Zoey, pregnant with baby number three, suffers from Ehlers-Danlos Syndrome meaning she has hyper-mobile joints with low levels of stability. She is highly symptomatic during pregnancy due to the effects of the hormone relaxin. Zoey is working closely with Accredited Exercise Physiologist Chelsea Ciano to use exercise to increase the strength and stability of her joints, core and pelvic structures to promote optimal alignment and reduce her risk of injury, pain and fatigue. Also, the pelvic floor muscles need to be continuously be trained and strengthened to allow confident participation in daily activities.
Pregnancy is a time of great change – both physically and physiologically. Therefore, additional care and consideration are required when participating in exercise. In the absence of complications, 30 minutes or more of moderate exercise on most days of the week should be the goal. Safe, appropriate exercise has minimal risks and many confirmed benefits for most women. However, for some pregnant women, there may be times when exercise and physical activity may not be appropriate or may need to be modified and/or supervised. It is important to be aware of these contraindications to exercise. Since each pregnancy is different, women should discuss their exercise plans with their exercise physiologist for specific, up-to-date advice and assistance.
Pregnancy Exercise Myths and Truths
- You cannot let your HR exceed 140bpm when exercising during pregnancy.
Myth. We now have a much better understanding of blunted HRR in pregnancy due to increased blood volume and respiratory rates. The most effective way of measuring intensity during pregnancy is no longer through heart rate, but through RPE- The ‘talk test’ (able to talk, but not able to sing) is a good and accessible indicator of moderate intensity work.
- No supine work past the 12 weeks.
Myth. The advice to not perform exercise in supine position is regarding BP and compression on the vena cava. Some women may feel symptomatic (dizziness, nausea, syncope), while laying on their backs, others may feel fine. Short periods of supine work (i.e. 1-3 sets of exercises) under supervision is okay, however use precaution.
- It’s not safe to do abdominal work during pregnancy.
True. Contraindicated abdominal exercises around trunk flexion (i.e. sit ups) are discouraged during pregnancy due to risk of abdominal separation (diastasis recti). Abdominal musculature and tissue around rectus and the linea alba is stretched and weakened as the uterus grows. The same applies for early post-natal clients while these structures are still recovering. However, working the abdominal muscles as part of ‘core’ strength exercises are very important during pregnancy.
- Pilates and yoga are the best forms of exercise to do during pregnancy.
Myth. Functional strength training also has a huge role to play. More than 60% of all pregnant women experience low back pain, and strengthening of abdominal and back muscles could minimize this risk. Whilst stretching, strengthening and connecting with deep abdominal and core musculature is important, yoga and pilates are not the only options for pregnancy exercise!
- If I never exercised before pregnancy, now is not the time to start, and I should take it easy and rest.
Myth. For healthy pregnant women the guidelines recommend at least 150 minutes per week of moderate-intensity aerobic activity. The guidelines also advise that pregnant women who habitually engage in vigorous-intensity aerobic activity or who are highly active “can continue physical activity during pregnancy and the postpartum period, provided that they remain healthy and discuss with their health care provider how and when activity should be adjusted over time” Women who were previously sedentary are encouraged to begin regular activity, but exercise the necessary precautions as you would with any previously sedentary individual, especially within the first trimester.
Thanks to our contributors this month:
Chelsea Ciano AEP at Family Fit Exercise Physiology
Esme Soan AEP at Pear Exercise Physiology: Pregnancy & Women’s Health or on Facebook
For more information:
American Congress on Obstetrics and Gynecologists: Physical Activity and Exercise During Pregnancy and the Postpartum Period http://www.acog.org/Resources-And-Publications/Committee-Opinions/Committee-on-Obstetric-Practice/Physical-Activity-and-Exercise-During-Pregnancy-and-the-Postpartum-Period
Find an Accredited Exercise Physiologist www.essa.org.au
Exercise Right www.exerciseright.com.au
Exercise is Medicine Australia www.exerciseismedicine.org.au