Exercise in Pregnancy with DabbourPhysio

I’m Hanna Dabbour and I’m a Senior Women’s Health Physiotherapist – I’ve been asked to contribute to this great site by covering some common questions about exercise that people have when pregnant.

What do I need to know about exercise when pregnant?

Firstly, there is no reason to cease exercising when you are pregnant. In fact, maintaining your strength and fitness will help you with the birth and allow you to get back to normal quicker as well as allowing for an easier pregnancy.

But, there are some things you need to consider:

1. In the first two trimesters, focus on exercises you have done before – when you are pregnant is not the time to start to train for your first marathon or take up high-intensity training. The reason for this is that in these trimesters, particularly the first, heavy fatigue is common and due to progressing laxity of your muscles and ligaments, you are more likely to hurt yourself. But if you stick to what you have done before and what you know well, there is no reason for you to not continue – just remember to allow some leeway for your situation.
2. If you are new to training, or in the third trimester, I would recommend swimming, Yoga or Pilates – the first is gentle on the body but provides a good workout, while the latter both focus on body-weight exercises and can be as gentle as you need them to be. Light-gym work is also a good option as you can easily adjust effort level and the exercises you do.
3. In terms of exercises to avoid; anything that requires you to lie flat for longer periods or puts direct pressure on your stomach, or exercises that put strain on your core muscles directly. This includes crunches of all forms, the plank and similar static core exercises. If you go to a Yoga or Pilates class, be sure the instructor is aware and have been trained in pregnancy Yoga or Pilates and they should easily be able to adjust the class.

 

How important are pelvic floor exercises?

In one sentence – you should be doing them now and for the rest of your life.

When you talk about pelvic floor exercises you are actually talking about pelvic rehabilitation, which is a particular skill of Physiotherapists that focus on dysfunctions of the pelvic floor and the pelvic floor muscles.

The reason you hear so much about the exercises is that pelvic dysfunction is a very common in women of all ages, and particularly after giving birth. In short, the pelvic floor – with its associated muscles, tissues and ligaments – provides a ‘platform’ for your bladder, uterus and rectum.  If it is weak or damaged, it can cause pain, altered sensations or be unable to undertake its main job of supporting the region and controlling the openings of your urethra, vagina and anus.

The main cause of pelvic floor dysfunction is childbirth, surgery, obesity or weakness through ageing. This is one of the reasons we have to keep doing the exercises, as to reduce the strength reduction that happens when you get older.

But, during childbirth in particular, the muscles can tear, be cut during delivery (such as when forceps is used or during an episiotomy), and lose strength generally from exhaustion or simple become lax. A dysfunctional pelvic floor can lead to a number of problems and make you unable to enjoy the same activities you did previously – many struggle to continue to run, jump or do other high impact exercises such as aerobics, weight lifting as well any number of sports that mimic problematic movements.

But, don’t be alarmed. With some work, you can be back to normal soon enough, and if you need help, well that is why there are Women’s Health Physiotherapists.

So, this is where pelvic floor exercises come in, both before and after birth as it forms a crucial part of pelvic floor rehabilitation and it usually the first and last step towards a return to normality. The aim of the exercises is simply to return your pelvic floor to its previous strength as well as help to treat or minimise any other problem.

Some tips:

• After birth, begin as soon as you feel comfortable. Early on you may not feel very much or the muscles may be very weak. Keep doing the exercises!
• I recommend to do them every time you feed your baby – do them until you can’t feel anything anymore.
• Expect to see improvement in 6-8 weeks but it may take 6 months or more of diligent exercising until you return to full strength.
• If you haven’t had a baby, or you have returned to full strength postnatally, try to do the exercises once a day.
• There is no need to do more – if you do it too much you may end up with an overactive pelvic floor which can cause pain!
• If you are unsure of how strong your pelvic floor is, don’t be afraid to ask your GP for a referral to a Women’s Health Physiotherapist and they can check it for you. If you have any symptoms, such as heaviness, leakage you should also see a physio as they can help you.
• A physiotherapist can also advise you in terms of when you can return to regular exercise and other high impact activities.

 

What is a pelvic floor app?

There is an increasing trend around apps and gadgets – more and more are hitting the market every day. In the past few years, a number of mobile apps have appeared to help you exercise your pelvic floor. Typically they give you regular alerts as to do them, and provide you with detailed instructions of how to do the exercises correctly. Some also provide other exercises that can be done while exercising your PFMs.

Overall, compliance with exercises over time is greatly linked to improving your pelvic floor, so it is hard to oversell anything that assists with this as well as helping to ensure you do them well. In the UK, the NHS app (Squeezy) and the TENA app (My Pelvic Floor Fitness) are the most common apps for this purpose, although many other countries have followed suit and released their own apps.

If you are interested in more information about pelvic floor gadgets and aids, I did an overview on the topic for Babycentre: Pelvic Floor Gadgets and Aids

    

Hope this all helped! If you are struggling with exercise when pregnancy, doing your pelvic floor exercises or anything else related to prenatal or postnatal issues, please don’t be afraid to seek advice – it is what we are here for. Let me know if you have any questions let me know or visit my website for more information.

For some other reading on related topics, please check out the following posts:

Pelvic Floor Rehabilitation

Post Pregnancy Exercise

Hip Pain During Pregnancy

Sex after Birth

DabbourPhysio is a Norwich-based Physiotherapy Clinic specialising in Women’s Health and Musculoskeletal problems, rehabilitation Yoga and Pilates classes as well as Hypnobirthing and Antenatal workshops.

The current Yoga/Pilates Pregnancy and Postnatal classes run on Tuesday afternoons. The Physiotherapy rehabilitation classes, YogaPhysio and PhysioPilates, are on Mondays, Wednesdays and Saturdays.

DabbourPhysio also offer the Healthy Mummy Assessment, a postnatal check-up that can help reduce the risk of having problems later in life as a result of giving birth.