What are recommended and contraindicated stretches for pregnant women?
During pregnancy, women usually become more flexible due to a hormone called relaxin. Relaxin causes joint laxity in pregnant women, which can make it easy for them to overstretch. Unlike muscle, overstretched connective tissue does not spring back to its original length, leaving the body vulnerable to injury. Relaxin circulates in the body for up to a year after giving birth; therefore, avoid overstretching during this time. Now is not the time to break stretching records. Approach stretching as you would exercise. Comfort is the key; each woman is different. Be sure that your client gets a doctor’s approval prior to engaging in an exercise/stretching program.
Some basic guidelines include:
- Avoid ballistic movement, rapid changes in direction and exercises/stretches that require extremes of joint motions.
- Frequent change of positions may be required to avoid supine hypotensive syndrome, but be careful of sudden changes in posture to reduce possible orthostatic hypotension.
- Avoid lying on your back for long, especially after 20 weeks of pregnancy.
- Avoid prolonged periods of standing, especially in the third trimester.
- Avoid Valsalva manoeuvres and encourage proper breathing during exercise.
Postural changes also occur during pregnancy that will require correction. Due to the enlargement of the midsection, a forward shift in a woman’s center of gravity occurs. The result is a progressive increase in lumbar lordosis and a compensatory increase in thoracic kyphosis. Enlargement of the breasts add to the increase in kyphosis. Hence, the shoulders become rounded and the head shifts forward. This change in posture causes the woman’s posterior neck muscles to become tight. Also, having a forward head and rounded shoulders could cause weakness in the scapular adductors and upward rotators. Help your client by having her stretch and strengthen appropriate muscles.