Walking by trimester
Exercise during pregnancy can seem a little
daunting. Being a "baby factory" is exhausting in itself,
without the pressure of extracting yourself from the sofa to pound
the pavements! However, research reveals numerous
benefits of exercising during pregnancy. Once you know the basic
guidelines, it can be as simple as grabbing your trainers and going
for a walk.
The benefits of exercise are well proven, and include lowering
blood pressure, protecting against heart disease, helping to
maintain a healthy weight, improving bone mineral density, and
reducing the risk of developing colon and breast cancers. The Royal
College of Obstetricians and Gynaecologists now suggest that all
women should be encouraged to participate in aerobic and
strength-conditioning exercise as part of a healthy lifestyle. Just
30 minutes of exercise on most, if not all, days of the week
can result in:
- Improved circulation (which may help with varicose veins and
swollen calves)
- A reduction in pregnancy aches or discomforts such as back pain
and constipation
- Improved muscle tone
- Reduced fatigue and improved energy levels
- Improved quality of sleep
- Enhanced self-esteem and a more positive body image
- Increased production of "feel-good" hormones to help stave off
depression
- Reduced risk of developing gestational diabetes.
If that isn't enough to persuade you to
find your trainers, then remember that exercise also helps to build
stamina and improve your ability to cope during labour, not to
mention improving your ability to get back in to shape once baby
has been born. It is now also considered safe that even previously
sedentary, but healthy, women can start an exercise programme
during pregnancy.
If you are pregnant and still reading,
then congratulations - you've taken the first step towards a
healthier pregnancy, not to mention looking good and feeling
energised. But you may still be wondering exactly how hard,
how long, and how often you should exercise. Let's have a look at
some of those issues and simplify things so you can really start
glowing!
A simple stroll
Pregnancy is certainly not the time to commence any form of extreme
or complicated exercise regime. And while attending
pregnancy-specific aerobics, pilates, yoga, or aqua-natal classes
can be beneficial, they don't always fit in with the family or the
budget. Simply walking on a regular basis can provide you with many
of the positive benefits mentioned above. Walking is not only
inexpensive, but also low-impact, meaning less strain on your
joints and less chance of injury.
First trimester: Start as you mean to go
on
If you are planning a pregnancy, then it is wise to still adhere to
the following exercise recommendations as you may become pregnant
and not know it yet. Always check with your LMC or doctor before
commencing any exercise programme. This is just to ensure you have
no risk factors that may inhibit your ability to exercise while
pregnant. These may include things such as a history of premature
labour, miscarriage, problems with your cervix or placenta,
anaemia, vaginal bleeding, severe joint pain, and some chronic
diseases.
Keep abreast of the situation
Before you commence, it is vital you have a well-fitted, supportive
bra to protect enlarging breast tissue. While every woman is
different, it is not uncommon for breasts to increase up to a cup
size or more throughout pregnancy, and the delicate tissue needs to
be supported, even with walking. It is advisable to avoid underwire
bras as these can become uncomfortable and may contribute to
blocked ducts, especially if they don't fit perfectly. You may
prefer a traditional soft-cup sports bra, and some women find that
wearing two bras (or a small crop top over a bra) will reduce
their discomfort while exercising.
Feet first
Supportive walking shoes are vital for ongoing comfort and support
for the arches of your feet. Hormones that are released during
pregnancy to help soften the joints of the pelvis can also affect
the feet. Many women make the mistake of wearing shoes without
enough arch support. Softening ligaments, coupled with increased
weight gain can lead to fattening of the arches and increased foot
pain. Shoes designed specifically for walking may be a good choice
during pregnancy. Some women even find that their feet go up half a
size during pregnancy, so if purchasing shoes during pregnancy -
consider going slightly larger.
Let's get started
If you have maintained a regular walking programme prior to
pregnancy, then a reasonable goal would be to maintain a good
fitness level without trying to reach peak fitness. Aim for around
30 minutes of moderate intensity walking on most, if not all, days
of the week. If you haven't done any recent exercise, then begin
with around 15 minutes continuous walking around 3-4 times per
week, and gradually build up to 30 minutes, 5-7 days per
week.
A warm-up is more important during
pregnancy and can be as simple as walking at a slower pace for
about the first five minutes. This will allow time for your heart
to pump blood around your body, ensuring sufficient oxygenation for
your working muscles, and for your baby. By starting out at a
gentle pace you are also less likely to injure your joints. A
cooling-down period at the end of your walk is also important - so
slow down the pace for 3-4 minutes at the end of your work-out; to
allow the cardiovascular system time to adjust to the change in
pace of activity.
Some basic leg stretches after your walk
are a good idea,specifically your thighs, hamstrings, and the long
and short calf muscles. If you aren't sure how to do these four
stretches, then check out the cool-down stretches at www.activesmart.co.nz. Aim
to hold each stretch for at least 30 seconds. You should feel
a stretching sensation, not pain.
Listen to your body
Without individual assessment it is difficult to be prescriptive
about the intensity of a programme. The most important factor here
is that we are aiming for a moderate level of exertion - not
over-doing things or pushing yourself too hard. You should be able
to hold a conversation, talking comfortably or with a moderate
effort but certainly without gasping or feeling unable to talk. Due
to an increase in resting heart rate and decrease in maximal heart
rate during pregnancy, using target heart-rates as a guide of
exercise intensity is not recommended.
Up to 70% of pregnant women unfortunately
experience morning sickness. Try to be sensible; if you've been
throwing up all morning then it may pay to rest in the afternoon.
On the other hand, if you feel only mildly queasy, then a light
walk in the fresh air may actually be just the thing you need. Try
and take some deep breaths while walking, as this will improve
oxygenation and aid with relaxation of your muscles.
You are always the best judge of how you
are feeling. If you are unwell or have a fever, then don't
exercise. If you feel unwell while walking, are short of breath,
develop any pain in your pelvis or back, or have any unusual
symptoms, then stop exercising and seek advice from your LMC. Never
exercise on an empty stomach - you need fuel from food to exercise
as your baby requires this energy to grow. So aim to eat regular
meals -------and have a healthy snack on hand at all times.
One of the most important considerations
when exercising during the first trimester is to avoid overheating.
Both exercise and pregnancy raise your metabolic rate and core
temperature - which, if left unchecked, could affect the baby's
development. To avoid overheating, ensure you drink frequently
before, during, and after exercise and avoid exercising on very hot
or humid days.
The second trimester: Get glowing
This is the time most women feel at their physical best during
pregnancy, as energy levels and nausea tend to improve.
Concentrating on your posture while walking will help to engage
your core muscles and may even help to prevent lower back pain.
Walk tall and imagine a piece of string attached to the top of your
head lifting your taller. Try "hugging" baby towards your spine by
slightly flattening your lower abdomen, but DON'T hold your breath.
Remember, this is subtle, and holding your tummy in too tightly can
do more harm than good. Try to keep your arms and shoulders
relaxed. You can check this regularly by shrugging your shoulders
up to your ears and letting them go again.
If you feel like an extra challenge and
would like to tone your arms a little, try walking with some light
1-2kg hand weights.
Third (and final!) trimester
Well done on exercising throughout the first two thirds of your
pregnancy, you are now on the home straight. Healthy pregnant women
can continue to walk up until their due date. If you are able,
continue with your 5-6 times per week walking programme.
As the baby grows, don't be surprised if
you feel a little uncomfortable at times as your expanding uterus
can compress your organs, including your lungs. In addition, if you
start to feel any sharp pains or aching in your pubic bone, your
upper thighs or your lower back, then don't hesitate in seeing a
women's health physiotherapist - they will be able to assess the
problem and modify your exercise accordingly.
Despite the best shoes and adequate rest,
most pregnant women will experience foot pain at some point in the
final trimester. Try applying hot or cold packs, foot massage,
remove your shoes and elevate your legs, and avoid high heels and
any high impact exercise. If the foot pain persists, consider
seeing a physiotherapist or podiatrist who specialises in
pregnancy care.
Walking, not waddling
In the later months of pregnancy, many women develop a
characteristic waddling gait. This is often due to changes in their
posture and centre of gravity. When this happens, the gluteal
(bottom) muscles tend to get "left behind", so to speak. Avoid
waddling by staying tall, gently "hugging" your baby (as mentioned
above), and engage your gluts by squeezing your buttock as you
extend each thigh.
If you are finding that your bulging
abdomen is becoming uncomfortable while walking, you might want to
continue your walking programme in the water. Just be sure that the
temperature of the water doesn't exceed 28-29 degrees celsius, to
help avoid overheating.
Engaging, isn't it?
Any time from about 37 weeks your baby may "drop" or the head may
start to engage in your pelvis. Sometimes this puts extra pressure
on your pelvic joints, which can make walking feel a little
strange. You may also experience occasional electric shock
sensations, but this is usually just due to the pressure of the
baby's head in your pelvis. As long as it doesn't bother you too
much, you can usually continue walking. If in doubt, always speak
with your LMC or women's health physiotherapist.
If you've managed to walk regularly
throughout your pregnancy, then give yourself a pat on the
back. Along with all the health benefits, you will have
improved your stamina to help you manage during labour, as well as
preparing yourself physically for the demands of motherhood.
references
- Bainbridge, J. "Obesity expert calls for pregnancy guidelines
to be revised." British Journal of Midwifery 16.4(2008): 253.
- Barakat R, Stirling, JR, and Lucia, A. "Does exercise training
during pregnancy affect gestational age?
- A randomized controlled trial." British Journal of Sports
Medicine 42 (2008): 674-78.
- Paisley, TS, Joy, EA, and Price, RJ. "Exercise during
pregnancy: A practical approach." Curr Sports Med Rep2 (2003):
325-30.
- Royal College of Obstetricians and Gynaecologists. "Statement
No 4: Exercise in Pregnancy." January 2006.
- American College of Obstetricians and Gynecologists.
"Guidelines for Exercise in Pregnancy 2002."
- Sports Medicine Australia. "Exercise in pregnancy."
sma.org.au/wp-content/uploads/ 2009/10/WIS-ExPreg.pdf
Lisa Yates is a mother of two young girls and an experienced
physiotherapist with a special interest in women's health. She
walked and swam during both her pregnancies and still enjoys
walking with her girlfriends along the beautiful Taranaki
coastline. In 2008 she co-founded FiLiFit Ltd to help nurture
healthy lifestyles. Lisa is passionate about education and
together with midwife and personal trainer
Fiona Ross, she developed The Core & The Floor (available
from www.filifit.com). This
comprehensive DVD is a must have item for every woman to safely and
effectively get in shape after pregnancy and childbirth.
As seen in OHbaby!
magazine Issue 12: 2011
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