Pregnancy & physiotherapy

Authored by Sue Lin Kalisch.

Even if your Physio is a male, or hasn’t had children themselves, their extensive knowledge of anatomy, biomechanics, and injuries, makes them an ideal source of information and advice for solving your pregnancy pain problems. Senior Physio and Pilates Instructor, Sue Lin discusses some of the common questions and misconceptions regarding exercising whilst pregnant, and post-partum.

Is it safe to exercise while I’m pregnant?

A resounding YES!!!! It is so important to maintain your fitness during pregnancy. In a nutshell, you’ll be carrying extra weight and blood volume, not to mention a little someone is pressing up against your diaphragm (bottom of your lung cavity), so you need to increase your cardiovascular fitness to simply help you get through your day to day activities.

This will become super important once you start to get bigger, and even more importantly, you need to be fighting fit to get through labour. Labour is pretty much like running a marathon, except you’ll probably be going at it for closer to the length of time it takes to complete an Ironman distance triathlon (3.86km swim, 180.25km bike ride, followed by a 42.2km run, or approximately 12-16 hours). No sane person would even attempt that sort of race without training, because it’s risky to push your body that hard without preparation! Needless to say, we should really be taking the same approach to preparing our bodies for pregnancy and childbirth, because it really does help to make the process faster and easier, and reduces the risk of injury.

So what sort of exercise is best?

The answer here is not so clear, because it really does depend on the individual, but this is where your Physio can point you in the right direction, or offer sound advice.

Generally, if you are already exercising, it is perfectly fine to keep doing what you’re doing (within reason), with a few modifications as you progress along. For example, weight training should be fine, but you don’t want to be trying to continually up your weights and smash out a bench press PB – maintenance of your strength and fitness is the key.

Modifications to certain moves and activities are based on the changing biomechanics of your body, and other factors such as joint laxity, and oxygenation of your tissues. For example, avoiding deep lunges which can stress your pubic symphysis, not laying on your back after the first trimester, and taking extra breaks during your session to keep your heart rate and breathing under control.

If you haven’t been exercising, and need to get started, you really can’t go wrong with walking, swimming, or specific pre-natal exercise classes such as yoga or Pilates. The key areas of your body to work are your aerobic capacity, legs, postural muscles, shoulder girdle, balance, and of course your pelvic floor!

Caution should be taken with contact sports, but with other sports (netball, sailing, jogging to name a few), it’s safe to keep going until you start to become uncomfortable, or develop any symptoms such as incontinence, or unusual pains around your pelvis. Most of us are pretty good at listening to our bodies and knowing what is best for us, but if you have any doubt, don’t be afraid to ask your Physio.

How does exercise help during pregnancy?

In addition to promoting general health and wellbeing of the mother and baby, there are a number of key benefits to be gained from exercising during pregnancy.

  • Improved cardio vascular function i.e.. Not getting as breathless whilst doing the grocery shopping, or walking up a flight of stairs.
  • Decreased incidence of aches, pains, cramps, and leg swelling.
  • Reduced risk of gestational diabetes and high blood pressure.
  • Improved fetal stress tolerance – meaning your baby copes with the birthing process better!
  • Studies show a lower incidence of operative deliveries, longer labours, and premature births.

Anecdotally, we see women who’ve exercised during pregnancy ‘bouncing back’ quicker, and feeling stronger sooner after delivery.

My friend has to wear a brace around her hips, should I be using one too?

Everyone’s pregnancy experience is different, so you may or may not need one, or you may even require a different type of support. So before you rush out and buy something, or use someone else’s brace, it’s a good idea to come in for an assessment.

I’m having a c-section, my pelvic floor will be fine!

I hate to break it to you, but it probably wont. Sure, it may not be torn or have contact damage, but it’s still going to be stretched and weakened from the effect of various hormones on your soft tissues, your increased weight plus the weight of the baby, and your changed posture and centre of gravity.

The only way to ensure your pelvic floor muscles make it through your pregnancy without incident, is to train them. Prepare them for pregnancy, keep working them all the way through, and start working them again straight afterwards.

Having a strong and well-functioning pelvic floor will help to maintain good posture during, and after pregnancy, reduce the incidence of incontinence, and if you chose to deliver naturally, having good pelvic floor function actually makes delivering your baby easier.

I didn’t have any problems with delivery, so I can just go straight back to exercising whenever I like, right?

Again, I’m sorry to be the bearer of bad news, but that’s probably not such a great idea! It will probably be ok to start walking when you feel ready, but for some women, their body may not even be ready to do that. The safest thing to do is have a post-natal check-up at around 6-weeks post-delivery, with a Physio who has training in women’s health.

At this check-up, we assess for rectus abdominis diastasis (RAD or DRAM), which is any gap between your stomach muscles, pelvic floor muscle function, and if you have one, we check your caesarean scar. We will guide you through any rehab exercises and self-treatment to do, and give you advice about how to slowly get back into your chosen exercise.

It’s not strictly necessary to come at 6 weeks, but it is definitely recommended before you go back to exercise. The longer you leave it, the more difficult it will be and the longer it will take to return, hence delaying your return to exercise.

But I don’t have time to do rehab or exercises!

We hear this excuse a lot, and we guarantee, that with Physios being the masters of problem solving, we can tailor your rehab to suit your situation.

This includes scheduling your treatment sessions around your requirements, even having someone on hand to hold a crying bubba if needed! Most exercises can be modified to be done in different positions, or even in stolen moments during the day. Incidental exercise, as we call it, is super easy, but super important, and can be done without the need for equipment or a lengthy time commitment, just a minute here and there will do the job!

Baby steps!

Please don’t compare yourself to celebrity mothers who regain their flat stomach, and post airbrushed gym selfies 2-months after giving birth. It is important not to pressure yourself or push yourself to achieve unrealistic goals. It might take you longer than you anticipated to get back to where you want to be, but the most important thing is that we work together to accomplish your goals. Working with your Physio to achieve this prevents any long-term damage, or problems which may develop down the track.

Never be afraid to ask us questions. Don’t even feel silly if you ask the same question of us multiple times because you’ve forgotten the answer, or need reassurance. We are here to help.

Sue Lin Kalisch

Senior Pilates Physiotherapist

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