The changes in a woman’s body that accompany pregnancy, coupled withthe strain of carrying a growing fetus, put stress on a woman’smusculoskeletal system. Back and wrist pain and leg cramps are among the most frequent complaints.

More than two of every three pregnant women complain of back pain atsome point. Low back pain rates increase with advancing maternal age;such pain is also higher in women who have already given birth and inthose who have had such back pain during previous pregnancies. As theuterus enlarges, it moves the body’s center of gravity forward, causingan increase in the normal curve of the spine. This puts stress on thejoints and ligaments of the lower back. In addition, hormones producedduring pregnancy cause the pelvic ligaments to loosen and the joints toopen. This, too, can cause pain. Back pain can be particularly severe if a woman gains more than the recommended amount of weight duringpregnancy.

To avoid pain, women should avoid standing, wear comfortable shoes,sit in chair that provide firm support, and sleep on a firm mattress.Changing position often can also help, as can scheduled periods of rest, with the feet elevated to flex the hips and decrease spinal curving.Sitting pelvic-tilt exercises and aquatic exercises have been shown todecrease pain.

Wrist pain may occur because of swelling, leading to CTS. Anothercondition that may involve this area is de Quervain’s tenosynovitis, aninflammation of the tendons of the back of the wrist. Leg cramps,particularly at night, are another common symptom during pregnancy. Such cramps may sometimes signal a calcium deficiency—possibility of whichyour doctor should be aware.

Exercise During Pregnancy
Provided thatappropriate precautions are taken, exercising during pregnancy has manyhealth benefits for women. Those who engaged in regular exercise beforebecoming pregnant should continue to do so. For women who have not yetadopted a regular exercise routine, this may be an excellent time tobegin. In addition to providing musculoskeletal benefits, regularexercise is beneficial for the cardiovascular system and helps preventexcessive weight gain. Both the mother and fetus benefit from exerciseduring pregnancy. Women who exercise regularly during pregnancy may have shorter labors and less need for surgical delivery. There is alsoevidence that beginning a moderate plan of weight-bearing exercise early in pregnancy can enhance fetal growth.

The American College of Obstetricians and Gynecologists (ACOG)recommends that all women of childbearing age exercise moderately for 30 minutes on most days. While recognizing the overall benefits of awell-planned exercise regime that is monitored by the physician, ACOGalso cautions that vigorous exercise should be avoided, or at leaststrongly curtailed, in certain women. For example, women at high riskfor preterm delivery or who have had second- or third-trimester bleeding should not engage in aerobic exercise, while women who are excessivelyobese, have poorly controlled hypertension, or are heavy smokers, amongother factors, should engage in vigorous exercise to only a limitedextent. Each pregnant woman’s overall health, as well as each potentialexercise activity, should be evaluated for its benefits and risks.

Guidelines for Exercise During Pregnancy

  • Do not exercise on your back after the first trimester of pregnancy, and avoid prolonged periods of motionless standing.
  • Stop if you become fatigued; do not exercise to exhaustion.
  • As your pregnancy progresses, modify your exercise activity; forexample, you may switch from weight-bearing exercise such as jogging tononweight-bearing exercise such as using a stationary bicycle orswimming.
  • Make sure you drink enough water and wear appropriate clothing sothat you don’t become too hot. Make sure that the room in which youexercise is an appropriate temperature and has adequate air circulation.
  • Be aware of nutritional requirements. Pregnancy alone requires anextra 300 calories a day; additional caloric intake depends on thelength and intensity of your exercise routine.

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