Advantages of Aquatic Exercise During Pregnancy

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April 21, 2011

By Karen Woodman, Obstetrics PT

I love to take advantage of our large therapy pool for treating pregnant patients. Why? The American College of Obstetricians and Gynecologists (ACOG) recommends immersion as one of the most effective forms of exercise during pregnancy. ACOG states there have been no reports of harm to the fetus during aquatic exercise.

Benefits include:

  • Buoyancy: The belly floats relieving pressure and pain in the groin and back with immersion. Usually exercise in the pool is pain-free.
  • Hydrostatic pressure: Are your feet and ankles swollen? The hydrostatic pressure of the water pushes edema (extra fluid) right back into your cardiovascular system reducing swelling.
  • Decreased weight-bearing: Working at hip level in the water takes 30% of the pressure off your spine, while working at chest level reduces gravitational pressure by 60%!
  • Thermodynamics: Your body temperature adjusts 25 times faster to water temperature than air reducing the risk of overheating. During pregnancy, your core body temperature (usually 98.6°F) can increase quickly during exercise to dangerous levels with associated risk of fetal deformities. Our pool temperature averages 88°F, warm enough for a comfortable workout while cool enough to be safe for exercise.
  • Resistance: Water provides gentle resistance in all directions, challenging your balance and building muscle with every step. The harder you work, and the deeper the water, the greater the resistance.
  • Hemodynamics: Immersion immediately lowers maternal blood pressure and heart rate promoting cardiovascular fitness. Studies suggest immersion also decreases risk of increased fetal heart rate during exercise.

What Does a Prenatal PT Do?

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April 12, 2011

By Karen Woodman, Obstetrics PT

What’s the difference between your traditional exercise instructor and a prenatal PT? While both may be beneficial, there are significant differences between the two. Studies have shown that individualized physical therapy treatment programs with specifically designed stabilization exercises are more beneficial than traditional exercise or group exercise classes in reducing back and pelvic pain during daily activities.

Here’s why: A prenatal physical therapist has the experience and training to identify impairments during pregnancy and differentially diagnose the culprit(s) causing the problems. This is done through a thorough postural and musculoskeletal examination, in addition to gait analysis and physical exam of the lumbar spine and pelvic girdle. The patient is educated in how their body is changing, why they are in pain, and what to do in order to manage their symptoms and improve their functional strength for daily activities, labor and delivery, and recovery afterwards.

If you are having problems with back, pelvic or sciatic pain that are keeping you from participating in exercise and daily activities, ask your physician for a referral to a physical therapist trained in obstetrics. With the right help, you can regain your life, reduce your pain, and then rejoin that fun exercise class to stay in shape!

After the Baby: Regaining Abdominal Strength

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March 14, 2011

By Karen Woodman, Obstetrics PT

The abdominal muscles aid in breathing, coughing, sneezing and bowel movements. They provide stability to the trunk and stabilize the spine during lifting. They also help you maintain good posture, so there are lots of important reasons to strengthen your stomach muscles!

During pregnancy, the abdominals are stretched, weaken and often separate (known as diastasis recti). When the muscles remain separated, they can’t work efficiently and can contribute to low back and pelvic pain, and a flabby appearance, and can have long-term implications to your health. So, it is important to check for, and heal, a diastasis recti.

To check yourself for a diastasis recti:

  • Lie on your back with your knees bent. Place your fingers in the center of your belly just above or below the belly button.
  • Slowly lift your head and shoulders off the mat while feeling for a separation of the muscles. Check how many fingers you can insert horizontally into the gap between the belly muscles.
  • If you have a separation of 2 fingers or more at your six-week checkup, ask your doctor about a referral to a qualified physical therapist. Do not start an exercise program doing sit-ups or crunches without consulting with a physical therapist first, as these exercises may actually worsen an existing diastasis recti!

Source: APTA Section on Women’s Health. Postpartum Recovery. Revised by Karen Woodman 3/1/2011.

Baby Body Mechanics: Protect Your Back!

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February 24, 2011

By Karen Woodman, Obstetrics PT

Correct posture principles when caring for your baby:

  • Keep your back slightly arched and bend your knees when lifting your baby.
  • Before standing or lifting, pull in and lift your lower belly muscles, continuing to breath.
  • Hold your baby close to your body.
  • Try using support when carrying your baby (i.e. slings, Baby Bjorn, Snuggli, etc.).
  • Sit straight and tall when breastfeeding; do not lean down into the baby.
  • Support your baby during feedings with a pillow/Boppy.
  • Try alternate nursing positions (football hold, side lying, cradle, or cross cradle).
  • Carry only what’s needed in your diaper baby, or better yet, use a backpack.
  • Use the stroller attachment for your car carrier instead of hauling it around.
  • Avoid pushing your hip out to hold and carry the baby. Instead try to carry Baby with weight balanced over both legs and the baby front and center.

Source: APTA Section on Womens Health Postpartum Recovery handout.

For Providers … Your Patients May Benefit from Obstetrics Physical Therapy!

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February 17, 2011

By Karen Woodman, Obstetrics PT

Physical therapists are uniquely trained to treat musculoskeletal dysfunctions. An Obstetrics PT specializes in the evaluation and treatment of women during pregnancy having pain or dysfunction related to pregnancy, delivery, or postpartum. Postpartum problems may arise immediately after delivery or anytime during the first year.

Who should be referred?:

  • Back, sacral, hip, pelvic and rib pain
  • Neck or upper back pain
  • Headaches
  • Sciatica, carpal tunnel, thoracic outlet or other nerve symptoms
  • Decreased ability to perform work or home activities
  • Weak or tight muscles
  • Balance deficits
  • Urinary urgency or stress incontinence during pregnancy
  • Patients who desire to start or continue a safe exercise regimen
  • Diastasis rectus abdominus greater than 2 cm

Referrals can be phoned, faxed or emailed to:

Compass Rehabilitation Center
250 E. Saginaw Street
East Lansing, MI 48823
Phone: (517) 337-3080
Fax: (517) 337-3082
www.Compass.Rehab

Please include the following information on the script:

  • Treatment diagnosis (back pain, sciatica, etc)
  • Please note OB or Postpartum on the script!!!
  • Any precautions
  • ‘PT eval and tx’ Attn: Obstetrics PT
  • Please include a frequency and duration for treatment (i.e. 3 times per week for 4 weeks)
  • If possible, please include the nurse’s name and direct number for PT staff to contact.

Please feel free to contact our office if we can be of assistance to you!

Yoga and Exercise Build Strength During Pregnancy

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February 15, 2011

By Karen Woodman, Obstetrics PT

Yoga is a safe way to improve flexibility and build your strength during pregnancy, but there are some precautions. Keep in mind the following recommendations before you start any yoga program:

  • Avoid extreme end-range twisting movements. Remember, your ligaments are lax and you are more prone to spinal injury with extreme movements, especially if you are combining twisting and bending (never a good idea, actually).
  • Avoid ‘Downward Dog’. Yes, I know…it is a common yoga pose, but it is not recommended during pregnancy because the increased pressure of the abdomen being pushed into your ribcage in a prolonged standing with head down position compromises the diaphragm and your ability to breath. It also can lead to lightheadedness. Just skip it to be safe.
  • Avoid ‘hot’ yoga. You don’t want your core body temperature to rise over 102 degrees or there is an increased risk of neural tube defects.
  • Drink lots of water…you can dehydrate quickly with exercise.
  • Monitor your tolerance to exercise. If you feel like the exercise is causing you to pant or feel hot and sweaty, slow down.

To get started, try this Top Ten Pregnancy Yoga website for review of some of the videos available. Please let me know about any other good ones out there! I am not making any specific recommendations, so keep in mind the above tips when choosing any exercise program, and have fun!

http://pregnancy.about.com/od/fitnesspregnancy/tp/aa112602a.htm

Pregnancy Related Lower Back Pain News Report

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February 8, 2011

For pregnant women, back pain can make it hard to walk or do daily activities, often forcing a woman into bed rest. Compass Rehabilitation Center in East Lansing, Michigan has a solution. WILX News 10 has a special report on this new back pain therapy.

 

Nine months of back pain through pregnancy is especially taxing. The Compass Rehabilitation Center has a program made for women, by women.

“In a month my pain had gone from being so bad I couldn’t walk or stand, to like a 2, which is really nothing.” – Melissa Cooke

Physical Therapy Tips for Pregnant Women

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February 1, 2011

  1. Wear shoes with good arch supports. All your ligaments are stretching out including the ones on the bottom of your feet.
  2. Pace yourself and keep hydrated! Your body temp raises quickly during exercise now that you are carrying extra cargo.
  3. Watch your posture, especially while sitting for long periods of time. Sit as tall as you can, on your ‘sitz bone’ instead of your tailbone.
  4. Breathe! Another reason to watch your posture is to allow enough room for your lungs to expand. Your baby has already taken up real estate in your belly pushing your diaphragm into the ribs.
  5. Do your Kegels! The pelvic floor muscles cradle your growing uterus and provide support for the bladder and bowel. If they get weak, you leak!
  6. Move! Now is not a time to take up a new sport, but you can usually continue with familiar activities with modifications. Avoid high impact sports and anything that is going to put you at risk for falling on your belly. Rule of thumb: If it hurts, modify it or don’t do it.
  7. Strengthen your inner abdominal muscle, the Transverse Abdominis, by pulling your belly button up and in while sitting or standing tall. This will help prevent back pain and help you get your flat stomach back.
  8. Consider asking your OB for a prescription to physical therapy if you are having back, pelvic, hip or other pain that is affecting your daily life. We can help!