Symphysis Pubis Dysfunction (SPD) or Pelvic Girdle Pain (PGP): Minimising Pain During Everyday Activities

This is part 2 of 3 posts covering SPD / PGP during pregnancy. Yesterday I posted on Exercises for SPD / PGP, today its about living with it!

A Few Tips that Might Help:

DO:
• Be as active as possible within pain limits and avoid activities that make the pain worse
• Ask for help! Many household chores & everyday activities may be difficult or painful – ask for & accept help wherever you can get it
• Rest & relax when you can. Sitting on a large exercise ball is often more comfortable than a chair & easier to get up from.
• Sit down to get dressed and undressed – avoid standing on one leg
• Wear flat supportive shoes
• Avoid standing for prolonged periods (someone else’s turn to do the ironing:))
• Try to keep your knees together when moving out of the car.  A plastic carrier bag on the seat may help you to swivel (another top tip from the Association of Chartered Physiotherapists for Women’s Health)
• Sleep on your side with a pillow between your legs
• Try different ways of turning in bed e.g. turning under or turning over with your knees together and squeezing your buttocks
• Roll in and out of bed keeping your knees together
• Take the stairs one at a time or go down on your bottom (top tip from Nisha at the Nine Month Club – see her blog for more)
• Use a small rucksack to carry your stuff around – this leaves your hands free to hang onto something for support or to use crutches if you’ve been given them

AVOID activities which make the pain worse:

• Standing on one leg
• Bending and twisting to lift or carrying a toddler or baby on one hip
• Crossing your legs
• Sitting on the floor
• Sitting twisted
• Sitting or standing for long periods
• Lifting heavy weights (shopping bags, wet washing, vacuum cleaners, toddlers)
• Vacuuming
• Pushing heavy objects like supermarket trolleys
• Carrying anything in only one hand

Of course not all of these activities CAN realistically be avoided – you may have to lift & care for other children, pick up something or go to the supermarket. Just try to get as much help as you can, go slowly & think before you move.

Stay as active as you can. Follow your physiotherapist’s guidelines & keep doing the core activation & pelvic floor exercises described in yesterday’s post EVERY DAY. You will get some relief as well as be training your vital core muscles in preparation for your post-baby flat tummy!

Thanks again to the Association of Chartered Physiotherapists for Women’s Health for their great guidelines & also have a look at the Pelvic Partnership for more tips & information on SPD / PGP.

All No More Excuses personal trainers are experienced & knowledgeable when dealing with SPD / PGP – if you would like to meet with a trainer for a free consultation then just fill out the form in the column on the right.

What strategies worked for you? Please share your SPD / PGP stories – I know many women suffer (1 in 5 pregnancies) but often don’t realise how common the condition is. If you know something that does or doesn’t work, please leave a comment here!

Symphysis Pubis Dysfunction (SPD) or Pelvic Girdle Pain (PGP) During Pregnancy: How Exercise Can Help

Symphysis Pubis Dysfunction (SPD), now referred to as Pelvic Girdle Pain (PGP) describes pain in the joints that make up your pelvis. They include the symphysis pubis joint (SPJ) at the front &/or the sacroiliac joints (SIJ) at the back. The result is pain felt across the front or back of the pelvis, which can range from mild discomfort to severe pain.

This is the first of 3 related posts on SPD / PGP coming over the next few days. I have dealt with exercises first as that’s what so many of you have asked for! The next one will deal with everyday activities & minimising discomfort & the third will give more of an explanation of the diagnosis & causes. Apologies offered at the outset  that these posts are a little longer than usual!

If your SPD / PGP is causing you pain, you should be referred to a physiotherapist who will assess the position and the symmetry of movement of your pelvic joints, especially the sacro-iliac joints at the back of the pelvis. Treatment will involve a combination of joint realignment or mobilisation and soft tissue or muscle treatment.

When the body is experiencing pain, muscles tighten & compensate, causing asymmetry & misalignment of joints. It is important that you receive treatment from a physiotherapist, chiropractor or osteopath to correct this, as well as carrying out these exercises on a daily basis, preferably 2-3 times every day. Complimentary therapies such as acupuncture or cranial sacral therapy may also provide relief. Please share your stories on what has or hasn’t worked for you!

Exercise cannot realign joints or tighten ligaments affected by the hormone relaxin, but it CAN help to stabalise the pelvis by strengthening the muscles that support it.

The muscles that need to be strengthened to improve stability for SPD / PGP are the core muscles, particularly the Tranverse Abdominus (TVA) & the pelvic floor. Depending upon the level of pain & range of movement, bodyweight exercises such as a supported squat (adapting the depth of the squat & how far your open your legs) will also improve strength & stability.

SPD / PGP Exercise No.1 TVA Activation: To start identifying & ‘engaging’ your transverse abdominus, you need to practice abdominal or belly breathing. Sit on a chair, exercise ball or cross-legged on the floor & place your hands on your belly. Breathe in, fill your lungs & let your belly expand. Then exhale, emptying your lungs, whilst drawing your belly button right back towards your spine. Keep your shoulders down & your neck relaxed.

SPD / PGP Exercise No.2 Pelvic Tilt: Get on your hands & knees, with your hands directly underneath your shoulders & your knees directly underneath your hips. With good neutral posture position, inhale, allowing the TVA to relax. On exhalation draw the bellybutton towards the spine & contract the PF. Draw the pubic bone toward the belly button & your pelvis will tilt slightly. Avoid excessive spinal movement. Hold in for a count of 10, then relax for a count of 10. Keep going for 2 minutes.

You can also do a pelvic tilt from sitting on an exercise ball. Sit tall at ‘12 o’clock’  (i.e. not on the edge) of the ball, hands folded across chest, exhale & draw navel to spine as you roll the ball forwards slightly as your pelvis tilts. Lift pelvic floor and engage your TVA. Control the movement with your abs not your shoulders. Inhale & return to neutral spine as the ball rolls back to the starting position.

SPD / PGP Exercise No.3 SuperMum (adapted): On all fours as above, with your hands directly underneath your shoulders & your elbows slightly bent. Engage TVA & raise your left hand & right knee approximately one cm off the ground (no higher). Remember to breathe (!) & hold this position for 5-10 seconds before lowering & repeat with the right hand & left knee. If you start to wobble, focus again on engaging TVA to stabilise yourself, then lower. Keep alternating sides for 2 minutes.

Make sure to not allow the hamstring to tighten & that the pelvis does not load (shift) into the hip that is in contact with the ground. Your core muscles should be doing the work!

SPD / PGP Exercise No.4 Kegels: Kegels or Pelvic Floor Exercises are often described as stopping yourself from urinating, but are more actually more effective if you imagine you’re trying not to fart… if you pull in your sphincter muscles (but don’t squeeze your buttocks), your vaginal muscles will also tighten. Then imagine you’re trying to stop yourself from urinating – try to differentiate & identify front, middle & back. Squeeze & release them from front to back, then back to front.

Try quick squeezes, as you contract & release the muscles for just a second at a time. Do this 10 times, rest for a couple of seconds, & then do another 10. Also longer holds. Starting with 5 seconds, repeat 5 times. Take a minute break then do the set again. You can build up to 10 second holds with 10 repetitions. Do both types & aim to do the whole set 2-3 times a day. It might not feel like much, but as well as stabilising your pelvis, these exercises are the difference between post-baby bladder control & wetting yourself. They’re worth it…

SPD / PGP Exercise No.5 Hip Bridge: Lie on your back with your knees bent & feet flat on the floor. Push down into the floor with your hands & raise your hips, off the floor. Your feet, shoulder blades & head remain on the floor, & your chin will tuck into your chest. Hold for 3 seconds before lowering hips back to the floor. Again remember to engage TVA as you raise & exhale, take a breath as you hold, then lower as you inhale.

Only exercise on your back for short periods of time during pregnancy & only if you are comfortable. If at any time you feel breathless, dizzy or uncomfortable, simply roll onto your left side & then slowly come up.

SPD / PGP Exercise No.6 Adapted Squat: Strengthening the muscles of the lower body will also help to stabilise the pelvis, & so try some squats, but with adaptations: Stand side-on to the back of a chair or sofa & hold onto it for support. With legs only just wider than hip distance apart, lower your bottom down as if you were going to sit down. Keep your knees behind your toes & only go as low as is comfortable. Imagine your tail bone is reaching away down to the floor behind you, rather than sticking your bottom up in the air. To come back up, exhale, engage TVA & push up through the outside of your feet & your heels. You will feel the muscles in your backside & thighs working.Repeat 10 times.

Keep active, as doing nothing at all will make the pain worse. Walk as much as you can, using smaller strides if large steps are painful. Walk with good posture – don’t hunch your shoulders or bend forward from the hips. Drop your shoulder blades down & draw them together, engage TVA, breathe deeply & look straight ahead.

Try to do each of these exercises at least once a day. They will only take a few minutes. If your pain is severe & debilitating make sure you also get referred to a physio, chiropractor or osteopath to realign your pelvis. Your muscles will be inhibited from allowing these exercises to work for you properly  if they are overcompensating for misalignment or pain.

Please let me know how you get on, & share your stories on what has or hasn’t worked for you!

Next post on this topic coming very soon: Alleviating pain for SPD / PGP during everyday activities.

When it Doesn’t Quite Go To (Birth) Plan – Re-Connecting With ‘You’

Chatting to a new postnatal personal training client yesterday about the particularly traumatic, & frankly pretty crappy, birth she had experienced, I was reminded yet again of how little of this whole pregnancy & postnatal ‘thing’ we actually have any control over.

DH has taken 2 kids & a dog for long walk, leaving me to my laptop & my pot of Redbush… bless him. So I’m indulging in some Sunday afternoon empathy for the sisterhood.

I had to change some of the wording of my advertising for my pregnancy & postnatal personal training business after I had my first child. You see I used to tell potential clients how easy their birth would be if they just followed the correct pregnancy exercise regime. How quickly they would pop out their baby with their finely tuned pelvic floor muscles & how swiftly they would zing back to energetic gorgeousness.

Then I had a go at that birth thing. And boy did I feel short-changed. In the weeks that followed I figured that it was just so unfair. I did everything right! I had eaten, relaxed & exercised by the book, so how come I didn’t get my perfect birth?

The lesson came shortly afterwards when my visiting midwife put it in perspective & stopped me feeling quite so sorry for myself. ‘You think most women can still hold a squat position after 24 hours labour?’ she asked. She reminded me of my aerobic fitness & stamina, of my core & lower body strength & of how my nutritional knowledge had enabled me to nourish my severely hemorrhaged self so quickly back to vitality.

That was 4.5 years ago & since then I had another baby (not exactly a walk in the park either) & my team & I have trained hundreds of pregnant & postnatal women. Many have had much more traumatic or physically damaging birth experiences than mine. Just as many of them had fantastic, unassisted & empowering experiences.

But the lesson Mother Nature & my Midwife taught me, & that I now try to convey to my clients, is that whilst there is an awful lot about labour & birth that really is in the lap of the Gods… there is also quite a lot we can do to help.

By looking after our physical well-being, we give our bodies the best possible chance of being able to cope with whatever is thrown at us, & of recovering our strength afterwards. By eating for optimum health, exercising correctly & having confidence & respect for our body, we allow it to do (& bounce back from) incredible things.

I work with postnatal personal training clients on ‘re-connecting’, especially when they have preferred to ‘cut off’ from certain body parts when faced with incontinence, flab or stretch marks. Your body’s ability to recover & look fabulous is still there, but again, it needs some help in the form of very specific exercise & great nutrition.  A flat tummy & restored body confidence unfortunately doesn’t ‘just happen’ for most of us!

I do hope you will leave a comment & let me know what you think! Birth is a very big deal, & I know only too well how many women continue to be affected by their experiences (good & bad) many years later. This post is not supposed to be about who has a ‘perfect birth’ & who doesn’t, but rather how a little self love & physical TLC can go a very long way, whatever the experience. Please share your thoughts!

Is Your Pregnancy or Postnatal Personal Trainer Any Good?

How are you supposed to know if your pregnancy or postnatal personal trainer in London or Surrey actually knows what they’re doing?!?

Are you a mum who uses a ‘general’ personal trainer, boot-camp or gym instructor who may be giving  you inappropriate or ineffective advice?

I have just completed another few days of back-to-back Mummy Tummy Masterclasses, & have thoroughly enjoyed sharing my knowledge so that pregnant women & mums can exercise more safely & effectively.

But the women I meet on these sessions (some of whom have, or have had, personal trainers) are often surprised to hear that certain exercises will make diastasis recti (split abdominals) WORSE… but these exercises have been included in their personal training or gym programme.

Does your pregnancy or postnatal personal trainer encourage you to spend long workouts on cardio machines (treadmill, bike, cross trainer) at steady speeds? Does your pregnancy or postnatal personal training programme really address the postural shifts of pregnancy & mothering? Are you wasting your time with small muscle group exercise like bicep curls?

If so, you’re not getting the best advice & won’t get the results you’re after! I shall cover qualifications & credentials in a different post, but why not do a quick check on your programme to make sure that what you’re doing (& what you’re paying for!) with your pregnancy or postnatal personal trainer or gym instructor is actually going to WORK.

• Forget the fat burning zone! IE long sessions of steady cardio. The most effective way to lose postnatal fat & build lean muscle mass is to INTERVAL TRAIN. You need to be constantly surprising & working your body by changing intensity, speed & duration of your workout.
• Pregnancy & mothering (feeding, lifting… & cuddling!) put us in a permanently hunched posture, shortening & tightening the muscles of the chest & front of the shoulders, whilst stretching & weakening the upper back. Strengthening exercises should concentrate more on working the upper back (IE rowing, or pulling type movements), than the chest (pushing movements). Aim for a ratio of 3:1 upper back work: chest. The upper back needs strengthening & the front needs stretching to ‘even you out’. Push-ups are great exercises, but need to balanced with upright rows, pull ups & the dumb waiter.

For the Dumb Waiter, keep shoulder blades relaxed & down, then move hands out to the side, keeping elbows in & squeezing shoulder blades together.

• Any crunch, sit-up or jack-knife movement will make diastasis recti (the gaping of the abdominal muscles experienced by up to two thirds of pregnant women) WORSE. Core work is absolutely vital during pregnancy & afterwards, & should concentrate on activation of the TVA & pelvicfloor muscles. You need to work the rectus muscles (the split ones) in a linear, not gaping direction. A plank is great, a crunch is not!

• For maximum efficiency, core strength & stability concentrate on large muscle group exercises using body weight. Examples are squats, lunges, pull-ups or planks. Or use multi-tasking exercises such as squats with a shoulder press or upright row with a resistance band. Standing there doing a bicep curl is boring, inefficient & won’t burn any fat!
• Your CORE should be involved in all these exercises, not just the specifically abdominal exercises. Again, multi-task your exercises, it’s what we’re supposed to be good at, & it’s realistic for busy mums!
• Are you getting expert instruction on dealing with your  symphysis pubis dysfunction (SPD) or back ache caused by postural & hormonal changes or imbalances?

For general safe pregnancy exercise guidelines see here, but if you’d like anything clarified or explained further, please just leave a comment here or contact me – I want to DE-mystify pregnancy & postnatal personal training & exercise so please let me know what you’d like more on!

Pregnancy Personal Training at 35 Weeks!

Meet one of our  pregnancy personal training clients! This is Geraldine, 35 weeks pregnant & looking simply amazing! She is being trained by Jacqui O’Shea, one of the brilliant pregnancy personal training team at No More Excuses.

Her programme includes a twice-weekly 30 minute brisk walk outside, interspersed with strengthening exercises, followed by 15 minutes of pelvic floor exercises & stretching. Pelvic floor exercises are done every single day, plus she sees Jacqui twice a week for a very focussed session of core, postural & strength work.

These pregnancy personal training sessions, totally focussed on building & maintaining core strength, are the key to a truly effective pregnancy training programme.

Try these 2 great pregnancy exercises from Geraldine’s programme to tone & strengthen your core muscles, improve posture & relieve back ache!

Superman (left) From an all-fours position, hands under your shoulders, knees under your hips. Take a deep breath, and as you exhale, tighten your abdominals and raise opposite arm / leg off of the floor to hip / shoulder height. Hold for 5 seconds, then do the other side. Repeat 10 times.

The Clamshell. Lie on your side with knees bent.  Keeping your feet together, raise the top knee until you feel your hip starting to roll backwards.  At this point, return to start position & repeat. Do this 15 times on each side.

Two great exercises for during pregnancy… & afterwards too! Find more great exercises for pregnancy here

Please note that if you’re suffering from SPD one or both of these exercises may not be suitable. Please leave a comment or contact me if you would like me to post on some SPD adpatations!

What about you? What are (or were) your favourite pregnancy exercises? What worked for you? I’d love to hear your stories!

PS As well as working with some of our clients, Jacqui also runs Total Personal Training in Surrey – ‘The Friendly Face of Fitness & Fat Loss’!

Festive Pelvic Floor Exercises!

Try your pelvic floor exercises in time to Christmas carols today! I’m liking ‘Little Donkey’ for the long slow ones, ‘Hark The Herald Angels’ for some quicker ones, & for the impressively toned pelvic floors & undercarriages amongst you, how about ‘Deck the Halls’ (I’m squinting a bit on the fa la la la…)

If you’ve forgotten how important these exercises are, as part of your pregnancy OR postnatal exercise routine, check out this previous post… or try skipping or trampolining for a quick reminder!

Keep squeezing ladies – these muscles matter!!

Diastasis Recti, Pregnancy Pelvic Girdle Pain, Symphysis Pubis Dysfunction, Rectus Distension… What Does It All Mean?

Diastasis Recti is one of the causes of your mummy tummy, Symphysis Pubis Dysfunction means you can’t get out the car comfortably when pregnant… and then there’s the acronyms for all these pregnancy & postnatal aches & pains: SPD, PSD, PGP, DR, RD. You need a copy of Gray’s Anatomy just to give a name to your sore joints & back ache once you’re pregnant!

Confused? You’re not alone. A few new clients lately have been feeling a little flummoxed by some of the terms being used for whatever it is they’re suffering from…  sometimes midwives, antenatal teachers, doctors, personal trainers or your best friend, don’t use the same language.

So I’ve done a mini glossary of the ones you’re likely to come across or suffer from. Hope it helps, & if you have any others you’d like to know about, do ask!

Diastasis Recti, Rectus Diastasis or Rectus Distension all refer to a very common separation of the rectus muscles at the front of your tummy during pregnancy. I post frequently on this condition & here you can find some instructions on how to test for diastasis recti, which exercises are recommended & which ones you should avoid.

Diastasis Symphysis Pubis (DSP) is not the same as diastasis recti, it is an actual separation of the Symphysis Pubis Joint. This can only be confirmed by diagnostic imaging by a doctor or physiotherapist.

Pregnancy-Related Pelvic Girdle Pain (PGP) & Symphysis Pubis Dysfunction (SPD) refer to the same thing.

Pelvic Girdle Pain is the term more used more nowadays, but both refer to pregnancy-associated pain, instability & dysfunction of the Symphysis Pubis Joint &/or the Sacro-Iliac Joint.

Pain may be a minor discomfort, necessitating some modification of movement… right up the scale to severe pain & disability. Make sure you consult a physiotherapist or professional trainer who specialises in this area, & don’t go to just any generic exercise class or instructor.

The joints affected are the ones at the front & back of the pelvis. You may feel pain over the front of the pubic bone at the front, across your tummy, or across one or both sides of your lower back, or down your legs.

You may feel a clicking or grinding in your pelvis & have difficulty walking, especially up or down stairs. This ’shearing’ movement (one leg in front of the other) or abduction (legs out to the sides) may also hurt, making getting in or out of a car, your bed, or any number of other everyday activities, painful.

Pregnancy-Related Pelvic Girdle Pain affects around 1 in 5 women, at varying degrees of severity. Around 7% of women continue to have problems postnatally.

In general:

You will be advised by your Midwife or doctor to avoid or adapt as many painful movements as possible. So avoid heavy lifting, go carefully & slowly up stairs; keep your knees together as mush as possible when getting on or out of the car; roll over onto your side to get out of bed…but many of these are part of life, & can’t realistically be avoided.

You can however help to alleviate pain with correctly prescribed core strengthening exercises.

The stability of your joints is affected by the pregnancy hormone, relaxin, but also by the strength of the muscles that hold them in place. Do NOT go to a generic class or instructor with PGP, they cannot be expected to accurately prescribe the correct exercises for you. But controlled, guided core strength & lower body resistance work will definitely help to strengthen & stabilise your joints, & reduce pain.

Let me know what else you need on these conditions – I know from my clients that they are  commonly diagnosed, but also often misunderstood pregnancy & postnatal considerations which affect the exercise you can comfortably undertake.

Pregnancy Pelvic Floor Exercise… So, SO Important!

If you only manage one pregnancy exercise (& please do more!), then it has to be pelvic floor exercises. All pregnancy exercise programmes should include these – if yours doesn’t – get a new one!

I’ll spare you the diagram (I’m guessing you know where they are!) but what do they do?

Your pelvic floor muscles act as a muscular ’sling’ which supports your internal organs (it literally holds them in preventing prolapse), provides bladder & sphincter control & gives you better orgasms…

If you’re pregnant now, you’re also going to need them to push your baby out. …So, they’re probably the most important pregnancy exercise you’ll do!

Pelvic Floor exercises during Pregnancy are VITAL to keep your core muscles in shape as pregnancy progresses! If you have a vaginal delivery, strong muscles stretch more easily than weak ones, so a ‘toned’ pelvic floor has a better chance of avoiding episiotomy (cutting) & tearing. If you have a c-section, the pelvic floor is not spared I’m afraid – it will still have been stretched & put under pressure during pregnancy by the weight & gravity of your baby!

After your baby is born, postnatal pelvic floor exercises should be the first exercise you do – there is no time limit – start as soon as you can remember to! Many, many mums are all too familiar with ’stress incontinence’: a slight leak (or worse) when coughing, sneezing, jumping, trying to run for a bus, laughing…

…and just like spilt abdominal muscles & a mummy tummy, a weak pelvic floor does not have be ‘just part of being a mother!’

Pelvic floor exercises (or Kegels named after the gynecologist who ‘invented’ them) can be done anywhere, anytime. no one knows you’re doing them but you, & you don’t have to put your trainers on to do a set! You can be lying down, sitting or standing, in the car, in a meeting or feeding your baby!

Pregnancy Exercise: How to do Kegels:

Kegels are often described as stopping yourself from urinating, but are more actually more effective if you imagine you’re trying not to fart! Yes really – if you pull in your sphincter muscles, your vaginal muscles will also tighten. Then imagine you’re trying to stop yourself from urinating – try to differentiate & identify front, middle & back. Squeeze & release them from front to back, then back to front… (having fun yet?! )

Try quick squeezes, as you contract & release the muscles for just a second at a  time. Do this 10 times, rest for a couple of seconds, then do another 10.

Also longer holds. Starting with 5 seconds, repeated 5 times. Take a minute break then do the set again. You can build up to 10 second holds with 10 repetitions.

Do both types, & aim to do the whole set 2-3 times a day. Seriously, it might not feel like much, but these exercises are the differences between post-baby bladder control & wetting yourself! They’re worth it!!

Important to remember when doing pelvic floor exercises / kegels:

• Don’t hold your breath! Try counting out loud to make sure you breathe
• When you release, don’t push out or down, just let go
• Make sure other, bigger muscles aren’t doing the work instead – there should be NO contraction in your backside, stomach or inner thigh muscles
• Your pelvis, tummy, shoulders or anything else shouldn’t move – make sure you isolate the important pelvic floor muscles

Finally, if you’re having trouble identifying the right muscles at all, try doing the exercises at first sitting on a fitball (swiss ball), as this can help you to feel the contraction in the early postpartum weeks when you may have limited sensitivity.

Good luck with your pregnancy exercise & get squeezing!

Pregnancy Exercise Tips: What, How, Why & How Much??

How do you build the stamina and strength required for labour, birth and beyond with SAFE pregnancy exercise?  You can prepare your body to cope, and to recover quicker, through preparation during pregnancy: by safely staying fit and healthy, and by working with your changing body.

Regular pregnancy exercise will improve fitness, maintain a better self-image, and help you to feel positive about your pregnancy, your labour and your delivery.   Don’t try to dramatically increase your fitness during pregnancy, (however you can start exercising now, even if you didn’t before – start with just walking, and some of the exercises in this post) but look to maintain a basic fitness level.

Modify your pregnancy exercise programme as your pregnancy progresses, LISTEN TO YOUR BODY, and don’t over-exert yourself.

There is no evidence to support the fear that pregnancy exercise increases the risk of miscarriage, premature labour or of congenital defects. All available evidence indicates that a low-risk pregnant woman, with the consent of her Midwife or Doctor, will gain significant health benefits from continuing or starting a regular exercise programme.

What Type of Pregnancy Exercise Should You Do & How Often? Aim for a balanced pregnancy exercise programme, including both aerobic exercise (when your body keeps moving and your heart rate is elevated for a length of time) and resistance training (to build muscle strength). Aerobic exercise could include walking, low impact aerobics, swimming or cycling. Try to do 20-30 minutes of aerobic exercise, 3-4 times a week, and choose something you enjoy! Reduce intensity and/or duration as your pregnancy progresses.

A Fit Ball (sometimes called a Birth Ball) can be invaluable throughout pregnancy, during labour, and for exercising afterwards. Sit on the ball instead of a sofa or chair to maintain good posture and strengthen your core muscles (stomach and lower back). By focussing on sitting up straight on the ball you can help prevent backache and other discomforts caused by slouching and bad posture.

Try other positions on the ball to ease discomfort, and help your baby to move into the right position in later pregnancy.

Your pregnancy exercise programme should include strength training to tone and shape your body. Strength exercises will not give you big muscles, but simply strengthen the areas of the body most weakened by the postural effects of pregnancy, and your changing centre of gravity and posture.

The important muscles to strengthen during pregnancy exercise are your upper back (to prevent slouching), lower back and core muscles (for posture, support and strength) and the backs of your thighs and bottom (these muscles can get weaker and stretched during pregnancy due to postural changes).

The most important thing to remember when exercising during pregnancy is that weight loss, or reduced weight gain, should NOT be your primary goal or focus. You are exercising and eating well in order to be strong and fit, and to give yourself the stamina needed over the coming months… enjoy fresh air and exercise with this in mind, and you’ll look and feel great!

Pregnancy Exercise & Nutrition: How Much Weight Should You Gain During Pregnancy?

When thinking about your pregnancy exercise & nutrition: How much WEIGHT GAIN IN PREGNANCY is too much? Or too little? How much of it is ‘BABY FAT?’

The most common pregnancy exercise question I get asked as a pregnancy personal trainer must be: ‘HOW MUCH WEIGHT SHOULD I PUT ON?’

Well every pregnancy is different. Some women gain a lot of weight (3.5 stone / 50+ pounds / 23kg), while others gain very little (1 stone / 15 pounds / 7kg). The answer partly lies in your pre-pregnancy body weight. For example, if you are around 5′ 6″ / 168 cm tall & weigh 10 stone 7 lb / 147 pounds / 67 kg then a healthy weight gain for you might be between 25 to 35 pounds / about 2 stone (11 to 16kg).

You do need to remember, though, that while weight gain charts can be helpful guidelines, I strongly urge you not to get too hung up on them. The best goal of any pregnancy exercise programme is not to worry about weight gain, but to take good care of yourself! REMEMBER (& I know this is stating the obvious but many women do seem to forget!)…

NOT ALL YOUR PREGNANCY WEIGHT GAIN IS FAT!

Your pregnancy weight gain is made up of the following (with approximate weights):

• Your baby ! (6-8 lbs)

• Placenta (1.5 lbs)

• Amniotic fluid (2 lbs)

• Uterine enlargement (2 lbs)

• Maternal blood volume (3-4 lbs)

• Maternal breast tissue (1-2 lb)

• Maternal body fluid (4 lbs)

• Maternal fat stores (roughly 7 lbs)

Secondly, weight gain during pregnancy is HEALTHY! It means your baby is growing well. If you’re active, following a sensible pregnancy exercise programme, eating healthily & not taking your pregnancy for granted, your weight gain during pregnancy & your weight loss afterwards will NOT be an issue. Your body is resilient! It will bounce back if you treat it well.

Remember (and trust!) that the extra weight WILL come off after you deliver your baby. If you’re active, you WILL get your pre-pregnancy body back… It’s only 40 weeks… so enjoy it!

If you feel you’ve already gained more than you should as a result of too little activity &/or overindulging, it’s never too late to turn over a new leaf! If you haven’t been exercising, start some pregnancy exercise today: a daily walk is a great start. And if you’ve been eating too much processed or take-away food, do your best to prepare & eat home-cooked meals with lots of vegetables!

It goes without saying that the foods that will make you gain unnecessary fat during pregnancy are the same foods that do you & your growing baby no good either.

So when someone offers you slices of cake or cookies telling you ‘Go on! You’re eating for two!’ – Your baby really doesn’t need those hydrogenated fats, sugar & empty calories any more than you do!

Actually, pregnancy is a great time to really start to think more carefully about what you are eating in terms of the nutrients you & your baby need. If you won’t change your eating habits for your own sake – at least do it for your baby’s! Remind yourself that there’s a little miracle going on in that bump… your body is an amazing, incredible machine, that is quite literally making a baby – brain, skeleton, nervous system, eyes, hair, every last bit of him or her is developing from scratch inside you!

Your body needs good fuel in order to do the best job it can – in the form of real, unprocessed, fresh food & plenty of good fats (Omega 3 & 6). If you choose your pregnancy foods with your baby’s development in mind, combined with sensible pregnancy exercise, then you won’t go far wrong & you won’t put on unnecessary weight!