"CPT copyright 2014 American Medical Association. All rights reserved. CPT is a registered trademark of the American Medical Association."

Exercises during pregnancy - Useful tips


ANTENATAL EXERCISE

INTRODUCTION:

The Position that pregnant women adopt for exercises should be carefully considered. Women should not be asked to lie flat in the later second and third trimesters because of the dangers of supine hypotension. Instead, a half-lying position with the back raised to an angle of approximately35° can be used.

Exercise the abdominal muscle antenatally will ensure speedy return to normal postnatally, effective pushing in labour and the lessening of backache in pregnancy. An important function of the abdominal muscle is the control of pelvic tilt. As the ligament around the pelvis stretch and no longer give such firm support to the joints, the muscles become the second line of defence, helping to prevent an exaggerated pelvic tilt and unnecessary strain on the pelvic ligament. It must be remembered that overstretched ligaments and weakened abdominal muscle during pregnancy can lead to chronic skeletal problems postnatally as well as backache antenatally. To prevent this and to maintain good abdominal tone, exercises for the transversus muscles and rectus muscles are taught.
Exercises that involve the oblique abdominal muscles should be avoided in later pregnancy because these muscles are inserted into the linea Alba. If twisting movements are performed, there is the danger that the shearing effect may pull the linea alba and the rectus muscle bellies apart. If this occurs, the condition is known as diastasis recti and is more often diagnosed postnatally.


TYPES OF ANTENATAL EXERCISE:

1. Transversus exercise
2. Pelvic tilting or rocking
3. Pelvic floor exercise
4. Foot and leg exercise
5. Breathing awareness

TRANSVERSUS EXERCISE:

Sit comfortably or kneel on all four with a level spine. Breathing in and out, then gently pull in the lower part of the abdomen below the umbilicus keeping the spine still and breathing normally. Hold for up to 10 seconds then relax gently. Repeat up to 10 times.

This exercise tones the deep transverse abdominal muscles, which are the main postural support of the spine, and will help to prevent backache in the future. When mastered, this simple exercise can be practiced in any position and whilst doing other activities. The transversus muscles should be tensed when standing for any length of time and before moving and handling objects.

PELVIC TILTING OR ROCKING:

Do this in a half-lying position, well supported with pillows, knees bent and feet flat. Place one hand under the small of the back and the other on top of the abdomen. Tighten the abdominals and buttocks, and press the small of the back down on to the underneath hand. Breathe normally, hold for up to10 seconds then relax. Repeat up to 10 times. Pelvic tilting can be performed sitting, standing or kneeling.


PELVIC FLOOR EXERCISE:
A great strain is put on the pelvic floor during pregnancy because of hormonal influence on the pelvic floor fascia, the weight of the developing fetus and the altered pelvic posture. It is important, therefore to teach pregnant women pelvic floor exercise antenatally in order to maintain the tone of the muscle so they retain their functions. The muscle will also relax during parturition and regain their former strength their former strength quickly during the puerperium.
All women should be able to perform the following simple exercise, which can be practiced anywhere and at any time.
Sit stand or half-lie slightly apart. Close and draw up around the back passage as though preventing a bowel action then repeat around the front two passages as though preventing the flow of urine. Draw up inside and hold for as long as possible, up to 10 seconds, breathing normally, then relax. Repeat up to 10 times.

This exercise will build up the endurance of the postural slow twitch fibres in the pelvic floor but the exercise can also be performed quickly for up to 10 times without holding the contraction. This works the fast twitch fibres which are needed to work quickly to prevent leakage (e.g. when coughing). All women should practice this exercise very regularly antenatally, particularly after emptying the bladder. For those with diminished pelvic floor awareness, attempting to ‘stop midstream’ occasionally or ‘gripping’ on to an imaginary tampon that is slipping out may assist the ability to contract the correct muscles.

FOOT AND LEG EXERCISES:

The circulation during pregnancy particularly the venous return is sluggish and this can lead to problems such as cramps, varicose veins and edema. To help to prevent these following simple exercise and advice will improve the circulation.

Sit or half-lie with legs supported. Bent and stretch the ankle at least 12 times. Circle both feet at the ankle at least 20 times in each direction. Brace both knees, hold for a count of four, and then relax. Repeat 12 times.
These exercises should be performed before getting up from resting, last thing at night and several times during the day. Women should be discouraged from standing unnecessarily and encouraged to put their feet up whenever possible. Crossing the legs at the knee or ankle will impede circulation further. If varicose vein or edemas are present, support tights may be prescribed with the appropriate advice to put them on before allowing the legs to drop over the edge of the bed.

BREATHING AWARENESS:

It is important to be aware of one’s own natural breathing rhythm so variations can be recognized if they occur.

Sit comfortably with eyes closed. ‘Listen in’ to your breathing, concentrating especially on the outward breath, recognizing the short pause before the inward breath naturally follows. Keep the movement fairly low down in the chest and be aware of your own breathing rate whilst resting.
A few deeper breaths occasionally will help the venous return and aid the oxygen supply to both the pregnant women and the fetus, but only three or four deep breaths should be taken at a time as hyperventilation is more likely during pregnancy.




Popular Posts