guide to fitness - during and after pregnancy in the cf

7/22/2019 Guide to Fitness - During and After Pregnancy in the Cf

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Acknowledgements

ParticipACTION has developed the Guide to FitnessDuring and After Pregnancy in the Canadian Forces. Inpreparing this resource ParticipACTION worked with adistinguished team of experienced exercise scientists,sport medicine specialists, and fitness professionals.

Canadian Forces

Dr. Wayne Lee, CD, Ph.D., PFLCDirector Human Performance and Health PromotionCanadian Forces Personnel Support Agency

Major Darrell Menard, BPE, MA, MD, Dip Sport MedStrengthening the ForcesInjury Prevention Program

Margo Burns, Ed.D. (PH), MPH, M.Sc. (A),RRCP, RRT(A),Strengthening the ForcesInjury Prevention Program

Debra Reid, Ph.D., R.D.Strengthening the ForcesNutritional Wellness Program

Jacqueline Laframboise, B.Sc., M.Sc., PFLCStrengthening the ForcesHealth Promotion Manager,Ottawa

Major KJ Breeck, MD, MHSc, ABPM(AM), CDCAS D Air PM&S 4-2

Ben Ouellette, B.Phys.Ed., PFLC, CSCSResearch & Development CoordinatorCanadian Forces Personnel Support Agency

Principal Authors

Dr. Lynneth Wolski, Ph.D., University of Victoria

Dr. Howie Wenger, Ph.D., University of Victoria

Technical Contributor

Susie Langley, M.S., R.D., Nutrition Consultant,

Toronto, Ontario

Writer

Gord Stewart, M.Sc., Victoria, British Columbia

G U I D E T O F I T N E S S D U R I N G A N D A F T E R P R E G N A N C Y I N T H E C F

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Illustrator

Kelly Dukeshire, Saanich, British Columbia

Design/Layout

Indigo Sky Graphic Design, Victoria, British Columbia

ParticipACTION

Art Salmon, Ed.D., Project Manager


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Congratulations on your pregnancy. Women play a very

important role in the day-to-day operations of the Canadian

Forces and great efforts have been made to help our female

personnel strike a happy balance between their professional

and family lives. As part of this ongoing effort, under the

umbrella of our Health Promotion Program Strengthening

the Forces, we have developed this guide to help you

maintain optimum health and fitnessfor you and your

babythroughout your pregnancy. Designed in an easy-to-

follow format, it includes advice and guidance from world

leaders in pregnancy and exercise.

Enjoying an active lifestyle plays an important part in

developing and maintaining the operational readiness of all

Canadian Forces personnel. You will also discover as you

read and use this guide that exercise plays a crucial role in

a healthy pregnancy. Both you and your developing baby

will benefit greatly by following the advice in this excellent

guide. I wish you the best for a healthy and fit pregnancy.

VAdm GE JarvisADM (HR-Mil)


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viii

Third Trimester

The Effect of Body Changes on Exercise 42The Effect of Exercise on Your Pregnancy42Safety & Comfort42

Nutrition & Hydration Reminders 43Exercise Guidelines 43Training Prescription44

Post-Partum

The Effect of Body Changes on Exercise 46The Effect of Exercise on Your Recovery from Labour and Delivery46Safety & Comfort47

Nutrition & Hydration Reminders 47Exercise Guidelines 48Training Prescription49Getting Back into Your Regular Program 56

Additional Resources

Personal Training Record


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4

Healthy Eating

Pregnancy is a time to take care of yourself by eatingenough to fuel your needs and to build a healthy baby.Your energy needs are even higher if you are exercisingor breastfeeding. Expect to gain about 11 to 16 kg(2535 lbs) during your pregnancy.

Let the rainbow be your guide. Include a variety offoods from Canadas Food Guide to Healthy Eating, bothwithin and among the four food groups to assure thatyou and your baby get all the essential nutrients. Get acopy of Canadas Food Guidefrom your PSP healthpromotion or fitness staff and use it to understand

serving sizes and the number of servings you require.Eat meals and snacks at regular intervals to main-

tain a constant energy source for your developing babyand for your own working muscles during exercise. Trynot to skip meals or go too long without eating. Includeat least three food groups to balance your breakfast andall four food groups at lunch and dinner. Here are somesample nutritious meals:

BreakfastHigh fibre cereal, milk and fruit/juice.

LunchCanned salmon sandwich, garden salad withvinaigrette, 1% milk and an apple.

DinnerChicken, beef or veggieburger with rice,baked potato, pasta or whole grain roll, plus steamedor raw veggies, fresh fruit and vanilla yogurt.

Use high carbohydrate snacks to fill the gap,

especially before and after exercise. Good choicesinclude a banana and yogurt, a crunchy granola bar,chocolate milk, 100% fruit juice, wheat crackers withpeanut butter, and trail mix.

Here are some tips to get the most out of theCanadas Food Guide to Healthy Eatingsfour foodgroups.

Grain ProductsGo for the grains7 to12 Food Guide-size servings perday (or more if you are very active!). Grains are MotherNatures prime fuels for energy, plus B vitamins, ironand fibre. For long-lasting carbohydrates, trust fibre-richwhole grain breads and cereals.


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Limit your caffeine. Limit coffee, tea and colas to

(a total of) 02 cups per day. Consuming too much

caffeine can lead to dehydration which will decrease

physical performance and can also reduce breast milk

production.

Avoid alcohol. Drinking beer, wine and spirits

throughout your pregnancy can be harmful to your

developing baby. Alcohol should also be avoided

when breastfeeding as it can be passed along to the

baby in breast milk.

Get enough salt. It is not necessary to restrict

salt/sodium intake during pregnancy. If you sweat a

lot during exercise, you may need to replace sodium

by sensible use of table salt, condiments (mustard,

pickles, ketchup, soy sauce, salsa), tomato or

vegetable juice cocktail and soups.

Be careful with herbal teas. Herbal teas generally

considered safe by Health Canada when used in

moderation (23 cups/day) are: citrus peel, ginger,

lemon balm, linden flower, orange peel and rose hip.

Chamomile teas are likely not appropriate for use

during pregnancy. They have been reported to have

adverse effects on the uterus. Discuss the safe use of

herbal teas with your health care provider.

Choose the right energy bar. If you enjoy energy

bars when you are active, be sure to pick one with

more carbohydrates than protein to help you get

ready foror recover froma workout. Energy bars

should not be considered as a meal replacement.

Play it safe.Avoid raw meats, seafood, eggs and

unpasteurized soft cheeses, hot dog wieners and pts

to minimize the risk of contracting food-borne

illnesses. Always follow safe food handling practices

to reduce the risk of food poisoning. Fresh water fish,

swordfish and fresh tuna can be a source of contami-

nants such as mercury. Contact your local public

health office for any restrictions in your area.

Many popularherbal supplementssuch as gingsengand echinecea havenot been provensafe to use duringpregnancy and

when breastfeeding.You should nottake any herbalmedicines unlessdirected to do soby your physician.


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Stopping Smoking

Smoking and second hand smoke exposure duringpregnancy places the health of you andyour baby atrisk. Problems that can occur as a result of smoking andsecond hand smoke exposure during pregnancy includestillbirth, spontaneous abortion, lower birth weight,premature birth, placental abruption, reduced fetalgrowth, sudden infant death syndrome(SIDS), cleftpalate, cleft lip and some childhood cancers.

If you are a smoker, quitting smoking prior tobecoming pregnant or very early in your pregnancy isideal. But health benefits can be gained by abstaining

from smoking at anytime during your pregnancy. If youwish to stop smoking, please see your physician todiscuss treatment options. Your base/wing healthpromotion director can discuss any concerns you haveand provide information on smoking cessationprograms that are available.

Exercising SafelyThe average weight gain during a healthy pregnancy is11 to 16 kg, with the greatest increases in the secondand third trimesters. Body fat increases as well, particu-larly in the first two trimesters. These changes will affectyour exercise abilities and your level of energy. Weightgain will also alter your centre of gravity and couldaffect your balance and coordination.

Here are some important general guidelines tofollow as you train:

Seek medical care early in your pregnancy. First, toensure that you and your baby are doing well. Second,to organize the specialized and personal care you willrequire during your pregnancy. Finally, to ensure thatyou and your baby are protected from unnecessaryoccupational hazards by the assignment of a temporary

medical category and employment limitations. Yourtemporary category and employment limitations willbe removed once you have fully recovered from yourdelivery. You should obtain clearance to continueparticipating in an exercise program from the physicianthat will be following you throughout your pregnancy.

Pregnancy is animportant time toconsider all your

lifestyle habits.Along with regularphysical activity,other importantpillars of a healthypregnancy includehealthy eating,effective stressmanagement,adequate rest,abstaining fromalcohol, and notsmoking.


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14

TrainingRoutines

DuringPregnancy

Your training sessions will include aerobic activity,strengthening exercises and easy stretching movementsfor warm-up and cool-down. Follow the guidelinesprovided for safe and effective training. The Training

Prescription chart for each trimester will refer you to thestrength training circuits detailed in this section. Usethe Personal Training Recordat the back of the Guideto keep track of your workouts.

Warm-up, Cool-downand Stretching

A good warm-up is an important component of yourtraining routine. At the beginning of each session doapproximately five to ten minutes of light aerobicactivitybrisk walking, easy marching, or jogging.Follow this with a 5 minute period where you performthe stretching sequence shown here to help prepare youfor the workout. Take your time with these exercises. Tocool down at the end of the session, run through the

stretching sequence again. For each exercise, stretch slowlyto the end of your

range of motion and hold for 2030 seconds.

Most of these exercises involve stretching one side ofthe body at a time. Pause briefly after the stretch,then repeat on the other side.

Stretch until you feel a gentle tightness and hold atthat point. Dont bounce in an attempt to be able tostretch further. If you feel pain, you are stretching toofar.

Breathe naturally and try to relax all your muscles asyou do each stretch. Dont hold your breath.

Exercise number 8 may become more difficult asyour pregnancy progresses.


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Stretching Sequence

Neck and Upper-Back Stretch

While standing, grasp hands together andreach the arms out in front at chest height.

Shoulder/Chest Stretch

Stand facing the wall,placing your palm

and forearm againstit, then turn yourbody away from thewall until you feel agentle stretch in yourchest and shoulder.Maintain a smallbend in your elbow.

Thigh Stretch

Holding onto the back of a chair for balance,bend one leg up behind you and grasp theankle. Slowly move the leg back until you feela gentle stretch. To increase the stretch youcan push your hips gently forward.

HamstringStretch

Using a chair forbalance, place oneleg in front with theheel on the floor.

Keep your legstraight and bendforward from thewaist until you feel agentle stretch in the back of your leg andbuttocks. Remember not to bounce duringthis exercise.

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Seated Rowingfor mid/upperback/Posterior shoulders

Sitting on the ground with your legs extended,back straight or slightly leaning back, hook the

tubing under the soles of your feet. Reachforward and grasp the tubing such that youhave some resistance when you start rowing.With your elbows bent, pull backwards untilyour hands are at your side. At the end of thismovement your shoulder blades should besqueezed together and your chest pushedforward. Slowly return to the start position.

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Note: you should beable to get the rubbertubing needed for theseexercises from your PSPfitness staff. If you areuncertain about thewritten instructions askthe PSP fitness for ademonstration andexplanation.


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Shoulder Pressfor Shoulders

Seated, push the handles up from shoulderheight until the arms are fully extended over-head and then under control return to the

start position.

Tricep Extensionsfor Triceps

Hands close together and elbows bent 90,push hands down until the arms are straight

and then under control return to the startposition.

Bicep Curlsfor Biceps

Arms down in front and fully extended,grasping the bar with the thumbs facing out.

Curl the bar, pulling the hands up under thechin and then under control return to thestart position.

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talkpace for comfort and safety. Just talkorJTmeans you are able to talk comfortably (withoutlaboured breathing) while exercising.

If you have been exercising for longer than

45 minutes per session, reduce your timeto 45 minutes.

If you have been exercising for less than 45 minutes,stay at the same duration you have been doing.

If you were inactive before becoming pregnant,gradually increase your aerobic activity to 2030minutes per session.

Drink plenty of fluids, before, during and after exercise!

If anything starts to hurt or you feel faint or dizzy,STOP. You should see your doctor before exercisingagain.

During strength training

Use proper breathing. Exhale on the effort of eachrepetition and dont hold your breath.

Do not go to failure on any of your weight sets.

Take sufficient rest periods between exercises and sets.

Sip on fluids throughout each training session!

Myth:

Taking baths will causegerms to get in thevagina and infect yourbaby.

The Truth:

Baths are great forpregnant women foreasing aches andpainsand for relax-ation. The temperatureis what can be theproblem. Avoid hottubs or baths with

temperatures above38 C (100 F).


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42

The Effect of Body Changeson Exercise

Physical changes in the third trimester include:

increased uterus size

continued weight gain of 36 kg

return of fatigue

increased need to urinate

increased looseness in your joints

heartburn and indigestion

muscle cramps swelling in the hands, feet and ankles

disrupted sleep.

The Effects of Exerciseon Your Pregnancy

Exercise in the third trimester helps you prepare for

the birth of your baby. Maintaining a regular exercise

routine at this stage can help offset many of the

discomforts of late pregnancy.

The exercise you have done throughout your

pregnancy offers benefits duringlabour and delivery.It can lead to:

increased pain tolerance

shorter labour with less intervention

decreased incidence of vaginal tearing

decreased chance of needing a c-section

decreased chance of needing a forceps delivery

Safety & ComfortReview the Exercising Safelytips on page 8 and the

First Trimester Safety & Comfortinformation on page

33 and use this as a guide for activity during this

trimester as well.

ThirdTrimester


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Your centre of gravity changes with advancing preg-nancy. This may cause you to lose your balance moreeasily. Be careful even when walking and exercising!

Your joints are also becoming looser at this stage in

preparation for delivery. This can also affect yourstability. Be sure to decrease your exercise intensityat this time.

It is important to listen to your body, particularlynear the end of pregnancy. Even if you are feeling reallyenergetic it is important not to overdue it. Follow yourprogram and allow your body to store energy for labourand delivery.

Nutrition & HydrationReminders You need to maintain your energy. Follow the

Healthy Eatingtips and advice on pages 47 andCanadas Food Guidefor best results!

It is important to gain a healthy amount of weightduring pregnancy. Pregnancy is not a time fordieting. Eat well and stay activebut while you areeating for two, you dont need to eat like two!

Exercise Guidelines Move to activities with less risk of falling. Activities

such as stationary cycling, stairmaster, brisk walking,swimming, elliptical/cross trainer machine or aquafit-ness exercises may be more comfortable and saferthan running or cycling as pregnancy progresses.

Reduce your exercise duration to a maximum of30 minutes if you have been exercising for longer.

Move from circuit training using stack weights/

machines to body-resistant exercises only. Stretching should be gentle! Do not stretch to the

point of pain.

Be sure to stop if you experience pain or fatigue. Yourgoal is to go into labour and delivery feeling wellrested and physically ready!


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Getting Back intoYour Regular Program

Depending on individual circumstances, and discussion

with your physician, you might be able to return toyour regular training program as early as 18 weeks. Seeyour PSP fitness staff for help transitioning back intoyour regular training. Remember that you will probablyhave to start back in at a lower level than where youwere prior to your pregnancy.

In the coming weeks and months you will stillhave many challengesbalancing your responsibilities

at work and your activities as a new mom. Look afteryourself. Pace your efforts and dont let yourself getoverly tired. Tend to your babys needs and enjoy yourtime together.


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The following are some additional resource materials onthe topic of exercising and nutrition during and afterpregnancy:

Mothers in Motionis a Website produced by the

Canadian Association for the Advancement ofWomen in Sport.www.caaws.ca/mothersinmotion

Canadian Academy of Sports Medicinehas a position paper on Exercise and pregnancy

www.casm-acms.org

American College of Sport Medicine

has a comment on Exercise and Pregnancy.http://www.acsm.org/health%2Bfitness/pdf/currentcomments/Pregnant.pdf

Your Pregnancy: Expect the Benefits of ExerciseHealth Trackis a series of articles fromThe Physician and Sportsmedicine.http://www.physsportsmed.com/issues/1996/07_96/pregnant.htm

Active Living During Pregnancya booklet produced by the Canadian Society forExercise Physiology (ISBN 1-896900-06-2)

www.csep.ca 1-877-651-3755

Gregory A.L. Davies, Larry A. Wolfe, Michelle F.Mottola, and Catherine MacKinnonJoint SOGC/CSEP Clinical Practice Guideline:

Exercise in pregnancy and the postpartum period.Can. J. Appl. Physiol. 28(3): 329-341. 2003

Health CanadaNutrition For a Healthy Pregnancy:National Guidelines For the Childbearing Years.Ottawa: Minister of Public Works and GovernmentServices Canada; 1999www.hc-sc.gc.ca/hpfb-dgpsa/onpp-bppn/national_guidelines_cp_e.html

Best Start and Nutrition Resource CentreHealthy Eating For a Healthy Baby. Toronto:Best Start; 2002www.beststart.org

AdditionalResources


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YourComments

We appreciate your input. Please send any comments orsuggestions to:

Major Darrell Menard, MDDCOS Force Health Protection

Canadian Forces Medical Group Headquarters1745 Alta Vista DriveOttawa, Ontario K1A 0K6

[email protected]


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