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