stretching
Mamas on Bedrest: Dr. Linda Burke-Galloway Reviews Updated Recommendations for Exercise During Pregnancy
June 28th, 2011
The post below was written by one of my idols and mentors, Dr. Linda Burke-Galloway. Dr. Burke-Galloway is an OB/GYN who practiced for years providing care to high risk pregnant women. She is now a nationally recognized patient advocate, a legal expert in cases involving high risk obstetrics and Medical Malpractice and is the author of The Smart Mother’s Guide to a Better Pregnancy. In this post from her blog, she reviews ACOG’s Guidelines for exercise during pregnancy.
Exercise while pregnant has always been a controversial issue. The days of of “eating for two” to justify inappropriate eating habits is passé. Nine years ago, The American Congress of Obstetrician-Gynecologists published guidelines regarding exercise and pregnancy. Essentially they recommended 30 minutes or more of moderate exercise each day for pregnant women in the absence of medical or obstetrical complications. The Center for Disease Control’s (CDC) recommendations for an “active lifestyle” does not exclude pregnancy.
In the June 2011 issue of Obstetrics and Gynecology, Gerald Zavorsky, Ph.D and Lawrence D. Longo, MD, wrote an excellent article on exercise and pregnancy. They recommend exercise intensity that increases the heart rate to at least 60% of its maximum capacity during pregnancy to reduce the risk of gestational diabetes. Other recommendations for pregnant women are as follows:
• Pregnant women aged 18 to 45 may do 8 to 10 muscular strength exercises for one to two sessions per week on nonconsecutive days. One aerobic training session can be replaced by a muscle strengthening session in the weight room or at home
• Use lighter weights and more repetitions. If you usually perform leg presses with 35 lb for 8 to 12 repetitions, try 20lb for 15 to 20 reps.
• Avoid walking lunges because they may rise the risk of injury to connective tissue in the pelvic area
• Be careful with free weights because they may involve the risk of hitting the abdomen. Use resistance bands instead that offer different amounts of resistance and varied ways o do weight training and should pose minimal risk to the abdomen
• Try not to lift while flat on your back. In the second and third trimesters, lying on your back may cause the uterus to compress a major vein that could limit oxygen received by the fetus
• Zavorsky and Longo recommend that you listen to your body. If you feel muscle strain or excessive fatigue, modify the moves and reduce the frequency of the workouts. “Pregnancy is not the time to perform heavy weight lifting.” Instead, they should do muscle strengthening exercises according to the prescribed guidelines because it will burn calories and increase the resting metabolic rate.”
As always, please consult your physician or healthcare provider prior to starting an exercise program and remember, a healthy pregnancy doesn’t just happen. It takes a smart mother who knows what to do.
While Dr. Burke-Galloway’s post is directed towards women having uncomplicated pregnancies, once again I want to reiterate that Mamas on Bedrest need to ”exercise” as well.
OB’s and Midwives emphasize the benefits of weight management, maintenance of cardiovascular endurance, maintenance of muscle strength and tone as well as a decrease in the overall aches and pains of pregnancy as the main reasons women should engage in regular prenatal exercise. Secondarily, they emphasize exercise as a way to ward off Gestational Diabetes and possibly Gestational Hypertension which may lead to pre-eclampsia. All of these benefits of prenatal exercise are even more important to mamas on bed rest, women who are at increased risk of these complications (if the don’t already have them!).
Very few OB’s recommend specific exercises for women on bed rest. For that specific reason I developed Bedrest Fitness. It is a simple yet effective set of exercises that women can do while in bed. I also want to add that women on bed rest should regularly stretch, I recommend hourly, to maintain circulation and to decrease the risk of developing bed sores as well as blood clots in the legs.
As Dr. Burke-Galloway stresses, always check with your health care provider before starting any sort of prenatal exercise program. If ysou have questions about exercise while on bed rest, send an e-mail to info@mamasonbedrest.com. And for those interested in more structured and supervised exercise for women on bed rest, join us this fall for online Bedrest Fitness Classes! Details and registration will be available soon!
LIsten to the Mamas on Bedrest Podcast Interview with Dr. Linda Burke-Galloway Here.
Mamas on Bedrest: Do You Have “Linguine Legs”?
March 8th, 2011Bedrest Coach Darline Turner-Lee is offering mamas on bed rest a free webinar on March 11, 2011 at 11am CST. The webinar will review the basics of bed rest exercise including getting into the correct position in bed, the use of pillows, the use of an exercise band to perform active and passive movements and a sampling of exercises mamas can do. To participate, send an e-mail to info@mamasonbedrest.com.
Walking Gets Mama into Shape After Bed Rest
July 5th, 2010I was really excited to see several new mamas out walking with their babies in the sunshine this morning. Walking is an excellent way for mama to lose the pre-pregnancy weight and spend time with her baby. Additionally it is an exceptional way for a former mama on bed rest to regain her lower body muscle strength,endurance and her pre-pregnancy physique.
After as little as two weeks of inactivity, a mama on bed rest can lose substantial muscle strength and endurance. Judith Maloni, Ph.d, notes in her publication, Astronauts and Pregnancy Bed Rest: What NASA is teaching us about inactivity,
“Many mamas who deliver after being on prescribed bed rest report that they have difficulty standing up, get dizzy when they first stand up and they have hip and leg pain.”
Many Mamas are unable to support themselves while standing, let alone themselves and their babies immediately post partum! The longer that a mama had been on prescribed bed rest, the longer-and perhaps harder-it is for her to regain her pre-pregnancy strength, endurance and her pre-pregnancy physique.
Most obstetricians advise new mamas not to engage in vigorous physical activity before 6 weeks post partum. While this is sage advice as it applies to engaging is structured aerobic activity, heavy lifting or strenuous activity, it does not apply to walking. In fact, new mamas should take a short walks daily-beginning almost immediately. At first, this may simply be walking down to the nursery to see their newborns. Once they are home, it may be walking around the house, around the yard or around the block. The sooner mama can begin re-engaging her muscles and reactivating the dormant connections between her brain and her limbs, the sooner she can begin the reconditioning process.But let’s not get ahead of ourselves here. I want to keep this post purely on walking and the early post partum mama.
So there I was, walking my 9 laps around the park in my husband’s home town (a mile=3 loops around the park path and I walk 3 miles), watching the mamas walking with their baby strollers and several important tips came to mind that insprired this post.
- Start with a good pair of athletic shoes. It is very likely that you will need to buy a new pair of athletic shoes after you have your baby. Your feet probably swelled or spread to accommodate the added weight of your pregnancy. For some women, myself included, their feet are now a full size larger (or more) as a result of their pregnancies. Even if you are able to wear the same gym shoes you wore while pregnant, you’ll probably notice that they have stretched and/or worn in such a way that they no longer provide adequate support to your feet now. For example, I “waddled” when I was pregnant and to be able to support my weight, I walked on the outside of my feet. Once I delivered and my weight shifted back to a more even, central distribution, my old shoes actually caused pain in my calves when I wore them to walk. If you can afford to do so, get new athletic shoes.
- Wear a good supportive bra. It’s summertime and while tank tops are appealing, be sure to wear a good, supportive bra when you walk. “But walking is low impact,” you may be thinking. True enough, but if you are nursing, you may have noticed that your breasts are not only heavier but also more sensitive than normal. The mere feeling of cloth against your nipples or extra movement of the breast tissue may be very uncomfortable right now. Make sure to wear a bra that keeps you cool and “wicks” moisture away from your breast as well as one that helps minimize movement.
- Wear an abdominal support if necessary.I had cesarean sections with each of my children and my belly was very tender post partum-especially after the birth of my son, my second c-section. I wore a support garment after both pregnancies to help relieve pressure on my belly. There are several good one on the market and Special Addition Maternity and Nursing Boutique has several great support garments-I bought mine there and you can order online and get sizing support during normal business hours.
- Get a good walking stroller. If you can, get a stroller that is designed for walking. These strollers will have larger wheels and the wheels often pivot so that they are easy to turn and maneuver. Today I saw a Graco stroller that had handles that were similar to those that competitive bikes have so that mama can either grip them with her hands or rest her forearms on them. Additionally, many strollers allow you to adjust the handles so that your arms rest comfortably at your sides, not too high and not too low. Very ergonomic!!InStep, BabyTrend and other jogging strollers are great brands to start with. Also, check sporting goods stores as they often stock jogging strollers.
- Once you have the right equipment, you need to walk with the correct posture. Be sure to stand up straight behind the stroller, not hunched over the handles. New mamas often have rounded shoulders from the weight of their pregnancies, nursing and constantly bending forward to care for their babies. Likewise, mama should not be bent at the waist with arms extended in front of her pushing the stroller as if she is hoisting a huge bolder up a hill like Sisyphus. This stance will lead to arm, shoulder, neck and back pain. It’s important that new mamas stand up straight behind the strollers as they walk to minimize pain or injury.
Once mama has these few essential pieces of equipment and posture pointers, she is ready to begin an initial walking program and the journey back to her “pre-pregnancy” self. Our next blog post will address some specific training techniques mamas can use to enhance their walking program.
Still on bed rest yet want to maintain muscle strength and tone? Order Bedrest Fitness, the first DVD fitness program modified specifically for mamas on bed rest.
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