Why Does Pelvic Health Matter? “Because I don’t want my uterus falling out of my vagina.”

I’m revisiting exercise during pregnancy in today’s post, and per the norm, it’s hard to beat the concise wording of my colleague, Julie Wiebe, PT in her blog post:

“Q&A: Do I have any advice on exercise during pregnancy?  Do I!”

In it she comments on alignment: “know what good alignment is and maintain it as best they can”

Using breath as an exercise tool: “Learn the pistoning relationship between the diaphragm and pelvic floor, and stay connected to it throughout the pregnancy…Use the Piston before each exercise rep! I teach ‘Blow before you go!’”

What to avoid:“NO crunches! NO crunches!”

Please read her full post and watch her fab webinar!  Hint-hint: in recognition of National Women’s Health Week, Julie is offering 20% off of her webinar this week only (Only $36!!)!

Keep reading for more insights on exercise during pregnancy from physical therapist, Laura Robbins.

Can you tell we think this stuff is important….?

-Jessica

 “Because I don’t want my uterus falling out of my vagina.”

Since I was a teenager, the most exciting aspect of being a female athlete has been knocking down consecutive three pointers to the dismay of my all-male opponents and then hearing them arguing with each other, “Why don’t you guard the girl?”  So last week after my husband’s best friend questioned why I hadn’t played pick-up basketball with them earlier in the week, I had a brief period of weakness and thought that maybe I should give it a try. I had a rep to maintain.  Instead, I immediately replied, “After I deliver the baby, if my uterus is falling out of my vagina, I don’t want to think back and question if it was because of basketball.”

I’m 18 weeks pregnant and my favorite sport (basketball) is one of the activities that the American College of Obstetrics and Gynecologists (ACOG) highly recommends not doing when one is pregnant. This is mainly for the protection of the fetus within the uterus. However, I’ll let you know that being a pelvic floor physical therapist has taught me many lessons some of which, I’ll admit, are in the interest of self-preservation. One of those lessons: prepare your body for the future by doing preventative exercises in the present. In this situation, my lesson requires me to stop playing basketball (well, at least for the next 6+ months or so).  This means avoiding high impact activities (to me: jumping, pivoting and boxing out) to prevent my pelvic organs from slowly creeping gravitating towards the ground.

A history of exercise during pregnancy:

The ACOG has gone through a series of progressive changes over the years regarding the pregnant patient and exercise. In the 1950s, activity was limited to walking 1 mile per day (divided into multiple sessions)(1). In 1985, they recommended 15-20 minutes of exercise three days a week.  By 1994, their statements changed to recommend mild to moderate exercise (vague, right?) 3 days per week. Most recently, in 2002, the ACOG deemed it safe to exercise at a moderate level (in uncomplicated pregnancies) for 30 minutes most days of the week.

Current and past research suggests that exercise during pregnancy can decrease frequency of pregnancy-related symptoms, facilitate labor, improve recovery from labor, and enhance maternal psychological well-being (1). To personalize this: now I’m pregnant, I have a desire to get a good sweat on, and I need a definition of ‘moderate exercise’.  What is safe for exercise during pregnancy?

According to the ACOG, walking, swimming, cycling, and running (but according to Marathon physical therapists please refer to Jessica’s McKinney’s blog why running during pregnancy is not all it’s cracked up to be) are safe aerobic exercises. Since you’re probably waiting for me to stop rambling here are some exercises I like that are safe and can facilitate the appropriate core stabilizers (muscles) that can protect and prevent future symptoms, both during and after pregnancy…

yoga

Exercise: Bird/Dog

Position: on your hands and knees

Target muscle(s): core, back, gluteus maximus

Instruction: Prior to movement, tighten your deep transverse abdominis muscle by gently “hugging” the baby by thinking about bringing your belly button to your spine. Lift one arm to shoulder height while at the same time extending the opposite knee. Release and repeat on opposite side.

Suggested frequency: 5 times each side; 3 sets; 3-4x/week.

y2

Exercise: Sidelying leg lifts

Position: Laying on your side, bottom leg bent and top leg straight

Target muscle(s): gluteus medius

Instruction: Keeping your top leg in line with your spine, lock your knee and lift your leg towards the ceiling.

Suggested frequency: 10 times each side; 3 sets; 3-4x/week.

y3

Exercise:  Dumbbell Lifts on Ball

Position: Sitting on a firm exercise ball

Target muscle(s): core/deltoid/biceps

Instruction: With natural upright posture, slowly engage your deep abdominal muscles by gently pulling your belly button to your spine. Lift arm to shoulder height and slowly lower down. Repeat on the opposite side.

Suggested frequency: 5 times each side; 3 sets; 3-4x/week.

References:

1. Morris S.N. and Johnson NR. Exercise During Pregnancy. The Journal of Reproductive Medicine. 50:181-188, 2005.

2. ACOG Committee Opinion No. 267. During Pregnancy and the Postpartum Period. Obstetric and Gynecology. 99:171-173, 2002.

-Laura Robbins, DPT, is a physical therapist specializing in obstetrics and female and male pelvic health. She practices at Marathon Physical Therapy in Newton and Dedham, MA, blogs occasionally for Share MayFlowers, wears flowers regularly in support of Share MayFlowers, and chats folks up daily about the importance of improving education and access to care for new moms and for everyone with a pelvis.

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