Year VII., number 2.
Exercising During Pregnancy: researched-based recommendations
Keywords:pregnancy, musculoskeletal health, functional exercise, up- per and lower crossed syndrome, pelvic floor
Exercise offers many benefits to both mother and baby before, during and after pregnancy. It is becoming increasingly accepted that the expect ant mother’s level of physical health during pregnancy (Morris and Johnson, 2005) will influence their recovery post-partum. Recent research also supports this hypothesis and official guidelines en- courage mothers experiencing low-risk, normal pregnancies, to take part in daily exercise – albeit with modifications to their otherwise regular routine as the foetus grows (AGOG 2015, Clapp, 2006) as the pregnancy progresses. More than ever before, the emphasis of musculoskeletal health is in moving pain free and continuing exercise to late on in the term of pregnancy to prevent, reduce and manage discomfort. Many expectant women develop sometimes temporary – so-called upper and lower crossed syndromes (UCS and LCS)– characteristic to the LCS is lumbar lordosis, which contributes to the very high prevalence (<50%) of low back pain in pregnant women (Wang et al, 2004). Balance may be affected by the changes of the body’s centre of gravity (COG), predisposing pregnant women to an increased risk of falling. Another musculoskeletal change during pregnancy is increased ligamentous joint laxity – thought to be secondary to the influence of the increased levels of oestrogen and relaxin. Theoretically, this would pr edispose pregnant women to increased incidence of strains and sprains (Artal and O’Toole, 2003), lower back pain and pelvic girdle pain (Gutke et al, 2008, Maclennan etal., 1986). In each and every case, the use of corrective and preventative functional exercises are needed that mimic activities of daily living (ADL) in conjunction with activating the pelvic floor muscles. It is imperative that the pelvic floor regains its strength soon after birth to avoid post-pregnancy complications such as incontinence. Postural changes can also be required to encourage one’s posture to return to its pre-pregnancy state and to thus avoid chronic musculoskeletal problems.