Thursday, April 4, 2013

Exercise & Pregnancy: 101

+JMJ+

I don't know why this woman wanted to workout
in a shirt that's too small...
A few weeks ago a friend asked if my workouts had changed much since becoming pregnant. My immediate response was to say no - that except for maybe one exercise and switching from running to walking I hadn't needed to change much. Then I started thinking about it...and realized that I had almost subconsciously changed several things when it came to exercising and being pregnant. How had I overlooked this?

After reflecting a bit I realized that with my educational background it's easy to take for granted how much I know about fitness and wellness -which in turn makes it easy to overlook or downplay the subtle, seemingly unimportant changes I quickly made to my workouts once I became pregnant.

Before I continue and sound like some fitness know-it-all, let me say that I have a science degree in Kinesiology as a Fitness Specialist. Most people don't really know what that means and I used to get asked in college if my major was "lifting weights." While that was certainly a topic covered extensively in my coursework, saying "yes" to that question would completely ignore all of the other things I had to study as well.

Essentially my major required me to take science classes about human physiology, anatomy, exercise physiology, motor learning, physics, biomechanics, personal training "special populations" (understanding various medical issues, medications, and how that translated into exercise limitations), etc. On top of that I had to take courses that required hands on fitness testing, exercise program design, and personal training individuals that were apparently healthy as well as those that were cardiac rehab or cancer patients.

At this point you can probably start to see how I overlooked a lot of the subtle changes I made to my exercise program when I was asked about it...because when I exercise my brain is thinking about a whole lot of things the average person probably isn't. Realizing all of this has prompted me to want to record some of the things I consider subtle or even trivial but could possibly benefit others that don't have the same background as me (and for me to look back on when I go through any future pregnancies). So here we go!

Disclaimer: any of my personal recommendations or descriptions of exercise in pregnancy should not be considered a substitute for anything you have been told by a medical or health practitioner. It is your responsibility to follow the advice of your doctor and listen to your body. If you decide to work with a personal trainer, make sure they are properly certified through ACSM, ACE, or another nationally accredited organization. Anything I say in this blog entry is meant to be a helpful resource, but does not take into consideration any pre-existing conditions or medications beyond having an apparently healthy pregnancy. For more specific medical questions or advice, seek the counsel of your doctor.

The Warm-Up
A proper warm-up is crucial for anyone exercising - but it's especially important for pregnant ladies! Our bodies are now carrying more water and blood and depending what week you're on, it's much easier to get lightheaded from standing up, changing positions, or doing anything that requires a shift in blood flow or oxygen too quickly.

Things to consider

  • Slowly warm-up and ease into your first exercise for at least 2-5 minutes
  • Begin with exercises that target major muscle groups (i.e. quadriceps, hamstrings, gluteus, etc.)
    • This is better than beginning with smaller muscles because it will get your blood flowing and adjusting to the workout much more quickly
  • Take advantage of this time to remember about and focus your breathing into a regular pattern
    • Never hold your breath during exercise - especially if you're pregnant!
My warm-up recommendation
Walk. Regardless of whether or not you intend to complete any cardiovascular exercise beyond a warm-up, walking for at least 2-5 minutes engages several major muscle groups and is an efficient way of preparing your body for more targeted exercises. While walking you can also prepare your upper body by doing some stretches (i.e. roll your shoulders, stretch your shoulders [don't push directly on the elbow joint - hold the arm on either side of it], triceps, chest, upper back [you can reach forward/touch the treadmill for balance], neck, etc.) if it's comfortable for you to do so.

On a treadmill: begin at a speed of 2.5-3.0 with no incline, according to what feels comfortable for you. Slowly increase the speed every 30-45 seconds, stopping at a speed that slightly increases your breathing without making you feel out of breath. 

Cardiovascular Exercise
National recommendations state that we should partake in 30 minutes of cardiovascular exercise on most days of the week, if possible. Even 2 or 3 days/week of cardio can make a significant difference in our health and how we're feeling, especially during pregnancy.

Things to consider
  • Breathlessness or shortness of breath are common symptoms of pregnancy (especially during the first trimester, in my experience). Listen to your body and do NOT push it if you feel short of breath. If you need to take a break, take it...and ease back in when you can. If you feel you can keep going but need to slow down, then by all means slow down! Slow down to a point where you can comfortably breathe and won't feel light-headed or nauseated. Oxygen is also being distributed to the baby, so it can take more time to ease into exercises requiring more oxygen.
  • High impact aerobics generally aren't good during pregnancy. If you were a runner pre-pregnancy, running is still an okay choice as long as it still feels comfortable (and you may need to slow down significantly). 
  • It is safe to partake in weight-bearing exercises (walking, jogging, running) and/or non-weight-bearing exercises (swimming, stationary cycling) but you should listen to your body. Some women find weight-bearing exercise beyond walking to be uncomfortable, especially later on in pregnancy when you have more weight pushing on your joints.
  • You do not need to do 30 consecutive minutes to receive cardiovascular benefits. A perfectly acceptable option is to break your cardio into three 10-minute increments. If 20 is all you can manage, I personally recommend trying to do it all in one bout (adjust speed/intensity accordingly).

My cardiovascular recommendation
Walking or swimming. You'll see great benefits with either of these activities without pushing your body to dangerous limits. Plus, they're likely to be the most comfortable activities - and can easily be modified and taken at a leisurely pace on days you simply don't feel amazing.

Strengthening Exercises
Some women can only manage to walk during pregnancy - which is perfectly understandable and healthier than not doing anything at all. However, if your body is up to it, strengthening exercises are a highly recommended addition to your workout routine.

Things to consider
  • To avoid muscle imbalances, make sure you always work out opposing muscle groups. For example, if you work biceps, don't forget to work your triceps. Chest: Upper back. Abdominals: Lower back. Quadriceps: Hamstrings. Adductors (inner thighs): Abductors (outer thighs). You get the idea.
  • Exhale each time you do a contracting/lifting/pushing motion. Inhale on the release. Another way of saying this is to exhale each time you do a concentric contraction, inhale on the eccentric contraction. If you're confused about what this means for a specific exercise, ask me. :)
  • Do not hold your breath - ever! 
  • Beyond the first trimester do not exercise in the supine position (on your back). Your added weight can cut off blood flow/oxygen if you do this too long (you may even pass out).
    • There are plenty of ways to modify or substitute supine exercises to work the same muscle group(s) during pregnancy, so for specific questions, just ask me.
  • You may find yourself unable to lift the same amount of weight (and there are obvious lifting limitations beyond the first trimester); an easy way to modify is to do less weight and more repetitions to achieve the same results.
  • You'll have to ease up on or modify any core exercises (crunches and the like are not going to work with your baby bump - and remember you can't do anything on your back beyond the first trimester).
  • Give yourself time to recover in between exercises (take at least a 20-30 second break before moving on to the next).
  • It will become harder to balance as your baby bump grows and your center of gravity changes - so adding all those versa disk or BOSU ball tricks to work your core may become unnecessary and even dangerous (depending on what you use them for).
  • Kegel exercises are highly recommended during pregnancy, but these can be done virtually anywhere, anytime and aren't necessarily a workout for the gym.

My strengthening exercise recommendations
Try to work the major muscle groups, always focus on breathing, avoid anything on your back (beyond the first trimester), allow adequate recovery time, and consider doing less weight (and more repetitions). Personally, I recommend free weights/dumbbells to anyone who understands proper lifting technique because it also engages your core for balance. However, if you're new and/or are unfamiliar with proper body alignment, I recommend utilizing weight machines or equipment that isolates one muscle group at a time.

Cool Down and Stretch
Just as a warm-up is key, so is a proper cool down. You should never abruptly stop any cardio or strengthening workouts because your heart needs time to recover to a resting rate. 

Things to consider
  • Take a minimum of 2-5 minutes to cool down.
  • On a treadmill: slow down to at least a 2.0 speed, slowly decreasing the speed as you get closer to finishing.
  • Stretch any muscle groups you worked out. Need ideas? Ask me.
  • Keep your head elevated above your heart (any stretch that drops your head down to the ground and beneath the level of your heart can cause major dizziness/lack of oxygen if your heart hasn't properly slowed down yet)!
  • Pregnant women are more prone to muscle cramps because it's much easier to become dehydrated when your body demands so much more water - so don't skip the stretching!

My cool down and stretching recommendations
Walk. At the very least, stretch out your major muscle groups. Stretching when your muscles are warm is the single best time to increase flexibility (and it will leave you less sore).

General Tips for Pregnant Women During Exercise
  • Carry a water bottle with you and take a sip every 5-10 minutes. At the very least, take a trip to the water fountain immediately after any cardio and in between every few strength exercises. As a pregnant woman you need a lot more water than before. 
  • Wear clothes that fit. It sounds obvious, but it's really important not to cut off circulation during a workout. If you carry really low like me, you'll find yourself needing actual maternity bottoms far sooner than many other women (roll top capris, shorts, or pants are perfect!). The cheapest place I've found quality workout maternity bottoms is Old Navy.
  • Buy some sports bras that have padding (I found great deals at Marshall's - about half the price you'd find a sports bra for at Target). If you don't understand why this will be helpful, contact me and I'll tell you. 
  • Sports bras with adjustable straps are also great - because you are going to keep on growing and don't want to have to buy new sports bras every month.
  • You may need to get a pair of tennis shoes that are bigger if'/when your feet swell.
  • If you sweat during your workout, go home and change your underwear. Pregnant women are highly susceptible to developing yeast infections (because of all your body's hormones going crazy and potentially getting off balance) and a moist environment can be a contributing factor. Thankfully I'm not speaking from experience here.
  • You'll discover a lot of prenatal workouts (within yoga, Pilates, etc.)...and if those work for you, that's great! I think a lot of women don't realize you can just do normal workouts - like what I've discussed above - during pregnancy as long as you modify or avoid certain exercises and listen to what your body is telling you.
  • Listen to your body!!! Don't push it. Take care of yourself and that beautiful baby.

Thus ends my random compilation of fitness tips during pregnancy. For some purely medical reading on the topic, check out this resource. Hopefully this is helpful for some of you. If nothing else, it gave me the opportunity to reflect on how much my body has changed and how blessed I feel to know how to accommodate these changes in a healthy way during pregnancy...and how blessed I feel to be able to maintain my workouts! I know not all pregnant women are able to do this due to nausea, complications, etc. If you're unable to workout during pregnancy, don't be hard on yourself. Everyone is different and has varying needs, so do what you and your doctor know is best for you. :)

"For You formed my inward parts;
You wove me in my mother’s womb.
I will give thanks to You, for I am fearfully and wonderfully made;
Wonderful are Your works,
And my soul knows it very well.
My frame was not hidden from You,
When I was made in secret,
And skillfully wrought in the depths of the earth;
Your eyes have seen my unformed substance;
And in Your book were all written
The days that were ordained for me,
When as yet there was not one of them."
Psalm 139:13-16

2 comments:

  1. To prevent common pregnancy related complications such as diastasis recti (abdominal separation), back pain, and pelvic instability, all pregnant women should strengthen their deepest abdominal muscle, their Transverse Abdominis, or TvA. This muscle is our internal “girdle” and when contracted, compresses the abdomen. As an added benefit, because the TvA is the primary, voluntary expulsion muscle, maintaining strength in this muscle greatly aids in the pushing phase of labor. Two safe TvA exercises for pregnancy can be found at:
    http://befitmom.com/diastasis_recti.html

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    Replies
    1. Yes! Thank you for adding this reminder!

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