By Barbara Pery Bind
Dr. Katie Vadasdi, a triathlete and alpine climber, has been busy training six days a week, swimming, biking, running and doing yoga, along with core and lower back/pelvic exercises.
But, she's not training for a race or a climb. She's eight months pregnant, and she's preparing to have her second child.
As an orthopedic surgeon and sports medicine specialist at Orthopaedic and Neurosurgery Specialists PC (ONS) in Greenwich, Vadasdi understands the imporatance of exercise during pregnancy. She stresses, however, that it is important to do it right and in consultation with your ObGyn before starting any workout regimen. To help pregnant women understand just how to do that, she will take part in a health education seminar, "Exercise Safely During Pregnancy and After" on Jan. 12 at the Noble Conference Center at Greenwich Hospital, 5 Perryridge Road.
Greenwich Citizen caught up with Vadasdi for some of the guidelines and tips she will cover at the discussion next week.
Why is exercise important during pregnancy?
In principle, you should exercise during pregnancy for the same reasons you exercise when you're not pregnant -- it's good for your heart, it helps you manage your weight, it improves your mood, your stamina and helps you maintain flexibility.
Just because you are pregnant, is no excuse to let yourself go. Exercise will also benefit your delivery and postpartum. In addition, doing regular exercises while pregnant has been shown to help prevent or treat gestational diabetes, reduce back pains and swelling.
It may also allow you to tolerate delivery with more ease and can be a big help in getting back in shape after giving birth.
Are there exercises that should be a priority for pregnant women?
With your doctor's approval, walking, swimming and yoga can all be excellent activities during pregnancy. Cardio exercise and pelvic and core strengthening are probably the highest priority.
Are there exercises that should be avoided while pregnant?
Exercises that should be avoided include all contact sports; sports requiring significant balance or activities where there is a significant risk of falling like skiing, cycling, horseback riding; scuba diving. Extremely high intensity sports should also be avoided. After your first trimester, it is also recommended to avoid any exercises where you are on your back.
You say, "Just because you're pregnant, doesn't mean you can't exercise. But it is important to know how to exercise safely."
What are the top five things pregnant women should consider before exercising?
1. Do you have any medical conditions that may place you at greater risk?
2. What was your pre-pregnancy exercise program? If you were a runner prior to becoming pregnancy, you may continue running. If you weren't, don't start running while you are pregnant.
3. How do you need to modify your activities to make them safe during pregnancy-both to protect your baby and to prevent your own injuries?
For example, there is an increase in relaxation or laxity in your ligaments during pregnancy-especially in your back and pelvis, but also in your knees, ankles, etc...
This may make you more prone to back injuries, falling, and ankle or knee injuries such as ankle sprains. Even something like hiking can place you at risk of spraining an ankle. You might want to consider walking sticks/poles or staying on even ground. It is also important to avoid overheating, dehydration and elevating your heart rate too much.
4. Always be prepared with nutrition, hydration and be ready to stop or rest at anytime during your workout. Your body will not respond to exercise the way you are used to, so it is incredibly important to be aware of the changes in your body and the subtle signs of low blood sugar, dehydration, overheating or just fatigue.
5. Always discuss your exercise goals with your ObGyn MD prior to initiating a pregnancy exercise program
How much exercise/exertion is safe during pregnancy? Is there a point in time at which someone should stop exercising?
The amount of exercise that is safe during pregnancy is dependent on your pre-pregnancy activity level. The American Congress of Obstetricians and Gynecologists state that is safe to continue with your pre-pregnancy activities but with modifications to avoid increasing your heart rate too much, dehydration and overheating. If you did not exercise prior to your pregnancy, you can begin with as little as 5 minutes per day and add 5 minutes each day until you reach 30 minutes per day. There may be changes in your pregnancy that require you to stop or further modify your activities. This will be determined by your ObGyn, so it is crucial to maintain your regular appointments and discuss the specifics of your exercise program.
What are some physical indicators that a pregnant woman should stop exercising?
There are many, and this list includes just some of the more common ones. You can obtain further detail from your ObGyn. In general, you should stop exercising and contact your doctor if you have any vaginal bleeding or leaking, cramping or contractions, chest pain, increased shortness of breath, increased swelling. If you experience any of these, you should share it with your ObGyn immediately.
Do exercises vary by trimester? If so, what are your recommendations?
There are different factors that will cause you to change your activities from one trimester to the next.
It is not recommended to do any exercises on your back after the first trimester. Your center of gravity changes along with the weight gain that occurs during pregnancy. This places greater stress on your joints during impact exercises such as running and increases your risk of falling as your center of gravity moves forward. Running generally becomes more difficulty as pregnancy progresses, many of the positions in yoga may become difficult over time too.
Are there injuries women are more prone to during pregnancy?
With increased relaxation in ligaments that comes with being pregnant, you are definitely more prone to ankle sprains, sacroiliac joint and pubic symphysis pain and discomfort and low back pain.
Lastly, you're now about 8 months pregnant -- how have you modified your own sports routine during pregnancy? Are you still exercising?
I modified my activities at the very beginning of each pregnancy. I worked with my ObGyn on a program that allows me to maintain my activity level while being safe for my baby and me.
Just before my first pregnancy, I was training at a very high level, preparing for and competing in an Ironman Triathlon. Once I became pregnant, I made significant changes to my program, reducing the time and intensity in all my activities. I've maintained the same approach during this pregnancy, stopping all contact and impact sports and activities where there is a risk of falling. For example, I've chosen not to cycle outdoors so as to avoid any risk of falling or having an accident. I still bike frequently but on a trainer indoors. I do not rock climb or ski during pregnancy.
I have also eliminated high-intensity exercise. I still do interval workouts, but I do not increase my intensity to the same level. I am very aware of my heart rate and walk up hills or take breaks when necessary to make sure it does not get too high.
I am also very focused on my nutrition and hydration. I learned quickly that my body when pregnant does not respond to exercise the way in which I am accustomed. I always have food and water with me when I exercise and am mentally prepared to turn my long run into a long walk if it is too hot outside, or my sacroiliac joints hurt or if I just don't have the energy to complete a work out.
My runs overall are definitely slower and shorter, but I have been able to train close to six days a week. I continue to swim, bike, run and do yoga. I also do some core and lower back/pelvic exercises. I think this combination of activities has allowed me to continue exercising into my third trimester.
Vadasdi will be joined at "Exercise Safely During Pregancy and After" by Dr. Catherine Berzolla, ObGyn, of Putnam Gynecology and Obstetrics of Greenwich and physical therapist Alicia Hirscht of ONS Physical Therapy to address common concerns and safety guidelines for physical activity while pregnant. The seminar, which runs from 12:30 to 1:30 p.m. on Jan. 12 at 5 Perryridge Road, is free and open to the public. Registration is required, by calling 203-863-4277 or 888-305-9253.