Libby Norris: Simple and safe exercises for expectant mothers

It can be tough to find the energy and time to workout before, during or after a baby.  So why bother?  Regular bouts of exercise can certainly help to you to maintain a healthy body composition but has a long list of amazing benefits:

• increased energy and stamina - the energy invested will pay off!
• reduced leg cramps
• reduced inflammation
• improved digestion
• improved balance and posture
• increased strength - you're going to need that!
•  muscle balance - this gets totally thrown off before and after
• reduced back strain
• improved recovery - this I a huge win in my books!
• sets up positive habits for post baby life

Choosing what and how you exercise, though, can be tough part.  There are broad ranges with recommendations and everyone you speak with will have their own personal story and opinion.  

Understanding WHY some guidelines are in place, however, might help you to decide the right FIT for you!

1. Screening FIRST
Whether you do or don't currently exercise, check with your physician first.  There may be some things you want to modify due to any medical issues or conditions and you always want to err on the side of caution.  

If you're working out at a club, they should ask you to complete a ParMedX for Pregnancy form.  Check www.libbynorris.com <http://www.libbynorris.com> as I'll have a copy posted.  These are standard forms all fitness facility use as a screening but this one also includes tips and information for fitness guidelines.  

Guidelines vary based on your fitness level and activity before you get pregnant.  If you've been working out you can continue with activities you've been doing but you still want to modify.  This is NOT the time to sign up for mixed martial arts or a Tough Mudder run.  If you haven't been working out, you can still start, but it's a very gradual process.  I'll post specific steps and stages on my site as well.  

2. Modify intensity
We hear this all the time as a general recommendation, but you definitely want to be aware of why.  When you're pregnant, your heart rate may increase up to 20%, your blood volume increases 30-50% and your cardiac output increases by 40-50%.  At rest, you're body is already working harder.  This would be like jumping into a class after you've already warmed up on the treadmill - you're going to get tired sooner!  

In addition, you want to avoid dramatic elevation or changes in your own core temperature.  How would you like it if someone kept changing the thermostat!  It's a matter of both safety and comfort for both of you, so think of the following modifications:

• take longer and be more gradual warming up and cooling down
• stay between 60-80% of maximum heart rates for peak cardio IF you're already exercising and closer to that 60% if you're not accustomed to working out; if someone has been completely sedentary and/or is obese, exercising at 20-40% of that maximum heart rate is sufficient to realize an aerobic benefit
• Quick Calculation for Maximum Heart Rate:  220 - age  x % target
• But if you have been sedentary, ALWAYS check with your physician first!
• Use the "Talk Test" - this is easy to use anywhere and simply means you should be able to complete a sentence comfortably without gasping.  Try singing one round of "Happy Birthday".    If you can't make it through that, it's time to slow down!
• avoid intense intervals - you can still do your favourite classes and training, but if you're in a circuit or cycle class, focusing on gradual increases and decreases more like rolling hills that peaks and valleys!

3. Focus on breathing
This may sound obvious, but when you're pregnant, the rib cage flares to allow for adequate room for the lungs.  Oxygen consumption also increases by 15-20% during pregnancy BUT the oxygen stored in your blood and muscles (called your oxygen reserve) actually decreases.  

How does this affect you?  Well, again, you get tired more easily but it can also be tougher to breathe depending on your posture and where the baby is sitting.

Quick tip:  Take the arms up and out as you breathe in.  This helps take the pressure off and allow more air in

4. Posture practice
Your posture gets thrown off during and after a baby.  Added belly weight and girth tend to exaggerate the curve in your low back causing hyperlordosis which results in more low back pain.  Discomfort through the final trimester can also cause women to shift into awkward postures just looking for temporary relief.  

After the baby is born, posture becomes an even greater issue as maneuvering with a newborn consistently challenges balance.  In addition, exercise can have a positive impact on body image and increase your body's ability to bounce back after.

5. Controlled stretching
Staying flexible is great, but you can get too much of this when you're pregnant.  Less relaxin, estrogen, progesterone & elastin cause relaxation of the ligaments and cartilage around joints and rib cage to expand.  This all happens to make room for the baby, but can leave you susceptible to injury if you aren't careful as it's easier to over-stretch and pull or strain these areas.

What will needs more attention during and after pregnancy:
hip flexors - lengthen
quadriceps - lengthen
lower back - here, you want to stretch but also strengthen so work in both directions
chest/pectorals - open out and back
internal rotators of the shoulders - stretch open and back
neck and shoulders and rhomboids (shoulder blades) - depress or press downward

6. "Sport" Specific Strength
The "wonder" of child bearing and birth can end up feeling like marathon with a full court press at the end.  Like any athlete, you want to train specific for the challenges to increase strength, endurance, avoid injury and optimize recovery!  Here are some tips and guidelines for conditioning:

• avoid supine exercise after the 1st trimester - this refers to exercises lying on your back to Supine Hypotensive Syndrome which  5-10% of women experience; when the uterus is enlarged, it places pressure on the inferior vena cava (the one that returns blood to the heart from the torso and legs) and can cause nausea, dizziness and difficulty breathing
• high reps, low weights - use weights comfortable for lifting at least 12-15 repetitions; this helps to avoid breathing and joint issues as well as maintaining moderate intensity
• avoid overhead lifting - pressing weight overhead tends to increase the heart rate and blood pressure; opt for shoulder and chest exercise options below shoulder height (there's lots!)
• use bands - are a great option as they are easy to vary based on your stage and energy plus they provide a consistent resistance and may be easier to control for joint safety
• focus on posture - because your body is thrown off, pay particular attention to your posture while doing strength training as your posture changes throughout your pregnancy as do your daily physical demand with your baby and toddler!
• focus on balance - spend time on muscles that are being challenged by the changes in your body and daily activity; stretch the chest and strengthen your back; focus on the rear shoulder area vs. the front; incorporate functional exercises that reflect the activities (new and old) you need to do in a day including hip hinges (bending forward), squats, lifts and core
• standing and seated core - opt for core exercises focused on stabilizing vs. crunching; there are also lots of options standing and seated that won't increase risk of abdominal separation including roll backs, modified planks, bridges, etc.

Additional tip:  Check for Abdominal Separation Regularly
A strong core is definitely an asset during and after pregnancy as well as during delivery.  Be cautious working core, though, to avoid abdominal separation which can make all of those plus your recovery a lot more challenging.

Quick test:

• Lie on your back with your knees bent and your feet flat on the floor
• place your fingertips just above or below your navel
• Lift your head and shoulders off the floor and pull your chin to your chest
• Press firmly on your stomach, feeling for any separation between the bands of vertical muscles
• If the separation is greater than two fingers' width, you should be careful not to strain your abdominal muscles as you exercise
• Ask your medical caregiver or exercise instructor how you should modify your exercise.

Post Natal Exercise
This is different for absolutely everyone and it's critically important to listen to your body.  Start back with workouts once you feel up to it and gradually add both time and intensity.  Follow the same guidelines initially for cardio, strength and flexibility.  Err on the side of caution with intensity but it is a great opportunity to start being a positive role model with your new family member!

Use our link here on Canada AM to my site where you'll find additional information and outlines for pre and post natal exercise.
If you have any questions on how and where to get started with your workouts, contact Libby at www.libbynorris.com.  We love your feedback, questions and suggestions for segments.