The Fit Life – 2019.16 – Pregnancy & Fitness
“Pregnancy should be considered one of the single most athletic events of a woman’s life”
– Dr. Shannon Bloch
Pregnancy should be considered one of the single most athletic events of a woman’s life yet many women get “side-lined” due to conditions both prenatal and postpartum such as; low back pain, sciatica, pubic symphysis dysfunction, SI joint dysfunction, piriformis syndrome and many many more. Although some of these conditions definitely may make you not want to exercise, movement and exercise is usually the most beneficial thing when these conditions are present – just with certain modifications.
Just like any athletic event, training should always be done before hand. Pre-pregnancy training should include getting the body strong, specifically the core and posterior chain. Pregnancy causes many postural changes, most specifically the curve in the low back (lumbar lordosis) and anterior pelvic tilt. A weak core and posterior chain (hamstrings and glutes) increases the lordosis and pelvic tilt so getting these strong beforehand can help minimize postural changes and weakness in the affected musculature that will inevitably be affected with the growing belly.
This is the most important time to be active as many pregnancy related conditions are caused by muscular imbalances and the body’s compensation abilities. Some of the most common conditions requiring change and adaptations include:
Low back pain:
Usually due to the increased strain on the back from the changing lumbar lordosis.
- Strengthening and activating the posterior chain to take stress off the back
- Loosening the hip flexors to help with pelvic tilt
- Core strengthening (**in ways that avoid flexion)
- Manual therapy
- Bird dogs
- Dead bugs
- Glute bridges
- Samson stretches
Sciatica/ Piriformis Syndrome
Most cases of sciatica during pregnancy are actually piriformis syndrome meaning that the piriformis muscle deep in the glute region is pressing on the sciatic nerve so the problem is actually coming from the glute region not the back. It is important to see a health care professional who can address which it is. The piriformis muscle attaches to the pelvis and usually gets affected as the pelvis moves throughout pregnancy.
- Stretch the piriformis muscle
- Mobilize pelvis
- Manual therapy
- Pigeon stretch
- Clam shells
- External hip rotations
- Avoid internal hip rotations
Pubic Symphysis Dysfunction
Pain along the pubic bone, usually late in pregnancy as the belly grows.
- Loosening the adductors (main muscle group attaching to the pubic symphysis)
- Manual therapy
- Cossack squats
- Side lunges
It is important to remember that the body spent 9 months undergoing changes and may not be ready to get back into regular exercise at that 6-week mark that most people expect. The key for postpartum is to take it slow and start with the basics, you have a new body and it needs to relearn proper movements. The pelvis may not be in the exact same position as it was pre-baby so squats, lunges etc. may look a little different now.
The most important thing to focus on postpartum is re-strengthening the core. Every woman will have some degree of diastasis recti (separation of the transversus abdominal muscles) following pregnancy and the goal is to allow it to heal by avoiding movements that create coning such as sit-ups, crunches, v-sits etc. until it is stable.
When getting back into exercise postpartum, slow is fast. The key should be starting with core strengthening and basic exercises gradually increasing with weight and resistance. Stability should be the goal so that the body does not get injured. Postpartum retraining and recovery will affect how your body moves from here on out.
Most active women should be able to enjoy a comfortable healthy pregnancy, having to make only minimal changes to their exercise routine both pregnant and postpartum. Some pregnancy related conditions such as low back pain are inevitable but can be quite mild and controlled with proper knowledge, adaptations and care. Make sure to keep your trainers in the loop when it comes to any pain/discomfort or modifications you may need to make as well as make sure you have a good health care provider (chiro, physio, manual therapist etc.) who has training in pre and postnatal care.
Check out Dr. Shannon Bloch’s Instagram for videos of exercises and more tips! @drshannonbloch
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