Exercising Safely During Pregnancy - "Julie a 33-year-old women"

Case study ( 6253 views as of May 22, 2024 )

Julie is a 33-year-old women who has recently discovered she is pregnant with her first child. Prior to conception, she was training for a half marathon, running 3 times a week with her running group and doing some strength training 1-2 times a week. Since her positive pregnancy test, Julie has stopped running and is unsure of what type of exercise is safe for her. She visits an exercise specialist for a consultation.

A discussion with the exercise specialist reveals that Julie has no medial diagnoses that need to be considered. Julie is currently 140 lbs - a 6-lb weight gain from her pre-pregnancy weight of 134 lbs. She is 14 weeks pregnant, and is just now beginning to feel better after she dealt with morning sickness during her first trimester. Julie has a history of repeated ankle sprains in her right ankle from her volleyball-playing days in high school and university, but is able to run distances with little pain. She does note some back stiffness since becoming pregnant.

The exercise specialist gives Julie a structured exercise program consisting of some cardio and strength exercises that is suited for her second trimester of pregnancy. He reviews the basics of exercising safely in her pregnancy, and gives her some tips to consider as her pregnancy progresses. The goal of the exercise program is to maintain Julie's fitness during her pregnancy.

Julie may wish to consult with an orthotics specialist to assess her need for orthotics, given her history of ankle injuries, a physiotherapist to assess her back pain, and could try prenatal yoga. Julie could visit her family doctor as well to ensure her pregnancy is being well managed, and a dietitian for prenatal nutrition advice. Finally, Julie could speak with her pharmacist about any medication she is currently taking, in order to determine the safety of over-the-counter medications while she is pregnant.


Conversation based on: Exercising Safely During Pregnancy - "Julie a 33-year-old women"

Exercising Safely During Pregnancy - "Julie a 33-year-old women"

  • In the postpartum period, it is essential to consult with your physician before starting or resuming any exercise routine, typically around the six- to eight-week mark after giving birth. While engaging in exercise, there are important indicators to monitor. If you experience pelvic pressure or pain during exercise, it is advisable to pay attention to these symptoms. Additionally, if you notice any urinary incontinence (losing urine) while exercising after the six- to eight-week mark, it is important to take note of this as well. Furthermore, it is crucial to ensure that you are not experiencing any vaginal bleeding or discomfort, breast discomfort, or irregular discharge while exercising. Staying well hydrated and maintaining an adequate calorie intake is also important, especially if you are breastfeeding, as your caloric needs increase during this time. Failure to follow postpartum guidelines can have negative consequences. It is highly recommended to schedule a visit with your physician around six to eight weeks postpartum to determine the most suitable exercise program for you based on your specific circumstances. There are comprehensive guidelines available for the postpartum period, and your physician can provide personalized recommendations to support your recovery and overall well-being.
  • During pregnancy and after childbirth, women experience postural changes that can significantly affect their biomechanics. These changes are often characterized by an increased curvature in the upper thoracic spine (kyphosis) and a pronounced curvature in the lumbar spine (lordosis), resulting in an exaggerated S-shaped curve. These postural changes can have a profound impact on the body's biomechanics. Additionally, the shifting center of gravity due to the growing baby's weight places different shearing forces on various joints, such as the sacroiliac joints, pubic symphysis, and thoracic spine joints. Promoting good posture is crucial during the prenatal and postnatal phases. This involves developing a strong core and stability. However, postnatally, women may experience physical strain and discomfort due to the effects of labor and breastfeeding, which can further affect their posture. If women are experiencing issues with posture during pregnancy or after childbirth, it is recommended that they consult a local physiotherapist. The physiotherapist will be able to assess their specific needs and provide appropriate guidance and treatment to address any postural issues they may be facing.
  • Exercise during pregnancy is generally safe and beneficial for most women. However, in high-risk pregnancies, it is crucial to obtain medical clearance before engaging in exercise, both independently and with a personal trainer. High-risk pregnancy conditions that may require caution or modifications in exercise include: High blood pressure during pregnancy Carrying multiples (twins, triplets, etc.) Vaginal bleeding Placenta previa (diagnosed after 26 weeks) Incompetent cervix Pre-existing medical conditions like heart or lung disease In cases of absolute contraindications to exercise, exercise termination may be necessary. These absolute contraindications can include conditions such as heart disease, lung disease, incompetent cervix, risk of premature labor, second and third-trimester bleeding, ruptured membranes, or preeclampsia. It is crucial to discuss these conditions with your doctor and follow their guidance. Relative contraindications to exercise may necessitate exercise termination as pregnancy progresses. These relative contraindications can include severe anemia, irregular heartbeat, chronic bronchitis, type 1 diabetes, obesity, extreme underweight, intrauterine growth retardation (small-for-date baby), poorly controlled hypertension, orthopedic limitations, seizures, hyperthyroidism, or smoking. Consulting with your doctor is important to evaluate the risks and benefits of exercise in such cases. If you are experiencing any of these high-risk conditions during pregnancy, it is essential to discuss your exercise plans and concerns with your healthcare provider. They can provide personalized guidance on what type and level of exercise is safe for you and your baby.
  • Pelvic pain can indeed be a common issue both during and after pregnancy. Prenatal pelvic pain is complex and can be attributed to various factors. The pelvis consists of muscles that provide stability, and surrounding muscles also contribute to its stability. Ligaments play a role in closing the pelvic area. However, during pregnancy, the hormone relaxin causes ligaments to loosen, which leads to muscular compensation to maintain pelvic stability. Pregnant women may experience pelvic pain originating from the sacroiliac (SI) joints, pubic symphysis at the front of the pelvis, or the pelvic floor muscles. This pain can also radiate to the back, making diagnosis challenging due to its multifaceted nature. Postnatally, it is not uncommon for pelvic pain to persist for approximately six weeks after childbirth. If pelvic pain continues beyond this period, it is advisable for women to seek the assistance of a local physiotherapist or healthcare provider to address these concerns. A physiotherapist specializing in pelvic health can provide a comprehensive assessment and develop an appropriate treatment plan to address prenatal or postnatal pelvic pain. They can offer guidance on exercises, manual therapy techniques, and lifestyle modifications to alleviate discomfort and promote optimal recovery. If you have questions or concerns regarding pelvic pain before or after pregnancy, reaching out to a local physiotherapist would be beneficial.
  • Pelvic pain can be present pre and postnatally. Prenatally, pelvic pain is quite complex. It can be due to a number of different issues. The pelvis is like a bowl, and in the pelvis you have some muscles that sit and try to provide stability. And then all around the pelvis, you have different muscles connecting and trying to provide that stability as well. And these create a type of closure. Now, the other part of closure is created by the ligaments. Now because of the relaxin hormone in the body, the ligaments will loosen, and then the muscles will try to compensate to still create that amount of stability in your pelvis. So the issues that pregnant women can have can be through the SI joints, through the pubic symphisis at the front, or just muscular as in in the pelvic floor and these all can create pelvic pain which also can refer to the back. So it's multifaceted and difficult to diagnosis what the issue is. Postnatally, pelvic pain may linger for about six weeks. If women continue to have pain after six weeks, we recommend that they go see their local physio or care provider to address these issues.
  • It seems like avoiding sports where there is risk of contact or falling would be good, but what about weight training? Should pregnant women stick to light weights, or how would the guidelines for each trimester differ?
    • I cannot believe that light weight training would be avoided during early pregnancy. Seems like old school..
    • Each individuals body is different, therefore a doctor should be consulted. I wanted to do light weights when I was pregnant but my doctor told me that I should not. I was told to walk and do stretching exercises instead.
  • My wife Chantal exercised throughout her pregnancy and it helped a lot with stress and sleeping. I think the bottom line is to keep moving as long as its ok with the doctor and there are no medical conditions that should stop it.
    • During my pregnancy I did a lot of walking and stretching, as okayed by my doctor. She told me this would help with the delivery of the baby. I followed her directions and had a great pregnancy and easier birth.
  • In my experience more and more women are choosing to continue to exercise during pregnancy. Its smart that she consulted an exercise specialist for advice
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