To avoid blood pooling:
- limit the time you spend standing still
- keep your toes and legs moving if you do have to stand for a long period.
To prevent heartburn and indigestion interfering with your exercise:
- avoid positions where your shoulders are lower than your hips
- take frequent small sips of water during exercise.
To help relieve constipation:
- eat a well-balanced diet rich in fibre and drink plenty of water
- practise pelvic rocking — some women find it helps relieve bowel discomfort.
To protect your feet:
- as mentioned above, wear supportive low, wide-heeled shoes as much as
possible and exercise in shock-absorbing footwear
- avoid constant walking on concrete when walking for exercise
- consider being fitted with orthotics by a podiatrist.
'Packaging problems'
All pregnant women experience some discomfort from the compression and stretching associated with the growing uterus. Before you were pregnant, your uterus was much smaller than the size of your fist. By the end of your pregnancy it will be about the size of a punching bag — and that's if you're having only one baby! The packaging of the structures within your abdomen will obviously need to be rearranged to accommodate this growth.
Effects on the rib cage
Towards the end of pregnancy, your uterus will press up under your diaphragm. The work of breathing will become harder, especially during moderate to high-intensity exercise. You will feel short of breath more easily. To compensate for the limitations of your diaphragm, your ribs will flare out to the side as you breathe, which may cause a sharp pain under your shoulder blades that radiates to your chest.
IMPLICATIONS FOR EXERCISE
- you will need to avoid moderate to high-intensity exercise during the last trimester of pregnancy.
- you should avoid sudden changes of aerobic intensity in your ^exercise program.
- sustained, light to moderate aerobic work is preferable.
- you should add upper-back flexibility exercises to reduce the risk of rib pain.
- you should seek physiotherapy treatment if rib pain is a persistent problem.
Pelvic-floor pressure
The pelvic floor is the group of muscles that attach in a hammock-like fashion to the base of your pelvis. An important function of these muscles | is to support the abdominal and pelvic contents above them, including your bladder and uterus.
The design of the pelvic floor is considered inherently poor because, firstly, the group of muscles that form the pelvic floor have only a small amount of muscle fibre, but a large amount of fibrous tissue and, secondly, they are interrupted by the urethra, vagina and anus. Maybe the pelvic floor wasn't designed to take all the weight from above at all? Perhaps we were designed to walk around on all fours as the theory of evolution suggests!
During pregnancy, there is an increased risk of incontinence (involuntary loss of urine). The three major contributing factors are:
- the increased pressure on your bladder and pelvic floor as your uterus expands
- the increasing amount of space your uterus occupies within the pelvis as your pregnancy progresses, which makes it impossible for your bladder to hold as much urine as before
- the hormone relaxin, which softens the structures of the pelvic floor so that they become less efficient in holding up your pelvic organs. This can also add to the discomfort of vulval varicose veins and haemorrhoids.
When you pull, push, lift or carry loads, cough, sneeze, vomit, run, jump or laugh heartily you increase the pressure within your abdomen, which will jeopardise an already 'at risk' situation even further.
The pelvic-floor muscles may not be able to hold against this extra pressure and stress incontinence may be the consequence. (Stress incontinence is the involuntary leakage of urine caused by an increase in impact or stress pressure within the abdomen.) The best defence you have is to avoid situations that place added strain on your body and to improve the strength of your pelvic-floor muscles.
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