Written by Kristjan Briffa
Kristjan Briffa graduated as a Physiotherapist in 2004. He became a full member of the Society of Musculoskeletal Medicine in 2009 in the UK, expanding his knowledge in Orthopaedic Medicine. In 2014, he successfully completed his Masters in Sports Physiotherapy at the University of Bath (UK). He has a special interest in Kinesiology, which helps to understand the way the body moves. He is also a certified clinical Pilates instructor through the Australian Physiotherapy and Pilates institution and uses clinical Pilates as a powerful tool to help treat his patients.
EXERCISE AND BACK PAIN DURING PREGNANCY
Back pain during pregnancy is a common occurrence. It is reported that more than 50% of pregnant women will be affected by LBP. This is normally a result of changes occurring in the female body as the foetus develops. During the 9 month period the foetus grows bigger and heavier, causing changes in the body to accommodate these changes. This results in postural compensations required to maintain balance while standing. The changes in the weight distribution increases strain on the musculature and ligaments in the lower back, while the stomach muscles become weaker. Also, a hormone called relaxin increases during pregnancy which helps make the joints more lax to help accommodate the growing foetus but weakens the static support of the lower back and pelvic area. These changes decrease the ability to maintain a neutral spine leading women to experience LBP or leg pain.
The risk of developing LBP is reduced with regular exercise before and during pregnancy. Unfortunately, there are a lot of myths and misconceptions which keep women away from regular exercise during pregnancy.
These are some of the most common concerns expressed by women with regards to exercise during pregnancy:
- “I never was an active person before, now is not the time to start exercise”
To the contrary, pregnancy should be your motivation to start moving more regularly. The real hazard is inactivity which could contribute to excess weight gain, in turn leading to those postural adaptations which cause LBP. There are few medical conditions which require rest during pregnancy, so it is always best to get the go-ahead from your gynaecologist. However, for the vast majority of pregnant women, at least 30 minutes of moderate exercise is recommended on most days of the week. Walking is one of the easiest forms of exercise. It provides moderate aerobic conditioning with minimal stress on your joints.
- “Strength training during pregnancy will cause joint injuries”
During pregnancy the body is flooded with the hormone relaxin which tends to loosen up ligaments, making joints more lax in preparation for delivery. However, in recent studies it was found that low to moderate intensity strength training is safe and helps mitigate certain joint aches and pains which occur as a direct consequence of joint laxity. Strength training helps maintain good muscle tone throughout the body which acts as active stabilisers of the joints. Strength training could involve the use of machines within a health and fitness centre, or simple body weight exercises such as push ups, and squats (no, squats will not trigger labour!) done at home. It is always recommended that professional advice is sought to make sure the exercise is done in the right form.
- “Is running harmful to my baby?”
As long as there are no existing joint and ligament issues, running is not going to harm the baby. The foetus is safely floating in the amniotic fluid. Rather, it is how much the mother-to-be runs that one should be careful of. It is very important that you learn to pace yourself. Intense exercise increases the oxygen and blood flow to the muscles and away from uterus. In general, one should be able to talk normally while performing a workout. If you cannot then you are probably pushing too hard. This all depends on the level of fitness you had before pregnancy. If you used to run before this period, it is safe to continue doing so as long as you are comfortable and you get the green light from you gynaecologist. If you weren’t an avid runner before it may be sensible to stick to walking starting from 10 minutes and slowly building up to 30min walks.
- “Can I do a core workout during pregnancy?”
It depends. Some core exercises, such as crunches, may pose a threat during pregnancy. While performing exercises which require a supine position, one of the major veins responsible to ordain the blood back to the heart could be compressed by the growing uterus. This could lead to unnecessary dizziness. Proper core stability exercise in the form of pilates is more appropriate. This form of exercise could help maintain the best muscle tone and muscular endurance to maintain a neutral spine offsetting possible harmful postures.
Unfortunately, there is no known exercise regime which could give a 100% guarantee against LBP or other related musculoskeletal issues during pregnancy. However, with proper planning, exercise awareness and common sense there are ways to prevent or alleviate such issues. One important note to take home is that regular exercise can help you deal with the physical changes a pregnancy will put you through and help you achieve the stamina required for the challenges ahead.