It's a common misconception that exercise during pregnancy is only safe for women who were physically active prior to becoming pregnant. However, according to the American College of Obstetricians and Gynecologists (ACOG), pregnancy should be viewed as a time to embrace healthier lifestyles regardless of how active or healthy you were prior to pregnancy. (1)
ACOG states that it is safe to continue exercising, or begin exercising if you are healthy and experiencing a normal pregnancy (1). There are certain conditions or complications that make exercise unsafe during pregnancy so we recommend always consulting your obstetrician prior to beginning an exercise routine. Once cleared by your doctor, establishing an exercise routine during pregnancy can be very beneficial to you and your baby.
In an article released by ACOG, Physical Activity and Exercise During Pregnancy and the Postpartum Period exercise during pregnancy has shown many benefits including;
In regards to exercise, ACOG makes the following recommendations:
Another great source of information, The 2019 Canadian guideline for physical activity throughout pregnancy recommends the following; (The following recommendations are intended for women without conditions or complications that would contraindicate exercise during their pregnancy. Please talk with your doctor to decide what is best for you and your pregnancy.) (2)
1. “All women without contraindication should be physically active throughout pregnancy.”
2. “Pregnant women should accumulate at least 150 minutes of moderate-intensity physical activity each week to achieve clinically meaningful health benefits and reductions in pregnancy complications.”
3. “Physical activity should be accumulated over a minimum of 3 days per week; however, being active everyday is encouraged.”
4. “Pregnant women should incorporate a variety of aerobic and resistance training activities to achieve greater benefits. Adding yoga and/or gentle stretching may also be beneficial.”
5. “Pelvic floor muscle training (PFMT) (eg, Kegel exercise) may be performed on a daily basis to reduce the risk of urinary incontinence. Instruction on the proper technique is recommended to obtain optimal benefits.”
6. “Pregnant women who experience light-headedness, nausea or feel unwell when they exercise flat on their back should modify their exercise position to avoid the supine position.”
Did you know that less than 15% of women meet the minimum recommendation of 150 minutes of moderate intensity physical activity during pregnancy? (3)
At Alliance Physical Therapy, we have a pelvic floor physical therapist and a Postpartum Corrective Exercise Specialist that want to help you navigate this exciting time in your life! We have the skillset to help manage:
Medical Imaging for this article’s purposes consists of MRI, xray, CT scan, etc (there are a plethora of other tests, but these are the most common for musculoskeletal conditions).
These are typically seen as the gold standard for diagnosing musculoskeletal injury and conditions. They’re very valuable because they provide a much deeper look at what's going on. They also provide significant insight that we couldn’t receive without surgically going in and looking.
For instance, If I fall and twist my knee, and am having instability, pain, swelling, etc. The MRI will do a fantastic job at ruling out an meniscus or ligament tear. This would help the provider and patient in decision making on surgical or non surgical outcomes. THIS IS A GREAT TOOL for many instances.
However, it’s not all peaches and cream with imaging.
Here’s where it gets tricky.
Some conditions are completely normal for most people and medical imaging doesn’t give us the whole story. This is a fact and we know this through the research. A study by Yamamoto (2011), proved that of the 283 subjects, 65.4% showed rotator cuff tears and had no symptoms involving the shoulder.
Another study by Nakashima (2015), analyzed 1,211 HEALTHY volunteers with NO PAIN ages 20-70 years for presence of disc bulging. “Most subjects presented with disc bulging (87.6%), which significantly increased with age in terms of frequency, severity, and number of levels. Even most subjects in their 20s had bulging discs, with 73.3% and 78.0% of males and females. (See the visual below for more examples in the study. Remember, these percentages were people WITHOUT pain/symptoms!
Another study done by Herzog (2017) took ONE single patient. The patient had 10 MRIs done in 3 weeks taken by 10 different radiologists. What they found might surprise you! 49 different issues were reported…. but ZERO findings were reported across all 10 reports! This goes to show the degree of high variability in the reported findings of the SAME patient within a short time period.
As you can see, it is extremely important to match up clinical findings with the imaging. This gets even more important with chronic conditions that just gradually came on over time. So if a 50 year old presents with generalized low back pain across both sides of the lower back and wants to get an MRI, a bulged disc is more likely than not going to be present on the MRI ! The conversation quickly can move to discuss surgical options (discectomy or even fusions) when in reality we don’t know for certain if the bulged disc is causing the pain. Especially because there were no signs of radiculopathy (pain down into the leg, numbness, tingling, etc)
This is why it’s critical to match clinical signs and symptoms with the MRI.
MRIs help exclude serious and sinister issues, but they don’t always tell us exactly what is causing pain. This has led much of the medical community to simply call these common conditions “wrinkles on the inside.” When you hear words like “degenerative disc disease, arthritis buildup, spondylosis, bone on bone” don’t panic. Some amount of this is completely normal with aging!
To recap: medical imaging as a GOOD THING. And it provides us with many answers we would otherwise wouldn’t have. However, we need to use caution especially with decision making on more chronic conditions and conditions that don’t match up clinically!