoga

This can be very beneficial during pregnancy as it helps you breathe and relax, which in turn can help you adjust to the physical demands of pregnancy, labour and motherhood. It calms both your mind and body, providing the physical and emotional stress relief your body needs throughout your pregnancy.

It is important however, not to over-stretch as this can strain your already vulnerable joints. In preparation for childbirth your uterus releases a hormone called relaxin which is responsible for the increased laxity of your ligaments. This is essentially to allow your pelvis to open up when you give birth. Relaxin is not however, pelvis specific and will also affect the other ligaments of the body, making you vulnerable to joint pain and dysfunction.

Running

Only do this if you were a regular runner before getting pregnant. Certainly don’t take it up now if you’ve not been a runner before. Even as a pre-pregnancy runner, you will still need to be careful as you become larger and your centre of gravity shifts affecting your balance as there will be an increased risk of falling. As with all exercise during pregnancy, it is important not to allow your body to overheat.

It’s not okay to jog if you have placenta previa, where the placenta covers the cervix, because too much jolting can make you bleed. It’s also unsafe if you have pregnancy-induced high blood pressure or are at high risk for a preterm delivery. Remember that the more weight you are carrying, the more strain is being placed on your joints.

Resistance training with weights

Watch that you don’t lift any weights above your head, as this places too much pressure on your low back and will significantly increase your heart rate.

Exercises to avoid:

- Abdominal crunches or sit ups are not recommended as the superficial longitudinal muscles of your abdomen (rectus abdominus) separate in the middle during pregnancy to allow room for the growing uterus. A gap of 2 finger widths down the centre of your abdominals is normal but straining this area will lead to prolonged separation post-natally which can lead to a weak lower back. It may also make it more difficult to restore your abdominal tone.

- Any contact sports like touch rugby, netball or hockey

- Skiing – there is a risk of falling over as your balance will be affected and also the risk of someone else ploughing into you which is something you can’t predict or control

- Horse riding and cycling – due to the risk of falling off. If you are a particularly good cyclist and have been cycling up to the point of getting pregnant, you may want to continue with great care. As you become larger, your centre of gravity would have shifted making your balance on the bike more of a challenge. You will probably struggle to ride anyway after 4-5 months as your bump gets in the way.

This list is not exhaustive. If you are not sure, ask your GP.

Nicki de Leon, Sportsister
The Women’s Sports Magazine

Nicki de Leon is a sports injury physiotherapist with over ten years experience treating elite sportsmen and women and professional dancers. She was the official physio of the British Paralympic swimming team for over three years and attended the Paralympic Games in Athens 2004. Nicki is also a new mum herself.

Reproduced with kind permission of Sportsister magzine.

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