Exercise During Pregnancy # 2: Intensity, Exercises, (Un) Safe Moves, When Not to Exercise and Much More
In the first part of the article on exercise during pregnancy, we explained the effect of physical activity on the mother and child during pregnancy and after childbirth. However, not everyone is familiar with exercise precautions during pregnancy. These measures are seldom discussed (in detail) during pregnancy counseling (honor exceptions) and sometimes only to the extent that we hear "yes, do everything in moderation". But it's a very broad concept, isn't it? So what is the famous rate with which to approach the exercise?
Let's look at what you most often asked:
How much should I exercise during pregnancy?
What intensity of exercise is "allowed"?
Is it appropriate to exercise with weights?
What exercises are not appropriate?
When to stop exercising?
First (and most importantly), let's not forget that not every woman can exercise during pregnancy. Whether you can exercise or not depends on your doctor and your medical condition. Let's take a look at diseases, respectively. medical conditions that are among those when exercise should not be at all:
severe heart disease
hemorrhage
multiple pregnancies
weakened cervix (cervix)
abnormal placental position (eg placenta previa)
premature contractions or a previous pregnancy with preterm birth
severe anemia
pregnancy hypertension (high blood pressure) and preeclampsia
ruptured membranes
restrictive lung disease
The following medical conditions are among the hazardous conditions that may prevent exercise during pregnancy:
diabetes that is not under control
extreme morbid obesity
extremely low body weight of a woman
epileptic diseases
decreased thyroid function
hypertension (uncontrolled)
orthopedic limitations
unevaluated heart rhythm disorders
excessive smoking
epileptic diseases that are not thoroughly treated / controlled
Of course, consult your doctor about everything. If you have any of the above-mentioned difficulties that limit you, in any case have no regrets that you are limited in exercise due to health reasons. Your health and the health of your children is paramount. Remember what your body is capable of (a new person and life grows in it!) Than what is currently "incapable" (training). Remember that pregnancy is only temporary and some time after childbirth you will be able to slowly return to activities that are limited during pregnancy, of course, as far as possible.
If you are lucky that nothing limits you, then there are a few rules that can be followed. You must have read a few articles or heard similar claims about exercise during pregnancy. I noticed mainly that there are two extremes. The first is that pregnant women are vulnerable people at risk and therefore should not engage in any physically demanding activities. The other extreme, in turn, leans towards the type of thinking: "pregnancy is not a disease, do not argue and work hard!" Yes, there are many claims that if a woman did not exercise before pregnancy, she should not start any new activity during pregnancy. However, recent data support the fact that women who did not exercise before pregnancy should start with fewer activities and lighter intensity, which may increase over time according to feeling and health status (always consult your doctor). This does not mean that (as the first extreme claims) you cannot be active at all and you just have to lie (of course there are such cases, which I will write about below).
So, if you did not exercise before pregnancy, you should not start with activities of moderate difficulty or exercises / movements (eg running) that you have not performed before. For example, you should start with 10 minutes of light aerobic activity a day (such as walking), gradually increase to 30 minutes of walking a day (5 times a week) and follow a few rules / precautions important during pregnancy. If you have discussed this with your doctor and you have his consent and warnings, you have also exercised before pregnancy, you could perform at least 150 minutes of moderately demanding physical activity per week. Of course, if you're okay, you have enough energy and you don't have complications or difficulties (explained below).
It is ideal to divide these activities into smaller stages during the week. For example, 30 minutes a day, 5 times a week. Of course, always listen to your body and if you can't control it, don't overdo it and you better get more rest. I know that in reality it is not so simple, especially in the first trimester, when many women are terribly ill (vomiting, migraines and the like - in addition to all other duties and time constraints). In many of these conditions, they can last longer and in some cases even the unpleasant Hyperemesis Gravidarum attacks, when exercise is completely impossible.
Precautions during exercise during pregnancy
We often hear the phrase "mainly listen to your body". However, many women have no idea what exactly to listen to (especially when it comes to their first pregnancy) and this is perfectly normal. Therefore, it is important to consult with doctors, experts in the field and educate, respectively. consume scientifically verified and reliable information in the field. That's why we write such articles :) As I mentioned, if you practiced before pregnancy, it is possible that you will be able to continue (but not the extremes!). Of course, as far as possible (see activities below) and if your health allows it. Good food, sufficient energy intake and sufficient hydration are also important.
Remember that exercise during pregnancy is not about exceeding its limits or comparing with others, respectively. competing against others in the "same stage of pregnancy" (this of course also applies to non-pregnant women).
"(Un) safe" activities during pregnancy
Activities such as swimming, walking, low / moderate cycling (stationary bike), running (if you ran before pregnancy), racquet sports and exercising with dumbbells (strength training) are generally considered safe activities during pregnancy. Contact sports (boxing, football, basketball, etc.) are considered dangerous, as well as activities where the risk of falling is high (eg skiing). Parachuting and other activities at altitudes of 1585 meters and above are definitely dangerous and should be avoided. The same goes for activities such as gymnastics and diving. You should also be careful about "overheating" and activities in which the internal body temperature rises excessively. This problem is rare in fitness centers or rooms with adequate ventilation / air conditioning.
Anaerobic activities
These very high intensity activities (HIIT style) should not be practiced during pregnancy, mainly because the lung reserve is smaller during pregnancy, which means that the ability to exhale carbon dioxide is also lower during these demanding activities.
Over-stretching
Relaxin (a hormone that helps ligaments "relax") is produced in larger amounts during pregnancy. These processes can make the areas around your joints appear looser and can cause nausea, especially in the iliosacral joint (lumbar and sacrum joints) and in the pubic area. However, despite these changes, this hormone is great because it allows us to give birth vaginally by allowing the pelvis to expand.
It is because of these changes that we should be more careful when stretching, practicing yoga and similar movements. To reduce the risk of prison injuries. We should also avoid activities such as sprinting and jumping, in which there is a sudden stop, especially in the third trimester, when we carry more weight in the torso area. Always listen to your body and if something is uncomfortable or painful for you, stop it and let your body rest.
Lying exercises
This exercise should be avoided especially during the second and third trimesters, as the heavier weight of the baby and uterus in this position can push the vena cava (hollow vein), which carries blood from the lower limbs back to the heart. This "pushing" can cause nausea or dizziness due to a reduction in blood flow and oxygenation of the upper body. If this happens to you while lying down (it doesn't even have to be during exercise), it is recommended to sit down slowly and breathe deeply, slowly.
Change position
It is also necessary to pay attention to the change of position during exercise (from lying to sitting, getting up from sitting, etc.), as with the growing abdomen, the center of gravity also shifts, which can affect the balance. Therefore, care must be taken during exercise.
Proper involvement of deep abdominal muscles
Proper involvement of the abdominal muscles is one of the most important things to keep in mind during all exercises. If you do not know how to properly engage and "control" the core, ie the center of the body, during any of the exercises, it is recommended not to perform these exercises and find a similar exercise in which you practice the muscle group.
How to observe those inappropriate exercises?
One of the most visible signals is the so-called abdominal "coning".
Exercises in which we most often observe coning:
rest before doing
sit-ups / skracovačky
pulling the pulley wide
plank
crank
sometimes even exercises on four, such as bird-dog
Said coning may worsen diastasis and therefore these exercises should not be performed. This effect can also have a simple daily movement, such as getting out of bed, so it is important not to get up with a belly-like movement, but to turn on your side and help yourself with your hands. This method of getting up puts less strain on the back and abdomen, while the risk of the coning effect is minimized.
Heart rate monitoring
It has often been argued for many years that women should not have a heart rate higher than 140 beats per minute during exercise during pregnancy. However, it is not appropriate to focus on just one number. Especially when it comes to heart rate, because everyone has different boundaries and the heart rate itself at rest is quite different for each person. Therefore, mom's heartbeat is not an indication of exertion level. Despite what has been claimed for years, a mother's increased heart rate does not mean that the same changes occur in the fetus / fetal heart rate. Research suggests that mild, strenuous exercise should not upset the fetus. So how do we make sure we don't overdo it with intensity?
Of course, in addition to the well-known "perception of your body and warning signals", try for example the so-called "discussion test of effort, resp. exhaustion ". Try talking during exercise. You should be able to communicate in fluent sentences and maintain a light conversation without being out of breath, although your heart rate may be slightly elevated. If your heart rate and breathing increase so much that you are short of breath and unable to maintain a continuous conversation or feel weak, stop exercising and rest until your breathing and heart rate decrease.
Symphysis Pubis Dysfunction (SPD) or pelvic girdle pain / symphysolysis:
It is manifested by musculoskeletal pain in the pelvic area. This pain can spread and resound to the hips and inner thighs. SPD often begins in the second to third trimesters. I think it is appropriate to mention this pain under a separate point, as the SPD may limit certain activities. It's very individual, but in general, if you have an SPD, you should limit your activities to:
jumping
run
pushing heavy objects
lifting heavy weights
one-sided exercises, resp. exercises in which the pelvis is not in an even position, such as lunges
twisting, ie various exercises with dialing
It is also recommended to pay attention to getting up properly, when instead of spreading the legs together, you move them together to the position from which you want to stand. This movement is also very important when getting out of the car (an activity that many of us perform automatically). If you have SPD, I recommend that you also deal with a physiotherapist or orthopedist, as well as a gynecologist.
Exercise on unstable surfaces
It is recommended not to exercise on unstable surfaces (eg OSU ball) during pregnancy due to the increased risk of falls, which endangers not only the unborn child but also the mother and can lead to serious complications.
When to stop exercising?
For the safety of the woman and the unborn child, it is recommended to stop the activity immediately and contact a doctor if you experience one of the following symptoms during exercise:
dizziness
Headache
total muscle weakness
vaginal bleeding
chest pain
dyspnea (difficulty breathing)
unusual reduction in the amount / intensity of the baby's movements
pain or swelling in the calves
amniotic fluid leakage
abdominal cramps / premature contractions
Trimester measures & tips (along with the measures explained above)
First trimester:
Of course, if you can exercise at all, since I barely stood on my feet due to "morning" (er, 24 hours) nausea (and I know many women have a similar one). Consult your doctor before starting any activity. Use the above-mentioned talking effort test. Adjust the intensity of exercise to pregnancy.
Second and third trimester:
Adjust or eliminate exercises that cause excessive pressure in the abdominal cavity (cranks, planks, abdomen / shorteners, etc.). Adjust and reduce or eliminate exercises with a greater impact (eg jumping and running). Adapt exercises such as squats (for a broader stance), deadlifts (for sumo deadlift) and unilateral exercises (minimize or eliminate in the case of SPD), as these exercises can have a greater effect, resp. causing pain in the hips and of course a growing stomach can get in the way. Adapt exercises that require a position after lying without inclination (incline), e.g. bench press, glute bridge (perform in a tilted position / leaning on a bench instead of lying on the ground).
A few rules at the end:
Always consult your doctor before starting any activity during pregnancy
Make sure you get enough hydration
Consume enough nutrients and quality nutrients
Do not exercise in rooms with excessive temperature or humidity
Be careful when changing positions
Don't overdo it! Always listen to your body and stop activity if you feel pain or other difficulties mentioned above. Exercise during pregnancy is for health and "maintaining" physical condition, not for exceeding your limits
I recommend working with doctors and adequately qualified professionals in the field, such as physiotherapists, pelvic floor specialists, nutritionists / dieticians.
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