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Exercise during and after Pregnancy

05/06/2017
pregnancy

Resilience of the Human body

Ask any physio and they will tell you that the human body is an incredible thing. Our ability to recover, grow and change is phenomenal when we think about the physical processes our bodies undergo every minute of every day throughout our entire lives.

Even at rest without being able to tell, our bodies are changing in the most amazing ways. Organ systems from our skin, stomach lining and even bones are constantly being remodelled with old cells being removed and replaced with new cells.

When our bodies are required to recover following significant change or injury, that’s when the body really kicks it up a gear and the changes that occur are often more drastic. In response to injury or physical insult, our bodies subconsciously increase production of the regulatory proteins and hormones that are responsible for tissue repair and growth. This enables our broken bones to fuse, cuts to seal up and muscles to heal.

The amazing resilience of the body is no better summarized than during the processes of pregnancy and childbirth.

 

Pregnancy

During Pregnancy, the body undergoes significant change both physiologically and from a biomechanical point of view. Not only is there significant increase in fluid composition (in the form of increased blood volume and amniotic fluid) but the overall weight of the expectant mother can increase from 11-17kg in normal healthy adults to accommodate the fetus. This shifts the centre of mass forward which causes a compensatory increase in the lumbar lordosis or curve to compensate.

body-changes-during-pregnancy

 

Along with the shift in centre of mass, the body releases hormones that soften ligaments to accommodate the growing fetus. Unfortunately, as a side-effect of these changes, many expectant mothers often experience SIJ instability, lower back pain, Knee and foot pain, separation of the rectus muscles of the abdomen and other areas. Much like the effects of pre-conditioning (or ‘prehab’) in the lead up to joint replacement surgery, by staying fit and active throughout pregnancy, you can improve your recovery after childbirth.

 

Pregnancy and Pilates

A great way to prepare your body for the changes that come with pregnancy and childbirth is to ask your Physiotherapist about Pregnancy Pilates. Our Pregnancy Pilates program has been designed to cater to the body as it changes in the lead up to childbirth. Unlike most exercise programs that increase in intensity as you go, Pregnancy Pilates actually eases off as you progress through your pregnancy. This ensures that the exercises remain safe, yet are effective in maintaining muscular control and stability as long as possible.

Although Pregnancy Pilates can be effective in improving symptoms such hip and back pain, there may come a time where the physical changes of pregnancy prevent participation or make exercising too uncomfortable. Almost half¹ of all women will experience pregnancy-related lower back and pelvic girdle pain at some stage during pregnancy. If this occurs, it’s good to know that along with massage, postural education and tissue release, your Physiotherapist can recommend some passive supports to help in symptom management in your last trimester.

Supportive braces and aids such as Pregnancy Shorts are used by many women who swear by them in terms of the support and comfort they provide. These shorts are designed to fit discretely under clothing to help stabilize the core and support the lower back and hips during the last trimester of pregnancy. Such supportive garments can assist you not only in comfort, but may actually allow you to maintain your activity levels where back pain may have prevented you from participating.

Thankfully, once childbirth has taken place most of these changes are reversible due to the amazing resilience of the human body. This process can however take months to occur.  Most women can suffer from separation in their abdominal muscles during pregnancy and after 5-7 weeks of giving birth up to 36% may still have evidence of this2. In addition, pregnancy-related pelvic girdle pain can still occur post-pregnancy with up to 20-25% of women still experiencing pain in the months just after child-birth¹. This is why many women can benefit from physiotherapy intervention – both in terms of active treatment and exercise as well as prescription of passive supports such as Recovery Shorts – to facilitate a quicker, stronger recovery.

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Exercise after Pregnancy – facilitating recovery

As mentioned in our previous blog on Pilates, these types of exercise are excellent in conditioning the muscles in a global sense and can help improve stability of the core and pelvis. For new mothers, the benefits of exercising may be much greater than just getting stronger.

Benefits include…

  • Weight loss
  • Hasten recovery
  • Increased energy levels
  • Muscle strength and toning
  • Social interaction
  • Psychological well being
  • Reduced anxiety and depression

There are no hard and fast rules about when to start exercising again after having your baby but after 6-8 weeks, generally the body is ready for reintroduction into some form of exercise program. Research suggests a combination of different types of exercises including aerobic or cardiovascular training and resistance exercise is required to yield the best results.

Core stability training is very important and should form part of every new mothers’ exercise program. Your pelvic floor muscles will also have been affected by pregnancy so it is very important to learn pelvic floor exercises correctly and do them on a regular basis.

Top 5 tips for exercising after pregnancy

  1. Start gradually with low impact exercise
  2. Drink plenty of water
  3. Wear a supportive bra
  4. Exercise after breast feeding
  5. Include core stability training and pelvic floor exercises

If you are currently pregnant or are planning to start a family, feel free to chat to one of our physiotherapists about exercise, pilates or what to changes to expect from a musculoskeletal point of view. Although all our physios are professionals who are able to provide advice and treatment, we have recently welcomed a female physiotherapist who you can talk to if preferred.

References

  1. Wu, W.H., Meijer, O.G., Uegaki, K., Mens, J.M., Van Dieen, J.H., Wuisman, P.I., et al. (2004). Pregnancy-related pelvic girdle pain(PPP), I: Terminology, clinical presentation, and prevalence. Eur Spine J, 13(7); 575-589
  2. Spitznagle, T.M., Leong, F.C., & Van Dillen N.R. (2007). Prevalence of diastasis recti abdominis in a urogynecological patient population. International Urogynecology Journal, 18(3); 321-328

 

 

Vatche Douzmanian

Physiotherapist

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