How to Safely Exercise When Pregnant

Remaining active during a pregnancy may help reduce some discomforts and help prepare the body for delivery. Acute exercise generally increases oxygen uptake, heart rate, stroke volume, cardiac output, and lung volume during pregnancy. Remember to complete the “PARmed-X for Pregnancy” health screening prior to participation in a prenatal fitness class or other exercise. Medical clearance should be obtained prior to exercise for women who were sedentary prior to pregnancy or have a medical condition.

Benefits:

• reduced backaches
• reduced constipation and bloating
• may help prevent gestational diabetes
• improved weight management
• increase in energy
• improved mood
• improved posture
• better sleep patterns
• development of muscle tone
• promotes strength and endurance
• better coping with labour

Contraindications to Exercise:

Absolute Contraindications:

• hemodynamically significant heart disease
• restrictive lung disease
• incompetent cervix/cerciage
• multiple gestation at risk for premature labour
• persistent second or third trimester bleeding
• placenta prevue after 26th week of gestation
• premature labour during current pregnancy
• ruptured membranes
• preeclampsia/pregnancy-induced hypertension

Relative Contraindications:

Exercise Recommendations:

Aerobic Exercise

Intensity: Moderate intensity exercise is encouraged for women with a pre-pregnancy body mass index (BMI) of less than 25 kg per squared meter. However, women with a pre-pregnancy BMI of greater than 25 kg per squared meter should engage in light intensity exercise.

Resistance Exercise

Pregnancy, Exercise & Massage Therapy

FEEL YOUR BEST

Let us start by reviewing the facts; 40-42 weeks is 10 months, not 9.  However, the amazing journey to motherhood can actually comprise a year-long (or more!) period of metamorphosis.  The question I hear repeatedly from patients during their pregnancy, (including the 3 months post partum ‘trimester’) is:

“Are Exercise and Massage Therapy Safe?”

The simple answer for uncomplicated and healthy pregnancies (and 4-6 weeks post partum following straightforward vaginal delivery) is YES. After receiving the go ahead from your midwife or obstetrician there are some simple guidelines to follow.

EXERCISE

Pregnancy and exercise

According to the Public Health Agency of Canada’s “Healthy Pregnancy Guide”, Regular physical activity during pregnancy can:

• improve your mood and self-image

• help ensure appropriate weight gain

• help you relax and reduce stress

• promote better sleep

• increase your muscle tone, strength and endurance

• help build your stamina for labour and delivery

• speed up your recovery after labour and delivery

• help increase your energy levels

Two Main types of Exercise

There are two main types of exercise to consider: cardiovascular and strength training. While continuously monitoring your current pregnancy status thru the trimesters is important, you must also heed your pre-pregnancy level of fitness.

The Society of Obstetricians and Gynecologists of Canada advises that with the go-ahead from your health care professional, for those with at least 6 months of previous activity, “sports or workouts” can be safely continued. They further advise that for those with a history of inactivity, to start exercising in the second trimester; adopting a “low and slow” (low impact) regime including both cardio and muscle toning exercises.

There are many pregnancy specific exercise programs available in the community including yoga and weight lifting classes. If you or your health care provider have any questions regarding whether or not you are fit enough to participate, ask your fitness professional to use the screening tool, the Physical Activity Readiness Medical Examination for Pregnancy, produced by the Canadian Society for Exercise Physiology, available here:

http://www.csep.ca/cmfiles/publications/parq/parmed-xpreg.pdf

Precautions

• avoid exercises in the supine position (lying on her back) past 16 weeks
• avoid bouncing exercises, activities that cause falls and contact sports
• stretches should be controlled
• avoid abdominal exercises if diastasis recti (splitting of the connective tissue midline in the front abdomen wall) develops

MASSAGE THERAPY

Neck Massage

How it helps

Health link BC suggests the use of massage therapy during pregnancy as an aid for “relaxation and to help relieve muscle tension and pain”. The body makes many accommodations for the growing fetus and endures hormonal changes in joints to allow for eventual delivery. For some the resultant laxity or looseness in the joints is pain free but other women unfortunately experience aches and muscle pain adapting to the added weight and postural changes that occur during pregnancy.

The Massage Therapist’s Association of British Columbia suggests that massage therapy during pregnancy can:

• Reduce general muscle tension and pain
• Decrease stress, tension and anxiety
• Improve mood and sleep
• Decrease back and pelvic pain
• Reduce headaches
• Manage symptoms of edema and sciatica

What to Look For

Choose a therapist with the right training. All registered massage therapists in BC receive education that applies to the treatment of pregnant patients.

Be aware that special pillowing and modified tables may be used and/or your treatment position could eventually remain in side lying for your comfort and safety.

Certain essential oil usage during your treatments should be avoided. Rattray and Ludwig list these as: basil, bay, clary sage, cypress, fennel, frankincense, hyssop, jasmine, juniper, marjoram, myrrh, peppermint, rose, rosemary and thyme. (p 185, Clinical Massage Therapy, 2000)

In ALL pregnancies there are certain signs and symptoms that need to be addressed immediately! According to the Canadian Society for Exercise Physiology these include:

• Excessive shortness of breath
• Chest pain
• Painful uterine contractions (more than 6-8 per hour)
• Vaginal bleeding
• Any “gush” of fluid from vagina (suggesting premature rupture of the membranes)
• Dizziness or faintness

The Last Word

Every woman and every pregnancy is different. I know women who because of their pre-pregnancy athletic lifestyles completed ½ marathons at 7 ½ months gestation, managed step aerobics until 7 months and did yoga until the day of delivery. It would be folly to start training for a 10km timed event, if you were not already fit enough to complete one before pregnancy. And eventually, like a patient who stopped bike commuting to work at 7 months, safety must be your priority. 

Be smart, modify as necessary and listen to your body!

References

http://www.phac-aspc.gc.ca/hp-gs/guide/04_pa-ap-eng.php
http://sogc.org/womens-health-information/
http://www.healthlinkbc.ca/healthtopics/content.asp?hwid=tn10070
https://www.massagetherapy.bc.ca/

Call INSYNC PHYSIO at 604-566-9716 to book your Massage Therapy appointment today.

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Michelle Robichaud, Registered Massage Therapist Send Email

BHSc, RMT

Michelle has had varied experience in her massage therapy career, working in sports, spa and general practices in Vancouver, Whistler and Victoria.  After graduating from the WCCMT in 1996, she upgraded her basic diploma to enhance her practice skills and then went on to complete a Health Science Degree from Thompson Rivers University (2011). Michelle is a member in good standing with the College of Massage Therapists of BC and the Massage Therapists Association of BC.

After 15 plus years of practice Michelle remains passionate about her profession and is keen to continue learning; she loves helping people feel better. Michelle employs various techniques such as trigger point therapy, fascial release, joint play and Swedish massage to help address headaches, pregnancy related issues, sports injuries and work related concerns, such as low back pain.  From recreational sports enthusiast to computer programmer at the desk, many different people can benefit from massage therapy. 

Michelle stays active with her young family enjoying biking, hiking, yoga, golf and fitness classes.