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Physical Activity During and Post-Pregnancy
Women who continue to exercise throughout pregnancy have a higher incidence of uncomplicated, spontaneous delivery and their length of labor was shorter than those that did not exercise by nearly one third.
- Exercising during pregnancy provides greater energy reserves and enables women to cope more easily with everyday tasks of living.
- Staying stretched and flexible reduces back discomfort, muscular tension, and leg cramping. It also helps to maintain good posture and assists with labor positions.
- Women who exercise throughout their pregnancy gain, on average, 8 pounds less than women who do not exercise.
- Exercise helps to keep the digestive system regular and aids in avoidance of hemorrhoids.
- Babies of women who exercise throughout the pregnancy are less stressed during the delivery process.
- Women who do not exercise during their pregnancy retain 3 times more pregnancy weight then those who exercise.
- Moms who exercise regain, on average, 85% of their pre-pregnancy abdominal tone, while non-exercisers only gain 48%.
- Exercise helps reduce swelling!
- Moms are better able to meet the demands of motherhood when they feel fit and healthy.
You need to be able to monitor your own comfort and fatigue levels; you are responsible for knowing how you feel during exercise. Listen to your body for warning signals and acknowledge your personal limits. Pregnancy is not the time to initiate an extensive exercise regime and exercise too hard—it is a time to prioritize your health.
Your frequency of exercise depends on your level of fitness, how the pregnancy is progressing, and the intensity and type of activity. Three days per week is the minimum amount needed to achieve any benefits.
Aim for a minimum of 30 minutes (or more depending on your fitness level) of cardio per day. That time can be broken up (two 15-minute segments, three 10-minute segments, etc.) depending on how you are feeling during your day. Aim for a minimum of 4 days per week, taking days off when you feel the need to do so.
Rate of Perceived Exertion
This is the best way to monitor your workload when exercising. It is a scale of 1-10; 1 being the equivalent of lying in bed, 10 being the equivalent of absolute exhaustion, and a non-pregnant workout between an 7-9.
When you are working out, you want to be a 4-6 on your exertion scale. This exertion level should not be accompanied by discomfort or undue fatigue. If this is the case, you may need to decrease the intensity or duration of your workout.
You should do cardio/aerobic training that you enjoy and feel comfortable doing. For example, if you have been doing step aerobics and enjoy them, continue to do so with the help of an instructor who will modify high impact exercises for you, or will have you remove a riser or two.
As your body grows and changes, what you can do may change, so remain flexible in your activities. You will want to avoid any kind of contact sport, downhill skiing, and scuba diving.
Due to the constantly changing pregnant body, muscles can easily become tight and sore. Stretching can reduce the tightness and soreness, especially low back pain discomfort, alleviate lower leg cramping, and help to maintain correct posture and alignment. Stretch every day.
- Don't point your toes during a stretch—it can cause intense foot cramping.
- Hold each stretch for 30 seconds or more; it takes time for the muscles to relax.
- Avoid bouncing or forcing a stretch.
- Discontinue any stretch that feels uncomfortable or painful.
- The best time to stretch is when muscles are already warm (after a workout, warm shower, or using a heating pad).
Strength training is a must for soon to be moms. Babies, car seats and strollers and laundry baskets all get heavy after repeated amounts of lifting. Here are some tips to help you stay strong and meet the demands of motherhood.
Strength Training Tips
Targeting Muscle Groups
Aim to work all your major muscle groups twice per week and work your opposing muscle groups (if you work triceps, work biceps, etc.). This is the time to maintain your fitness level, not increase it, so lifting one set of weights, 10-12 repetitions is all you will need to do to receive the benefits.
If that leaves you asking, “How much weight should I lift?” The answer is the amount of weight you can lift 10-12 times without muscle failure/complete exhaustion. This is a great time to use exerbands and exertubes. Avoid maximal static lifts (lifting as much as you can), and do not hold your breath while you are lifting.
Limit the supine position (laying on your back) after the first trimester to 30-60 second bouts and lie on the left side between sets. Excellent core exercises include the Sahrmann Series.
A series of exercises developed by Shirley Sahrmann, a physical therapist specializing in abdominal rehabilitation, are what is recommended. These exercises are designed to target the area most weakened by pregnancy (below the belly button) without creating stress on the back and abdomen.
They're incredibly effective, but it's critical to master each level before moving on to the next one.
When to start?
After a cesarean section, you can start these exercises once the incision has healed and you do not feel pain when contracting your abdomen. If you had a vaginal birth, you can begin these exercises once any incisions or tears are healed.
The first exercise to try is simply pulling your belly button in towards your back. Hold for five seconds and release. Keep breathing as you hold and try and work up to 5-10 of these tractions several times a day.
Lie on your back with your arms at your sides, knees bent, feet resting on the floor. Inhale and exhale a few times. Don't flatten your back or tilt your pelvis, just let the natural curve in your back remain. Breathe in slowly and deeply. Now, breathe out and tighten your stomach muscles, pulling your navel towards your spine.
Remember to concentrate on contracting the muscles below your belly button without flattening your back. When you can contract and relax your abdominal muscles without moving your back, you have learned to properly isolate the correct muscles. You can then try the first Sahrmann exercise.
Sahrmann Exercise #1
Lie on the floor with knees bent and arms at your side. Hold your tummy in by doing your basic breath contraction. Keeping one knee bent, slowly slide the opposite leg out until it is straight with the floor, and then slide it back up to bent knee position. Relax your tummy,
Repeat with the other leg. Remember not to flatten your back and to keep the curve of your spine relaxed. When your abdominal muscles are contracted it helps to stabilize your pelvis while your legs and lower tummy muscles work. This prevents strain in your back muscles and trains your abdominal muscles to protect and support your spine. When you can comfortably do 20 legs slides on each side you are ready to move on to exercise #2.
If you are in the second or third trimester, modify this exercise by placing a stability ball between you and the wall, so that you are at an angle.
Sahrmann Exercise #2
Lie on floor with knees bent and arms at your side. Pull in on your tummy and hold, then raise one knee towards your chest and slowly straighten it out parallel to the floor-about 2-3 inches above the floor without touching it. Return extended leg to starting position, knees bent, feet resting on floor, tummy relaxed. If you are in the second or third trimester, modify this exercise by placing a stability ball between you and the wall, so that you are at an angle.
Repeat on opposite side, keeping one knee bent as you extend the other leg. Work up to five repetitions on each side without stopping, building to 20 repetitions or more on each side before moving on to exercise #3.
Sahrmann Exercise #3
Use your basic breath as you bring your legs up one at a time towards your body with knees bent. Keep one leg bent as you slowly lower the other leg down to the floor and back up. Repeat on the opposite side, working up to ten times each leg before moving on. Again, if you are in the second or third trimester, modify this exercise by placing a stability ball between you and the wall, so that you are at an angle.
Sahrmann Exercise #4
Use your basic breath as you bring both legs up, knees bent. Slowly extend one leg out, parallel with the floor but not touching it. Return the leg to the starting position and repeat with opposite leg. Work up to 10 repetitions each leg. Again, if you are in the second or third trimester, modify this exercise by placing a stability ball between you and the wall, so that you are at an angle.
If the arch in your back keeps popping up during the exercise, then you're not strong enough to progress to this level and need to go back to the previous exercise until you build greater strength.
When you can repeat this exercise 20 times on each leg without discomfort or arching your back, move on to exercise #5.
Sahrmann Exercise #5
Bring both legs to your chest using the basic breath one at a time. Straighten both legs up in the air, at a 90-degree angle from your hips. Keeping your legs together, slowly lower them down toward the floor. Only lower your legs as far as you feel comfortable doing so.
If you feel your back beginning to arch, bring your legs back up and lower legs again only as far as you can without arching the back. Work up to 20 repetitions. If you notice back pain with this exercise, discontinue doing #5 and maintain at level #4, as well as if you are in the second or third trimester.
The pregnant body is very sensitive to conditions that are too warm. Pregnant women do not run the risk of developing high core temperatures if the following precautions are taken:
- Exercise in a climate-controlled environment and avoid hot/humid conditions.
- Discontinue exercise if symptoms of overheating occur—lightheadedness, nausea, faintness, excessive sweating, and feeling uncomfortably hot.
- Avoid exercising for a prolonged period at a high intensity.
- Maintain hydration with at least 12 glasses of water per day, and more in hot weather. Your urine should be the color of light lemonade.
Before you start exercise, get the OK from your doctor. They may have concerns that they have not shared with you regarding reasons you should not exercise. After you receive permission, get started by doing the things you enjoy—no matter the week or month of pregnancy you are in.
Reasons to stop exercise during pregnancy may include:
- Vaginal bleeding
- Dyspnea prior to exertion
- Chest pain
- Preterm labor
- Decreased fetal movement
- Amniotic fluid leakage
- Calf pain or swelling
- Muscle weakness
After baby arrives, you can begin to walk slowly 1-7 days following delivery.
Stop exercise postpartum if you have the following symptoms:
- Dizziness, nausea, faintness, or extreme shortness of breath.
- Fever of 100.2 degrees fahrenheit or higher for 24 hours or longer.
- Red, warm, painful area on either breast or excessive breast tenderness.
- Loss of bladder control or leakage on exertion that continues 4-6 weeks after delivery
- Inability to urinate or pain during urination
- Cesarean incision opens or has increased pain or drainage
- Red, warm, tender, or painful area on either leg
- Severe pain
Ensure you lift correctly to preserve the health of your back. Kneel to the item (or child), bring close to your body, and rely on your large muscle groups (glutes, hamstrings, and quadriceps) to lift the item. Perfecting your lifting technique now will help you lift a car seat later and protect your back.
Many problems associated with pregnancy such as urinary incontinence, bowel dysfunction, low back pain, and pelvic pain, can be the result of poor pelvic floor strength. The best way to increase pelvic floor strength is to begin Kegel exercises before labor and delivery.
- Contract the pelvic floor muscles and hold the contraction for 10 seconds. Release and repeat.
- Slowly contract the pelvic floor muscles progressively tighter to a count of 5 and then release to a count of 5. If it is difficult to perform the contraction for 10 seconds, holding it for 3-5 seconds. Slowly increase the length of isometric contraction muscles become stronger.
- The abdominal, buttock, and thigh muscles should not contract or tense when performing the pelvic floor exercises.
This exercise will help to strengthen your back and stomach muscles and low back pain.
Place yourself on hands and knees on the floor. Extend your leg simultaneously, while pulling your navel in and keeping your hips stationary. After one breath, return to the start position and repeat on the opposite side (left arm, right leg).
Repeat this exercise 10 times.
Scar tissue can be treated with a gentle massage technique that will help the scar become less noticeable and heal more effectively.
Once the stitches are removed or dissolved, and the incision is healed, grasp the scar gently between the thumb and finger and roll both against the grain and with the grain, moving along the length of the scar.
For the best results, massage should be done two to three times per day, five to ten minutes.