Transcription:
Pre and Post-Baby Fitness and Wellness Tips

Introduction: Here's another edition of the BayCare Health System’s podcast series BayCare HealthChat with Melanie Cole.

Melanie Cole: Welcome to BayCare HealthChat. I'm Melanie Cole, and today we're discussing pre and post baby fitness and wellness tips. Joining me is Shailja Reuter. She's an Occupational Therapist, Pre and Postnatal Corrective Exercise Specialist and Certified Group Fitness Instructor at BayCare. Shailja, it's such a pleasure to have you with us today. So, what changes does a woman go through regarding her anatomy and the way her body changes in hormonal changes, and the physiology of the prenatal and postpartum body?

Shailja Reuter: It's definitely important for us to understand what is occurring with her changing body. Just so you can participate in exercises safely and effectively, you want to have that awareness with the area that you might be more prone to injury, pain, discomfort. There are several hormones to consider throughout pregnancy and postpartum that tend to increase, and that would be a stress hormone. And so, we want to make sure we regulate our stress levels. We don't want to tax the adrenals by doing extra exercise, especially postpartum. We have tissues and ligaments that become more lax. So there could be a separation with your abdominals. We want to avoid overstretching. There may be less stability in your ankles, so you may have more loss of balance. There's also decreased smooth muscle activity that helps regulate blood flow through the arteries. So, you might notice more blood pooling if you're sitting in one position for too long.

Also, you may notice breathlessness, sudden rise in heart rate, blood pressure fluctuating when you change positions. And of course, there is the moodiness and exhaustion that could occur. The good news is that certain exercise can help regulate these hormones and prepare you for less risk for injury. We also may already have existing muscle imbalances prior to getting pregnant. So, when you're adding the 25 to 35 - pound weight, you can accentuate that more with the posture in your alignment and your balance could be compromised further. So, you want to activate the core, learn the correct exercises to start engaging core function. We also want to be aware that certain muscle groups become tight as a result of pregnancy. We want to be careful to not overwork our hip flexors, our lower back, our thighs, chest, and the shoulders. There are also muscle groups that become weak as a result of pregnancy. And that is the pelvic floor, the upper back muscles, the shoulders, the buttock and our abdominal wall. So, we want to start focusing on strengthening these areas as well.

Host: So, before we talk about the benefits of exercise, when is the best time (because that's a question I've received for years) to start an exercise program. If you've never exercised, when you find out you're pregnant, is that a good time to start? Or how soon after delivering a baby, can you start exercising? Give us some specifics about when it's safe to begin and really what you want people to ask their providers before they do begin an exercise program. If they are somebody that's never really exercised before.

Shailja Reuter: Yes, I agree. Definitely want to get clearance from your OB or midwife. But as soon as you know you're thinking about getting pregnant or become pregnant, it's a good idea to start exercising. If you've never exercised before you definitely want to ease into it. There's a lot of modifications that need to take place through each trimester, as I mentioned, because of the hormones.  But if you're somebody who was into CrossFit, running, yoga, it's fine to continue that into your pregnancy as well. Keeping in mind that those hormones are shifting. Now postpartum, the first six weeks we want to be careful to not tax the adrenals, as I mentioned, that stress hormone builds up. So those first six weeks is really time for rest, repair and rebuilding. So, you want to just gently reestablish your core connection, work on posture and alignment. Your daily movements would include your breathing, your pelvic floor activation. Some easy type of exercises to start with are Tai Chi and walking. And again, always clear that with your OB and your midwife as well.

Host: Tell us a little bit about what can occur if you're performing improper exercises during or after pregnancy, because that's really a big thing. You don't want to injure yourself and make it so you can't exercise anymore. But tell us a little bit about some of the things that can happen if you're not doing it right. And if you haven't consulted somebody.

Shailja Reuter: Yes, absolutely. So, there's a term called diastasis recti and that is where your abdominal walls can separate. So, if you're doing a lot of crunches and not activating the core and engaging the proper breath, you can start to separate the abdominal walls even further, and that would compromise your alignments, possibly increase incontinence. So, the first thing to do is to make sure that you're not doing a whole bunch of crunches. You want to work from the inside, your deep abdominal muscles with the breathing. Also, we want to avoid too many pushups and tricep dips because we are already working that chest and have that rounded posture with pregnancy. So, if we're constantly doing pushups and tricep dips, we're only going to increase that further. We also want to avoid jerky types of movements that can lead to a disc herniation, pelvic pain, sacroiliac joint dysfunctions, sciatica. We want to be careful not to do a whole lot of plyometrics, which are like jumping and the seated abduction machine, where you're opening your legs and closing them. Also, avoid sitting in a chair or standing for too long. You'll have that blood pooling, as I mentioned, that can increase your varicose veins as well. And even just creating a low stress environment as well. Because it's not just your body, but it's mental part of it as well. Also with flexibility, since our hormones have already outstretched everything, we want to make sure we don't overstretch. Doing stretches that feel good for you are fine, but having a trainer stretch you out even further could pose a problem. Foam rolling is a really good way to decrease the tension in your muscles.

Host: So, Shailja you mentioned abdominal crunches and people want to keep those strong abdominal muscles. However, as you get into pregnancy and you don't want to compress your descending aorta. You don't want to, you know - people think of squishing baby. At what point should you not be lying on your back doing exercises, whether you're wanting to do pelvic tilts or any of those things?

Shailja Reuter: So, the first trimester is perfectly fine to be on your back. It's the second and third trimesters that we want to avoid being on our back. All that weighted pressure from the uterus is pressing into our lower spine. So, to work the core, it's better to be either on an incline, on a bench, on a bolster or sitting even on an exercise ball where you're still able to engage the core on an unstable surface.

Host: Well, thank you for that because, you know, people want to know what exercises, so let's get a little specific here. What about weights? Can you lift weights? And if you were someone who lifted weights before you were pregnant, can you lift them while you're pregnant? And what about afterward? How long do you have to wait before you can start lifting and I'm talking lightweights, not heavy ones.

Shailja Reuter: It's perfectly fine to lift weights. The main thing you want to do is you're activating your core. So that involves the diaphragm. If you're holding and locking your breath while lifting weights, you have that risk for a disc herniation and possibly even incontinence. So, it doesn't matter how much weight you're lifting, it's just how you're breathing along with that. And again, with postpartum, we want to avoid too many strenuous activities the first six weeks, unless you were somebody that was really into CrossFit and lifted throughout your entire pregnancy. You may be able to tolerate that a little bit sooner than most moms.

Host: And what about runners, Shailja, because runners are a dedicated bunch and they don't want to stop even when they're pregnant. They want to get right back into it as soon as they've had that baby. Tell us a little bit about something like running.

Shailja Reuter: Running's fine as well. Again, postpartum, I would hold off on the first six weeks. Maybe a brisk walk would be better. And especially with this heat, you would make sure you're not getting dehydrated. The Florida heat is really tough on the body postpartum, as well as pregnancy. So, if you were breastfeeding, especially you need all that hydration as much as possible. So, I would caution on running, but a light brisk walk or jogging would be probably more appropriate in those first six weeks.

Host: This is really important information. Give us some helpful tips to get started and to stay motivated. I've had two children, I know that as it gets along a little bit, you kind of feel like: well, I'll exercise when I'm done having the baby, I don't need to worry about it. You get a little unmotivated. Give women some helpful starting tips and motivation. Wrap it up with your best advice.

Shailja Reuter: Sure. Well, there's lots of benefits to exercising. There's really no risk to it. So, if you want to have an easy recovery, easy labor. You want the babies to not have excessive weight during labor, then exercise is your great way to do that. Also, for babies, there's a lot of benefits by exercising. They tend to transition to life outside the uterus, much quicker than most babies with moms that did not exercise. So, you might want to get up with a partner, your own partner, another mommy friend, and start working out together. Have a vision board, remind yourself why you're doing this. Create some images, maybe journal what you want your goals to be, have a calendar with a checklist. You can start with a trainer or coach. There's a lot of great YouTube videos out there for pre and postnatal. As long as you clear that with your OB or midwife. There's local libraries that offer classes, you can create your home gym, some few pieces of equipment, like a resistance band, a stability ball, five to 10 pound weights is good. You can even create your own equipment with water bottles and use your chair and wall for balance. And again, always refer to a PT pelvic floor specialist or your OB if you're having any type of discomfort. But it's not just about movement. It's also breathing. It's nutrition. It's a lifestyle. A new lifestyle that you have to get used to in your thoughts. It's also mental as much as it is physical.

Host: It's really great information and so important for women to hear. Thank you so much for joining us today and really giving us a great starting point. And some really good advice about exercising when pregnant and for postpartum as well. And that concludes this episode of BayCare HealthChat. To learn more about BayCare's maternity services, please visit our website at www.Baycarematernity.org for more information. And to get connected with one of our providers. Please also remember to subscribe, rate, and review this podcast and all the other BayCare podcasts. I'm Melanie Cole.