Four Key Post-Pregnancy Fitness Tips: Part 1

While pregnancy is a wonderful time for an expecting family, it can also be very challenging physically for the mom-to-be. The growing baby (with his/her weight), hormonal swings, impaired thermoregulatory ability (sweating) and altered metabolism can all work together to make climbing a flight of stairs difficult, let alone working out five days a week.

By the end of nine months, you will have a happy baby, but potentially a deconditioned body as well.  While the best defense for physical recovery after pregnancy is a good offense (staying reasonably active as long as possible during pregnancy), sometimes that doesn’t always happen.  So, now what?  Over the next two posts, I’ll be discussing four post-pregnancy fitness tips to get mom back on her feet and moving, before her baby does.

*Note: Today’s post will discuss getting your body up and moving again, gradually and safely.  The next post will discuss posture, movement patterns and nutrition.

1. Get your core and hips realigned and firing again

The baby bump does more than get a lot of well wishes from friends.  It has also probably tightened or weakened a number of your hip, core and lower back muscles.  This situation may also be exacerbated if you had a c-section or have diastasis recti (splitting of the abdominal wall due to the pressure of the baby pushing against your belly).  Often a result is what we call “lower crossed syndrome” where you’re standing more in a “swayback” position:

Lower Cross Syndrome

Lower Cross Syndrome
Courtesy of Zach Dechant Sports Performance Training

 

Getting your core and hips back in the game (and for some, the upper back muscles) is a crucial first step to exercising well again.  All of the forward weight will have likely made your chest, hip flexors and lower back tight while weakening your upper back muscles, trunk stabilizers (abs) and hip stabilizers (abudctors).  Here are a few stretches and exercises you can do to get everything in line again:

Hip Flexor Stretch

Chest Pinky Ball

Hip Pinky Ball

Cat/Cow (don’t force either movement, stay long through your spine, lightly engage your abs, return to neutral after doing a few repetitions):

http://www.ehow.com/video_4440759_cat-cow-prenatal-yoga-position.html

Bridges

Hip Hikes (you can put a small, soft ball between your hip and the wall to create pressure rather than your knee, focus on driving down through the heel of the standing leg – less is more with this exercise, don’t drive up through the raised leg or hip)

Mini Band Side Steps

*Interesting side note: If you have diastasis recti, you want to make sure you avoid spine-flexing movements that cause you to push your abdominals out like crunches and sit ups.  You need to focus on keeping your belly button drawn in and firm when moving and focus on trunk stability exercises (using your abs to stay steady, rather than actively moving your spine) like planks, side planks, cable extensions/Palloff presess and dead bugs.

2. Focus on consistency before intensity

Don’t try to hit the gym, or the ground running just as hard as you did before you got pregnant – unless you’re Paula Radcliffe.  Your body can start to decondition within a few weeks of stopping exercise, so if you’ve been doing little, to no exercise in the previous few months, you’ve got some catching up to do.  Your body has also gone through a number of changes (potential diastasis recti, c-section, altered hip/core firing patterns from the baby bulge) that could leave you at increased risk for injury if you go straight back into intense exercise.  Finally, if you’re not sleeping well (which is to be expected with newborns), your body isn’t setup to adequately recover from highly intense workouts.

If you want to get moving again, first get clearance from your doctor.  C-sections typically require a little more recovery time.  Once cleared, focus on moving a little bit each day, especially since you probably won’t be able to stay away from your newborn for more than a little while at a time.  Getting your core and hips firing again is a great place to start (see tip #1 above).

As far as intensity, consider starting at around 30-50% of your pre-pregnancy loads, but by all means feel free to do less if something feels out of sorts.  Bodyweight and resistance band exercises – squats, modified or wall/ledge pushups, resistance band rows/pulldowns, step ups, core exercises – in addition to walking/light jogging are a convenient way to get some exercise in at home while still being near your baby.  If you notice that you have rounded/hunched shoulders and forward head posture, consider doing more pulling/rowing exercises than pushing.  If you have access to a gym and dumbbells/cable machines, that’s fine too.  Again, start lighter than normal – you have plenty of time to build back up.

*Interesting side note: Research has shown that bouts of high intensity exercise (intervals, HIIT/Crossfit style classes) can potentially increase amounts of lactic acid in breast milk, which may not be appealing to breastfeeding babies.  If you do choose to perform HIIT while breastfeeding, you may want to feed your child prior to exercise, and/or wait a couple hours after HIIT exercise to let the lactic acid clear from your body.

That’s it for Part 1 – check out the next two tips in early September.  Let me know in the comments below if either of these tips were useful for you!

Modifying the Seven Minute Workout

The Clock is Ticking...Choose Your Interval Exercises Wisely.

The Clock is Ticking…Choose Your Interval Exercises Wisely.
Photo Courtesy of Microsoft Images

High intensity interval training, often abbreviated as HIT or HIIT, has become quite the rage in a world where time is precious and the last thing most people want to do these days is “slave away” on a treadmill or elliptical for an hour.  I wrote a blog post about three tips to maximize your interval sessions here.  While the easiest and most common way to perform an interval is through traditional cardiovascular exercises (jog/run, elliptical, stair climber, rowing, etc.), there are other ways.

Brett Klika and Chris Jordan recently published a paper in a sports and exercise journal describing the effects, benefits and precautions of a specific type of interval training: high-intensity circuit training (HICT).  The appeal of HICT is that it can be done anytime, anywhere with one main piece of equipment: you.  It focuses on rotating through a series of 9 to 12 bodyweight exercises that challenge different areas of the body (upper body, lower body, core, etc.) in rapid succession.  The authors recommend performing 30 seconds of an exercise – for a target of 15 to 20 repetitions – and then moving onto the next one within 30 seconds (they prefer less).

Their example workout was well-described in a Fitness info-graphic in the NY Times.  If you perform all 12 exercises for 30 seconds and only take 5 seconds off between, then you have a seven minute workout.  Interestingly, my colleague at Hospital for Special Surgery measured how many calories someone burns doing this workout using a Parvo metabolic cart (it’s expensive, and accurate) – 52 calories.  That translates to nearly 450 calories an hour – pretty good.

And now some insights from the research article and my own thoughts:

Insights from the Research Article

  • Exercise selection should be focused on a balanced (i.e. pushing, pulling, squatting, core) rotation through all large, major muscle groups that can be modified for safety and appropriateness based on the location and client’s ability level.
  • Form and technique are paramount before moving with increased intensity.  Don’t perform intervals with exercises that you can’t do properly and perfectly for 15 repetitions – because you’ll probably be doing them tired now (imagine your last exercise in the circuit).
  • Caution for: Overweight/obese (stress on joints), detrained, previously injured, elderly, or for individuals with comorbidities. For example, individuals with hypertension should avoid isometric exercises (wall sit, plank, and side plank) that can lead to holding your breath, often referred to as the Valsalva maneuver.  Unfortunately, doesn’t a lot of the fat loss population land in one of these categories?
  • Specificity of Training: Although HICT can be an efficient means by which to improve health and decrease body fat, it may be inferior to creating absolute strength and power, specific endurance, and other specific performance variables.  What’s your goal?
  • Building in Recovery: The authors recommend minimizing total rest, stating that recovery can be improved by placing an “easier” exercise after a harder one.  Their example is a plank after jump squats.
  • Repeats: The authors mention you can perform the circuit multiple times for a longer workout.  If you perform the 7 minute version, and you take 2 minutes off after each full circuit to recover, you can do 3 circuits in 25 minutes or so.

Jason’s Thoughts

Usefulness

  • These workouts alone will not help you run a marathon, lift really heavy things or be the best at a sport.  However, they provide a great calorie burn and good general conditioning in a short period of time – which is what most of the population needs.
  • It also allows people to get away from the traditional 45 minute slog on a treadmill, elliptical or other piece of cardio equipment.  If you enjoy your workout more, you’re more likely to do it!  You can do this on the road, at home, anywhere.  You can also add a few pieces of equipment in (kettlebells, battle ropes, jump ropes, resistance bands, mini bands, stability ball, etc.) and have endless variations.
  • These workouts are NOT one-size-fits-all.  You need to make sure you are giving the right exercises (see first insight at the beginning), at the right intensity (too little = no effect, too much = injury) to the right person (age, weight, current activity level, ability to move properly, etc.) at the right time (injury history?  Training goal?).  This is why a good trainer with knowledge of movement and exercise science can go a long way in getting you results and keeping you safe.

Rest Time

5 and even 15 seconds between exercises is a really, really short time, so be careful if you’re just getting off the couch.  The traditional recommendation is for beginners to start with a rest period equal to twice the interval length, if that interval is an all-out effort.  Some of these exercises may not be an all-out effort, but if this is all new to you, give yourself at least that 30 second rest time between exercises, particularly the ones that leave you breathless afterward.  You can always make it harder in the future – as long as you’re not injured from working unrealistically hard in the recent past.

Exercise Selection (from the Seven Minute Workout exercise examples, see the NY Times link):

2. Wall sit – can add an upper body movement like wall slides (raising arms up and down while keeping the shoulders down in its sockets to mobilize the shoulders) or external rotations (starting with elbows at a 90 degree angle against the wall, arm and palms down, then slowly rotate your arms and palms up without moving your upper arm).  Here’s an example, no need to use the bar:

4. Abdominal crunches – Most people are seated in trunk flexion all day at a desk, so there’s little need to train trunk flexion further.  It’s very easy to go too far on a crunch and create discomfort on the neck, shoulders or lower back.  I’d rather see someone do heel taps, leg cycling (move one leg at a time), dead bugs or partial trunk curl ups learned correctly. Here’s an example:

5. Step Up onto Chair – Chairs are high.  If stepping up that far creates sloppy form (either on the way up, OR down), then start lower – like on a stair.

6. Be sure to squat right.  Part 1.  Part 2. (links to previous post).

7. Dips – Most people go too low and place excessive anterior (forward) stress on the shoulders, which can lead to shoulder injury.  Don’t go too deep by controlling your descent.  Or to get a similar effect, consider close grip pushups with your body raised up to reduce that anterior strain (start against a stable window sill or countertop)

3. & 11. Pushups & Pushups w/ Rotation – Learning to stabilize rotation is good, but first be sure you can do a proper pushup.  To make this more manageable, you may need to elevate your upper body, or preform modified pushups from your knees.  I wrote a blog post about performing a proper pushup here.  Once your pushups are solid, then focus on adding movements like rotation.  A great beginner anti-rotation movement, which you could do in place of the pushups with rotation is shoulder taps:

13. The missing exercise: pulling.  It’s really hard to do a “pull” exercise like rows, lat pulldown or pullups without equipment, but to stay totally balanced, there should be a pull in this list.  A small investment in a light, portable $5 to $10 resistance band can do the trick.  I’d say put it in place of one of the sets of pushups or the dips.

Tell Me: What has your experience been like with interval workouts?  How would you modify the seven minute workout to meet your needs?

Why I Love…and Hate Yoga, Part 2

Keeping Yoga Safe

Image: sakhorn38 / FreeDigitalPhotos.net

Over the past couple weeks I’ve received a few responses and inquiries as to what aspects of yoga I dislike – it seems that more people have gotten hurt performing yoga than I thought. I hope this post sheds some light on the dangers of improperly performed yoga so you can take steps to minimize your injury risk while still enjoying a practice that you love. Take a breath…this is a long post.

What Looks Right is not Always Right

When properly performed, yoga can be great for promoting body awareness. But the problem is, whom or what are we listening to when in class? All too often we look at the people to the right, to the left and in front of us (the instructor) as our sole sources of guidance rather than listening to our own body. Many times instructors give great cues such as “feel a lengthening, stretching sensation through the chest/spine”, but instead we look at what they are doing (curving up into a full upward dog) rather than what they are saying. So we contort ourselves to look like them, all the while forgetting what we are supposed to be feeling. And as a result we often crunch our lower backs in a vain attempt to lengthen through the chest or spine. The key to doing things right is making sure you feel them in the places you are supposed to feel them!

The two most common issues of improper movement are lack of mobility and lack of stability.

Lacking Mobility – Many of us are tight from sitting and typing at a computer all day and then come to a yoga class to “stretch out”. Then we see that really flexible, hypermobile (to be discussed) person next to you doing all sorts of unstable crazy movements and think, “I should do that too!” See where I’m headed with this?

The issue for tight individuals (including myself) is that we do not necessarily have the mobility yet to get ourselves into these poses and positions. In other words, our muscles and connective tissue are pretty tight so making ourselves look “flexible” requires an extraordinary amount of effort…usually from muscles and joints that were not designed to move us in that particular way. And when the wrong muscles and joints do the work, you can bet that discomfort and pain will follow in due time.

Well respected yoga instructor Leslie Kaminoff depicts the situation well when discussing the spine: “Spinal extension is not necessarily the same thing as bending backward and spinal flexion is not necessarily the same thing as bending forward.” In other words, our chronic postures and positions can make it harder for us to move properly in space using the right muscles and joints, so we must make sure we only move until we get the sensation we are supposed to feel in a particular pose rather than pushing ourselves to look like the person next to us.

A great example is one of the most basic poses: Volcano Pose (standing back bend). Many people will start here and bend backward to “open up” the front of their body. The problem is most people are very tight in their chest and hips due to sitting all day, so they end up going way too far back and rather than feeling the stretch in their chest, abdomen and hips, they get a big ‘ol crunch in their lower back. This situation happens in many other poses as well such as cobra and upward dog.

Another example is that many people will use their lower back muscles when bridging rather than engaging their glutes and abdominals. Most of us put enough strain on our lower back throughout the day that we don’t need to add more during yoga practice.

Lacking Stability – Why is it that so many of the people that take yoga are really flexible? Or at least seem that way. Probably because we like to do what we are good at. But what if all of that “flexibility” comes at a price: our ligaments and tendons. Those who have hypermobility (aka double jointed-ness) at particular joints can probably move and contort their bodies into all sorts of positions that can make a veteran yogi jealous. But should they be in those positions?

The answer lies with one word: stability. Stabilizing means being able to move and hold a yoga pose due to engaging your muscles to create support, rather than just hanging in our tendons or ligaments. Hypermobility means that the ligaments and tendons are more pliable, so they can be forced further, even if they don’t really want to be there. So if you are constantly using your mobility (flexibility) to get into positions that you can’t stabilize, odds are it’s only a matter of time before you start feeling discomfort or pain in those joints.

Or consider if you are hypermobile in one joint (i.e. the shoulder) but tight in another (the upper back/thoracic spine). Odds are you are going to make up for tightness in one area by moving excessively through the other. See the discussion on lacking mobility above.

So what to do? Focus on feeling what muscles should be engaged to move and stabilize you as you move into and hold a pose. For example, when doing any sort of arm bind, make sure the shoulders are firmly down in their sockets by engaging the muscles underneath the armpits. If engaging those muscles means you can no longer perform the bind, then you may not have the stability yet to go there safely. For trunk movements (i.e. cobra, up-dog, etc.) make sure the abdominals stay engaged and for lower body movements, the glutes are usually a good idea.

So forget what looks right…do what FEELS right.

A great tip: Ask yourself three questions in any pose:

  • 1. Do I feel the movement/relaxation where I am supposed to feel it?
  • 2. Do I feel discomfort anywhere else?
  • 3. Can I breathe normally?

The answers should be Yes, No, Yes. If you don’t answer the questions this way, adjust yourself until you do. Usually it means easing up on the intensity of the pose so you stop forcing the wrong muscle to work.

Yoga is not a “Workout”

I’m not a big fan of the recent wave of using yoga as an intense, sweat-inducing workout. Yoga was designed thousands of years ago to allow practitioners to get better in touch with their emotions (meditation) and controlling movement in their body…not how many calories they burned in a session. If you want to raise your heart rate and rock your body, do some cardio intervals or lift some weights.

I consider the new fad of “Power” yoga to be a bit of an oxymoron. Don’t get me wrong, advanced yogis are amazingly powerful and balanced…you need it when suspending your entire body on your forearms! But they didn’t get there by doing sun salutation or another Vinyasa flow as fast and intensely as possible. If they did, they probably would have injured their lower backs long before mastering their practice.

Another style of yoga that I must discuss in this section is Bikram (aka hot yoga). In my opinion, Bikram yoga is not ideal for the vast majority of the American population. The purported benefits of Bikram yoga exist, but the complications of straining our muscles or bodies in a 110 degree room for 60 to 90 minutes creates more risk than reward.

Bikram yoga practitioners often cite three aspects of why they feel that heat helps them practice better (though I am sure I’m missing a few):

  • 1. The warmth will help the muscles warm up quicker and move better
  • 2. Sweat helps remove toxins from the body
  • 3. The heat helps them “deepen” their practice

Here’s my response:

  • 1. A well-structured gradual yoga progression can be just as effective at warming up the body. And once the muscles are “warm”, they do not need to be warmer. Our internal body temperature is a balmy 98.6 degrees and muscles don’t get much hotter when exercising.
  • 2. Sweat is not the only way to remove toxins from the body. The whole point of blood flow is to transport nutrients and remove waste. And how do we promote blood flow to an area? We move it. You don’t need to be in a sauna to move your muscles.
  • 3. Sweating profusely can lead to an increased risk of dehydration. And a few times I’ve heard that Bikram instructors do not want people to drink water because it lets them practice better or get a better connection with the sutras. That’s positively insane. I do not find being dehydrated to the point of passing out or deliriousness to be a way to deepen your practice…it’s a way to lose focus and increase risk of injury.

Take yoga to build body awareness, mobility, stability and balance. Don’t take it to get your “sweat on”.

Over-Zealous, Under-Educated Instructors

There are many fantastic yoga instructors out there and this section is not designed for you. But unless you intricately understand how the human body works (muscles, joints, connective tissue, organs, etc.) and how each of your poses impacts people with different medical and orthopedic conditions and restrictions along with ways to regress and correct them, then you may want to consider getting your “learning on”. Face it, we are living in a society where being injured or having a constant ache/pain is the NORM, not the exception. We need to step up our game as practitioners to meet the increased needs of our clientele.

If I could provide three pieces of advice to yoga teachers that will serve you well no matter how much you know:

  • 1. First do no harm: If someone tells you a pose hurts, back them out of it until it no longer hurts or learn modifications and regressions to get them a similar effect without pain.
  • 2. Never place force onto a person’s body: I have heard too many stories of yoga teachers that SEVERELY injured students because they pushed down on them when they were in a pose. Never, ever, ever place force on someone’s body. You can touch them, but the touch should be designed to bring awareness to a part of the body, not added strain. A great example, if someone is sagging in plank pose, place your hand in the small of their lower back and ask them to engage their abdominals to push their back into your hand. You gave them something to focus on, but you did not put pressure ON them.
  • 3. Don’t stop learning: The most frustrating thing I hear when someone asks a yoga teacher why they chose a particular pose or why a particular pose hurts, they say, “I don’t know…it’s just what I learned from my teacher.” I’m sorry, I think that’s a bullcrap response. When someone asks you a question and you don’t know the answer say, “That’s a great question, and I’ll find out for you.” Get the answer, learn it, and store it away in the memory bank. I’m sure someone else will have the same issue down the road. The more you know, the better you will be.

This is why I have greatly enjoyed teaching aspiring yoga practitioners. I want them to be able to answer the question, “Why?” Both for their students and for themselves.

Why I Love…and Hate Yoga, Part 1

Keeping Yoga Safe

Image: sakhorn38 / FreeDigitalPhotos.net

Inspired by the NY Times article, “How Yoga Can Wreck Your Body”, I took a moment and began to reflect on my experiences with yoga: as a class attendee, an exercise physiologist working with clients and as an anatomy and physiology instructor, training groups of soon-to-be yoga teachers in Jersey City.

My gut instinct is one of thankfulness that I have learned enough about the human body to have a basic understanding about what it can…and cannot do. I translate that knowledge into my own practice. However not everyone has this built in awareness and unfortunately most yoga instructors, even seasoned veterans, may lack the background in anatomy and physiology to understand the subtle compensations that people can make during yoga practice that can lead to joint and muscle problems down the road.

I will be breaking down this topic into two posts. The goal of this first discussion is to provide insights into why yoga can be beneficial for many people when performed correctly. In Part 2 I’ll be discussing some of the common reasons why people end up getting injured performing a practice that is designed to make us move better, not worse!

Yoga Can Develop Range of Motion and Flexibility

When performed properly, yoga is one of the best ways to develop range of motion and flexibility primarily due to the fact that most poses are designed to take you to the limits of your range of motion. Our body learns and improves by a principle called “progressive overload,” which states that the body improves by small, incremental challenges. So in the case of yoga, we challenge our body to engage certain muscles and move into poses which then take us to the end range of motion in other muscles. Holding those poses teaches the body that those muscles must gain range of motion for subsequent classes/practice. Performing progressive overload consistently is what leads to results.

Note that range of motion is not just stretching; you also develop range of motion through engaging muscles. Most muscles in the body come paired with another muscle, usually on the exact opposite side of the body. The key to good movement is the balance that exists between the strength and flexibility of each muscle pair. However, excessive sitting, staring at computer screens all day and poor exercise form can create chronic compensations that lead to imbalances and potentially injury.

Yoga can help us reclaim this balance by re-educating our tight muscles to become flexible while strengthening our weakened muscles. The key of course, is knowing which muscles tend to be tight and which tend to be weak. A perfect example is a common yoga pose and exercise: the bridge. Sitting all day can make our hip flexors tight and our glutes (a.k.a. our butt) weak. A bridge allows for the opposite movements: the glutes engage and the hip flexors must stretch.

Yoga Can Build Body Awareness and Balance

When performed at a steady, controlled pace yoga allows the student/attendee to become aware of their muscles, their movements and their breathing. Coming into a pose and holding it for a number of seconds (but not minutes), can allow someone to take stock of what muscles are engaged and how they are breathing. Good yoga instructors should be giving cues on proper alignment, what muscles should be active and ideally, which muscles should not be active. Listen to them and then listen to your body. Do you feel what they are describing? Or are you feeling uncomfortable somewhere that “doesn’t feel right”? If it doesn’t feel right, don’t do it. You may not have the flexibility to get into the pose (or the depth that you’ve moved) or you may not have the strength to stabilize the body in the pose.

The best way to know if you are actually stable in a pose is to check your face, neck and breathing. Your breathing should not be forced or strained nor should you be holding your breath. Your neck and face muscles should be toned, but relaxed…not on overdrive. If anything, make sure your chin is slightly tucked down and back. If you can’t relax your neck, face or breath, then you need to probably ease out of the pose a bit, modify the pose or skip it for now.

I’m on-board with sensible levels of barefoot balance training for most people that do not have significant foot issues. Many have flat feet due to functional (a.k.a. movement compensation) rather than structural (a.k.a. genetic bone deformities or long term dysfunction) problems. Most of this comes from wearing shoes all day which deprive our feet from its natural interaction with the ground. Since yoga is typically performed barefoot, it provides a low-impact, safer introduction to teaching the foot to stabilize the body compared to other popular, high-impact barefoot training modalities like running or jumping. Remember it’s progressive, not extreme, overload.

Yoga has Benefits beyond Flexibility: Stress Management

Physical activity has been shown to have stress-reducing effects. While most yoga classes are not the same as sessions of cardio intervals or strength training, there is significant engagement of muscles over an extended period of time, usually about an hour. In addition, there are periods of higher intensity during the session, such as a sustained pose that can increase muscular engagement and cardiovascular demand. So for many, yoga may fall under the category of “moderate” activity, which can reduce stress levels.

Beyond movement, spending an hour focusing on breathing, movement and posture can take our mind off of the 10,000 stressors and worries that we are dealing with for the other 23 hours of the day. From a purely substitution perspective, giving your stress-system an hour “off” can slowly help turn the tide from being constantly stressed to being…well, moderately stressed. And any reduction in stress levels is good, because stress can impact everything from our social interactions (how well do you get along with others when you’re stressed?) to our eating habits (ever hear of stress eating?).

If this article has sold you on yoga, then great! But be careful, start slowly, be mindful, don’t push it too hard too fast, and if it hurts, stop. Remember progressive overload. If you are interested but want to wait until my next article which discusses why I hate yoga, then you’re probably not alone.

Don’t you just hate cliffhangers? 🙂

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