42 min

Physical Activity and Pregnancy MSK Matters

    • Medicine

This episode is for all women of childbearing years and all of the healthcare practitioners who provide care to these patients!

The new CSEP Physical Activity throughout Pregnancy Guidelines provide evidence around the benefits and safety of being active throughout pregnancy, for both mother and baby. Physical activity is now seen as a critical part of a healthy pregnancy. Following the guidelines can reduce the risk of pregnancy-related illnesses such as depression by at least 25%, and the risk of developing gestational diabetes, high blood pressure and preeclampsia by 40%. Providers should be educated on the absolute and relative contraindications for exercising during pregnancy to help guide patients safely.

Pregnant women should accumulate at least 150 minutes of moderate-intensity physical activity each week over a minimum of three days per week; however, being active in a variety of ways every day is encouraged. CSEP has created a Get Active Questionnaire for Pregnancy that providers can use to assist with safe exercise prescription.

Pregnant patients should be treated for musculoskeletal pains the same way all other patients are treated. This includes assessing, working up and investigating patients appropriately. Treatments should include active rehabilitation with the mainstay of most MSK pains being treated with exercise. Women should be offered medications, as needed, always trying to use the lowest effective dose possible. First line treatment includes acetaminophen (4g/d max) and second line includes the use of opioids. MSK low back pain is very common! 20-30% will have pain that impacts quality of life and function. Pain education and a multi modal plan should be incorporated just as one would for the general population.

Women often need to be “cleared” to return to exercise, and the 6 week mark is a classic timeline, but this is arbitrary. Waiting for clearance does not mean no movement for 6 weeks. Women should be reassured that early gentle activity is reasonable. This can include activities such as restorative yoga and walking.

Share this episode widely with anyone who treats women of childbearing age.  It is our role to encourage women to be active, and as healthcare professionals, we need to work on minimizing barriers to exercise. This includes having conversations and discussions with patients that movement is necessary before, during and after pregnancy!

Additional Resources: 
1. https://www.researchgate.net/publication/335928424_Returning_to_running_postnatal_-_guidelines_for_medical_health_and_fitness_professionals_managing_this_population 
2. https://www.pregnancyinfo.ca/
3. https://www.rosttherapy.com/rost-moves-mamas/
4. https://csepguidelines.ca/pregnancy/ 
5. https://bjsm.bmj.com/content/54/18/1114

This episode is for all women of childbearing years and all of the healthcare practitioners who provide care to these patients!

The new CSEP Physical Activity throughout Pregnancy Guidelines provide evidence around the benefits and safety of being active throughout pregnancy, for both mother and baby. Physical activity is now seen as a critical part of a healthy pregnancy. Following the guidelines can reduce the risk of pregnancy-related illnesses such as depression by at least 25%, and the risk of developing gestational diabetes, high blood pressure and preeclampsia by 40%. Providers should be educated on the absolute and relative contraindications for exercising during pregnancy to help guide patients safely.

Pregnant women should accumulate at least 150 minutes of moderate-intensity physical activity each week over a minimum of three days per week; however, being active in a variety of ways every day is encouraged. CSEP has created a Get Active Questionnaire for Pregnancy that providers can use to assist with safe exercise prescription.

Pregnant patients should be treated for musculoskeletal pains the same way all other patients are treated. This includes assessing, working up and investigating patients appropriately. Treatments should include active rehabilitation with the mainstay of most MSK pains being treated with exercise. Women should be offered medications, as needed, always trying to use the lowest effective dose possible. First line treatment includes acetaminophen (4g/d max) and second line includes the use of opioids. MSK low back pain is very common! 20-30% will have pain that impacts quality of life and function. Pain education and a multi modal plan should be incorporated just as one would for the general population.

Women often need to be “cleared” to return to exercise, and the 6 week mark is a classic timeline, but this is arbitrary. Waiting for clearance does not mean no movement for 6 weeks. Women should be reassured that early gentle activity is reasonable. This can include activities such as restorative yoga and walking.

Share this episode widely with anyone who treats women of childbearing age.  It is our role to encourage women to be active, and as healthcare professionals, we need to work on minimizing barriers to exercise. This includes having conversations and discussions with patients that movement is necessary before, during and after pregnancy!

Additional Resources: 
1. https://www.researchgate.net/publication/335928424_Returning_to_running_postnatal_-_guidelines_for_medical_health_and_fitness_professionals_managing_this_population 
2. https://www.pregnancyinfo.ca/
3. https://www.rosttherapy.com/rost-moves-mamas/
4. https://csepguidelines.ca/pregnancy/ 
5. https://bjsm.bmj.com/content/54/18/1114

42 min