Six reasons why aqua fitness is great for pregnancy

Just add water! For the ultimate low-impact workout, swimming and aqua exercise are perfect for keeping fit during pregnancy and toning up after giving birth. Lisa Yates explains.
Swimming is one of the most versatile, low-cost total body workouts around. Whether you are a busy mother, pregnant or postnatal, aquatic therapy may be the perfect way to spruce up your current (or non-existent) exercise regime. The physiological benefits of exercise are widely documented - improved muscle strength and tone, better cardiovascular fitness, lower cholesterol and fat, improved core strength and better sleep. Less well-known, however, are the mood-enhancing effects, making it a great weapon to combat winter blues. And with water aerobics, aqua jogging and water-walking available, you don't even have to swim to reap the benefits.
Here are six reasons why swimming and aqua exercise are great for pre- and post-natal exercise.

1. Decreased load/strain on the joints: As your body is immersed, water is displaced which creates the force of buoyancy. Quite simply, this results in a lighter load on the immersed joints - the deeper in the water you go the more the weight is reduced. So, by standing in water up to your belly button, you will off-load about half of your body weight. Go a little deeper (chest-height) and you'll have decreased the load on your joints by up to 70%!

2. Increased resistance to movement: Water is denser than air, creating increased resistance to movement and therefore requiring more effort from your muscles to move. If you want even more of a challenge simply push harder against the water.

3. Decreased swelling: Thanks to hydrostatic pressure on limbs, many find the oedema (fluid retention) in their legs is improved once out of the pool. The deeper you go the greater the effect.

4. Increased support: No matter what your size or shape, the water offers fluid support, making injuries less likely. Many women report feeling safer and less self-conscious exercising in the water - and it's great for those pregnant clumsy moments!

5. Improved mood: Studies have confirmed this finding with participants reporting decreased stress, tension and anger. You only have to witness the laughter of children playing in the bath or down at the beach to see that there is something therapeutic about being in the water.

6. Safe until delivery: For healthy pregnant women with no complications it is perfectly safe to exercise in the water right up until your due date. Always listen to your body and if you feel short of breath it is advisable to slow it down a little. As a general rule you should be able to talk while exercising during pregnancy.

Sink or swim?
Many women ask why they have trouble floating in the water. In general, the more body fat you have the more likely you are to float. This generally helps women, as we tend to have more body fat than men and are therefore more likely to float. The pregnant uterus, which is largely made up of water, tends to increase the tendency for floating. So even if you used to be a sinker you might find things actually change once you are pregnant.

Different strokes 

• Freestyle: Freestyle is very popular and great for all levels of fitness. It is excellent for upper body strengthening (handy for carrying children and looking really great in a tank top).
  Tip: Keep your legs as straight as possible and move from the hips without bending your knees. This keeps you more horizontal in the water (stops your legs sinking) and works your bottom more. If you don't like freestyle just use a kick-board with your arms out straight and kick your legs in the same way.
  Starting out:  Start with one or two laps of freestyle/kicking with the board then alternate with breaststroke or water-walking so you don't tire out too quickly.
• Breaststroke: Loved by nannas everywhere, breaststroke is a fabulous arm and chest toner and the frog-like kick is great for toning and shaping your inner and outer thighs.
  Tip: A great stroke for starting out, especially if your aerobic fitness isn't as great as it could be, or if you don't like fully submerging your head.
  Pregnancy: Be careful with this stroke if you suffer any pubic symphysis pain (groin pain), as it can exacerbate these symptoms. If you do experience this problem, avoid breaststroke until you talk to a women's health physiotherapist.
• Backstroke: This is often the "forgotten" stroke. Backstroke is great for strengthening the back muscles, which are vital for good posture both during pregnancy and afterwards for feeding baby. It will also help stretch out your chest and arm muscles which is lovely after swimming on your front.
  Tip: Backstroke is also great at toning the triceps (back of the upper arms) and the abdominal muscles.
• Deep-water (aqua) jogging: This is a fantastic option if you're not keen on swimming. It is also a great form of cross-training and equally useful if you're recovering from an injury. If you are pregnant or have just had a baby this can be the perfect way to continue jogging without adding any stress to your joints. 
  You'll need:  A floatation vest or belt. Most local swimming pools will have specifically designed belts that are usually free to use. In deep water, start jogging as you would on the ground or a treadmill. Aim to keep as upright in the water as possible.
       If you want to increase the intensity you can simply swing your arms higher or move them faster, creating more turbulence in the water and making you work much harder. Try jogging forwards, backwards, sideways or even diagonally. You can jog as you would on land with bent knees or, for an extra challenge, try a scissoring action with straighter legs.
• Aqua aerobics/aqua-natal classes: Many swimming pools run aqua aerobics classes, including some designed for pregnant women. This can be a great way to meet other pregnant women and the camaraderie can be as beneficial as the exercise itself.
  Tip: Inform your instructor if you are pregnant or have any particular problems such as pelvic pain. In general, if you have been feeling pelvic/groin pain with certain exercises (such as walking or going up stairs) avoid taking your legs too far apart.

Aqua exercise ideas
Wearing the aqua belt in deep water or standing in chest-deep water try the following:  
Arm circles: Rotate your arms in small circles in front of you as fast as you can. Do this for 30-60 seconds and then try the same behind your back - this is a little harder.
Strong arms: Stand with your knees slightly bent, your lower tummy pulled in gently and your arms by your sides with fingers together and palms touching your thighs. Take your straight arms up to the surface of the water and then pull them down to your thighs again. To work your arms harder, increase your speed. Repeat 15-20 times rest 20 seconds and repeat 10-15 times again. Don't forget to breathe!
Pelvic tilt: This exercise is fabulous to help with lower back pain and strengthening the lower abdominal muscles. Stand in chest/waist-deep water with your back against the wall and your arms up on the side of the pool. With a slight bend in your knees, tilt your pubic bone forwards, tucking your bottom under and flatten your lower back towards the wall. Hold for two to three breaths and then relax. Repeat this five times. I can't stress enough the importance of pelvic floor exercises for all women, but especially those pregnant or postnatal. See At risk of a pelvic floor  or Healing your pelvic floor   or go to www.filifit.com for more information.

Pregnancy pointers
Keep cool, baby: Exercising during pregnancy in warm water could result in your overall body temperature rising more than it normally would. To ensure you don't get over-heated avoid exercising in very hot weather and drink regularly throughout exercise. If at any point you feel hot or unwell take a break.  
Balancing act: When your tummy begins to protrude you will find your centre of gravity changes and at times you may feel off balance. Take extra care walking on wet surfaces and always use the ladder to get in and out of the pool as this takes the strain off your stretching abdominal muscles. Take your time getting out so your blood pressure has time to readjust and you don't get a shock when the full effects of gravity once again take hold and you have to support your bump again.
Complications: While water exercise is a safe form of pregnancy exercise, if you have any medical conditions it is best to check with your LMC/doctor before exercising during pregnancy.
Don't cramp your style: Pregnant women often complain of tightness and cramping in the muscles of the lower legs. Water exercise (often with toes pointed) can aggravate calf problems. Make sure you always stretch out your calf muscles by doing some standing lunges before getting out of the pool. 
Hunger buster: Many women report feeling ravenous after a water workout. Make sure you have a healthy snack on hand such as a banana so you are not tempted to fill up on "empty" calories such as chocolate for the trip home.
Waters breaking: While this is unlikely, if it does happen (and you are aware of it), it's best to get out of the water and follow the advice of your LMC.
Postnatal: It is advisable to wait around six weeks following a vaginal delivery and possibly longer following a caesarean delivery before getting into the pool. It is important to wait for any wounds to heal fully and until you have stopped bleeding. Check with your LMC before heading into the pool postnatally.





Lisa Yates began her career over 14 years ago teaching water exercise to pregnant women. She currently teaches hydrotherapy for rehabilitation purposes. Lisa swam during both her pregnancies and loved the feeling of freedom and weightlessness. Lisa is a physiotherapist and personal trainer with a special interest in women's health.  Together with Fiona Ross, a personal trainer, she co-founded FILIFT and produced The Core & The Floor (available from www.filifit.com), New Zealand's first post-pregnancy exercise DVD. For more information go to www.filifit.com .

References

• Cole, A & Becker B. "Comprehensive Aquatic Therapy." Butterworth Heinemann 2nd Edition 2004: 19-53.
• Kent, T et al. "Edema of pregnancy: A comparison of Water Aerobics and Static Immersion." Obstetrics and Gynaecology 1999 (94) 5: 726-729.
• Takeshim, N et al. "Water-based Exercise Improves Health- related Aspects of Fitness in Older Women." Medicine and Science in Sports & Exercise. 2002 (34) 3: 544-551.
• Swimming New Zealand. "Active Movement in Water During Pregnancy" http://www.swimmingnz.org.nz/uploads/fles/AM_in_Water_during_pregnancy_HO_17.07.06.pdf

As seen in OHbaby! magazine Issue 14: 2011

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