Month: June 2017

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    ​Experts agree, when you’re expecting, it’s important to keep moving. Pregnancy is an exciting time in your life, I should know because I am currently pregnant with my first child and due in September. Throughout your pregnancy, the body will go through many changes which are essential to adjust for the growing baby and will prepare you for the process of labor. With these changes, the body can become prone to injury. The most common injuries during pregnancy include; generalized low back pain, sciatica, piriformis pain, diastasis recti, sacroiliac joint dysfunction, pelvic floor dysfunction, etc. In a recent study, it was estimated that more than two thirds of pregnant women experience low back pain and nearly one-fifth experience pelvic pain. The reasons for pain or dysfunction may vary based on the individual however most likely due to the following changes that occur during pregnancy; increase in hormones that can cause joint laxity, weight gain, a change in the body’s center of gravity, developing poor posture, additional stress, etc. For example; weight gain during pregnancy can change your center of gravity which affects your posture and body mechanics that causes muscles to work harder throughout the day. An increase in this exertion causes fatigue which can reduce motivation to be active and overtime create muscle weakness.

    Current research states that both the mother and fetus can benefit from exercise. Some benefits include: improved cardiovascular function, decreased pregnancy weight gain, decreased joint and muscular discomfort, reduced incidence of muscle cramps and lower leg swelling, mood stability, decreased risk of developing gestational diabetes and gestational hypertension. Fetal exercise benefits include: decreased fat mass, improved stress tolerance, and advanced neurobehavioral maturation. According to the American College of Obstetrics and Gynecology (ACOG), and the American Society for Obstetrics and Gynecology (ASOG), normally healthy pregnant women may continue an already-established exercise regimen. However, if you would like to start exercising and don’t have an established regimen, it would be best to consult with your MD and physical therapist prior to commencing a program to avoid injury.

    I have been very blessed so far throughout my pregnancy because I have been able to avoid any pain or discomfort with maintaining a consistent cardiovascular program as well as strength training program. I currently walk at least 3 miles everyday and complete a weight training program 4-5 days per week. Everyone is different and may not benefit from the same program, and I would like to stress consulting with your OBGYN or a physical therapist before starting an exercise regimen to ensure safety. As a physical therapist and personal trainer, I am going to give you my personal top 5 exercises that I have been doing consistently to avoid pregnancy related injuries.


    #1. Clamshells- 15reps x 2 sets    
    Benefit: Strengthening the hip musculature.

    ​Setup: Begin by lying on your side with your knees bent 90 degrees, hips and shoulders stacked, and a resistance loop secured around your legs. If it is your first time doing this exercise, you may want to start without a resistance band.

    Movement: Raise your top knee away from the bottom one, then slowly return to the starting position.

    Tip: Make sure not to roll your hips forward or backward during the exercise.

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    #2. Pelvic Tilts on Swiss Ball-15 reps x 2sets
    ​Benefit: Strengthening abdominal muscles.

    ​Setup: Begin sitting upright on a swiss ball; if balance is an issue,then gently hold onto a chair beside you.

    Movement: Keeping your shoulders and upper body still, roll the ball backward and forward by moving just your pelvis. You should be using your abdominal muscles to create the movement.

    Tip: Make sure you maintain upright posture.

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    #3. Sumo Squats-15reps x 2sets
    ​Benefit: Strengthening buttocks and leg musculature. 

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    ​Setup: Begin in a standing upright position with your feet in a wide stance and toes pointed outward.

    Movement: Squat, bending at your knees and hips. Straighten your legs and repeat.

    Tip: Make sure to keep your back straight, weight in your heels, and do not allow your knees to collapse inward or move forward past your toes during the exercise.

    #4. Bird Dog -15reps x 2sets
    ​Benefit: Strengthening core musculature
    Setup: Begin on all fours, with your arms positioned directly under your shoulders.
    Movement: Straighten one arm and your opposite leg at the same time, until they are parallel to the floor. Hold briefly, then return to the starting position.Tip: Make sure to keep your abdominals tight and hips level during the exercise.

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    #5. Standing rows -15reps x 2sets
    ​Benefit: Improving postural stability

    Setup: Begin in a standing upright position, holding both ends of a resistance band that is anchored in front of you at chest height, with your palms facing inward.

    Movement: Pull your arms back with your elbows tucked at your sides, then return to the starting position and repeat.

    Tip: Make sure to keep your back straight during the exercise and think of squeezing your shoulder blades together as you pull on the band

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    ​BONUS Exercise:  Kegels (no picture needed)    
    ​Benefit: To help strengthen the pelvic floor
    Slow and Controlled (5-10sec holds): 2-3 sets x 15-20 reps
    Quick Contractions: 2-3 sets x 15-20 reps

    How to do a Kegel: This muscle group helps to control the flow of urine and the contraction of the vagina and anal sphincter which can be weakened by the pressures of pregnancy and delivery. To learn how to activate the muscles, try to stop the flow of urine the next time you are on the toilet. Once you understand the contraction needed, it is best to practice outside of the bathroom.  Try to practice holding the muscle contraction and working up to 5-10sec holds and slowly releasing the tension to work on endurance of the muscles. You can also work on “quick fire” contractions by working your way up to 15-20 repetitions at a fast pace.
    Tip: Try not to move your leg, buttock or abdominal muscles during the exercise.

    Specific benefits to Kegels:
    1) Pregnant women who perform Kegel exercises often find that they have an easier birth with more control over muscles needed during labor and delivery.
    2) Toning your pelvic floor musculature can help in endurance tolerance for labor and delivery as well as possibly help to avoid an episiotomy.
    3) Pelvic ​floor muscles prevent urinary incontinence, a common complaint throughout the pregnancy and during postpartum.
    4) Kegels can improve sexual activity especially postpartum when those muscles need to be strengthened and tightened.

    At Premier Physical Therapy, we have knowledgeable physical therapists who can help you before, during, or after pregnancy to treat and help prevent pregnancy related injuries based on your individual needs.
    Stay active and healthy!

    ​References.
    1. Boulvain M, Kayser B, Melzer K, Schutz Y. Physical activity and pregnancy: cardiovascular adaptations, recommendations and pregnancy outcomes. Sports Med. 2010 Jun 1;40(6):493-507.
    2. American College of Sports Medicine by Raul Artal, M.D., James F. Clapp, III, M.D., and Daniel V. Vigil, M.D., FACSM.
    3.  American College of Obstetrics and Gynecology (ACOG) Web site [Internet]. Exercise during pregnancy; [cited 2015 Mar 16]. Available from: http://www.acog.org/Patients/FAQs/Exercise-During-Pregnancy.
    4. Marques A, Stothers L, Macnab A. The status of pelvic floor muscle training for women. Canadian Urological Association Journal. 2010;4(6):419-424.