Abdominals and aquatic exercise in pregnancy
by Sara Kooperman
It is incredibly important to keep the abdominal muscles toned and
healthy during pregnancy. Abdominal muscles not only support the body,
but help maintain proper posture and body alignment. Additionally,
maintaining toned abdominal muscles helps with returning to
pre-pregnancy shape after giving birth.
In the past,
European thinking often stressed a need to do away with abdominal
exercises. Educators who observed the lengthening of the rectus
abdominis through progressing pregnancies supported this. They observed
that the rectus abdominis lengthened and the abdominal wall thinned
because of the growing foetus; therefore, they (wrongly) assumed that
the abdominal area did not need to be toned.
Unfortunately, all too often, fitness professionals and the general
public think that toned muscles mean inflexible muscles. However, the
opposite is often true. Healthy, toned muscles can actually have
greater flexibility, increased range of motion, better circulation and
a better ability to recover from injury, strain and/or stress.
Keeping the abdominal muscles healthy, especially during pregnancy,
helps the post-partum woman return to her pre-pregnant physique faster.
It also helps the pregnant woman maintain proper posture and body
alignment without sacrificing the health of the baby or herself. Like
any other muscle during exercise, the abdominals should be strengthened
as well as stretched.
In the aquatic environment, because the body is immersed in water,
which diminishes a sense of balance, the abdominals are used
continuously to help support, move and maintain the body’s integrity
during exercise. Performing abdominal exercises in a supine position,
possibly with the support of a noodle underneath the shoulders and
wrapped around the arms, is fairly easily adaptable to the pregnant
body. If one begins in a supine position and draws the knees into the
chest and then extends the legs away up from the chest, the abdominal
muscles contract and shorten. For obvious physical reasons, the knees
cannot remain together but will separate to accommodate the protruding
abdomen.
While the american college of obstetricians and Gynecologists (ACOG)
does not recommend a supine position after the fourth month of
pregnancy, in an aquatic environment a purely supine position cannot be
maintained by anyone at any time. The hips are always kept slightly
under the chest and head. this occurs because of the placement of the
buoyancy device, as well as the bodyweight distribution of the person.
Since there is no strict supine position maintained in horizontal
aquatic exercise, the ACOG guidelines can be easily adhered to.
Contraindications
The
only time that abdominal exercises may be seen as contraindicated
during pregnancy is when diastasis recti or a separation of the
abdominals occurs. A diastasis recti is a separation of the linea alba,
which is the tendinous material that holds the two sides of the rectus
abdominis together. The linea alba can separate or actually be Pulled
away, stretched and slightly torn during pregnancy. The condition is
quite common and most frequently occurs due to a genetic
predisposition, coupled with stress on the abdominal muscles. More
often than not the stress is caused from stretching of the obliques
when side bending, twisting and rotating. The obliques then put extra
pressure on the rectus abdominis and may encourage separation.
Other reasons exist, e.g., multiple gestations (more than one foetus)
or the woman has a shorter rectus abdominis and possibly a shorter
stature, so the baby’s development will protrude more in front putting
a dramatic stretch on a shorter rectus abdominis muscle.
Physiotherapists and doctors often recommend the pregnant exerciser
discontinue Abdominal work if the diastasis recti becomes prevalent.
However, recent research by physiotherapists has indicated that
maintaining strength and elasticity of the abdominal muscles may, in
fact, discourage further separation. This is because exercise increases
the tensile strength (combination of elasticity and strength) of the
connective tissue. Maintaining activity in an area that is predisposed
to injury may in fact discourage injury altogether or prevent further
injury. Muscle activities stimulate the body’s reparative processes
like blood circulation, nutrient supplementation and neurological
stimulation. Therefore, physiotherapists have encouraged pregnant women
who experience a diastasis recti to continue exercising their
abdominals, but to ‘approximate’ during the exercise. ‘Approximating’
refers to either wearing a support device that may hold the abdominals
together during exercise, or having the woman herself hold the two
sides of her rectus abdominis together. This approximation will help
prevent further tearing (or separation) while abdominal exercises are
performed.
In an aquatics environment a maternity belt can be strapped below the
abdominals, below the baby, as well as above the baby to discourage
further separation of the abdominals.
These belts can be worn comfortably underneath bathing suits or on top
of them (because support belts are often closed with velcro, however,
wearing them on top of bathing suits can damage fabrics).
Extreme care should be taken when one exercises with a diastasis recti for fear of increasing the size of the separation.
For legal reasons, all aquatic exercise professionals should adhere to
any doctor’s or caregiver’s advice regarding a discontinuance of
exercise. Overstepping one’s bounds as a fitness professional can
potentially lead to legal repercussions. If a woman in your class has
questions regarding a diastasis recti, refer her to her doctor or a
physiotherapist who specialises in obstetrics and gynaecology. Do not
attempt to continue her exercise program without the advice of a
childbirth professional – even if you disagree with the caregiver’s
recommendation, you must adhere to their advice.
With proper instruction, the pool provides a great environment for
pregnant women to maintain the health, strength and flexibility of
their abdominal muscles. In so doing, they can better prepare their
bodies for the physical stresses placed on it by pregnancy and
childbirth.
Sara Kooperman, JD
Sara is the CEO of SCW Fitness Education, founder of the MANIA Fitness
Instructor Training Conventions and CEO of Les Mills Midwest in the US.
The fitness editor of Oxygen magazine and a lecturer for the American
College of Sports Medicine, she frequently appears on CNN as a health
and fitness expert and has received AEA’s Global Award for Contribution
to the Aquatic Industry.
GROUP EXERCISE, MIND BODY & AQUA NETWORK • AUTUMN/WINTER 2009 • P12-13