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8/29/2019 1 Comment

Answering some common questions about exercise and pregnancy

Medical viewpoints on exercising while pregnant have changed drastically over the past century as more and more research has been carried out. Below are some common questions with answers regarding exercise in pregnancy. Feel free to email us with any questions that have not been answered below.

Is it safe to exercise during pregnancy?
Yes, for most women it is safe and there are many health benefits for exercising while pregnant including improving your mood, energy, posture, sleep, strength and endurance and also reducing backaches, constipation, bloating, swelling and preventing or treating gestational diabetes. For a small minority of women with high risk pregnancies it is advised to either not exercise at all or to exercise under the supervision of a qualified professional initially. It is always good to discuss exercise with your midwife or GP especially if you are starting any new exercise but if any of the following apply to you then it is essential; pre-existing heart condition, restrictive lung disease, severe anaemia, diabetes, pre-eclampsia, incompetent cervix, placenta previa or previous miscarriages past 12weeks.

But won’t my body overheat, or heart rate go up too high and damage the baby?
This theory has now been proven wrong by good quality research and clear guidelines have been developed. It is believed that during pregnancy our body may have the ability to reduce rises in core temperature to protect the fetus. Studies have been carried out monitoring body temperature while exercising as well as while immersed in hot water and the following has been proven to be safe (1).
  • Exercising for 35min at 80-90% of HRmax (220-age) in 25C & 45% humidity.
  • Exercising in water <33.4C for up to 45min.
  • Sitting in hot baths of 40C or hot/dry sauna (70c, 15% humidity) for up to 20min.

Can I still exercise if I have Gestational Diabetes (GD)?
There are huge benefits for exercising for women who are at risk of or have been diagnosed with Gestational Diabetes (GD). Research shows that exercising a minimum of 3 times per week throughout the entire pregnancy helps to prevent GD (2). Exercising also helps to control blood glucose levels by decreasing insulin resistance in the body, in some women it has been shown to eliminate the need for taking insulin (3). You may need supervision/monitoring initially if you are starting new exercise or increasing your current exercise regime because exercise decreases insulin resistance in the body which can reduce the amount of insulin needed if you are having additional insulin therapy so please also discuss with your GP.

How often and at what intensity should I exercise?
To get the benefits of exercise during pregnancy it is recommended to do 20-30mins of moderate-intensity exercise on most or all days of the week (4). Moderate intensity exercise would be described as “somewhat hard” but still being able to talk while exercising (not too breathless).

Are there any types of exercise that should be avoided during pregnancy?
It is recommended that all contact sports are avoided such as soccer/football, basketball, rugby and netball and any sports with a high risk of falling such as downhill skiing, water skiing, surfing, off-road cycling, gymnastics and horseback riding (4). However, if you have been involved with any of these sports up to the time of getting pregnant and are highly skilled in them then it is best to discuss it further with a health professional. Other activities to avoid are scuba diving, sky diving and “Hot Yoga” or “Hot Pilates”. As your baby grows inside you it is best to also avoid any exercise that involves lying on your back because in this position the weight of the baby can go directly on the main vein returning blood to your heart and also put pressure on your lungs causing you to be breathless.

Warning signs for when not to exercise or to cease exercising
  • Vaginal bleeding
  • Regular painful contractions
  • Shortness of breath before exercising
  • Dizziness
  • Headache
  • Chest pain
  • Calf pain or swelling
  • Amniotic fluid leakage
  • Muscle weakness affecting balance
 
  1. Ravanelli, Casasola et al 2018, Heat, stress and fetal risk. Environmental limits for exercise and passive heat stress during pregnancy: a systematic review with best evidence synthesis. British Journal of Sports Medicine, vol 53 (13), 799-805.
  2. Magro-Malosso, Saccone et al 2017, Exercise during pregnancy and risk of preterm birth in overweight and obese women: a systematic review and meta-analysis of randomised controlled trials, Acta Obstet Gynecol Scand, vol 96 (3), 263 – 273.
  3. Bung, Artal and Khodiguian 1993. Regular exercise therapy in disorders of carbohydrate metabolism in pregnancy – results of a prospective, randomised, longitudinal study, Geburtshildfe Frauenheilkd, vol 53 (3), 188-193.
  4. American College of Obstetricians & Gynaecologists 2015, Physical Activity and Exercise During Pregnancy and the Postpartum Period, number 650, December 2015.
1 Comment

8/19/2019 0 Comments

Incontinence - A Taboo Subject?

Do you have to stop and hold when you sneeze or cough?

Do you leak urine when you laugh too loud?

Are you worried about getting back into sports or fitness in case you leak?

Do you have a mental note in your head of where all the toilets are on-route when you go out in public?

Do you find yourself having to rush to the toilet with very little warning?

Do you always empty your bladder before sex for fear of leaking?

If you have answered yes to any one of these questions you would benefit from seeing a Physiotherapist with knowledge in women’s health or pelvic health. Unfortunately, incontinence is a topic that is not talked about enough. Most women are happy to talk about their birth experiences in detail but not the incontinence that can follow for weeks, months or even years after. Women usually dismiss it as part of having a baby and expect it just to come right by itself or think that they should just put up with it. At times incontinence can also occur completely unrelated to childbirth.
As women we are often so focused on looking after everyone around us that we neglect ourselves however if we hurt the muscle in our arm and couldn’t use our arm properly it’s likely we would go and see a physio so why is our pelvic floor any different? In France the government pays for women to have 8 physiotherapy sessions starting from 6 weeks after having a baby, it’s common knowledge that they need to rehab their pelvic floors after pregnancy and childbirth.
An NZ study by Lara and Nancy (1994) showed an overall prevalence of urinary incontinence in women of 34%. An earlier study by Holst and Wilson (1988) reported similar results with a prevalence of 31% but what was interesting with this study was that out of all the women with urinary incontinence only 35% of them sought out professional help. These stats are only looking at urinary incontinence, women can also be affected by faecal incontinence following childbirth, trauma or other causes. Unfortunately, our lack of openness to talking about these issues can often lead to a sense of isolation or depression. If you answered yes to any of the above questions don’t hesitate to book in for an assessment with a suitably qualified Physiotherapist today.

Holst K, Wilson PD (1998) The prevalence of female urinary incontinence and reasons for not seeking treatment. NZ Med J 101: 756–8.
Lara C, Nancy J (1994) Ethnic differences between Maori, Pacific Island and European New Zealand women in prevalence and attitudes to urinary incontinence. NZ Med J 107: 374–6.

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