// Help clients reap the benefits of prenatal fitness

Personal trainers often lack the confidence to train pregnant clients, but if performed safely, and with careful monitoring, there are only upsides to continuing regular exercise during this special time, as Marina Perry-Kuhn explains.

While a newly pregnant client may be ecstatic, for a trainer unfamiliar with the ins and outs of prenatal fitness the situation can seem a bit daunting. With little or no education on prenatal fitness, this wonderful news often leads to even the most regular of exercisers ceasing their training sessions, with many women – and their trainers – often scared of harming the baby. Little do they realise that there is simply no other time in a woman’s life when the benefits of exercising are as great as they are during pregnancy.

In addition to all the regular benefits associated with exercising, pregnant women who exercise efficiently will also experience benefits that ensure an easier pregnancy, enhanced endurance and stamina during labour, and a faster recovery post-delivery. These benefits include improved circulation to increase fluid retention and ease constipation, optimised lung capacity to enhance breathing, a reduction in varicose veins, haemorrhoids and back pain, and a stronger core to ensure a greater range of movement, balance and mobility. Overall, women need to stay as active and as strong as possible throughout pregnancy. Just like recovery from any major surgery or physically-draining experience, recovery is faster in a stronger, fitter, healthier body.

As with any other physical condition, exercising safely during pregnancy is simply a matter of appropriate exercise prescription; appropriate to their fitness level prior to pregnancy, appropriate to their strength and appropriate to their constantly changing body. However, while it is ideal to be able to continue to exercise throughout pregnancy, there are some medical conditions that will prohibit exercise. It is important for all pregnant women to seek approval from their GP or obstetrician prior to commencing an exercise regime, to ensure they are cleared of any pre-existing conditions that could harm them or their baby.

Understanding physical changes

During their 40 weeks of pregnancy, women’s bodies are performing one of life’s miracles; creating and growing a human life. Naturally, there are physical changes that must occur for this miracle to take place. Understanding these changes better enables trainers to exercise their clients safely, and to use specific methods to better control changes.

Weight gain

As the baby develops, weight will be gained. Exercising during pregnancy helps to keep weight gain to a healthy – and necessary – amount. Too often women gain more weight than they need, and struggle to shift the excess weight long after bub’s arrival.

Changes in posture

 As the abdomen grows in size, pregnant women often experience a shift in posture as their pelvis tilts forward, creating a bigger curvature in their lower back. Often this is the main reason why pregnant women experience excruciating back pain. Exercises, such as Pilates, that strengthen the obliques and transverse abdominis and lengthen the hip flexors, can help maintain better posture and alleviate back strain.

Growing bust

Women’s breasts grow during pregnancy in preparation for breast-feeding and, as a result, pregnant women often experience a greater rounding of the shoulders which results in a strained back and neck. Strengthening of the mid and upper back (specifically the rhomboids and lower traps), plus stretching of the pectoral muscles will work to circumvent these changes.

Changes to centre of gravity

The growing uterus pushes the abdomen up and out, affecting the position of a pregnant woman’s centre of gravity. This is why pregnant women often experience poor balance, as their bodies have not had time to adjust to the change. It is best, therefore, to avoid exercises that require a great deal of balance.

Joint instability

The body releases excess relaxin hormones during pregnancy as women’s joints loosen to allow the joint in front of the pelvis to widen, so the baby’s head can pass through during birth. This means joints are not as stable as usual, and don’t ‘stop’ like they do pre-pregnancy. For this reason, exercises requiring fast changes in direction are not recommended.

Fatigue

Creating a human is hard work. The body will, at times, experience fatigue due to the sheer physical stress of pregnancy. Sleep can also become difficult or broken (especially in the second and third trimesters), worsening the effects of fatigue. Regular exercise will increase daytime energy levels and ensure restful night sleeps.

Heat

Due to an increase in metabolic rate, hormones and blood, pregnant women experience a rise in body temperature. During exercise it is important to ensure pregnant women don’t overheat. Ensure your clients consider their temperature by wearing non-restrictive, breathable clothing, and that they stay well hydrated during a session. Exercising in a well-ventilated area is ideal for pregnant women, and direct sunlight and humid conditions should be avoided.

Fluid retention and circulation problems

During pregnancy, blood volume can increase by as much as 40 per cent, putting extra pressure on the heart. While clients should continue with gentle cardiovascular work throughout pregnancy, they should be careful not to raise their heart rate or blood pressure too high. Hormonal changes in pregnancy can affect the working of the valves in veins, meaning blood can pool in the veins (especially in the legs and rectum), resulting in varicose veins and hemorrhoids. There is also an increase in fluid in all of the body’s tissue, including lymphatic fluid (the body’s waste-disposal system), which can cause fluid retention problems for some women.

Exercise goals

As these changes take place within a woman’s body during pregnancy, our goals relating to exercise are three-fold; to keep cardiovascular fitness up, maintain strength throughout the body’s key muscles groups, and to maintain length and functional flexibility throughout the entire body. As a general rule of thumb, any exercise done prior to pregnancy is alright to continue during pregnancy, with the exceptions of horse riding, surfing (due to the risk of the board hitting the abdomen), sports that involve repeated, rapid changes of direction and contact sports.

Fitness: cardiovascular exercise

Walking, jogging, running, aerobics, swimming and cycling are all fine during pregnancy (at a similar level to that achieved prior to pregnancy) and can be taken up at any time. It is recommended that clients minimise exercise on uneven surfaces as the pregnancy develops, and avoid activity that requires a lot of balance or stability – as balance gradually reduces during this time. Clients should aim for at least 30 minutes of cardio activity on a minimum of four days a week.

Guidelines for cardio:

  • Think comfortable versus uncomfortable – always monitor heart rate. It used to be recommended to not exceed 140/145 beats per minute, or 60 per cent of maximum heart rate. Health organisations have since revised this recommendation, as it varies according to the starting fitness level of each pregnant woman.
  • Talk test – clients should be able to conduct a conversation without being more than a little breathless.
  • No dizziness, pain, or overheating.

Strength: resistance training

Light weights and therabands provide great ways of promoting both tone and strength during pregnancy. Pilates is also very good for increasing strength. Clients should aim to do strength work at least twice a week, with four times per week the ideal.

Prenatal exercises to focus on

Strong transverse and obliques
• Reverse curls
• Side lying double leg lifts

Strong glutes
• Parrallel squats
• Clam

Strong rhomboids and lower traps
• Rows

Strong shoulders, biceps and triceps
• Bicep curls
• Tricep push ups
• Lateral raises

Stretches
• Hip flexors
• Lower back – child’s pose

Guidelines for strength:

  • Pregnancy is not the time to introduce heavy weight training into a regime. Keep the weights (resistance) to light/medium, and work on more repetitions, keeping the muscles strong and toned.
  • Restrict time spent exercising flat on the back, as it decreases the blood flow to the uterus. Limit to approximately 3 to 5 minutes at any one time, especially after the first trimester.
  • Be mindful of posture throughout all repetitions. Keep the spine neutral, with the transverse abdominis always lifted and scooped in.
  • Stop contracting. After approximately 20 weeks, clients should avoid all exercises using flexion of the spine – specifically no sit ups. The focus should be on the lower abdominals; only transverse abdominis and obliques should be recruited.
  • Avoid single leg work. Uneven pressure through the pelvis is to be avoided. Try to keep both feet on the floor when applying pressure through legs.
  • Avoid any deep bridging where the pelvis rises above the heart/head level.

Flexibility: stretching

Stretching is crucial during pregnancy, with hamstrings, hip flexors, glutes, calves, chest and back all key areas to consider. As mentioned above, it is important not to over-stretch during pregnancy as the body produces excess relaxin hormones that increase joint laxity, with overstretching often leading to permanently loose joints.

If performed safely, and with good monitoring, there are only upsides to continuing with regular exercise during pregnancy. The key is to exercise your clients appropriately, focusing on exercises that will counteract the changes in pregnancy. Most importantly, remind your clients to always listen to their bodies, to ensure they gain the maximum benefits of prenatal fitness.

Sample prenatal exercises

Strong arms

Bicep curls
In seated position, wrap theraband around feet. Broad chest, neutral pelvis, transverse abdominis activated, arms extended at elbow and long. Breathe in to prepare (photo 1). Breathe out, pivoting/flexing at elbow joint drawing pinky to shoulder (photo 2). Breathe in, re-extend arm, opening at elbow. Three sets of 12 to 16.

Tricep push ups
In quadruped position with hands in line with shoulders and knees under hips. Hands one-hand distance apart with fingertips pointing forward, underside of elbow pointing forward, scapular stabilised, neutral spine (photo 3). Breathe in and lower the torso towards floor as elbows go straight back towards thighs, hinging at hip, nose moving straight towards fingertips (photo 4). Breathe out and press up away from floor back to start position.

NOTE: Avoid weight moving back through hips. Keep knees above hips. Ensure elbows stay inside the line of torso, moving straight back towards thighs. Do three sets of 8 to 16.

Lateral raises
Kneeling with pelvis neutral, ribs melted, hands by sides holding ends of theraband. Theraband placed under knees. Breathe out as knuckles move up and out to sides, keeping arms straight but soft at elbow (not lifting above shoulder height) (photo 5). Breathe in and lower arms back to side of thighs. Repeat. Three sets of 12 to 16.

Stretches

Hip flexors
Kneeling on one knee with opposite foot placed well forward of knee. Tuck pelvis posteriorly (pulling hip bones back, pubic bone forward) and then sink pelvis forward towards front heel (photo 6). Ensure the torso remains tall, with core constantly activated. Hold for one minute or more.

Lower back – child’s pose
With knees open, feet together, sink hips back over heels and release chest towards floor stretching arms out long overhead (photo 7). Hold and release into stretch and continue to breathe deeply. Hold for 30 seconds or longer.

 

Marina Perry-Kuhn
Founder of Queensland’s innovative class-based Pure Health Clubs, Marina is a fitness expert, business owner and mum. As a Pilates instructor with ten years experience, Marina created Pure Beginnings, a series of classes, programs and DVDs designed to maximise prenatal and postnatal fitness. Marina is dedicated to educating the public about the benefits and realities of exercise during and after pregnancy. For more information,
visit www.purehealthclubs.com.au or www.purebeginnings.com.au .


NETWORK MAGAZINE • SUMMER 2010
• PP21-24