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Exercise During Pregnancy

Amelia Iams, DPT

aquatic exercise during pregnancy

Exercise is important to include in everyone’s daily life, but it becomes even more important when you are pregnant. Pregnancy causes many changes in a woman’s body.  Hormone changes in the body cause softening of the ligaments, joint laxity, and instability in the ankles.  Hormones and anxiety can be the reason for increased mood swings.  Changes in the center of gravity due to a growing belly can cause increased occurrence of back pain.  Increased retention of fluid in the body causes swelling in both the hands and feet and can amplify complaints of constipation.

Exercise during pregnancy provides similar benefits to your body as it does during other times in your life, but it also can prevent and minimize changes in the body and pain or discomfort that occurs when you are pregnant. Some of the proven benefits that exercise during pregnancy includes are:

  • Avoidance of excessive weight gain
  • Maintenance or improvement in endurance, muscle strength, and flexibility
  • Reduction of the likelihood of gestational diabetes
  • Decrease or reduction in symptoms of low back pain or pelvic girdle pain
  • Reduction in occurrence of preeclampsia
  • Decrease in the risk of cesarean delivery
  • Reduction in psychological stress

The American College of Obstetricians and Gynecologists (ACOG) states “for healthy pregnant and postpartum women, the guidelines recommend at least 150 minutes per week of moderate-intensity aerobic activity (ie, equivalent to brisk walking). This activity should be spread throughout the week and adjusted as medically indicated.”  That is equal to about 30 minutes 5 times a week of moderate exercise.  Research also indicates that including both strengthening and aerobic exercise to your routine is important to help support the changes that occur in your body with pregnancy.

Despite all the benefits to exercising while pregnant, most women do not begin an exercise program and those who were exercising prior to pregnancy actually decrease their activity during pregnancy.   Through several studies and surveys, women have stated various reasons for decreasing their activity during pregnancy.  The two most common reasons are: not enough time and pain with movement associated with the pregnancy.

Choosing an exercise program that is safe, can be maintained during the entire 40 weeks of pregnancy, and can fit into a busy work and family schedule is a difficult task.   It is recommended that pregnant women avoid high contact sports and activities that have an increased risk for falls or impact, such as soccer, basketball, hockey, snow skiing, water skiing, and off road cycling.  Exercises that require jumping and quick changes in directions, such as Zumba, Cross fit, and trail running, are not recommended due to joint instability brought on by hormones.  Also high impact aerobics can be difficult to and uncomfortable to perform later in pregnancy.

An underutilized exercise avenue is aquatic exercise programs. Several research studies have advocated the use of pool exercises for women who are pregnant.  The natural properties of water help alleviate many of the adverse changes associated with pregnancy.  The buoyancy of the water will help to eliminate the stresses on the joints and to support the abdomen.  Women have reported feeling more comfortable moving in the water and able to assume better postures as a result of the additional support.  Hydrostatic pressure is an additional benefit when exercising in the water.  The pressure that the water exerts on the body helps to decrease the swelling in the limbs brought on by pregnancy.

Aquatic exercise is non-weight bearing and low impact, so stress on the joints is minimized. Water provides natural resistance to movement which helps to strengthen muscles and thereby incorporating both strengthening and aerobic exercise into one session.  This can help you meet both suggestions for a healthy body during pregnancy without increasing the time you spend at the gym.  Many women stop exercising as their pregnancy progresses because of decreased balance, increased swelling in their feet, or pain and discomfort in their back.  The water helps to support the body, and it is not likely that you will be injured falling in the water. Several studies have proven that exercising in the water during pregnancy helps to decrease low back pain and reduce time off from work due to pain and discomfort.  There are many benefits to exercising in the pool that cannot be achieved with land based exercise, therefore making it an excellent option for women during pregnancy.

There are many fitness centers as well as physical therapy centers that offer aerobic exercise classes in a pool and individualized pool exercise sessions. Choosing the right one for you should be based on several factors, such as cost, location, available time, and expertise of the instructor.  In some cases aquatic therapy can be covered through your health insurance when provided by a physical therapist.  A physical therapist can help design an exercise program that is individualized to you.  Other options to consider when choosing a pool are temperature of the water, depth of the water, and air temperature of the pool area.  Exercising in the water decreases your ability to sweat but there is increased loss of heat through skin contact with both the water in the pool and the air temperature difference in the pool room.  It is recommended that pools utilized for aerobic exercise for pregnant individuals be at about 80-86 degrees Fahrenheit.  Most pools at a gym are cooler to allow for longer time and more intense exercise while therapeutic pools at rehabilitation clinics will be warmer and offer increased comfort for those suffering from back pain.

Safety and monitoring your exercise regimen in the pool is important. The properties of water will naturally decrease the heart rate by increasing the volume the heart pumps out.  If you use your heart rate to gauge your exercise, it is suggested that you decrease your heart rate guidelines by 15 beats per minute.  When exercising in a pool is better to gauge your exercise intensity by using a scale called Borg Rating of Perceived Exertion.  A physical therapist can provide you with the scale and educate you on how to use it.  Dehydration with exercise can occur in the pool as easily as it can on land.  Having access to water during exercise can be important to avoiding any complications with exercise.

All exercise programs are most effective when you can choose an activity they enjoy and a program that is individualized to your needs and goals. We highly recommend water aerobics or any aquatic exercise for women during pregnancy. Aquatic exercise is an exercise program that women would be able to follow throughout the entire 40 weeks of pregnancy.

 

Amelia Iams, DPT is a Physical Therapist at FMH Rehabilitation Aspen Ridge in the treatment and management of sports related and orthopedic injuries.


Does your Bladder Dictate your Life? Let’s talk.

May 8th through the 13th is Women’s Health Week and the goal is to empower women to make their health a top priority and educate on the steps women can take to improve their health.  During the week, you can get the answers to top questions that are asked about Women’s Health. 

~Lynne Schill, Physical Therapist, Guest Author
Lynne Schill is a Women’s Health Physical Therapist at FMH Rehabilitation Women’s Center Crestwood. She has experience in treating women’s health diagnoses and has found this work to be extremely rewarding because of how significantly it can improve quality of life. Her compassionate nature coupled with an incredibly warm bedside manner inspires confidence, determination and empowers the individual to become proactive in their own recovery.

Does your bladder dictate your life? Do you have to plan your day around where the next bathroom is?  restroom signAre you afraid to leave your home for fear of not making it to the next bathroom or leaking? Do you feel something bulging in your vagina or have you been diagnosed with pelvic prolapse? Do you suffer from pelvic pain which affects your lifestyle and intimacy? Do you skip the jumping jacks or walk instead of run during your exercise routine?

May 8th through the 13th is National Women’s Health Week with the goal to empower women to make their health a top priority and to educate women on the steps to take to improve their health.   Women’s issues are important and most women suffer needlessly because they are not aware of the rehabilitation programming designed especially for women.

So, did you answer yes to any of the questions above? If so, you may be a candidate for women’s health physical therapy!  Physical therapy (PT) is a great alternative for women who don’t want to take medication and want to avoid surgery for incontinence, pelvic pain, and pelvic prolapse. Don’t let your bladder dictate your life or continue to suffer from pelvic pain, which can affect your lifestyle and intimacy.

Women often suffer in silence, not mentioning these problems to their healthcare provider and think they just have to “live with it”. However, there is hope—and help available, with physical therapists who have been specially trained to treat these conditions.

According to the National Association for Continence (NAFC), 26% of women between the ages of 18-59 have involuntary leakage, 20% of women over 40 also have overactive bladder, and 66% of women and men ages 30-70 have never discussed their bladder health with a healthcare provider.

It’s time to start the conversation!

My incontinence…

There are three types of incontinence: urge, stress, and mixed (which is combination of the first two).

Urge incontinence is when there are strong urges to urinate even though the bladder may not be full and there is an increased frequency of urination. Physical therapy treatment approaches include filling out a detailed three-day bladder log. Information gathered in this log includes the number of voids per day and night, how much is voided, what the patient was doing at the time, determining if the patient is drinking enough water, and identifying any dietary triggers.  Often, eliminating bladder irritants from the diet including caffeine, alcohol, citrus, carbonated beverages, and artificial sweeteners can help decrease or stop the problem.  Smoking can also be a factor, as can constipation.

Running to the bathroom and frequent emptying ‘just in case’ can actually make the problem worse. Teaching patients urge control techniques including standing or sitting quietly, doing a few quick Kegel contractions, and deep breathing can help decrease the urge. Another mistake women make is restricting their fluid intake.  This can not only lead to dehydration, but it can also cause the urine to be more concentrated, which can be irritating to the bladder lining and lead to further urgency.

Urge incontinence and overactive bladder sufferers can benefit from physical therapy relaxation techniques including deep breathing and nervous system quieting in order to help calm the bladder.

Stress incontinence happens with coughing, sneezing, laughing, exercising, or lifting. The increased pressure in the lower abdominal and pelvic region can cause leakage because of weakened pelvic floor muscles.  Pelvic floor muscles provide support to the pelvis and pelvic organs.  One exercise many women know that can help strengthen the pelvic floor is Kegels. However, it might be surprising to know that more than 50% of women perform Kegels incorrectly! A physical therapist can educate you further on pelvic floor anatomy to help identify which muscles you need to be contracting, how to isolate the contraction in order to do a correct Kegel, and then advise you on a home exercise program.   Strengthening the pelvic floor and lower abdominal muscles is especially important for this type of incontinence.  Also, modifying activities and exercise by avoiding a lot of heavy lifting, jumping and running can decrease symptoms.

My pelvic prolapse diagnosis…

Pelvic Prolapse is when a pelvic organ—such as your bladder, rectum or cervix—drops from its normal position. If you suffer from pelvic prolapse, you may benefit from postural education, strengthening of the pelvic floor muscles, activity modification, and positioning techniques to help reduce prolapse symptoms. Eliminating constipation is also important; a physical therapist can teach strategies to achieve regularity in order to avoid bearing down hard, which can potentially increase prolapse.

My pelvic pain…

Pelvic pain can be another life-changing problem for women—causing problems with simple daily activities and affecting intimacy. Pelvic pain and pelvic discomfort can be associated with menopause, post hysterectomy and other surgeries, trauma/injury, pregnancy/child birth, and pelvic malalignment. A physical therapist performs a thorough assessment and develops a program to meet individual needs.  Treatment may include hands on soft tissue techniques, biofeedback, and/or relaxation techniques.

Biofeedback is a valuable tool that is used to assess the muscle activity of the pelvic floor muscles and helps patients recognize when their pelvic floor is relaxed versus in a contracted state. While being coached by a physical therapist, the patient can become more aware of the pelvic floor muscles and how to use them via visual feedback.

Ask yourself, “Would I like to improve my pelvic health and quality of life without surgery or medication?” It’s time to do something about it and Women’s Health Week is the perfect time to start!

A Physical Therapist trained in treating pelvic floor dysfunction is available for your specific needs and diagnosis. Your bladder doesn’t have to dictate your daily routine; you don’t have to live with pelvic pain in silence. You deserve your life back!

Tx:Team Women’s Health Physical Therapy programs can be found at FMH Rehabilitation in Frederick, MD, St. Vincent Frankfort Hospital in Frankfort, IN, and St. Vincent Jennings Hospital in North Vernon, IN. Ladies, it’s time to take the steps to improve your health and Women’s Health Week is the perfect time to start!

 

 


My First Women’s Health Visit is Today

May 8th through the 13th is Women’s Health Week and the goal is to empower women to make their health a top priority and educate on the steps women can take to improve their health.  During the week, you can get the answers to top questions that are asked about Women’s Health. Let’s continue the conversation…

WH waitingWhat would I expect on my first visit?

In the first visit, a lot of history taking is done! The more history on the issues that the patient has, the more information can be gathered to work on the best plan of care.

You will be taken to a private treatment room where all you will receive one on one treatment. An extensive personal medical history will be taken as well as a thorough physical assessment of both external structures and internal structures.  From there, your plan of care will be discussed and patient centered goals will established.

How long would my physical therapy treatment last?

The initial evaluation will be approximately an hour.  Follow up visits will vary depending on your need and pain level.  As the pain begins to subside, frequency of visits will be gradually decreased.

What will happen during therapy?

This depends on the diagnosis. During the first couple of follow up visits, you will receive a lot of patient education surrounding your anatomy so you may visualize and understand what area of the body and which muscles specifically we will be targeting.  Your treatment plan might also consist of biofeedback, manuals therapy, and a home exercise program.

You will always be in a private room due to the sensitivity of the situation. Even if no internal work needs to be done, a private setting will allow you the freedom to discuss everything openly with your therapist.

Tx:Team Women’s Health Physical Therapy programs can be found at FMH Rehabilitation in Frederick, MD, St. Vincent Frankfort Hospital in Frankfort, IN, and St. Vincent Jennings Hospital in North Vernon, IN. Ladies, it’s time to take the steps to improve your health and Women’s Health Week is the perfect time to start!


Empower Yourself…Break the Silence on Women’s Health

May 8th through the 13th is Women’s Health Week and the goal is to empower women to make their health a top priority and educate on the steps women can take to improve their health.  During the week, you can get the answers to top questions that are asked about Women’s Health. Let’s continue the conversation…

 

How can Women’s Health therapy help?

This type of therapy is a conservative treatment approach which is an alternative to taking medications or even having surgery. Women’s health therapy can help you decrease pain, urinary or fecal leakage, and strength deficits.  Often being educated about lifestyle changes, addressing musculoskeletal factors, identifying and treating weakness or tightness in the pelvic floor muscles can have a big impact on a patient’s symptoms.

What if I feel embarrassed about my condition and it’s hard to talk about?SLP flyer web

It’s completely normal to feel embarrassed when talking about sensitive issues. Just remember, many women feel the same way.  Your therapist has a lot of experience in treating pelvic floor conditions and she will put you at ease about your evaluation and treatment.  The problem you are having is not uncommon, it’s just that people don’t talk about it.  It’s time to get the conversation started!

We don’t have to discuss everything the first day. If you need time to really get to know your therapist that is fine!  Sometimes, we just start with measurements until you become comfortable with your therapist. Being open and honest with your therapist will better help her to help you achieve your goals.

 

Tx:Team Women’s Health Physical Therapy programs can be found at FMH Rehabilitation in Frederick, MD, St. Vincent Frankfort Hospital in Frankfort, IN, and St. Vincent Jennings Hospital in North Vernon, IN. Ladies, it’s time to take the steps to improve your health and Women’s Health Week is the perfect time to start!


It’s Women’s Health Week! Questions? We Have Answers!

May 8th through the 13th is Women’s Health Week and the goal is to empower women to make their health a top priority and educate on the steps women can take to improve their health.  During the week, you can get the answers to top questions that are asked about Women’s Health. 

Pure, Natural, Beauty

Promoting Women’s Health & Wellness across the lifespan.

Women’s issues are important and most women suffer needlessly because they are not aware of the rehabilitation programming designed especially for women. Many patients suffer in silence from disorders caused from pregnancy, disease, musculoskeletal injury and surgery, or an unknown etiology.

Women’s Health physical therapists are trained to evaluate and treat the common conditions as well as more extensive diagnoses. The Tx:Team’s Women’s Health Program works with each patient on an individual basis with the ultimate goal of returning you to your daily routine as quickly as possible.  Physical Therapists work alongside you, the patient, to examine, treat, train, and educate.

Many of the diagnoses that women face are sensitive and can make a woman feel embarrassed. It’s time to get the conversations started! Since a women’s health program may be new to a majority of women, there are typically many questions surrounding how the program might help with your diagnosis or problem.

What does a Women’s Health Physical Therapist do?  

Women’s Health Physical Therapists provide specialized physical therapy services to diagnoses specific to women. These clinicians have received additional training for evaluation and treatment of the pelvic floor including both external and internal assessments.

What conditions does the Women’s Health Program address?

  • Urinary Incontinence
  • Pelvic Pain
    • Clitirodynia
    • Levator Ani Syndrome
    • Prudendal neuralgia
    • Vulvodynia/VVS
    • Dyspareunia
    • Coccygodynia
    • Tension Myalgia
  • Pelvic Organ Prolapse
  • Low/Mid Back Pain
  • SI Joint Dysfunction
  • Pregnancy related pain
  • PreNatal/PostPartum Conditions
  • Painful scars (c-section/episiotomy)
  • Diastasis Recti
  • Back Pain
  • Neck/Shoulder Pain
  • Painful Intercourse
  • Sacrococcygeal Joint Dysfunction
  • Osteoporosis
  • Lymphedema Management
  • Fibromyalgia
  • Gynecological surgery (pre/post op care)
  • Myofascial Pain Syndrome
  • Pain associated with Interstitial Cystitis & Endometriosis

Tx:Team Women’s Health Physical Therapy programs can be found at FMH Rehabilitation in Frederick, MD, St. Vincent Frankfort Hospital in Frankfort, IN, and St. Vincent Jennings Hospital in North Vernon, IN. Ladies, it’s time to take the steps to improve your health and Women’s Health Week is the perfect time to start!


Get Your Family Moving: Rake Leaves!

Family raking leaves

Family raking leaves

Autumn is a beautiful season with the changing of the leaves but it also brings about some hefty yard work in removing them. Raking leaves is actually very hard work and good physical exercise at the same time. Your equipment needs are simple: your body and a rake.  Raking burns about 300 calories an hour while toning your arms and strengthening your back and legs.  Just be sure to stretch first and, to avoid muscle pulls, don’t try to do the whole yard at once.

Regular exercise no matter what type can boost energy, build strength & stamina, improve balance and even help to reduce some signs of aging.

Tips for Safe Raking:

Do a pre-rake warm-up:

It may not seem like a workout, but you can burn nearly 300 calories during an hour of raking!

  • Walk around a bit before you start so your blood gets flowing.
  • Do a couple of stretches to prevent straining the muscles of your shoulders, neck, and back.
  • Side bends and knee-to-chest lifts help open you up and ready you for all of the raking, bending, and lifting you’ll be doing.

Practice proper raking posture:

  • To keep your neck and back happy, stand upright and rake leaves to the side of you, alternating your dominant hand now and then.
  • Bend at the knees – not the waist – when picking up piles of gathered leaves.
  • Keep the rake mostly perpendicular to the ground (i.e. between 65 to 85 degrees.) That will give your body easy leverage on the rake, making it easy to move, and easy on your body.
  • Avoid twisting to toss leaves. Instead, step to the side so your whole body switches position, not just your shoulders and back.
  • Switch sides now and then and take breaks, especially if you haven’t raked since last fall.
  • Take it easy on your back. Move your whole body and not just your spine.

Take rake breaks:

The repetitiveness of raking can become painful after a while.

  • Only rake small sections at a time as this will save energy. Take breaks when you get tired every 10 to 15 minutes.
  • Sip on water to stay hydrated.
  • Stretch to release tension you may have built up.

Using the proper techniques is essential. If part of your body is sore, it is probably telling you that you have overdone it or you are using the wrong technique. Rake so it’s natural and comfortable with the power of your movements coming from your legs.

So, get your family or even some of your friends involved and get your bodies moving! Also, don’t forget to look out for your pets or small children who may jump into your pile of leaves!

 


Posted in General, Wellness

Lucy in the Sky with Diamonds-Wellness Style

Therapists have a unique relationship with their itself, therapists also stress the importance of wellness throughout the year.  Our clinicians not only have strong beliefs in achieving goals of physical, mental and emotional wellness for their patients but also for themselves!  Lucy, PT, shares a piece that achieves all three: a call for exercise but delivered with some laughter.  Boost your goal to wellness with this awesome playlist!

Elite AthleteI LOVE to exercise! I equally LOVE music. When you put the two together, “What a Feeling!” as Irene Cara would sing. Music and exercise, exercise and music are certainly as great as Simon and Garfunkel or Sonny and Cher. Can there be a better duet than your favorite exercise with your favorite song?

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Posted in General, Wellness