Physiotherapist Jason T Smith shares his tips on avoiding injury when pregnant – Here is what you should and shouldn’t do with a big belly.
I can only image that as a pregnant mother-to-be the world suddenly seems fraught with newly apparent obstacles and ‘injury traps’. As a physiotherapist I frequently observe the way that new pregnant mums move and the new challenges they face. Carrying a lot of additional weight in the mid-section, notwithstanding the structural and hormonal changes that accompany pregnancy, add to the measures that mothers-to-be need to consider if they want to remain injury free.
Despite the increased risk of injury during pregnancy, I encourage mums to view this period of their life positively. You can still continue to move through the world and exercise, however, you simply need to change your expectations and training programs to align with your new physicality.
Here I’ve written a short guide to serve as foundational ‘rules’ to avoid injury when pregnant with a focus on the back and pelvis which seem to be the most susceptible to injury.
Watch your back!
You are more likely to experience back pain during pregnancy if you are overweight, in your second or subsequent pregnancies and if you have experienced lower back or pelvic girdle pain in the past. Obviously, getting into the best shape you can before conceiving can ensure that you minimise your chances of back injury or pain when pregnant.
For most women, pregnancy can affect the shape and mobility of your back. Your back may either flatten or arch further depending on your posture before pregnancy. For this reason pregnant women really need to protect their back when lifting and also when performing simple tasks such as bending, getting up from lying down, sleeping and climbing stairs.
Generally, you should avoid strenuous work, lifting and poor posture. If you do have to lift anything ensure that you hold the item close to your body, bend your knees and try not to twist your body. You should consider regular exercise, wearing more comfortable shoes, improving your posture, maintaining a healthy weight and ensuring your back in well supported when sitting down as strategies to avoid back pain.
Protect your pelvis.
During pregnancy your pelvis is affected by the pregnancy hormones oestrogen and relaxing. These hormones make the ligaments that support your pelvis stretch which is one reason why pelvic pain is more common than back pain during pregnancy.
Typically Pelvic Girdle Pain (PGP) is aggravated by seemingly innocuous activities such as walking, getting in and out of the car and climbing stairs. As difficult as it is to avoid these every day activities, you should concentrate on minimising these or at the very least, keeping your legs as close together as possible as a general rule. This would involve shortening your stride when walking or stair climbing and keeping knees together as you turn to exit your car.
Massage and gentle exercise such as swimming can help ease back and pelvis pain during pregnancy. Additionally, products such as maternity pillows and support belts can help you by taking some of the weight off your stomach muscles, pelvis and back.
Exercising whilst pregnant is important and can deliver benefits to both you and your baby such as an easier labour and faster post-pregnancy recovery. Recent studies have shown that exercise also benefits the development of your child’s intelligence! Regular exercise will ensure that you remain fit and keep your muscles supple which will in turn help to minimise the occurrence of back or pelvic pain.
However, there are definitely some exercises that pregnant women should avoid such as high impact activity and high risk activity (anything where you can fall or collide). First, it’s important to consult your physiotherapist for advice on the best exercise for your pregnancy. Mothers-to-be should definitely consider the types and frequency of the activity they did before they conceived. If you weren’t exercising regularly before you conceived, you need to take it slowly and get professional advice from your physio on where to begin.
In my opinion the best forms of exercise for pregnant women are swimming, walking (where no PGP is present), pregnancy Pilates (try a Mums in Motion™ class at a Back In Motion practice), exercising on a fit ball, water aerobics or riding a stationary exercise bike.
Pregnant women need to:
- Avoid overheating
- Watch their heart rate (keep to under 130bpm)
- Avoid lying on their back (after 13 weeks)
- Be aware of the effect of relaxing on their ligaments and avoid sprains
- Avoid rapid changes of position to reduce your risk of dizzy spells
- Avoid falls: consider how their changing shape affects their balance
Pregnant women should cease activity and see a doctor immediately if your experience any of the following:
- High heart rate
- Uterine contractions
- Vaginal bleeding
- Amniotic fluid leakage
- Excessive shortness of breath
- Back or pelvic pain
- Decreased foetal movements
Ensure you consult your physiotherapist if any pain presents during your pregnancy and for advice on undertaking a suitable exercise program to support a healthy pregnancy.