Training Considerations During Pregnancy: Part 6 Exercise for Pregnant Women
Abdominal Muscles
During pregnancy, it is important to check for advanced separation of the abdominal muscles in order to take precautions to avoid any further separation.
The abdominal muscle in the centre is divided by a seam, so the muscle is really two halves.
The hormones present during pregnancy cause this seam to soften and stretch as the abdominal muscles accommodate the growing baby. If the seam stretches enough, a separation of the abdominal muscle may occur.
A separation can happen gradually or as a result of sudden exertion if the abdominal area is weak. A pregnant woman may be unaware of the separation as it causes no direct pain. However, she might have increased backache, as the abdominal muscles are needed to control a pelvic tilt and maintain proper posture.
If any separation is found, avoid further separation by:
Doing mild abdominal strengthening while the client crosses her hands over her abdominal area to support and bring the muscles together.
Ensure client exhales as she lifts her head; this decreases pressure in the abdomen and allows abdominal muscles to work more efficiently.
Avoid abdominal bulging by making client conscious of contracting her abdominal muscles when lifting and avoid straining of any kind.
Pelvic Tilt
This exercise is very important because it is the building block of good posture and strengthens abdominal and back muscles. This therefore decreases back strain and fatigue. Practice it often.
Client to lie on back with knees bent.
Inhale through the nose and tighten stomach and buttock muscles.
Flatten the small of the back against the floor and allow the pelvis to tilt upward.
Hold for a count of five as the client exhales slowly.
Relax, repeat.
Other positions in which you can perform the pelvic tilt are while on your hands and knees or while standing upright.
* CAUTION: Ensure client DOES NOT arch back, bulge abdomen or push with feet to obtain this motion.
Sit-ups
There are two variations of sit-ups:
Forward Sit-Up
Have client lie on her back with knees bent and breathe in slowly through the nose.
Have the client breathe out through partially pursed lips as she raises her head, hands pointing to the knees or placed behind the head.
Have client tuck her chin toward her chest and lift her shoulders off the floor (not more than 45 degrees).
Diagonal Sit-Up
Have client lie on her back with knees bent and breathe in slowly through the nose.
Have her point her right hand toward her left knee while raising her head and right shoulder. Breathe out slowly through the mouth. Keep the left knee bent slightly and the heel on the floor.
Note: using a bosu ball or other roller in the base of the back allows upper sit ups to activate lower abs while supporting the lower back to prevent disc injury
Kegels
Kegel exercises tone the pubococcygeal (PC) muscle. This is the muscle you use to stop and start the flow of urine. Exercising this muscle helps prevent haemorrhoids, supports the growing baby and assists during and after labor.
Clients can learn to isolate this muscle by stopping the flow of urine a few times. Use this technique only to locate the muscle. Don’t exercise the muscle this way as it may lead to a urinary tract infection.
Instruct the client to squeeze the PC muscle for five seconds; relax for five seconds, then squeeze again.
At first, do 10 five-second squeezes three times a day. Work up to doing 100 Kegels each day.
Variation: Flutter exercises – squeeze and release, then squeeze and release as quickly as you can.
Arm/Upper Back Stretch (Flying Arm Exercise)
Raise your arms over your head, keep your elbows straight and the palms of your hands facing one another. Hold for at least 20 seconds.
Lower your arms out to your side. Keep your upper back straight.
Bring the backs of your hands together as far as possible behind your back and stretch.
Repeat 5 times.
Squatting
Move to the squatting position, knees over toes.
Keep heels on the floor; feel the stretch in the back of thighs.
Hold for 20-30 seconds. Gradually increase the time to 60-90 seconds.
Relax the head and arms throughout this exercise.
This is a good exercise to prepare for squatting during the pushing stage of labour.
Calf Stretch
Lean against a wall or firm surface.
Reach one leg out behind, keeping the heel on the floor.
Lean into the wall to increase the stretch of the calf.
Hold for 20-30 seconds.
Repeat with each leg.
This is a good exercise for the client to do before going to bed if she is bothered by leg cramps at night.