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Issue Date: September 30, 2001
Women & Workouts
Our FitSmart columnist addresses exercise during pregnancy, relieving tendinitis and staving off osteoporosis.
Q: My wife and I just found out we're having a baby next spring. Our doctor says it's fine for my wife to continue her exercise routine, but should she take any precautions?
Seth and Serena Katt, Fort Smith, Ark.
For most women, exercise is fine during pregnancy. In fact, working out during pregnancy has been shown to contribute to fewer varicose veins, better posture, less fatigue, fewer bouts with back pain, and less water retention and constipation. It also can reduce stress and improve mental well-being. And research suggests that fit women tend to have more stamina and a shorter, less-complicated labor.
But before embarking on a fitness regimen, all pregnant women should get a doctor's approval, as certain conditions (including pregnancy-induced hypertension, preterm labor, preterm rupture of membranes, incompetent cervix, persistent bleeding or multiple pregnancies) may indicate that a woman should not exercise or should modify her routine.
Here are some other basic guidelines for you to follow during this time:
Although you may continue one you've already started (with modifications), do not start a vigorous exercise program during pregnancy.
Reduce the intensity, duration and frequency of your exercise program with each trimester. For example, if you were walking three 15-minute miles each time, you should reduce your mileage and your pace sometime during the first trimester to 2 miles at a 16- or 17-minute pace. Reduce that again during the second trimester to 1.5 miles and adopt an even slower pace. During the last trimester, your regimen should be reduced again accordingly.
Your center of gravity is different now, so walk and exercise on flat, level surfaces and avoid downhill inclines.
Make sure you don't feel pain or become out of breath, dizzy or nauseated during your exercise sessions. Report any abnormal symptoms to your doctor.
If the aerobic exercise program you follow gets too uncomfortable, switch to another form of exercise.
Extend your warm-up and cool-down phases.
Monitor your body temperature; it should not exceed 101 degrees Fahrenheit during or after exercise (consider taking your temperature after your workout to be sure it is OK). Drink plenty of water before, during and after your workouts.
Eat a small snack before exercise to avoid becoming hypoglycemic.
Avoid overstretching. Your ligaments can become softer during pregnancy, so don't go beyond the normal range of motion or jar your joints with high-impact moves.
Q: I'm a 40-year-old woman, and I typically strength-train and do a cardiovascular workout twice a week.
Is there an exercise to strengthen my wrists? I get recurring tendinitis in both wrists, and I think my weightlifting regimen makes it worse. My wrists feel better when I stop using machines and free weights that involve my wrists.
This type of tendinitis is noticed most often after activities involving repeated lifting (such as picking up kids) or a side-to-side motion of your wrist (such as working on a computer). The problem is due to irritation of two tendons where they run through a very tight channel from the forearm to the thumb. Many people have two small separate channels for the tendons and are particularly predisposed to this problem.
Try to avoid any unnecessary wrist positions that are painful. Ice your wrist for five to 15 minutes at a time on the area that is most swollen and tender. See if your doctor might prescribe a splint or brace that will support both your wrist and thumb. A good book to check out on this is "The Jock Doc's Body Repair Kit" by Andrew Feldman (Griffin Trade Paperbacks, $16.95).
I consulted with Dr. Feldman, chief of Sports Medicine and clinical instructor at St. Vincent's Hospital in New York, who offered these tips:
Mild symptoms improve with a limited period of anti-inflammatory medication and by avoiding painful activities, especially if the problem developed during unaccustomed activities. It is less likely to resolve itself if it is related to light, repetitive work activities.
A cortisone shot into the sore area gives permanent relief to two out of three people with this problem, and it helps most others for up to two months.
Surgery helps more than four out of five people, but the others will have a new problem after surgery, such as numbness on the back of the hand or tenderness of the scar.
Q: Can you suggest any good weight-bearing exercises for someone with osteoporosis?
The good news is that although exercise has long been known to help younger women stave off the effects of this bone-thinning disease, a new study shows that intense physical activity can help older women achieve similar benefits.
The two types of exercise that are most important for building and maintaining bone mass and density are weight-bearing and resistance exercises.
Weight-bearing exercises are those in which your bones and muscles work against gravity. The best exercises to increase bone mass are the ones that produce a high force on the bone, such as dancing, hiking, soccer, racket sports and weightlifting.
If you are at risk for osteoporosis, try lower-impact exercises, such as walking, treadmill walking, stair-step machines, rowing machines, cross-country ski machines, water aerobics and low-impact aerobics.
For resistance training, incorporate weight-bearing activities that include balance challenges, such as squats, walking lunges or standing weighted leg lifts for your lower body, and push-ups, tricep dips or pull-ups for your upper body.
Weight intensity and repetition ranges are heavily debated because overuse or overtraining can have diminishing returns in your battle against bone loss. It really depends on your current fitness level, recent exercise history and nutritional intake.
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