Christiana Chiropractic, PC ...... (315) 409-0014

Download or Print This Article

Exercising for Two

As a family practitioner, Dr. BoTio often treats expectant mothers. Why are regular chiropractic checkups so important during pregnancy? Hormonal changes during pregnancy cause ligaments to relax, spurring imbalances among the bones of the spine (vertebrae) and hips. These imbalances are associated with a condition called vertebral subluxation, which may trigger pain and discomfort - the last things an expectant mother needs! Doctors of chiropractic are specialists at detecting vertebral subluxations and correcting them with gentle and effective maneuvers called chiropractic adjustments. In addition to caring for expectant mothers' spines, Dr. Christiana provides pregnant patients with researchbased advice on how to maintain optimal health during pregnancy. This week, Dr. Christiana is focusing on the role of exercise during pregnancy. Read on to learn how staying fit may insure a smooth pregnancy and delivery. Exercise Pain Away A recent report confirms what chiropractors have long observed: many of the common aches and pains associated with pregnancy, including low-back pain, result from overuse injuries that may be prevented with exercise (Bone Joint Surg 2000;82:625-32). The study looked at 15 women in the second half of their last trimester of pregnancy. The women were also evaluated one year after delivery. When researchers analyzed how specific muscles were affected while the pregnant women walked, they found that some muscles withstood additional stress, setting them up for injury. This imbalance may be alleviated through exercise, researchers report. Avoid Obesity Nearly one-quarter of women ages 25 to 55 in the United States are overweight. Obesity dramatically increases a woman's odds of developing cardiovascular disease, high blood pressure, diabetes and other disorders. Christine Olson, professor of nutritional sciences at Cornell University and author of a recent study, believes that excessive weight gain during pregnancy is partially to blame for the rocketing rates of obesity, which jumped nearly 60 percent since 1991. The Institute of Medicine of the u.S. National Academy of Sciences recommends that normal-weight women gain 25 to 35 pounds during pregnancy. Overweight and obese women are advised to gain 15 to 25 pounds, and underweight women are urged to add 28 to 40 pounds. However, according to Olsen's study of 577 expectant mothers, many women use pregnancy as an excuse to abandon exercise regimens and expand their meal portions. Mothers who "eat for two" often pack on additional weight - with more than 40 percent of women surveyed gaining more than the recommended amounts. These mothers were four times more likely to be obese one year after giving birth, compared with mothers who gained within the recommended range. "But even more disturbing," says Olsen, "was the fmding that 56 percent of the new cases of obesity in our study could have been prevented if the women had stayed within the recommended ranges for weight gain during pregnancy. Defuse High Blood Pressure High blood pressure during pregnancy, referred to as gestational hypertention affects roughly 12 percent of pregnant women. Five to seven percent of women develop preeclampsia, a condition characterized by high blood pressure, fluid retention and protein in the urine. This sometimes-fatal disorder significantly increases the risk of complicated delivery and is "treated" by inducing preterm delivery, a practice which may put the mother and baby at risk (J Reprod Med - 2000;45:293). Fortunately, a new study provides hope for women at high risk of preeclampsia. Investigators tracked 16 high-risk women (beginning at the 14th week of gestation) for 10 weeks. Prior to the study, none of the women - all of whom shared similar body compositions worked out on a regular basis. Half of the women began exercising on a treadmill or bicycle three days a week for 30 minutes. Half continued at their regular activity level. Those who worked out lowered diastolic blood pressure by as much as 4.6 millimeters of mercury. In contrast, women who did not exercise experienced no significant drops in blood pressure. A Clue About Blues Got the "baby blues"? Emotional depression - both before and after delivery - is common among new mothers. But take heart, regular workouts can chase away the doldrums and keep moms and moms-to-be feeling joyous (Aust N Z J Obstet Gynaecol 2000;40:442). One Australian study followed 18 non-exercising women and 25 women who adhered to a regular workout regimen. All subjects were expecting their fIrst child. Findings showed that exercising boosted body image and lowered risk of depression, anxiety and insomnia. Standard psychological tests also revealed that exercisers had dramatically superior levels of psychological well-being, compared with those who did not workout. Dodge Diabetes Gestational diabetes, the most common medical complication of pregnancy, often is related to obesity. It can be a serious threat to the baby, increasing the risk of traumatic delivery, stress in labor and neonatal complications. Exercise is known to have a beneficial effect on insulin resistance, a prelude to gestational diabetes, by making insulin receptors more sensitive to insulin in the blood stream. Research suggests that exercise may reduce a woman's risk of gestational diabetes especially among extremely obese women (also called "morbidly obese"). Reduce Risk of Cesarean If reducing the risk of disease in you and your child isn't enough to convince you to stay fit, consider this: regular workouts slash the risk of complicated delivery, including caesarean section. One analysis of 137 first-time mothers showed that "the odds of cesarean delivery were found to be 4.5 times greater for sedentary women than for active women." (J Obstet Gynecol Neonatal Nurs 2000;29:258-64.) The Ideal Prenatal Workout What type of exercise is ideal during pregnancy? When choosing an exercise program, look for low- to moderate-intensity workouts, such as power-walking or swimming. In addition, avoid activities that involve bouncing, such as high-impact aerobic dance or running - especially during the third trimester. Activities with a high risk of falling, such as skiing or fastpaced step-aerobic classes, should be avoided altogether. Before starting (or continuing) any exercise program, always check with your midwife or obstetrician. Ask her or him to provide you with a detailed list of "off-limit" exercises and quality prenatal workout classes. Also, ask your practitioner to instruct you on how to monitor your heart rate during exercise and calculate the maximum rate you can reach safely. You may also want to schedule a session with a personal trainer to modify your current exercise program. Three Times A Charm When it comes to exercising during pregnancy, three times is a charm, say Canadian researchers. It seems that three times a week is the ideal workout frequency for pregnant women (Am J Obstet Gynecol 2001;184:403-8). According to the report, which followed over 500 women, ose who worked out five or more times a week during their third trimester of pregnancy were five times more likely to have a low birth weight baby, compared with women who exercised three or four times a week. (Low birth weight is associated with a bolstered risk of several conditions.) And,. women who exercised no more than twice a week had double the risk of having a low birth weight infant, compared with women who engaged in three to four workouts. Is It OK to Start Exercising During Pregnancy? Traditionally, health-care providers were taught to instruct pregnant patients to exercise during pregnancy only if they had previously engaged in a regular workout program. However, in recent years, cuttingedge research has challenged this standard. Beginning a moderate exercise program during pregnancy is not only safe but also beneficial for most women. In a rece:l}.t experiment, investigators enrolled 46 nonexercising women eight weeks into their pregnancies. The women were assigned to one of two groups: 1) no exercise or 2) weight-bearing exercise three to five times a week. The offspring of exercisers had significantly higher birth weights, an indicator of good health, compared with the babies of non-exercisers. In addition, the placental function of women who exercised was superior to non-exercisers, indicating that exercise assisted the transport of nutrients and oxygen to the fetus (Am J Obstet GynecoI2000;183:1484-8). (Again, it's vital to check with your midwife or obstetrician before beginning any program.)

Our purpose is to educate and adjust families toward optimal health