Exercise and health in your pregnancy

Our exercise guru answers your queries about exercise and pregnancy health

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Avoid reflexology in your first trimester just to be on the safe side

Q:  I’m 25 weeks pregnant and I am have pelvic arthropathy. I have a support belt and am going to see a physiotherapist, but are there any additional exercises I can be doing?

A: To begin with, let’s look at the cause of this uncomfortable condition. In a non-pregnant state, the pelvis is jointed in a way that does not allow movement. Under the influence of pregnancy hormones, however, the cartilage of the joints becomes softer and allows the bone to move (in preparation for the baby’s birth). It is this movement and displacement of the bones that causes the pain, mostly around your pubic area and spreading out to the groin and front and back of thighs.

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Your physiotherapist will give you a tailored exercise programme to suit you, but there are lifestyle changes you can put in place to promote a less painful pregnancy. You will find lying on your back and trying to turn on your side will worsen the pain, so try to find comfortable positions and support to help you move when you go to bed. When you walk you will find yourself shortening your stride, making you almost waddle. Concentrate on keeping your posture lifted and as tall as you can stretch. Finally, avoid stairs or steps as much as possible – lifting and supporting this movement is going to be especially painful!

Q: I’m 18 weeks pregnant, and I have backache! Can any exercises help?

A: More than 50 per cent of pregnant women complain of back pain during pregnancy. The main culprit is the extra weight of the baby changing your centre of gravity. Hormonal changes during the early part of pregnancy offer other contributory factors, and you also have loosening ligaments between pelvic bones and joints in preparation for the birth. You should be strengthening both your abdominals (which support your bump) and your lower back (which supports your abdominals). So basic ‘cat curl’ exercises for your abdominals (sit-ups are out as you shouldn’t exercise while lying on your back from the first trimester onwards), while an exercise like ‘Superman’ will both improve your core stability muscles and strengthen your lower back. Try to keep the right posture – avoid artificial strain, walk properly and no slouching! These tips may also help: frequently change sitting position, avoid standing for too long, avoid high-heeled shoes and make sure you get proper rest and sleep

Q: Are there any exercises I can do to reduce the risk of SPD? I’m 12 weeks pregnant.

A: Symphysis Pubis Dysfunction, or SPD, can occur during pregnancy when the pelvic joints move, causing pain in the pubic or groin area. It’s often felt during the middle of your pregnancy, but can occur at any time. During pregnancy, the body releases a hormone called relaxin, which softens the ligaments in your body in order to make it easier for your baby to be born.

No one is quite sure what causes SPD, but experts think that if one side of your pelvis moves more than the other when you walk or move your legs (which is surprisingly common), this can lead to pain and inflammation at the symphysis pubis, the joint which connects the two halves of your pelvis together.

There are lots of exercises that you should avoid doing during pregnancy to help prevent SPD. Avoid anything that overly separates your legs, such as any straddling movements, for instance when you get in and out of the car or bath. If you do need to separate your legs, do it slowly and carefully. Exercise classes that incorporate inside and outside thigh exercises, squats and lunges should also be avoided. If you go swimming, don’t do breaststroke, and take care with the other strokes. Though swimming is highly recommended throughout pregnancy, this is the one activity that can feel like it is helping while you are in the water, but can cause an increase in pain when you get out. Follow the age-old advice – if it hurts, don’t do it!

Performing regular pelvic floor exercises and lower abdominal exercises can help reduce the strain on your pelvis. To perform a safe and easy lower abdominal exercise, get down on your hands and knees and level your back. Breathe in then as you breathe out, perform a pelvic floor exercise and at the same time pull your belly button in and up. Hold this contraction for 5 to 10 seconds without holding your breath or moving your back. Then slowly relax the muscles at the end of the exercise.

Q: Can you give me any tips for strengthening my back? I’ve had problems before and I’m worried that a bump will set them off again.

A: The key is to work on the lower back and abdominals, so you create a ‘corset’ of muscles to keep your bump supported and your lower back safe from strain. The best exercise is called the ‘Superman’. Begin on all fours, hands in line with shoulders, knees in line with hips, shoulder blades back and down. Try to lengthen the neck and spine, pulling your bump towards you. Now lift and straighten you right arm and left leg (like Superman flying!). Return and repeat with the left arm and right leg. Do this 10 times, rest for 30 seconds and then repeat.

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Q: I go for weekly reflexology sessions and have just found out that I am 8 weeks pregnant. My therapist has told me that I cannot have any more sessions until after 12 weeks as it may affect the baby. Will the previous sessions have affected the baby’s early development, and when is it ok to restart as I really enjoy the treatments?

A: To start with your most important query: reflexology should not harm the baby in any way. However, the reason for your practitioner’s advice is set by guidelines supplied by ITEC, the regulatory body for the practitioners of reflexology. According to Jan Parker Grafflin, RMANM, a qualified reflexologist based in Felixstowe, Suffolk, the reason is simply for precaution. “While there is no evidence that our treatments can cause miscarriage, a qualified reflexologist would advise avoiding treatments in the first trimester as miscarriage is common during this time.” From the first trimester onwards, you will find your treatment useful for all kinds of pregnancy complaints – from morning sickness, backache, digestive problems, through to puffy ankles and legs – and your practitioner should be able to help alleviate these discomfort. It can also play an important role during the birth. Many women have reflexology to encourage labour, especially if they are overdue. Reflexology can stimulate the release of oxytocin, the hormone that starts uterine contractions. But it can be used to keep the body calm and relaxed, even right up until labour. So don’t panic – take a few weeks off and then ask to carry on with your treatments.

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