Physical therapy in high-risk pregnancy: 14 correct postures, safe exercises to protect expectant mother and baby | Health

These are –

• Autoimmune diseases
• Diabetes
• High blood pressure
• fibroids
• HIV infections
• Kidney disease
• Obesity
• Mental health disorders (depression)
• Polycystic ovary syndrome
• Thyroid disease
• Blood coagulation disorders.
• Health risks related to pregnancy are
• Gestational diabetes
• Low birth weight
• Multiple gestation
• Gestational hypertension, preeclampsia and eclampsia.
• Placental conditions such as placenta previa or placental abruption
• Previous preterm birth
• AFI index level (too high or too low).
• Heart disease
• Liver disorders
• Recurrent pregnancy loss.

In an interview with HT Lifestyle, Dr. Mohanapriya (PT), Senior Executive Physiotherapist at Cloudnine Group of Hospitals in Chennai – OMR Branch, shared, “Reviewing recent research articles and personally as a physiotherapist, the role of physiotherapy exercises is very crucial in the management of high-risk tasks. Physical activity before and after pregnancy is known to benefit both mother and fetus. The WHO recommends a minimum of 150 minutes of moderate aerobic exercise a week.”

According to her, physiotherapy helps to reduce –

• High blood pressure
• It reduces the risk of weight gain in both mother and child
• It helps with postnatal recovery and weight reduction.
• Boosts mood and increases stamina
• Preparing for labor and recovery

She recommended that before you engage in physical activity, you can evaluate yourself with a speech test. How to perform this test –

• During physical activity, make the patient say some phrases if you are in low frequency exercises, you can say sentences without any difficulty.
• If it is about exercises of moderate frequency you can speak but you can make sentences with difficulty without continuity.
• If it is high frequency exercises, you would not be able to speak properly, you can only produce words without continuity. Based on these criteria we can evaluate the fitness intensity of the individual. In addition to aerobic exercise, we have an advanced exercise protocol that can be included in high-risk pregnant women.

Modification of daily activities

Dr Mohanapriya said: “In certain high-risk pregnancies, obstetricians recommend exercise after 28 weeks of gestational age and the mother will be advised to take complete bed rest. During this time, slow and moderate walking can be initiated. Especially after every meal to maintain blood sugar homeostasis and manage weight, increase blood circulation and prevent muscle cramps.” She advised –

• Try walking faster than you normally would to get your heart pumping.
• If you exercised before pregnancy, aim for at least 150 minutes of physical activity, such as walking, each week.
• If you are new to exercise, start easy and gradually increase the speed and distance.

If you plan to walk fast or take longer walks:

• wear comfortable shoes
• stand on level ground
• walk tall and pull your abs in
• make sure you can pass the “speaking test”
• avoid walking in hot weather – try to go out early or late in the day when it’s cooler
• bring water and healthy snacks
• Consider using a pedometer or step-counting app to track your movements and see your progress.
• Listening to music or trying new places to walk will help keep your walking interesting.

Mothers can engage in less invasive household activities such as cleaning, kitchen activities, pet care, cooking. So it can be a distraction rather than bed rest or no activities.

Postural correction and exercises

Dr Mohanapriya said: “Mostly mothers with prolonged rest or sitting, slouching, thoracic hump will have more strain on their back, which in turn leads to pelvic girdle problems. Awareness of postures such as sitting, lying and standing should be known by mothers with some back and back strengthening exercises.” These may include –

1. Back to wall/wall slides

• Use the wall for support as you position your body against the wall, pull your chin back, straighten your shoulders. Move your pelvis out. Take the time to really feel what it’s like to be in good posture.

2. Wall angels

• Stand next to the wall, position your head, shoulders, hands against the wall, gently raise your hands along the wall up to your head and lower it to your hips. keeps all parts of the body in a good position.

3. Pull your head back

• Keep your head straight and look forward keep your eyeball straight and tilt your chin towards your chest.
• Slots in the door
• Stand in an open doorway
• Extend your arms to the sides of the door
• Take a large step back with your right leg, leaning your weight forward into your arms. You should feel a stretch in your upper chest.
• Hold for a few seconds
• Repeat with the left leg.

4. Standing row

• Attach the middle part of the pulley to a button and pull with both palms and bend the elbows and crush the rib cage back, repeat several repetitions.
• Pulling the shoulder blade
• Squeeze the shoulder blade as much as possible. And hold for 15 to 30 seconds.

5. Pelvic floor exercises

• Pelvic floor exercises in the supine position may be included to prevent weakness of the pelvic floor muscles due to inactivity and to strengthen the muscles for future pregnancies.

6. Kegels

• This exercise serves to strengthen the muscles that stretch during pregnancy and childbirth. It also relieves persistent pain in the back, pelvis or coccyx.
• Imagine trying to stop yourself from peeing or passing wind halfway through and hold that position for ten seconds.

7. Pelvic tilt

• Lie with your head flat on a pillow and your knees bent toward the ceiling. Pull in your belly, keep your feet flat on the surface of the bed. Hold this position for about 4 seconds, breathing as you do so. Practice this as often as you can, pelvic floor exercises are best done 3 times a day.

8. Bridging

• This is posturally similar to pelvic tilt. To begin, position yourself with your head on a pillow, feet close to the bed and feet slightly apart. Slowly lift your back off the bed, lifting your bottom up. Then, bring your body back to the starting position.

9. Isometric exercises

Isometric strengthening exercises for the neck muscles to achieve correct posture and for the knee muscles can be included to overcome weakness in the muscles of the lower limbs.

• Press your palm to your forehead. Resist with your neck muscles. Hold for 10 seconds. Relax. Repeat 5 times.
• Do the exercise again, pressing the side of the head. Repeat 5 times. Switch sides.

10. Isometric exercises for the knees

• Place a towel under your knees, try to press down and try to hold for 15 to 30 seconds. Repeat 10 times.
• Place a pillow or wedge that can produce 15 degrees of knee extension. Do the movement and hold it for 15 to 30 seconds and repeat 10 times.
• Raising the right leg squeeze the knee as much as possible and raise the legs for 30 degrees and hold for 30 seconds and repeat the exercises.

11. Stretching exercises

Full-body stretching exercises should be included to relieve muscle cramps and muscle tightness. Including gentle warm-ups and stretching exercises, such as yoga asanas, can help relieve muscle fatigue and tightness.

12. Resistance exercises

May include, for example, light resistance training exercises using dumbbells, Thera band exercises, tension tubing for all muscle groups

13. Dumbbell Shoulder Press

14. The cat and the cow

Dr. Mohanapriya concluded, “When you start exercising, contact a physical therapist right away for an individualized exercise protocol tailored to prevent pregnancy complications.” See your OBGYN if any of the following symptoms persist –

• Breathing difficulties
• Chest pains
• Spotting or bleeding
• Pelvic pains
• Water leak
• Reduced baby movements
• Dizziness
• Headache
• inflation
• Muscle weakness

Disclaimer: This article is for informational purposes only and is not a substitute for professional medical advice. Always ask your doctor for advice with any questions about a medical condition.