Exercise During Pregnancy

Exercise does a lot to keep you healthy and some of those benefits are also true for pregnant women.

Exercise will:

  • reduce blood pressure
  • decrease cardiovascular risks like the formation of clots
  • help to maintain an ideal body weight
  • help to manage stable diabetes

Additional benefits specific to pregnant women include:

  • Improving the labor process and delivery. “Pregnant women who exercise have shorter labor times, and faster, easier deliveries.”
  • Exercise can also improve self-esteem and high self-esteem has been associated with a decrease in complaints of back aches, headaches, and fatigue.
  • Exercising women will also be more conditioned for difficult breathing.

Exercise continued after delivery will help to decrease varicose veins, leg cramps, and swelling in the limbs.

A fundamental function of exercise is promoting blood flow to deliver nutrients to where they are needed and eliminating stored toxins. The metabolism of calcium will also be improved. It will ultimately lead to healthier organs, stronger connective tissue, and denser bones.

There are a lot of changes that occur to the women’s physiology in pregnancy and this warrants safety considerations for the mother and the baby. Over-stepping the limitations in pregnancy can divert blood flow away from the growing baby to provide more to the mother’s exercising muscles. This could deprive the baby of oxygen and stunt his/her growth and put the baby in distress. Exercising conservatively can appease the additional risks of membrane rupture, placental separation, premature labor, direct fetal injury, or umbilical cord entanglement. With due caution and consideration, effects on the fetus by maternal exercise does not contraindicate exercise.

These are the 7 safety guidelines:

1. Heart rate needs to be less than 140 beats per minute

2. Exercise intensity should be low. You should be able to speak during the exercise without your breath becoming rapid.

3. Do not perform strenuous exercise for more than 15 minutes

4. Starting at 5 months pregnant, avoid exercising on your back

5. Avoid exercises in which you hold your breath and strain

6. Be sure that you are eating enough to meet the needs of the pregnancy and of the exercise.

7. Core temperature should not exceed 38 degrees Celsius/100.4 degrees Fahrenheit. Do not overheat yourself.

You should stop the exercise immediately if you experience any of the following:

  • back pain
  • feeling disoriented
  • extreme nausea
  • marked swelling
  • pubic pain
  • sharp pain in the abdomen or chest
  • feeling extremely hot, cold, or clammy
  • uterine contractions
  • any vaginal bleeding or gush or fluid from the vagina
  • decrease in fetal movement
  • blurry vision
  • dizziness
  • fainting
  • difficulty in walking
  • shortness of breath
  • pain or palpitations

If you have high blood pressure or heart disease, have had more than three miscarriages, or are pregnant with more than one baby, you should not exercise at all during pregnancy. If you have any pre-existing health conditions, then you should consult your doctor about exercise first.

Exercise recommendations for pregnancy:

  • Jogging. This is recommended if the mother jogged regularly before pregnancy.
  • Walking. A safe option because it does not involve jerky movements while still helping to condition the cardiovascular system. A good brisk walk for half an hour three times a week will ensure that you are getting the benefits of exercise. Your cardiovascular system will be strengthened when worked for at least fifteen minutes.
  • Cycling. This can be started during pregnancy because it is not a weight-bearing activity. A stationary bike is safer.
  • Aerobics. Avoid exercises that require you to be on your back, include jerky or bouncy movements, and deep flexion and extension after the 4th month of pregnancy. Low impact aerobics is tolerated well in the third trimester. Ballroom dancing or aerobic dance are great aerobic exercises.
  • Swimming. A great option. Avoid excessively cold or hot water though. Water aerobics is another option rather than swimming laps.
  • Weight lifting. Light weights can be used to maintain strength as long as you are breathing properly. No holding your breath and straining. Perform with caution. If unaccustomed to this exercise, begin with just resistance against gravity first.
 Racquetball, squash and tennis are fairly safe. Adjust the intensity of play as the pregnancy progresses.
  • Scuba diving. For experienced divers only. Do not exceed 1 ATM in pressure and limit the time to 30 minutes or less.
  • Yoga. Great for relaxation. Also helps to maintain muscle tone and flexibility. Best when accompanied by some form of aerobic exercise. Do not try to do the same amount as before you were pregnant.

A variety of exercise will prevent imbalance by overworking the same muscle groups and will ensure that all muscles get a turn.

Remember: Your cardiovascular system will be strengthened if worked at least three times a week for a minimum of fifteen minutes.

Exercises to Avoid:

  • All contact sports
  • Gymnastics
  • Horseback riding
  • Water skiing
  • Ice skating

Any exercise program should begin with a five-minute warm-up and aerobic programs should end with a five-minute cool-down exercise. The cool-down should include light stretching and relaxation exercises. This will help to prevent muscle stiffness after exercise and will help in bringing the heart rate and body temperature back to normal. All exercises should be performed on both sides.

Here are some exercises that are performed in the standing position that can be used to warm up or cool down:

  • Shoulder rolling. To loosen the neck and shoulder muscles, bring your shoulders up to your ears, back and down again. Perform six times.
  • Arm swinging. To release shoulder stiffness, increase circulation, and stretch your upper back, swing your arms from side to side by turning your upper body.
  • Knee raising. To loosen the knees and pelvic joints and gently massage your internal organs, bring each knee in turn up toward your chest and hold for two seconds.

Exercises for the neck and upper back:

  • Sit comfortably with your legs crossed. Slowly bring your head to the end of every position and hold for ten seconds at each position. That is, down to your chest, then back to look up at the ceiling, look over each shoulder and finally drop your head down to each shoulder. Repeat three times. This will relieve tension in the neck and upper back.
  • Cat stretch. Come to your hands and knees and keep a straight back. Round your back and look toward your knees. Then relax to a flat back and look toward the ceiling. Repeat five times.
  • Dog stretch. Keep your hands and heels on the floor and push your buttocks toward the ceiling. Repeat two times. This should not be performed beyond the first trimester.

Exercises for the lower back and legs:

  • Butterfly. Bring the soles of your feet together and allow your knees to relax out to the sides. Gently bring your knees up and down. Then with your knees down, slowly come forward and attempt to touch your feet with your head. Slowly come back up and breathe. Repeat three times.
  • Bridge. Lay on your back with your knees bent and your hands on the floor at your sides. Slowly raise your pelvis and lift your buttocks and lower part of your back off the floor. Hold for ten seconds. Then slowly come back down, bringing your buttocks down last. Repeat three times.
  • Alternate leg stretch. In a seated position, spread your legs apart. Bring one foot to the inside of the opposite thigh. Face the outstretched leg and slowly bring your head to your knee and stretch your arms forward. Do not strain or bounce. Slowly come up and repeat on the other side. Do this twice.
  • Squat. Squat down with feet flat on the floor, palms together in front of the chest and elbows pressing against the knees. Hold for 20 seconds while breathing normally. Then sit back on your buttocks and relax your legs. Repeat once. Work up to holding the squat for one minute.

Abdominal Exercises:

  • Sit-ups. In a seated position, have your knees bent with your arms extended over your knees. Slowly roll back one vertebra at a time until the shoulders recline. Then sit up. Repeat three times and work up to repeat ten times.
  • Alternate Leg Raise. Lay down and put your hands beneath your low back. Without straining, bring your leg up toward your head and hold for 20 seconds with normal breathing. Then lower your leg slowly while exhaling. Repeat with the opposite leg. If you have lower back discomfort or pain, bend the opposite leg with your foot on the floor. Repeat three times on each side.
  • Pelvic Floor Exercises
 The pelvic floor supports the bladder, uterus, and rectum. These supporting muscles can be strained during pregnancy and child birth. Kegel exercises work these muscles and can be done at any time. Practice stopping your urine flow midstream during each urination. Once you have mastered the urine stoppage midstream, you will know how to contract the muscles anytime not just during urination.

Reference: Pediatric Chiropractic. Anrig, Plaugher. Lippincott Williams & Wilkins, 1998
ISBN 10: 0683001361 / ISBN 13: 9780683001365.

Carpal Tunnel and our Modern world

What is Carpal Tunnel?

This is a condition that is defined by tingling and numbness in the hand and arm which usually occurs gradually over time.  It eventually leads to hand weakness and is due to an impingement of the median nerve which runs down the center of the forearm (when you are looking at your hand with the palm up).  There are several factors that can cause it, but most are due to the persons anatomy or a repetitive action by the arm and hand most typically due to overuse on the computer.  The bones of the palm form a tunnel that protects the nerve and the 9 tendons that helps the hand to function.

What are the Symptoms?

  • Aching:  One of the first symptoms to appear is not directly a symptom of Carpal tunnel but is a sort of “Canary in the Coal mine”, meaning it is the warning sign that tingling and numbness will follow.  It is an urgent message to see a practitioner to make sure that your hands and forearm anatomy are in proper alignment so more serious symptoms don’t develop.
  •  Tingling and Numbness:  Typically tingling is felt first, followed by numbness in the thumb, index and middle finger.  The ring finger will sometimes be effected, and the little finger is usually not effected because it is controlled by another nerve.  The sensation will be much like your hand has gone to sleep and you need to shake it to wake it up.  As symptoms progress, the numbness may go from occasional to constant.
  • Weakness:  Often dropping items or not being able to grasp very well progresses over time making symptoms much worse.  The most common weakness that occurs is the pinching movement of the thumb as this is controlled almost entirely by the median nerve.

What Causes Carpal Tunnel Syndrome?

It is a compression of the median nerve on the hand.  Here are the most common ways to get carpal tunnel in our modern world:

  • Repetitive jobs:  assembly line work, dental, computer work, and some construction jobs
  • Fractures
  • Pregnancy: increased swelling will sometimes cause carpal tunnel like symptoms till baby is born.
  • Women are more likely to get Carpal Tunnel due to having smaller carpal tunnels
  • Dislocation of the hand/wrist
  • Inflammatory conditions: Rheumatoid arthritis and many other disorders
  • Work with Vibrational tools

This is only a small list and many other things also can cause this condition.   Don’t assume you do not have carpal tunnel because your job factor isn’t listed here.

How is Carpal Tunnel Diagnosed?

It  is done by a thorough history or examination of your symptoms to see if you have some of the risk factors and how the gradual onset of symptoms or the trauma occurred.  The doctor will do a physical exam performing a series of orthopedic tests that put pressure on the Median Nerve in several different ways.  An Xray may be ordered or an Magnetic Resonance Imaging (MRI) will be done to rule out other issues such as arthritis, neuroma or other anatomical variations that may be causing the issue.  Lastly, a Nerve conduction study or a Surface Electromyography (EMG) study that will done to see if the median nerve is conducting a current all the way from the neck, elbow and into the palm.  This is to make sure that nerve damage isn’t occurring which would need to be addressed with a surgical option immediately.

How is Carpal Tunnel Treated?

If your history and exam only reveal a mild onset of symptoms, you can see a chiropractor that specializes in adjustments and soft tissue injuries.  We recommend that you see one that is specialized in the Graston Technique as it has been shown to be very effective for treating Carpal Tunnel and offers significant improvement in about 8 visits.  Graston releases the tight muscles and adhesions caused in the palmar forearm and will need to be iced after treatment as some minor swelling may occur.  Physical therapy may also be needed to strengthen areas of weakness that lead to the carpal tunnel issue originally as well as re-training those injured areas.  Splints may be recommended to keep the tunnel open and your wrist in as optimal a position as possible.  Corticosteroids are also tried if the previous more conservative treatments have failed.  We do recommend Corticosteroids over surgery.  Lastly if severe enough nerve compression is present, the patient will have to look at surgical options but we do recommend this as a last resort since the carpal tunnel is narrow and scar tissue can form post-surgically as well which causes further problems down the road.

We treat Carpal tunnel in our office and you can expect a combination of Graston therapy, Kinesio Tape and adjustments  for  the treatment regiment.  This is an area great concern. Silicon Valley has a lot of Carpal Tunnel issues because of how many of us use computers, cell phones and tablets on a daily basis.  Don’t wait for it to get so bad before getting it evaluated and treated.

How to take care of yourself during Pregnancy

**Eat Low Mercury Fish

  • Salmon
  • Tilapia
  • Polluck

 

** Don’t eat raw fish, alfalfa sprouts and unwashed vegetables as these can be area’s of bacterial storage and getting a bacterial infection can be very damaging to an baby growing inside of you.

 

**Drink safer water which means less chlorine and may require purchasing a filter such as Brita or a more expensive reverse osmosis machine.

 

**Choose Better body products:

 

Look at the EWG Cosmeticsdatabase.com

 

Avoid: triclosan, oxybenzone and essential oils as these can be teratogenic to a developing little one

 

**Wash all new cloths that are purchased as they often have a residue on them.

 

** Resist Caffeine and Alcohol.  Yes some cultures still have small amounts but babies have a longer half life in there body meaning that drugs like alcohol and caffeine stay longer in there system than ours, so be careful.

 

** Avoid Painting and other chemical intensive jobs around the house.

 

 

Remove the Dirty dozen foods or make sure they are organic.

 

1.    Apples

2.  Celery

3.  Bell Peppers

4.  Peaches

5.  Nectarines – Imported

6.  Strawberries

7.  Spinach

8.  Lettuce

9.  Lettuce

10.  Blueberries – imported and domestic

11.  Potatoes

12.  Raspberries – imported and domestic

 

(As a rule of thumb domestic produce is usually safer believe it or not, due to the more strict pesticide regulations.  If you are getting produce from a foreign country many regulations don’t exist and they can still use products like DDT.)

 

**Exercise Daily:  Squats and lunges are helpful in preparing muscles for labor.  Yoga is great for flexibility, which is helpful for reducing back pain and assisting with labor.   Keep up walking daily, hills are even better as this can help with blood sugar.

 

**Stop running around the 6th month this means around 24-25 weeks due to the laxity of joints women can be at risk for major damage in the joints.  Some women have even had to have hip replacements after delivery due to damage done during pregnancy.

 

** Start a Birth Plan and sign up for a birthing class.  These can help with stress management as you’re due date get’s closer preparing you for what is to come.  Here are some favorite books and classes.  (Avoid to much internet as it can overwhelm moms to be)

 

  • Birthing from Within By Pam Engand
  • What to expect when your Expecting by Heidi Murkoff
  • Harmony Birth Classes, Campbell  CA http://www.harmonybirth.com/
  • Mayo Clinic Guide to a Healthy Pregnancy by Mayo Clinic
  • Happiest Baby on the Block by Harvey Karp

 

Pregnancy and Chiropractic

Is chiropractic safe during pregnancy?

 

“There are no contra-indications to chiropractic care during pregnancy,” according to the American Pregnancy Association.  And when you think about how long chiropractics has been around, it could be considered one of the safest procedures that can be performed during your pregnancy. While all chiropractic professionals receive some training in school with regards to the special needs of pregnant women, only some doctors, like Dr. Walker at InHealth Clinic, continue their training and work with pregnancy in their practice.

 

Why should I have chiropractic care during pregnancy?

 

As you go through physiological and hormonal changes, your body becomes the perfect environment for developing a child. This can sometimes cause physical stress, which can improve with chiropractic care. Keeping your back joints and pelvis from misalignment and keeping you comfortable means that your baby will have the optimal amount of room in the pelvis to develop. This also means your baby will be in the best position possible for delivery reducing the intensity of back labor during your birth and preventing dysticoa (difficult labor).  Additionally, keeping your spine and pelvis in alignment can reduce the occurrence of breech positioned babies.

 

What happens if my baby is breech?

 

A wonderful chiropractor, the late Larry Webster D.C., developed a specific chiropractic analysis and adjustment which enables the chiropractor to balance the women’s pelvis and reduce pressure and stress on the uterus so that the fetus will reach an optimal position which is head down in the birth canal.  The Journal of Manipulative and Physiological Therapeutics reported in July/August 2002 that the success rate of babies turning vertex was 82% using the Webster Technique. The technique is widely used and much more comfortable than the external version that is performed in many cases. The highest success in turning a breech baby is achieved at 36-38 weeks. Once it gets much past this, the success rate drops due to the baby’s larger size taking up more room in the uterus. It is always best to seek chiropractic care as soon as you are told your baby is breech.

 

When is the soonest I can see a chiropractor post-partum?

 

The soonest is immediately, however most women tend to wait about two weeks until they have had time to adjust to being a new mom and have healed vaginally a bit. Our office does make house calls for one special group — our post-partum moms, whether for you or baby.  The earliest we have responded was four hours after a birth for a mom that had a C-section and the little one’s head was flexed to one side and not moving.  Mom was also having a burning low back pain, which was treated at this time.

 

What about preparing for labor? Are there things that I can do naturally?

 

Pregnancy may leave you concerned or tired. Here are a few things we treat with natural remedies.

 

  • Gestational diabetes – diet, minerals and botanical medicine
  • Stress – herbal stress reducing minerals
  • Preparing the uterus for labor – Uterine tonics
  • Breast soreness due to breast feeding – healing salves
  • Episiotomy healing – herbal poultices and sitz baths
  • Umbilical cord healing – salve and powder
  • Nutrition – vitamins, oils safe for pregnancy, and minerals
  • Preventing antibiotics for newborn – mom on a strong probiotic
  • Morning sickness – homeopathic remedies

 

We have more tools at our disposal, but the above give you some of the common needs of our patients.

 

Remember that chiropractic is safe as soon as you need it!  At inHealth, we are here to serve you during this very special time. If you have concerns or needs feel free to call our office, we never mind being a resource and promise to direct you to the best person to meet your needs.

 

Resources:

 

American Pregnancy Association:  http://www.americanpregnancy.org

BABI:   http://www.bayareabirthinfo.org/

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