Prenatal yoga is great medicine for pregnant women and a fantastic vehicle that improves flexibility, strength, stamina and helps to promote relaxation. However not all pre-natal yoga poses are appropriate for all pregnant women and some may cause more harm than good. When I was pregnant I did a lot of yoga but it was not until I started working with a physical therapist (PT) and having my PT supervise and tailor my yoga program that I really started to get to get pain relief and the most of out of my prenatal yoga classes. Woman’s health physical therapists (PT) can help assess your body and help to create safe and effective exercise program that will keep your body pain free, strong, and ready for childbirth. Women’s Health physical therapists are in a unique position to also help you maintain the pelvic floor muscles strong and ready for childbirth. Women need to know that you don’t have to see a PT when you are in pain, but that women’s health PT can play an integral role in wellness care and help to tailor yoga and strengthening classes just for your needs.
Everyone knows that pregnancy changes a woman’s body. These pregnancy-related changes can lead to back pain, incontinence, pelvic pain, organ prolapse, postural issues and balance problems. The great news is that women’s health physical therapist can guide you through your pregnancy and create and or modify exercise programs to combat these changes. Seeking advice from a PT will help put you on the right track to a strong body and a fast recovery in the post-partum period.
Now lets look at the advice we give to many of the pregnant women who attend physical therapy at my healing center, Renew Physical Therapy. We provide many types of advice and guidance but monitoring exercise programs for safety is something that we often do. We don’t discourage pregnant women from exercising but instead we help them to navigate and choose the right type of exercises for their current needs. Pre-natal yoga is close to my heart and something we recommend pregnant women do, but we do make modifications if needed. The next ten highlighted items are some of the advice that we give so that pregnant women can enjoy their pre-natal yoga classes safely and without risk of injury.
Top 10 Things to Avoid in Your Prenatal Yoga Practice: Expert Advice from Your Physical Therapist
1. What To Avoid In Your Prenatal Practice: Avoid postures that require you to lie on your back after the first trimester. Lying on your back can compress blood vessels and reduce oxygen going to your tissues and the baby. This is called supine hypotension and symptoms can include dizziness, shortness of breath, nausea and blurred vision.
Modification: During you’re your prenatal poses prop your upper body on pillows so the heart is higher than the pelvis. If you experience any signs of supine hypotension in your yoga class immediately turn onto your left side and stay there until your symptoms go away and avoid this pose in the future. If you are still experiencing symptoms seek the help of your doctor/midwife.
How a PT Can Help: A PT can show you how to prevent supine hypotension by modifying your exercises. Physical therapists are experts in exercise modifications and can help you modify so you don’t have to stop exercising.
2. What To Avoid In Your Prenatal Practice: Standing prenatal yoga poses can be extremely challenging during pregnancy. During pregnancy your center of balance shifts and your balance is thrown off and putting you at a higher risk for falls and sprain ankles.
Modification: Support your self in your standing poses with walls, chairs or props. When you add this support your risk for falls dramatically decreases and you are safer in the pose and the likelihood of a fall decreases.
How a PT Can Help: A PT can give you balancing exercises to promote your safety and reduce risk of falls. A physical therapist can also help strengthen your ankle muscles to help you improve your balance. PT can also help give you foot exercises to combat the changes that the feet undergo during the 9 months of pregnancy.
3. What To Avoid In Your Prenatal Practice: Relaxin hormone is produced during pregnancy and helps to widen the pelvic-girdle bones and relax the ligaments in the pelvic girdle area to facilitate delivery. This hormone is in its highest amount during the first trimester and last trimester. We see many women coming in with serious injuries in the first and last trimester because pregnant women are unstable in their bones and ligaments during this time. It is important to keep in mind that during pregnancy you might be able to go deeper into a stretch than you normally could but that does not mean that you should.
Modification: Proceed with caution in your yoga poses. Do not overstretch just because you feel you can go deeper into the poses. In pregnancy one must listen very carefully to the body’s signals. Know your limits because overstretching ligaments and unstable bones can lead to serious injuries.
How a PT Can Help: A physical therapist can determine what is your normal range of motion and stretching ability and modify your exercises to fit your body. PT are also well equipped to assess your body and to help you create safe exercise programs that do not overstretch vulnerable ligaments and muscles. The exercise programs that PTs create are specific for you and not a cookie cutter approach, but one that is unique for your current needs.
4. What To Avoid In Your Prenatal Practice: Symphysis Pubic Dysfunction (SPD) is a extremely painful condition that produces pain in the pubic /groin area with walking, positional changes and standing. This condition occurs when there is excessive movement of the pubic symphysis causing a misalignment of the pelvic girdle. Prenatal poses that require you to stand on one leg or to bring the legs wide apart can lead to further instability of this area leading to more pain and dysfunction.
Modification: Avoid all poses that require you to stand on one leg like tree pose and avoid poses that require the legs to be very wide apart. Keep your legs hip width apart or closer during all yoga poses helps to avoid further injury to the pubic ligaments. Also listen closely to your pain signals because your body is talking to you. Never override a pain signal from your body if you suffer from SPD. Your body is talking to you. If you have pain in a certain pose or if the pose just doesn’t feel right this is a signal that you need to modify the pose or stop doing it all together.
How a PT Can Help: Your physical therapist can show you have to fix pelvic girdle misalignment by using gentle muscle energy techniques. PT can show you which pregnancy belts can work best for you so you are more stable and have less pubic bone pain. PT can also massage the massage and release tension in muscles such as he inner thighs. The inner thighs can produce a downward effect on your pubic bone causing them to shear and become mis-aligned.
5. What To Avoid In Your Prenatal Practice: Don’t get breathless, overheat or raise your heart rate too high during your prenatal yoga classes. Your heart is working overtime during pregnancy pumping an extra amount of blood and working within the correct exercise intensity will provide you with good cardio exercise without exhausting you. You should never exercise to exhaustion.
Modification: You should be able to talk during your prenatal classes. This is call the “Talk Test” and it’s a good barometer of exercise intensity. If you can carry a conversation while working out then you are most likely within a desirable exercise intensity and heart rate.
How a PT Can Help: Your PT will show you proper breathing techniques and correct the spine and ribs using muscle energy techniques or mobilizations so your breathing is more easily facilitated. A PT can also show you exercises to promote good rib cage mobility. Ribs flare out and get wide during pregnancy and many times this can contribute to rib pain and shortness of breath. PT can also align ribs that are out of place or painful. A PT can help you to restore proper rib and spine function and can help you determine what exercise heart rate target is best for you and your baby.
6. What To Avoid In Your Prenatal Practice: Breath is everything and during pregnancy you may experience shortness of breath very easily. You are also breathing for two and breathing correctly during your yoga practice is a must.
Modification: Avoid any yoga breath work (pranayama) that requires you to hold for breathe or that can causes your body to overheat such as breath of fire. Instead focus on breathing in and out slowly and deeply through the nose. Breathing techniques that help with making deep sounds help to prepare you for working through the pain of labor.
How a PT Can Help: A PT can show you how to breathe effectively and can also show you how to breathe correctly during exercise. A physical therapist can show you which labor positions are the best for your body type and orthopedic condition. A PT can also should you how to breath effectively.
7. What To Avoid In Your Prenatal Practice: Many pregnant women suffer from Diastasis Recti Separation of abdominal muscles. Forward bending has the potential to make the abdominal separation larger and making the pelvic girdle region unstable. This instability can lead to low back pain, incontinence and organ prolapse. Forward bends also compromised the low back area possibility contributing to more low back pain and they also put excessive pressure on the abdominal area.
Modification: Yoga poses that require you to twist or bend forward should be avoided during pregnancy because they can put excessive pressure on your abdomen, low back and pelvic girdle region. Avoid back bends because they overstretch the abdominal muscles during pregnancy.
How a PT Can Help: A physical therapist can show you safe and effective core workout and show you how to correct your abdominal separation. A Physical Therapist can also educate you on activities that could be contributing to your abdominal separation, There are things you can learn to prevent your separation from getting more separated.
8. What To Avoid In Your Prenatal Practice: Avoid dehydration during your yoga class. Dehydration can lead to premature contractions and muscle spams
Modification: Drink plenty of water and bring a water bottle to your yoga class. Your water bottle is your best friend. Monitor the amount of sweat your body is releasing. Don’t over do it and make sure to continue to drink. Sweating causes you to loose water quickly. Avoid yoga studios that are hot.
How a PT Can Help: A PT can track your water intake and make recommendations. A PT can also help regular your bladder habits and help you with urge or stress incontinence or pelvic pressure. A women’s health physical therapist can access your pelvic floor muscles and put you on a pelvic rehabilitation program that will help prevent leaking and organ prolapse.
9. What To Avoid In Your Prenatal Practice: Stick with yoga classes that are tailored for pregnant women. Many times we treat women who are injured because they go to regular yoga classes. We have been working for years with Deb Flashenberg in New York at the fabulous Prenatal Yoga Center.
Modification: Avoid doing any power yoga, hot yoga or any advance yoga classes. These classes may cause you to overstretch your muscles, elevate your heart rate too high, or cause you to become exhausted. Stick with Prenatal yoga classes. Jump backs during sun salutations are to be avoided because you risk injury to the baby.
How a PT Can Help: Seek the advise of your physical therapist. Your physical therapist can guide you through all the prenatal exercise programs and help you choose one an exercise program right for you. A physical therapist can also modify your yoga program so you don’t get injured but instead get all the benefits of attending a yoga class. PT can experts in wellness care not just experts in pain. You can work with a physical therapist to set you up with appropriate and safe and targeted exercises. I call this Prenatal Intelligent Exercise Programing (PIEP).
10. What To Avoid In Your Prenatal Practice: Prenatal yoga poses that involve inversions encourage circulation away from the uterus and the baby. Inverted poses can also lead to low blood pressure can cause dizziness.
Modification: Avoid all inverted poses except for down dog. Down dog can be performed for short periods of time and this pose is great because it stretches the legs, calves and low back away. Down dog also unweighs the low back and pelvic region and is great for pregnant women who are suffering from pelvic pressure or organ prolapse.
How a PT Can Help: A PT can help design an exciting exercise program for you that can help reduce incontinence, back pain and increase stability and balance. Many times working the core muscles and the pelvic floor muscles simultaneously brings tremendous pain relief for pregnant women suffering from pelvic girdle pain. Seek the help of a Pelvic Floor PT.
In Conclusion: Please come in today and see one of our highly trained prenatal physical therapist. We will help you to navigate your exercise program and help you to stay pain free and strong throughout your nine months of pregnancy, and get you ready for labor and delivery. For a quick reference guide please refer to my book Ending Pain In Pregnancy. We can be reached at 212-213-4660 or go to visit our website www.RenewPT.com for more information.
