Exercising During Pregnancy

If you are pregnant and wondering if continuing to exercise is safe, you are not alone. If you Google “exercising while pregnant”, you are likely to get a multitude of hits with recommendations from various blogs, forums, and healthcare provider sites ranging from “Don’t do it” to “Of course you can still do pull-ups!” The Internet can be an excellent resource as you progress through your pregnancy, but it is important to be able to discern between anecdotal evidence, outright mistruths, and professional, evidence-based recommendations.

As you are likely receiving a list of “Do Nots” while you are progressing through pregnancy, maintaining a regular exercise program is very much on the “Do it!” list*. According to the American College of Obstetricians and Gynecologists, “Physical activity in pregnancy has minimal risks and has been shown to benefit most women, although some modification to exercise routines may be necessary because of normal anatomic and physiologic changes and fetal requirements” (ACOG, 2015)1. The benefits of physical activity during pregnancy are vast. While pregnant, some of the benefits of physical activity can include reducing maternal weight gain, reducing the risk of gestational diabetes, reducing gestational hypertension, reducing the risk for postpartum depression, and potentially reducing the need for Cesarean section and instrumental deliveries2,3. Need we say more?

Given all the benefits, it is important to know how to safely modify your exercise routine as you progress through your pregnancy. Whether you are a CrossFitter, Yogi, runner or do a little bit of everything, exercise modifications will be necessary to ensure safety for you and your growing baby. If you aren’t sure what exercises need modifications, or how to make those modifications, that’s where the Doctors of Physical Therapy at CSPT can help. Schedule an appointment today to learn how you can stay active and decrease pain throughout both your pregnancy and postpartum periods! 

*With all evidence provided in this article supporting exercise during pregnancy, it is important to note that there are certain circumstances that exercise may be contraindicated due to safety concerns for mother and growing baby. Contact your obstetric provider to clarify your risk should you have any concerns. 

References: 

1. American College of Obstetricians and Gynecologists, Committee Opinion, 2015. https://www.acog.org/-/media/Committee-Opinions/Committee-on-Obstetric-Practice/co650.pdf?dmc=1&ts=20190725T1812495503

2. Mottola MF, Davenport MH, Ruchat S-M, et all. Br J Sports Med 2018;52:1339-1346.

3. Ruben Barakat, Mireia Pelaez, Carmina Lopez, Rocío Montejo & Javier Coteron (2012) Exercise during pregnancy reduces the rate of cesarean and instrumental deliveries: results of a randomized controlled trial, The Journal of Maternal-Fetal & Neonatal Medicine, 25:11, 2372-2376, DOI: 10.3109/14767058.2012.696165

Ramping up to running season safely!

We know it’s still July, but fall races are already on the minds of many athletes, coaches, and parents. As such, we wanted to remind you that one of the best ways to prevent injuries during the fall is to be mindful of safely and effectively increasing the volume, frequency, and intensity of training after being off for the summer! 

As a clinic, we see a lot of injuries that are caused by a sharp increase in running frequency or the distance of runs (or both!) as athletes are preparing for their upcoming races. While every athlete’s tolerance is different, many athletes ramping up their training often experience injuries like plantar fasciitis, hip and knee pain, and overuse injuries such as shin splints or metatarsal irritation. 

With that in mind, you may be asking: what can you do to ward off some of these injuries and promote a successful return to running? The following are some general tips for ramping up your running in a safe manner:

1. Know that “one size fits all” does NOT apply when it comes to training programs! Each person is different and your body will respond differently than others to an increased workload. As the demands on your body are increased, your muscles, tendons, bones, and ligaments all have to adjust and adapt to the increased workload. When the load on these tissues exceeds their ability to adapt, this can increase the likelihood that you will suffer an injury.  It is important that, when running, you increase mileage and training frequency gradually to allow your body the time it needs to adapt. Structuring your training in this way can help reduce the risk of reinjury and prevent recurring injuries.

2. Cross-training! Runners love to run; however, cross-training in different forms of aerobic activities like cycling, swimming, elliptical, and rowing are all fantastic ways you can work on your aerobic capacity while decreasing stress on our body’s tissues as they adapt to increased workload on your run days. 

3. Strength training! There is a multitude of research available that points to increased resiliency of tissues when regularly exposed to strength training. One study, published by the British Journal of Sports Medicine in 2014, found that the incorporation of regular strength training for study participants reduced sports injuries to a frequency of less than one-third and decreased incidence of recurring overuse injuries to less than half.* 

4. Clean up your running mechanics! With the repetitive nature of running, small tweaks in your running form can potentially make a tremendous difference! How can you figure out if your running mechanics could use some work? Schedule an appointment with one of our Doctors of Physical Therapy for an evaluation where we will evaluate ways we can maximize your running abilities! 

References: *Lauersen JB, Bertelsen DM, Andersen LB

The effectiveness of exercise interventions to prevent sports injuries: a systematic review and meta-analysis of randomised controlled trials

British Journal of Sports Medicine 2014;48:871-877.

What is in an Home Exercise Program?

While many patients would love to have a physical therapist that could be with them 24/7 like Russell Wilson, for most, it is not a realistic aspiration. How do we achieve success instead? By implementing a cohesive home exercise program (HEP) for each patient. That being said, not all HEPs are created equal and we would like to provide some tips on what to look for with your own programs including what to expect from those here at Colorado Sports Physical Therapy.

1.       Programs should be created to fit YOUR individual needs. Many injuries come from imbalances in strength and mobility so your plan should look to address those needs. For some of us, that means more strength exercises and for others, it may mean mobility, flexibility, and range of motion activities.

2.       HEPs should have variations in intensity and should grow with you through your treatments. I like to tell my patients that by the time they are done with me, they should have 20-30 exercises that they can choose from ranging from easy to very challenging and that fall into different categories such as pushes, pulls, lateral movements, or rotational movements, to name a few. That way, you AND your body do not get bored, and you can vary your workouts depending on how you are feeling.

3.       A good portion of your activities should be able to be performed in the comfort of your own home. Sure, getting on a lifting program can be helpful (and the PTs at CSPT can also help with this), but in order to increase your chances of sticking with the program, it’s best to have activities that require minimal equipment and space. This way, you have NO EXCUSES!

4.       Your program should be something that you feel comfortable with. This means you have spent ample time learning the techniques and how to modify them. Remember our blog about pain? Exercises should not be triggering your pain, so make sure that you know the proper modifications in order to continue your progress on a day-to-day basis.

5.       Lastly, remember that the definition of insanity is to do the same thing over and over and expect different results. That means, if things are not working, CHANGE IT! Your HEP is meant to supplement your physical therapy sessions to help you get better faster so if you don’t see a change or you feel worse, talk to your PT about it. Chances are they have a whole host of other exercises in their repertoire that may work better for you!

With all this being said, the MOST important thing about a good home exercise program is your willingness to perform. Keeping to your homework will only help you get better faster, which is everyone’s goal. Want to get your very own HEP in place today? Reach out and schedule your initial evaluation today with our experienced team!

It's Fantasy Football Time!

Yes, it is just about that time of year again and if you are like us, you are excited about the prospect of the return of FOOTBALL! With the return of the NFL, it brings the return of fantasy football. Every year, I have patients asking me about who to draft and stay away from when it comes to injuries, so I would like to share some tips.

1.       Not everyone is Adrian Peterson. In fact I am pretty sure he is an alien. The vast majority of human beings cannot fully recovery from ACL surgery in only 6 months. I remember telling a friend of mine that, in no way, should you draft him. No one could have predicted that he would return to such a level so quickly and not re-tear his ACL. Also, side note, if you are having ACL surgery, please do not ask your PT to recover as quick as AD. Most return to sport protocols are more like 9-12 months at a minimum. Just look at the case of Jake Butt, the Michigan-turned-Broncos tight end who is almost at 2 years post op, but looking great!

2.       Some injuries can truly tank fantasy points. I had a great conversation with Dr. Mark Drakos from Hospital for Special Surgery in New York, who was also a team doctor for the New York Giants, and he referred me to a very interesting 2010 study out of Duke University regarding NFL players and Achilles ruptures. Basically, it concluded that only two-thirds of players in the NFL with Achilles ruptures return to play and of those players who do, their performance was significantly affected not just in the first season back, but over the next three. How did they measure their performance? In games played and fantasy points of course! What about Michael Crabtree you ask? Well in the first years back after his 2013 injury, he was not effective at all. It took him another 3 years to be a top target for the Raiders.

3.       Concussions are not to be messed with. Are you looking at players that have a history of concussions? If you are, don’t be surprised if they end up on the sideline again this year in concussion protocols. Even with the new tackle rules, I think you are still going to see quite a few this year because tackle form can’t be corrected overnight.

4.       Beware of the MCL sprain. I like to refer to this one as the most painful minor injury you can have. Every time you see a player cut or pivot, you are seeing them put strain the Medial Collateral Ligament (MCL). While surgery is usually not needed in this recovery, it tends to be incredibly painful and lateral movements can take your breath away. If your job is to juke and cut in order to dodge tacklers, you can imagine how painful that could be. 

Obviously, every athlete recovers differently and when it is your full time job to rehab, recover, and prevent injuries, you will get better faster, but hopefully you can use one or two of these tips to avoid getting stuck on the waiver wire with no one to pick up when your star goes down. Happy drafting everyone!