Staying Healthy During Pregnancy

Tidewater Physical Therapy’s own Brittany Rogers, PT, DPT recently sat down with MDTV to discuss pregnancy and how women can remain healthy and feeling good in their bodies during that exciting time.

Rogers treats patients at Tidewater Physical Therapy’s Great Bridge clinic in Chesapeake. Rogers, like many of the physical therapists at Tidewater Physical Therapy Inc. hold a Direct Access Certification through the Virginia Board of Physical Therapy and is available in many cases to evaluate and treat patients without a prescription from a physician.

Here’s what she had to share on pregnancy with MDTV.

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How does pregnancy change a woman’s body?

Pregnancy changes a body anatomically in many ways. Postural changes are the most common. A lot of the time, you tend to have a more forward position of your head and your shoulders, an increase in the curve of your upper back called the thoracickyphosis and the lower back called the lumbar lordosis. There tends to be an increase in the forward tilt of your pelvis, and sometimes the feet go wider apart making a wider base of support. These have been found to be related to an increase in weight gain, an increase of the center of gravity further to the front of your body, and also to a release of a hormone called relaxin which, as its name implies,is meant to increase the laxity of the ligaments of the pelvis, but it doesn’t only effect the pelvis, it can also affect other joints in the body such as the back, the knees, the SI joint which can cause increased pain.

Can you exercise while pregnant?

You can exercise during pregnancy, but you need to consult your doctor first. He is the one who is aware of your medical history, your past pregnancy history and any risks that you have in your current pregnancy. If you’re cleared by your doctor and you’ve been exercising already, you can typically just go on with your exercise program, but as your pregnancy progresses, you’ll need to make some modifications. If you haven’t been exercising and you have been cleared by your doctor, then you can typically begin an exercise program, but you’ll need to start slowly.

You need to make sure while you’re exercising that you consume enough calories, not only for the exercise, but for your pregnancy as well. Because although you’re exercising, you need to still gain weight with your pregnancy. And you also need to make sure that you consume enough water before, during and after your exercise.

What exercises are safe during pregnancy?

Exercises that are safe during pregnancy is a regular—about 30 minutes a day—moderate-intensity program. When you say moderate-intensity, the easiest way to test that is called a “talk test.” So while you’re exercising, if you cannot carry on a normal conversation, then you are exercising too hard. You want to make sure that you avoid overstretching and bouncing because your ligaments are already at an increased risk for injury due to relaxinincreasing the laxity in your joints.

A lot of stretching you should focus on are areas that are typically affected due to the postural changes so with your increased upper back curve, your chest muscles get tight, the increased lower back curve you tend to have too much arch in your back and your lower back muscles get tight, and also your hamstrings can tighten up as well.

Exercising during pregnancy can improve your pregnancy and overall health. It increases and helps you maintain your cardiovascular and respiratory endurance just so that your body is able to manage the excess weight gain you’re going to have. You’ll be able to do your daily activities, such as housework, easier. It’s also going to increase your endurance for the actual act of labor and delivery. Strengthening your muscles can also support your back and joints so you’re less likely to succumb to the postural changes and the knee and back pain that could occur.

Can exercise during pregnancy help keep my weight gain at a healthy level?

You can prevent excess weight gain but still gain the amount of weight that is appropriate for a healthy pregnancy. It’s also been found that those who exercise during pregnancy will return to their pre-pregnancy weight sooner. Exercise during pregnancy has also been found to ease labor and delivery. Studies have shown that those who exercise during pregnancy actually have a decreased rate of C-sections, improved birth weight,and have a decrease in the amount of labor by about 30 percent.

Begin with about 20 minutes a day, and as your body tolerates, slowly increase about 5 or 10 minutes per week as long as you’re not overtraining yourself. As far as strengthening, you want to follow the same rules essentially as prenatally, because your body still has those increase in hormones—the relaxin will still puts your joints and different parts of your body at increased risk for discomfort and pain. After you deliver, you are able to begin exercises on your back again.

How does physical therapy help during pregnancy?

Physical therapy can help treat someone who is pregnant. We can assess you according to your restrictions. If you have restrictions such as bed rest, or any other restrictions due to your pregnancy, we can design specific exercises and stretches that will help you improve your core strength, SI alignment to help decrease strain on your back and SI joints. Same things goes, for say the knee or foot pain, we can give you flexibility and stretching exercises and strengthening exercises that can strengthen those joints to support your weight gain and the increase in laxity that you’re experiencing.

Do I need a referral from my doctor?

We can see a patient with direct access. So if you are having pain, you can call our office, and we’ll be able to get you immediately in for an appointment and see you and assess your symptoms and design a treatment plan for you without you having to go and see your medical doctor first.

I had a patient that came in complaining of right glute pain that would refer down the back of her thigh to her knee after she was about 6 months pregnant. After I assessed her lumbar motion and hip motion, I looked at her pelvic alignment and noticed that she had an anterior rotation on her right side, so her SI joint was now misaligned. I did manually something called a muscle energy technique, where you use your own muscles to contract and rotate the pelvis back into alignment and then I was able to teach her how to do that on her own at home when she felt the pains beginning to return to her glutes and she was able to manage her pain. I also gave her strengthening exercises to help her maintain that hip stability so it wouldn’t keep rotating out and she was able to manage her pain without having to come back to therapy.