Exercise & Pregnancy

I have been asked  to address the subject of exercise and pregnancy. The truth is, I do not have anything brilliant to say. There are many medical and professional organizations who have outlined exercise prescription during pregnancy. Unfortunately, some of the advice becomes well known and widely accepted – while other pieces of advice seem to be overlooked.

What we know

We know that the supine (back down, face up) position is not safe after the first trimester – the risk of venous obstruction is too great. What does that mean? The fetus will not be fed and nourished.

We know that pregnant women should not perform the Valsalva maneuver. An instructor or trainer will not name this as the next exercise to perform. It is something that individuals do unconsciously – and sometimes consciously – during exercise. Oversimplified, it is holding your breathe under strain – and this is common during isometric exercises such as planks or wall sits. To learn more about the Valsalva maneuver, click here.

We know that pregnant women should avoid contact sports, or any any activity that could cause loss of balance or trauma to the mother or fetus.

Often overlooked

There are numerous precautions regarding exercise and pregnancy that are too often overlooked.

For example, the thermoregulatory control. Pregnant women need an increased awareness of the ambient air temperature, humidity, etc. because the pregnant body is less efficient at temperature control.

High-intensity exercise should be avoided. In part because of the less efficient thermoregulation. In part because of the stress it puts on the mothers cardiorespiratory system. If it is putting stress on mom, it is putting stress on baby!

Pregnant women tend to have greater ligament elasticity – a result of the change in hormones (just like females have different elasticity during different portions of their cycles). This increases the risk of injury, such as hyperextension of the joint.

Pregnant women must be cautious with weight- and load-bearing exercise. This could include anything from running and jumping to squatting and overhead pressing. Because the weight distribution is different, there is added stress to the spine (e.g.,common to experience lower back pain). If not careful, exercises could increase lumbar lordosis and cause temporary or long-term conditions.

The basics

Here are the guiding principles regarding exercise during pregnancy:

photo

The bottomline

If you have been active for months and years leading up to pregnancy – then you can maintain a much higher activity and intensity level than a woman who has not. There are certain positions that all pregnant woman should avoid – not because pregnancy is an illness, but for the safety and health of the unborn child. Some exercises are dangerous and extremely difficult to perform correctly when you have a baby belly!

NOTE: This is not intended to be an exhaustive article. I have linked to some key resources below. If you are pregnant, always talk to your doctor and consider working with a qualified fitness professional. Be informed. Be smart. And keep you and your baby safe!

Like what you read? Please comment and share below and visit me at Better By Becca.

References

http://www.ncbi.nlm.nih.gov/pmc/articles/PMC1724598/pdf/v037p00006.pdf

http://www.acsm.org/docs/current-comments/exerciseduringpregnancy.pdf

ACSM’s Guidelines for Exercise Testing and Prescription, Edition 8

McArdle, W. D., Katch, F. I., & Katch, V. L. (2010). Exercise Physiology: Nutrition, Energy, and Human Performance (7th Ed.). Lippencott Williams & Wilkins: Philadelphia.

Listen. Slow down. Rest.

My body has been telling me to slow down and rest. But my mind is fighting it – NO! I have difficulty with doing nothing – both physically and mentally. As my favorite surgeon noted, I am a “Go go go girl.” (Not to be confused with a go go girl.)

My back hurts.

My hip hurts.

My hands hurts, with small blisters beneath my calluses.

My foot hurts.

My knee has been popping (not a good sign).

There is a pinching pain between my shoulder blades.

My head hurts, pulling from my shoulder blades.

And yet, my mind does not want to slow down. I share this, not to complain, or to whine, or for sympathy. But to show that I understand and that I too fall into the trap. The trap of habitual exercise and not wanting to stop – for fear that you will not start again.

Slowing down and resting is something that I have actually gotten better at these last few years. Each of my injuries forced me to slow down – each of them designed for the function of forcing me to slow down (there is a reason for everything, isn’t there?). I have since become more in-tune with my body. I listen to it. While I am pretty good at slowing down or cutting back,  I am not so good at resting completely. I go a little bit stir crazy on rest days (although I force myself to take at least 1 rest day a week).

Avoid overtraining

Some individuals may suspect I am overtraining. I am not overtraining – simply managing a chronic, mysterious condition (narrowed down to being autoimmune). Most of my pain has nothing to do with my workouts. However, minor aches and pains can be good indicators to slow down and avoid overtraining. Has your body been sore for too many days in a row? Rest. Are you getting adequate sleep but still fatigued? Rest.

Avoid Injury

If your body is fatigued or you are experiencing some pain, there is a good chance that you will workout, compensate with other areas, and incur more pain or injury. Another injury does not appeal to me – I do not think it is worth the risk.

The bottomline

Listen to your body. Slow down when it needs it. Rest when it needs it. When it doubt, if you have been working out hard, rest.

Rest —

Playlist: I say jump and you…JUMP

As I build and compile workouts, I thought that I would share this playlist. Compiled for a plyometrics workout, what would be better than a bunch of songs about jumping? Nothing.

The JUMP list

  1. Jump – Kris Kross
  2. Jump Around – House of Pain
  3. Don’t Jump – Tokio Hotel
  4. Jump for my Love – Pointer Sisters
  5. Jump – Van Halen
  6. Jump on it – Sir Mix Alot
  7. Jump on it – SugarHill Gang
  8. Jumping Jack Flash – Rolling Stones
  9. The Red Jumpsuit Aparatuts – Face Down
  10. Jump, Jive an Wail – Louis Armstrong
  11. The Jump Off – Lil Kim
  12. Crank That Jump Rope – Soulja Boy
  13. Jumping All Over The World – Scooter
  14. Hey Baby Jump Off – Bow Wow
  15. Jump Da F*ck Up – Slipknot
  16. Jumper – Third Eye Blind
  17. No Jumper Cables – Aesop
  18. Jumpin Tonight – Big Joe Turner
  19. Jumpin Jumpin – Destiny’s Child
  20. Jump Around – Cypress Hills
  21. White Men Can’t Jump – Riff
  22. Jump – Simple Plan
  23. Jump – Madonna
  24. Jump – XTC
  25. Jump – The Moffats
  26. Jump – Kylie Minogue
  27. Jump with you Baby – B B King
  28. Jump Off – Bow WOw
  29. Jump – Girls Aloud
  30. Jump Start – Jethro tull
  31. Jump in the Fire – Metallica
  32. Jump they say – David Bowie

Have any you can add to my list?

A no-quit circuit workout

We played with video today. I have said before that I do not intend to share too many workouts, but it was on my heart to share this one.

A simple – but not easy – workout, comprised of 4 circuits. Rest 1 to 2 minutes between circuits.

Circuit 1 (3 sets, 15 repetitions, no rest)
Spiderman Pushups (each side)
Dumbbell Squat to Press
Chinups (or assisted Chinups)

Circuit 2 (3 sets, 15 repetitions, no rest)
Jump Lunge
Dumbbell Lateral Raise
Goblet Squat

Circuit 3 (3 sets, 15 repetitions, no rest)
Dumbbell Reverse Fly
DB Jump Squat
Superman Pushup

Circuit 4 (3 sets, 15 repetitions, no rest)
Dumbbell Step Up
Dumbbell Shoulder Press
Dumbbell Squat

You can view a video tutorial on this workout on my Facebook page.

Headstands versus handstands

This post will be short, sweet and to the point. One of my goals for 2013 is to be able to do headstands and handstands with complete control. So I practice. This is what I am finding: powerful

Headstands are far easier than handstands!

Does that mean my neck is stronger than my arms and shoulders? No, it is because my shoulders are always exhausted – I need to give them more rest!

The bottomline

I have learned another tidbit about the importance of rest. If I truly want to attain my goals, I may need to cut back on my shoulder work…

Planning a day of nothing

There is nothing on my calendar today. No classes to teach. No clients to train nor coach. No social events. Nothing. On my drive home from work last night (which was LONG due to inclimate weather), I told myself that I would allow myself to sleep in and then do nothing today – only leaving the house to workout.

I am amazed by how unmotivated I am. I awoke early, but remained in bed, reading and relaxing. I also began to plan out my day (yes, planning my day of nothing).

I should get out and shovel.

I should start some coffee – it will help me become motivated.

I should plan my workout – I can go to an empty gym this afternoon and do anything I want!!!

I should do laundry.

I should do my taxes.

I remained in bed. I was unmotivated. I sent a text to my former workout partner – we now live 5+ hours apart – expressing my lack of motivation. She concurred. HOW am I going to find some motivation, I asked myself.

Step 1 – Get out of bed.

Step 2 – Put contacts in so I can see.

Step 3 – Brew and drink coffee.

Step 4 – Just do it.

So here I am. Writing this post, drinking coffee, and occasionally looking out the window at the snow on the driveway. I guess I ought to go do something about that. And I will, as soon as I am done with this cup of coffee – – – –

Is shoveling snow a workout?

We have seen quite a bit of snow in the United States in the last few days. Big snow out East – burying cars and closing down full states. Here in Minnesota, we had maybe 6 inches already today and there is more to come. All this snow requires snow removal – arms and hands, shovels, brooms, and snow blowers. You bundle up to go to work – you come back inside huffing and puffing and a bit sweaty. You feel, “I got my workout in for today.” Snow removal – of any and all forms – is physical activity, but NOT a workout nor exercise. You see, all exercise is physical activity, but not all physical activity is exercise.

Part of the problem with today’s culture is that we falsely promote any physical activity as exercise or equivalent to working out. Similar to shoveling, walking is not a workout either. These are physical activities and best classified as ADLs (i.e., active daily living). NOTE: When individuals are sedentary, they must increase physical activity slowly and progressively. If someone is severely deconditioned, a walk may be a workout. However, these individuals progress quickly and a walk as a workout will not last long. And while you will burn more calories by increasing your ADLs than when doing nothing at all, without workouts, health and fitness improvements will be minimal to nonexistent.

What makes a workout?

Your workout should be more strenuous than shoveling snow – and no, I do not care how heavy the snow is or how long your driveway is. To obtain benefits, you need to push yourself out of your comfort zone. During a workout you should reach or exceed your maximum heart rate (although not stay there for too long).

A workout requires exercise. Unfortunately, exercise is not well defined. The common definition of exercise is, “activity requiring physical effort carried out, especially to sustain or improve physical fitness.” This is a vague definition that, in essence, has misclassified a myriad of human physical activities as exercise. In today’s mindset, almost anything can be termed exercise from walking, to playing a video game, to sex, to board games and beyond, including climbing Mount Everest.

One of the best scientific definitions  of exercise comes from Ken Hutchins:

Exercise is a process whereby the body performs work of a demanding nature, in accordance with muscle and joint function, in a clinically-controlled environment, within the constraints of safety, meaningfully loading the muscular structures to inroad their strength levels to stimulate a growth mechanism within minimum time.

The bottomline

I think of it this way, shoveling snow (or other means of removal) is a maintenance activity. If you are in a maintenance phase of your health, weight, and fitness, you can consider a long day of shoveling your workout and the world will not end. If you are on a journey to improve your health, weight, and fitness – shoveling CANNOT replace your workout. They are not equal nor synonymous. One day of shoveling and skipping your workout – the world will not end. But do NOT make a habit out of it. Do not use food as a compensatory reward, telling yourself that you worked for it – you will only be sadly disappointed when you are not pleased with your end result – after you thought you had worked so hard.

Finally, shoveling snow is not always easy. It burns calories. So does playing Twister or pattycake – are those workouts?

Which comes first – Exercise or nutrition?

The answer is very dependent on the individual and their current behaviors.

If you forced me to choose, I would choose nutrition (yes, the lesser of my expertise). As a society, we are accustomed to convenience food – psychologically and physically. I know individuals who do not eat vegetables. I know others who consume large quantities of Lean Cuisines. I worked in corporate America and had coworkers who ate fast-food EVERY DAY for lunch. I know individuals who do not cook. I know individuals who do not even own ovens or stoves with which to cook. I know individuals who do not eat. For most of these individuals, the best decision is to begin modifying nutrition.

Conversely, I know individuals who eat extremely well, but do not exercise. With a strong foundation in healthful nutritional habits, these individuals can focus on exercise and improved fitness.

There are the individuals who eat poorly and have never exercised, and managed to remain thin for most of their life. We all know someone like this. And then it hits – for women usually before or around menopause – unfamiliar weight gain. The naturally thin persons, having gained weight only at an older age, are probably my most challenging client population. They have never dealt with diets. Most have never stepped foot into a gym. You might think, “Great! A Blank Slate!” Sadly, not so great. Unless this client happens to also have a medical concern, it is incredibly difficult for the individual to see the need to alter nutrition. Having always been able to eat mindlessly – we are combating YEARS of unhealthy habits.

As humans, we do not like change. I know I do not like change. Change is hard. Imagine having had successful habits for 40+ years – and having me tell you that those once successful habits need to change because they are no longer tolerated by your body. You know it is true before I tell you, but you do not like the idea of change.

Further, in the Midwest, we are not afraid to work – we will work hard, for gain or no gain, because that was how we were raised. This same client, she will work her bum off during the 2-3 hours she spends with me at the gym each week. She will even work her bum off at the other activities I assign for her. But she will eat just the same as she has always eaten – and she will fight me tooth and nail on nutritional changes. Her results? The chances are she will not lose any weight.

Why are nutritional changes more difficult?

Have you ever thought about why nutritional changes are so much more difficult than increasing physical activity?

The act of eating involves its own reward system – as we digest and sugar enters our blood stream, our happy hormones (e.g., dopamine) are released into the brains reward center. Food makes you feel good – psychologically speaking. The positive feeling reinforces our eating behaviors (whether we realize it or not). Most individuals eat 5+ times a day – and have for their entire lives. Eating is a solidly established habit (i.e., behavior). Nutritional changes require behavior modifications; whereas, increased physical activity more often than not requires behavior increases or additions.

Often times, individuals can exhaust undesired behaviors through extinction and/or completely avoiding the behavior. Example, quitting smoking cold turkey. While this is not easy – it is easier that trying to change a behavior that you MUST engage in 5+ times a day. You must eat. Sometimes you have to learn to eat more often than you ever have before – meaning that you have more exposure to your food triggers.

Which comes first? ‘Stability’ skills

Research shows that most individuals do not maintain a weight loss for a significant period of time. This can be attributed to the perspective that it takes so much work to maintain a ‘deprived state’ (Kernan et al., 2012). Researchers taught individuals stability skills (i.e., being savvy, enjoying healthy lifestyle habits, making peace with the scale, and fine tuning lifestyle habits) prior to entering a behavior-based weight loss program. Results at six and twelves months showed that the individuals who learned stability skills had greater maintenance success than those who did not learn the skills.

What does this mean, you ask? They educated individuals on the basic principles of energy balance, nutrition, and physical activity (i.e., being savvy) prior to beginning weight loss. Knowledge is powerful! Individuals also began making small changes to nutrition – without necessarily depriving their minds or bodies – allowing their bodies and minds to adjust to the changes. Small steps like these can make big change a whole lot less earth shattering!

The bottomline 

First, change does not happen over night. Sometimes we have to make little changes on our way to a big change. I liken this to my need to ween myself from 2% milk – first to 1% and finally skim. Second, education is the first step to change. Learn about nutrition and small changes you can make – adding vegetables to each meal? – and move forward with confidence!

References

Kiernan, M., Brown, S. D., Schoffman, D. E., Lee, K., King, A. C., Taylor, C. B., Schleicher, N. C., & Perri, M. G. (2012). Promoting Healthy Weight With “Stability Skills First”: A Randomized Trial. Journal of Consulting and Clinical Psychology. Advance online publication. doi: 10.1037/a0030544.