It’s a topic constantly doing the rounds on traditional and social media; fuelled by the continuous procession of celebrities promoting their support for a certain approach, there are many opinions (informed or otherwise) which are often conflicting and confusing. So, where do I stand on the topic?
As a registered physiotherapist with a keen interested in women’s health and a mother of 3, I am often asked for advice by women who are either planning pregnancy, expecting, or in the early post-partum phase. I find the majority of the confusion centres around what type of exercise is safe – both for the mother and for the baby; and as a fit mummy myself, many ladies feel comfortable chatting with me about their personal wish to stay as fit as possible during pregnancy and beyond.
Exercise is also an extremely important and healthy tool some women use to relieve stress and clear their heads. Sometimes, women are almost ashamed to admit their need to continue with high levels of exercise, feeling that they should no longer be concerned with their own desires, but should be focused on the needs of their baby. (Moderate) exercise during pregnancy has in fact been found to improve the overall life-long physical and mental health of the mother when compared to those who do not exercise. How much? The recommended amount is 150 minutes of moderate exercise per week or 70 minutes of higher intensity, or a combination of both. There are no clear guidelines for upper limits, perhaps because not many pregnant women put their hands up to be tested to the limit while carrying a child.
My message: it’s ok (and actually quite normal) to want to continue with exercise you enjoy, but I do caution women to take care in certain areas:
1. EASE INTO IT. Don’t attempt to embark on a fitness frenzy when you find out you are pregnant: if you weren’t already doing vigorous exercise, you shouldn’t start now. It is safe though to begin with moderate exercise like walking, swimming, aqua-aerobics (recent studies have found it is safe for women to exercise in pools up to 33degC) cycling, gentle resistance exercise, gentle yoga…..the list is endless!
2. PRECAUTIONS. If you already enjoy higher intensity exercise, please continue! Personally I recommend the following modifications: STOP running and STOP sit-ups (I will address these later), EASE OFF on heavy weights (unless you are an elite athlete): the hormones circulating in your body are causing your ligaments to become lax, meaning that your joints are no longer as stable. High loads through your joints put them at risk without the full support of static stabilisers (ligaments); and STOP doing loaded exercise through an uneven pelvis: ie I do not recommend weighted lunges, step ups or any other exercise where both feet are not loaded evenly, again because of the lax ligament issue
3. BODY TEMPERATURE. Avoid raising your body temp too high – listen to your body, if you feel as though you are overheating, you very well might be. And NO EXERCISE when ill/feverish.
4. HEART RATE. Avoid raising your heart rate more that 75% of max (which is 220bpm minus your age). Your heart is already working at an increased intensity to pump around the 25% increase in blood volume (by end of gestation). Your other organs have similarly increased their output, so you can no longer push yourself to the point of exhaustion.
5. RISKY SITUATIONS. Avoid/take care in any exercises which put you at risk of falling/being struck. Also remember your balance and centre of gravity change as your tummy grows – give yourself a little extra slack – you might not be as nimble as you were without your bump!
6. LYING ON YOUR BACK. Avoid lying on your back in the 2nd half of the pregnancy as this can slow the return of blood to your heart.
Now, let me get to running and sit-ups! These are two that cause most of the controversy in the media. Many health professionals will have different views but I do not recommend either exercise (unless you are an elite athlete) and here are my reasons:
- ·RUNNING: risk of raising heart rate too high, risk of overheating, risk of damage to pelvic floor later in pregnancy, risk of falling, uneven forces through pelvis particularly as you fatigue
- SIT-UPS: the tummy needs to stretch in order to accommodate your growing belly, tightening the rectus abdominis by doing sit-ups will shorten the muscle belly. These shortened and tight fibres are then resistant to the stretching required and in my opinion, you are more likely to get a diastasis tear (hernia above you belly button). As soon as I found out I was pregnant each time, I switched my ab routine for cobra stretches (1st half of pregnancy only) – your abs get enough of a workout when you engage them for all your other exercises! Secondly – sit ups add a risk of back injury with the altered axis and loading around the spine when pregnant.
The other topic I discuss with women is their motivation behind wanting to exercise at high intensity. What are their personal goals around doing so? And, will modifying their fitness goals for a relatively short period of time actually be detrimental to their life long fitness? In my experience, most women who are fit before falling pregnant, very quickly return to this level of fitness after the baby is born. Muscle memory is very strong and when you combine this with being highly motivated to keep yourself fit, you have the perfect recipe for the long term health of both you and your baby, at whatever fitness level you desire.
Kate Boucher is a physiotherapist with over 13 years’ experience and mother of 3. She is a strong believer in a comprehensive, integrated approach to health. Kate enjoys working with mothers both pre and postnatally – whether it be to treat back and pelvic pain and instability or in addressing pelvic floor and core strength. She also understands the desire some have to return to high level sport and exercise and has intricate knowledge in establishing safe pathways for these goals to be reached.