Beginning an exercise routine while pregnant?

[RubyLu]

Never fear, I'll ask my provider(s) as well, but I was wondering what the rest of you've done. 

I've been largely inactive (other than chasing my 2 year old around the house and also walking 3 miles around the neighborhood each evening, which stopped two months ago due to Wisconsin weather). 

Now that I've learned I'm pregnant I want to start up more regular exercise to prepare for birth and to help with weight gain, which was excessive with my first pregnancy and which I haven't totally lost, but I don't want to risk injuring myself. What would be a good idea? I have an eliptical machine and I have yoga DVDs. I used to lift a bit and run a bit, but that was pre-daughter. 

Ideas? 

[jcregan]

Early on you might be able to do a bit more but I would plan on prenatal yoga and/or pilates and walking as the core of a plan since you have not done much before.

Maybe the elliptical more now and then see how that feels later.

I really like my yoga/pilates mix dvd.

[Mama Metis]

I was pretty active until I got pregnant, but the last 8 weeks or so it's been tough to get out since it's cold and I've been feeling so tired. My plan is to get back into things s l o w l y. If you start at 10-15 minutes on the eliptical, and up it by 5 minutes a week, or whatever feels right, you'll minimize risk of strain or injury. Also it feels less daunting (to me) to say "I'll spend 15 minutes working out today" versus "I need to get back to my old workout ASAP." And before too long an hour on the eliptical is no big deal. I'm also easing back into basic strengthening exercises, ie squats, lunges, pushups from my kness, etc. Also, yoga twice a week.

[Stayseeliz]

I'd stick with moderate intensity, low impact workouts like the elliptical and walking and maybe light weights. I was lifting HEAVY and doing high-intensity cardio before I got pg and now I'm only doing elliptical/treadmill and lifting twice a week. My belly is just too big at 22w and my back hurts. Exercise is great when you're pg but don't go overboard!!

[MegBoz]

FYI, I'm a certified fitness instructor & personal trainer.

TBH, there isn't much evidence on this. The bulk of the research out there was done by Dr. Clapp & is summarized in his fascinating book, "Exercising through your pregnancy." It was published like late '90s, early '00s or so. He started his research around 1980 because he said, at the time, no one knew! No research previously existed!

He also didn't study resistance training much (weight lifting - whether muscular endurance focused (low weight, high reps) or muscular strength training (heavier weights/fewer reps.) His study participants were runners or "aerobic dance" instructors (hehe - think Jazzercise in the 1980s!)

I'm fairly certain he didn't study people who BEGAN exercise after getting pregnant.

So if your HCP tells you, "NO, DON'T START an exercise program now!" Then I'd be really wary of said HCP, because that's simply not evidence based advice.

All that being said - here's what I recommend.

Dr. Clapp's research shows exercise is not only NOT the least bit harmful to the reproductive process, it's very beneficial for BOTH mama & baby! (I mention "reproductive process" because he also examined miscarriages & infertility - again, exercise had no negative effects here either.)

You were NOT previously totally "sedentary" - i.e. bed-ridden. You've been up & about, so it's not as though physical exertion of any kind is a TOTAL shock to your system.

Listen to your body! Be CAREFUL you have good form! Actually, I'd steer clear of pilates unless you take a class with a very VERY good instructor. Quite a few of those exercises have the potential to injure you if done incorrectly. & there are LOTS of lousy fitness instructors out there, so chose carefully (PM me if you want tips there. But someone who's also certified as a personal trainer is likely to have a greater depth of knowledge.)

Also, the vast majority pilates mat exercises (as opposed to those with the "reformer" machine) are done either flat on  your belly or flat on your back. The former is likely to be uncomfortable around the 4th / 5th month, & you're not supposed to lay supine (flat on back) at all past the 5th month. (I personally disobey this, but I have a huge & complex variety of reasons. I would NEVER recommend others disobey this rule.)

As for what sort of activity to do - something you enjoyis really crucial. I find yoga somewhat boring (even though I'm certified to teach it) & dislike pilates, so if those were my primary options, I probably wouldn't do any exercise. Try lots of different things.

Ease into it. Work at a "moderate" intensity - as I tell my cardio classes, "It shouldn't feel like a leisurely stroll through the park, but you don't want to feel as though you are sprinting through the park for your life." Gradually increase both intensity & duration (total length of workout). Be sure to warm up with each workout & cool down properly & stretch at the end. Also be sure there is balance in your workout i.e. if you do some bicep curls, work triceps, if you work abs by doing crunches, work lower back too. Make sure opposing muscle groups are worked equally.

if any of that above paragraph wasn't clear (i.e. you don't know what warm-up should be, you don't know what muscles & how to stretch them post-workout), definitely line up some sessions with a personal trainer or get some books or videos so you know some general basics. Or maybe see if you have a knowledgable friend to help.

Again, listen to your body. But get moving! :D It does two bodies good.

[RubyLu]

Originally Posted by MegBoz 

 "It shouldn't feel like a leisurely stroll through the park, but you don't want to feel as though you are sprinting through the park for your life." 

Hah! That made me giggle, and I can remember it. Thanks!

Thank you, everyone! I think I'll hop on my elliptical for a few mins and get out the prenatal yoga DVDs. I'm feeling more confident now. 

[MegBoz]

Originally Posted by RubyLu 
Hah! That made me giggle, and I can remember it. Thanks!

:) Glad it was helpful! It usually gets a smile out of my class participants too.

& it reminds me... many gyms have a "target heart rate" chart on the wall. <sigh> It's kinda silly, IMO. For one thing, it's all age-based. If you really want to do target HR training, it's better to use formulas that incorporate your resting HR as well - because that also takes your fitness level into account. The more fit you are, the lower your resting HR. So it's really silly to use the same "target HR" for everyone based purely on their age!

However, studies have shown that using what is known as "rating of perceived exertion" - RPE is really just as accurate! & that phrase about strolling/sprinting through the park is exactly that - RPE! How hard do you "perceive" you are working? People are pretty good at gauging RPE as it relates to HR, so unless you have some sort of heart condition, or are a serious athlete working at advanced conditioning levels, you really don't need to worry about monitoring your HR at all.

Pregnancy throws an interesting wrench into all of this. I find this REALLY fascinating... any HCP who tells you not to get your HR up too high, sorry to say, is misinformed.

As Dr. Clapp's book outlines, there is something called "the cardiac under-fill problem" in the 1st tri. Basically, your cardiovascular system - arteries & veins, begin to expand to accommodate the blood volume that WILL be increasing, but the cardiovascular system increases more quickly than the blood volume itself increases... so your heart beats MORE OFTEN to pump a smaller volume of blood around a bigger "piping" system (since arteries & veins really are like pipes.) This results in decreased blood pressure & can even result in fainting - so fainting being a sign of early pregnancy is actually NOT just an old wives' tale.

So if you monitor your HR, you may find it's much higher than RPE would lead you to believe it is. Don't worry about it. Don't even bother to monitor HR. (again, that is if you are healthy & have no sort of heart condition.) Having your HR very elevated isn't really a problem in and of itself - actually, it is a good thing!

ACOG used to have a restriction not to get HR over like 140 BPM, but they dropped that in like 1994! So, again, if you hear that restriction from an HCP, I'd be very concerned!

You want to be sure not to get overheated - that can be risky, but obviously if you're on an elliptical, you are indoors, so not a risk, plus its' winter anyway!

Enjoy your workout!

[homestyle]

Having your HR very elevated isn't really a problem in and of itself - actually, it is a good thing!

ACOG used to have a restriction not to get HR over like 140 BPM, but they dropped that in like 1994! So, again, if you hear that restriction from an HCP, I'd be very concerned!

Oh really?! Dang ... this "140" rule was why I quit running in the first tri. I really miss it. What do you think of starting up again in the 2nd? Can you point me to any sources to help me decide? Super thanks!

[MegBoz]

Originally Posted by homestyle 

Having your HR very elevated isn't really a problem in and of itself - actually, it is a good thing!

ACOG used to have a restriction not to get HR over like 140 BPM, but they dropped that in like 1994! So, again, if you hear that restriction from an HCP, I'd be very concerned!

Oh really?! Dang ... this "140" rule was why I quit running in the first tri. I really miss it. What do you think of starting up again in the 2nd? Can you point me to any sources to help me decide? Super thanks!

Definitely the best resource is the book, "Exercising Through your Pregnancy" by Dr. Clapp. Also a really interesting book. Well, LOL, I found it fascinating, but exercise physiology is interesting to me - been reading up on it for years now. Unfortunately my copy is still out on loan, or I'd type up some quotes for you.

Here's one link:

http://www.webmd.com/baby/guide/exercise-during-pregnancy-myth-vs-fact

"People are still stuck on this heart rate issue, and it was never based on anything concrete," says Riley, noting that ACOG abandoned the "target heart rate" concept a long time ago. What they and most experts now rely on as a guide is RPE, or rate of perceived exertion"

http://www.acog.org/publications/patient_education/bp119.cfm

Heart Rate

"The extra weight you are carrying will make your body work harder than before you were pregnant. Exercise increases the flow of oxygen and blood to the muscles being worked and away from other parts of your body. So, it's important not to overdo it.

Try to exercise moderately so you don't get tired quickly. If you are able to talk normally while exercising, your heart rate is at an acceptable level."

Hm, OK, that conflicts with what I know - the "Talk test" is another way of rating perceived exertion. I normally say that if you can carry on a conversation easily, you are NOT working all that hard - you should be able to tell me your name (i.e. you are not totally breathless), but not necessarily chit chat all through the workout. (hehe... this tid-bit comes in handy if I have people talking in class!)

But you'll notice they say, "so you don't get tired too quickly" - they say nothing of any sorts of dangers from having HR elevated, and they don't list any max HR number (that page has nothing else on any maximum HR.)

Obviously I "talk" while I workout because I have to constantly CUE the next move when teaching aerobics (step aerobics & cardio kickboxing) but I say about 2 words every few seconds. If I were to talk in continuous sentences, you will hear that I'm a little winded. So, again, I'm technically "able to talk" but not easily able to carry on a conversation, if that makes sense.

If you really want to get into technical details, it's true that blood flow to the placenta is decreased while you exercise -- since more blood has to go to those working muscles. & therefore blood & oxygen to the baby are also decreased - but the baby tolerates it very well. As a matter of fact, Dr. Clapp wrote that exercising women seem to build even more robust placentas!

Interestingly, Dr. Clapp's research included women who stopped exercising later in pregnancy, whereas they had previously kept it up at first. But I don't recall him mentioning the reverse. So, that leads me to believe there just isn't a lot of research out there on starting out in the 2nd tri - since there wasn't research on exercising in pregnancy at all before Dr. Clapp did his.

Plus I can imagine it's somewhat common to not be active 1st tri & then begin to exercise 2nd tri, after all nausea & fatigue are common in 1st tri & hardly anyone wants to exercise when feeling fatigued & nauseated!

So I figure starting in the 2nd tri - same rules would apply - listen to your body, ease into it, etc.

Out of curiosity, did your HCP tell you the 140 HR Max thing?

[homestyle]

Out of curiosity, did your HCP tell you the 140 HR Max thing?

Yup, she sure did. But I'm in Germany, with a German 'frauarzt', which is the same as an ob/gyn, I think. But not ACOG, right? I really like this lady, I'd hate to think I can't trust her. She did say it was fine for short bursts to be at 140, just not prolonged. Whatever that means exactly. I teach folkdance, and I am often talking all the way through as well, to give instructions ... and I'm def quite winded sometimes!

That was a ton of great info! Thank you!