There are many great reasons to continue exercising during your pregnancy. Exercise assists in maintaining your fitness levels, managing weight gain and also improves mental health. Furthermore, the risk of developing some conditions associated with pregnancy (e.g. gestational diabetes) is reduced.
Current guidelines tell us that we should regularly participate in both cardio and strength conditioning exercise throughout pregnancy. If you have medical or other pregnancy related concerns, exercise may be contraindicated so always get the ‘all clear’ from your doctor first. In this case, you may be allowed to do some forms of suitable exercise within medical guidelines.
If you are not currently active, always begin with comfortable, low-impact exercise. Walking is usually a good place to start. Aim to exercise 3-4 times per week for 30 minutes, and build up to daily if able. As far as intensity goes, if you can breathe comfortably and continue a conversation whilst exercising you are within recommended guidelines (RANZCOG).
If you are active, you can continue your exercise routine within comfort. Some programs may need to be modified, particularly as your pregnancy progresses. Lying flat on your back can cause your blood pressure to drop, so choose exercises in other positions. Sitting, standing, side-lying or 4pt kneeling are often more comfortable options. Cardio exercise can be maintained with brisk walking, cycling (stationary bike is of course easier and requires less balance) or swimming (freestyle will reduce pelvic strain compared to breaststroke). Strength conditioning can be continued with body weight exercises or light weights. Always ensure good breath awareness and avoid straining. Any discomfort or pain is always a warning to STOP.
Exercise should also include core stability work for the deep abdominals, back stabilisers and pelvic floor muscles. Strenuous core work is not recommended. Carrying good posture over into everyday life is a great way to maintain core support and minimise musculoskeletal strain. Throughout the day, aim to reduce the amount of time spent in static postures. Move regularly from sitting to standing or try a gentle walk regularly.
Patients often ask whether they can continue running and other high impact sports throughout their pregnancy. RANZCOG guidelines state “For women who are well accustomed to running prior to pregnancy, whether to continue should be decided on an individual basis, but there is currently no scientific evidence to support discouraging running for these women, provided they adjust their routine to accommodate changes in comfort and tolerance and monitor intensity appropriately.”
From a physiotherapy perspective, it is important to be aware that high impact sports place increased load on the musculoskeletal system. This includes the pelvic girdle and softened pelvic support structures. We know that weakness of the pelvic floor muscles and stretched pelvic ligaments and fascia contribute to developing prolapse and incontinence. This is worth considering! Temporarily replacing high impact sport with a low-impact alternative will be kinder to your pregnant body. Walking, cycling, swimming, aqua-aerobics, light weights, rowing, cross trainer, Pilates and Yoga are great pregnancy options. Finally, always avoid contact sports during pregnancy.
Brisbane Women's Physiotherapy will be launching Pregnancy Pilates classes from early 2018.
Kristen Ruhmann
References:
The Royal Australian and New Zealand College of Obstetricians and Gynaecologists (RANZCOG)