Prep Your Body for Pregnancy
Often when women are starting to consider conceiving a child they begin to ask a lot of questions about what they need to do to optimally prepare their bodies for this transition. What should I be eating? Should I take vitamin supplements? What sort of exercise routine should I be engaging in? An important place to start for the answers to most of these questions is of course with your OBGYN. However, physical therapy can offer many suggestions in how to best prepare your body physically for the demands of pregnancy and postpartum.
Many young mothers or expectant young mothers end up in physical therapy with one very common issue, low back pain. In order to maintain a healthy low back it is dependent on several different muscle groups working synergistically together to create a solid foundation. Often you hear people say the key to a healthy back is a strong core. But what is the core exactly? The core is made up of the muscles of the abdominals, specifically the transverse abdominals, the lowest level of the four abdominal muscle groups. The pelvic floor muscles, those that run from the pubic bone to the tailbone lining the base of the pelvis, the muscles of the hips and the muscles of the back. During pregnancy the body has to make numerous accommodations in all of these areas in order to carry and deliver a child to full term. It is because of this that many women suffer muscle imbalance, abdominal, core and pelvic floor weakness following delivery.
The best way to insure quick recovery following pregnancy is to make sure these muscle groups are functioning optimally prior to conception. There are a few simple exercises you can begin to do at home to start strengthening right away.
The first of which is called a transverse abdominal isometric. To perform this exercise, lie on your back with your knees bent. Place your fingertips just inside the your hip bones so they are resting on your abdomen. Perform an abdominal contraction by pulling your belly button towards your spine. Make sure when you do this you are not squeezing your gluteal muscles or holding your breath. If you are doing it correctly you should feel your abdominals tighten underneath your fingertips. Secondly, keeping your fingertips in the same location on your abdomen, perform a pelvic floor contraction, this is done by engaging the muscles that you would use to stop the flow of urine. If you are doing this correctly you should feel the same tightening of the abdomen under your fingertips. Begin by performing these exercises separately, holding 5-10 seconds with each repetition and do up to 10 repetitions each. Once you feel you have the hang of it, try to do the abdominal isometric and the pelvic floor isometric at the same time. It is likely that the pelvic floor muscles will fatigue before the abdominal muscles do, do not be concerned by this, it is normal.
Another exercise you can start builds on the exercise you just learned. Lie on your back with your knees bent, perform your abdominal and pelvic floor isometric contraction, then squeeze your gluteal muscles (buttocks) and lift the entire pelvis off the floor. For some people this may cause your hamstrings to cramp up. If this happens this is an indication that you have weak gluteal muscles and therefore, really need this exercise! Try to hold your pelvis off the floor for 5-10 seconds; you are working towards 10 repetitions of this exercise as well. For those of you that get really good at this exercise you can try to lift your hands off the floor or lift off one foot (that really makes it challenging).
Lastly, as I mentioned before, the pelvic floor works very closely with the musculature of the hips, so it can be engaged indirectly with hip internal and external rotation and breathing. Lie on your back with your legs straight. Take a nice deep breath filling your abdomen with air, as you do this simultaneously externally rotate your hips by pointing your toes away from each other. Then exhale your breath through pursed lips as you internally rotate your hips bringing your toes towards each other. You are working towards 10 repetitions of this exercise as well.
These three exercises are a good foundation from which to start as you begin to prepare your body for pregnancy. As many questions as you had about preparing your body for pregnancy you will likely have just as many, if not more after you deliver. A good resource for exercises to help restore muscle balance and pelvic floor function after delivery is a book by Janet A. Hulme, Solving the Mystery of the Pelvic Rotator Cuff In Human Function and Movement. This book has exercises you can begin as soon as two weeks after delivery. Good Luck!