Antinatal Physical Therapy

Antenatal exercises aim at improving the physical and psychological well-being of an expected mother for labor and preventing pregnancy-induced pathologies by various physical means. It generally includes low impact aerobic exercises and stretching exercises.

During the first trimester, pregnancy brings certain changes in the body for example: morning sickness, fatigue or low energy levels, nausea and increased secretion of the relaxin hormone. Exercise helps to overcome these changes and improves the mood and energy level of the mother. Healthy pregnant women should exercise for at least 150 min per week or 20-30 min everyday in moderate to vigorous aerobic intensity

Advantages of Antenatal Exercise

• Reduces morning sickness.
• Reduces insomnia, anxiety and stress.
• Reduces other pregnancy-related complaints, e.g.: fatigue, leg cramps, oedema of extremities, etc.
• Prevents excessive weight gain during pregnancy.
• Improves muscle strength.
• Improves core stability.
• Maintains muscle length and flexibility.
• Improves glycemic control^.
• Improves posture.
• Enhances relaxation.
• Prepares for physical demands of labour.

Precautions

• Exercises should be performed under supervision^.
• Avoid supine lying more than 5 minutes after 3 months of gestation.
• Do not hold your breath(Valsalva’s maneuver).
• Do not change positions quickly.
• Stay hydrated at all times (before, during and after workouts).
• Follow proper warm-up and cool-down process.
• Ensure bladder emptying before workouts.
• Avoid exercises which demands higher balancing and different groups of muscles.

      Cardiovascular Exercise

• The intensity of the workout will be decided by an assessment on pre-pregnancy fitness level.
• It is important to choose any aerobic activity based on one’s interests, such as walking, swimming, hiking etc.
• So if walking is the only cardio workout done by an individual, it can be practiced 20-30 minutes 3-4 times a week safely.

Stretching exercises

 Pectoral stretch

• This exercise helps in the opening of the chest and prevents the development of round shoulder.
• Nudge the ball in the corner or near the wall.
• Sit in a comfortable position keeping the back on the ball.
• Keep your hands by the side or clasp them behind your head.
• Rest the head on ball and let the elbows expand and open your chest.
• Repeat 3 to 5 times.

Piriformis stretch

• Piriformis muscleplays an important role in pelvic stabilization and ADL’s^.
• Sit on the chair with neutral pelvis.
• Now keep your foot over the opposite knee and bend forward from the hips keeping your pelvis neutral until you feel the stretch.
• Hold it for 20-30 seconds.
• Repeat for the other side as well.
• Do 3 to 5 sets.

Hamstring stretch

• Shortening of hamstring can cause back pain^[13]and pelvic misalignment.
• This stretch can be performed in various positions and bilaterally or unilaterally.
• Sit in long sitting position, bend one knee and try to reach your extended leg as much as you can.
• Hold it for 20-30 seconds and repeat it for 3-5 times on each side.
• During first trimester, supine lying hamstring stretch can also be done.

Calf stretch

• The more the available length of Tendo achilies, the more force production during push off phase of walking and greater stability.
• Place rolled towel, mat or foam roller on the floor.
• Place ball of the foot on the towel, mat or roller and heel on the floor. keep the leg straight. hold this position for 20-30 seconds.
• Repeat on the other side and perform 3-5 sets on each side.

Hip Opening Stretches To Do During Pregnancy

Butterfly / Tailor Pose

• sitting on the ground, bring the soles of shoes together, allowing knees to point out to each side.
• Grasping feet or ankles, draw both heels in as close to body as is comfortable.
• Lean forward slightly and hold that position. Focus on taking big deep belly breaths.
• For an even deeper stretch, press your thighs down with your hands or elbows to bring your knees closer to the ground. Hold that pose and focus on the stretch and your breath.

This is a fantastic hip-opening stretch for the inner thighs, hips, and groin. This pose not only helps widens your hips, but it also helps ease aches in lower back.

Squats / Garland Pose Stand with feet facing forward or slightly outward, shoulder-width or slightly wider than hip-distance, apart. 

• Slowly and fluidly bend your knees and lower your body, extending the arms out in front for balance if helpful.
• Balance your weight on the balls of your heels and pause.
• Breathe and slowly rise back up and then repeat the action.