stretching

Mamas on Bedrest: How Do I Regain My Strength After Bedrest?

October 9th, 2013

Former Mama on Bedrest Zoya sent me this question:

“I was on strict bed rest for 5 and a half months of my pregnancy, though i successfully gave birth to my DD, who is a healthy and naughty one year old now, i do not seem to have gained back even half my muscle strength. I have been a regular gym and outdoors person all my life but since late walking up a flight of stairs seems to be a task. This frustrates me into trying more and more of cardio and pushing myself to do more but i just feel set back further into pain and weakness. Ive been to doctors who who suggest recovery takes time.. but now i feel old and sad all the time..n im barely 26 !”

It’s not uncommon for mamas to have a hard time regaining their pre-pregnancy level of fitness after prolonged bed rest. But its important not to overlook a potential physiologic reason for the problem. In this week’s Video Wednesday Vlog, I answer Zoya’s question and make a few suggestions that all Mamas on Bedrest and former Mamas on Bedrest should take to heart.

Mamas on Bedrest: Regaining Muscle Strength After Bedrest

July 1st, 2013

A mama asked this question and I figured, rather than respond to her privately, I’d reply for the benefit of everyone.

Q: My daughter is 20 months old and I was on strict bed rest from 20 weeks until 36 weeks. My question is, “How long does it take before your muscles get back to “normal”? My leg muscles are still horribly weak. I work out, hike, ride horses and walk a lot. Will my muscles ever return to normal? Has anyone else experienced this?”

sidelayingBed rest has been long been known to cause bone loss, muscle weakness and loss and weight loss. The first studies done by NASA to determine the effects of weightlessness on metabolism established that in as little as 60 days, women on severely restricted activity can lose up to half their strength. What’s more, not even dietary changes can help. The NASA study showed that women placed on high protein diet lost even more muscle mass than women who made no dietary changes.

Exercise was the only intervention that NASA found to reverse the negative physical effects of activity restriction. In their study,

The exercise regimen included a 40 to 50 minute aerobic workout two or three times a week and 20-minute strength tprraining sessions two or three days a week. While lying on their backs, the women did multiple sets of thigh and calf exercises using a flywheel device similar to a typical leg press machine at a gym. They also worked out on a vertical treadmill.

While many may balk at the thought of the vigorous exercise prescription recommended by NASA being used for women on bed rest, there really isn’t any reason that women on bed rest can’t participate in modified exercise programs.

So let’s get back to our mama’s question. She is 20 months post partum and still feeling significant muscle weakness. When I reviewed the literature, there is consensus that bed rest does in fact significantly reduce muscle mass and strength, and according to Judith Maloni, PhD, in her publication Antepartum Bed Rest For Pregnancy Complications: Efficacy and Safety for Preventing Preterm Birth “the physical changes that occur during bed rest are not resolved by 6 weeks post partum.” Unfortunately, I was unable to find any publications that looked at the effects of bed rest on maternal physical health specifically, and no publications that were able to give a time frame within which a mama can expect to regain her pre-bedrest strength and endurance.

078One thing that I have seen coincidentally is that many women come off of bed rest, either just before or at delivery, and want to resume their pre-pregnancy activity levels immediately post partum and feel that something is wrong with them when they are unable to “jump right back” into their pre-pregnancy activities. I always recommend that “former” Mamas on Bedrest ease back into activity. Mamas who were on strict bed rest during their pregnancies for two weeks or more are significantly de-conditioned (the longer the bed rest stint, the more de-conditioned mamas body becomes), and the approach needed to regaining strength and endurance is not unlike that needed to retrain individuals to walk again after a significant injury (i.e. a car accident). People who suffered significant injuries resulting in weeks to months in a coma or in bed take months to years to regain their functionality. While the bed rest prescription does not create the same type of insult to the body physically as a traumatic injury, the effects on the physical function of the muscles and bones is very similar. So much like an injured person must go through weeks to months of physical therapy, Mamas on Bedrest should take a similarly slow, gradual, step by step incremental approach to regaining their pre-pregnancy physical strength and endurance. They may choose to work out with a personal trainer, a physical therapist or in a class specifically designed for post partum mamas, with emphasis on mamas who have been on prescribed bed rest.

So how can Mamas on Bedrest avoid or at least reduce the deconditioning they may experience as a result of bed rest? They must exercise while on bed rest! While the NASA study had the astronauts using flywheel cycles and weight, mamas on bed rest can perform modified stretches and strength training right from their bed. We put together a full set of exercises and stretches in our Bedrest Success Kit, yours free when you subscribe to our monthly e-newsletter (The upper right hand corner of this page!!), as well as several samples of exercises on the Mamas on Bedrest Youtube Channel.

So good luck Mamas! Let me know how this post helped you in the comments section below. I am eager to hear your success stories and other questions! You can also send e-mail to info@mamasonbedrest.com if you prefer a private correspondence.

Mamas on Bedrest: When Your Legs Won’t Rest

June 17th, 2013

Restless Leg Syndrome, involuntary twitching and tingling in the legs, can be a problem during pregnancy and a particular problem for Mamas on Bedrest. The increased weight as a result of pregnancy and the increased stress on the circulatory system are the major reasons that the symptoms occur. Restless Leg Syndrome is primarily relieved by changing positions and/or getting up and moving around-both options that are limited or non-existent for Mamas on Bedrest. Conditions such as pregnancy induced hypertension and pre-eclampsia often require that Mamas on Bedrest lay on their left sides to increase blood flow back to the heart from the lower extremities, relieving stress on the circulatory system. With this requirement, leg discomfort may be exacerbated with few options for relief. Restless Leg Syndrome can progress and become quite uncomfortable, limiting Mamas’ ability to rest. So how can Mamas on Bedrest manage this non-life-threatening but very annoying problem?

Massage. As previously stated in other posts, prenatal massage is an excellent way for mamas to relax tired, aching muscles during pregnancy. Because of the additional weight, mamas’ bodies shift to accommodate the weight and as a result, the musculoskeletal system shifts out of alignment creating stress on muscles, ligaments and tendons. Prenatal massage therapists are able to rub and soothe these tired, achy tissues and relieve tension, fatigue and pain.

Relaxation. Meditation, hypnosis and deep breathing can also help relieve the symptoms of restless leg syndrome. Calming the nervous system, relaxing the mind and relieving worry, stress and anxiety often relieve the tingling and twitching associated with restless leg syndrome.

Support your legs. Adequate support and positioning will go far to relieve leg pain and restless leg syndrome.  A Must have for Mamas on Bedrest is a Body Pillow, and positioning that pillow to properly support and align Mama’s body is essential. View our video on pillow positioning for a better bed rest.

Stretch. As previously stated, movement is essential to helping relieve symptoms of restless leg syndrome, yet movement for Mamas on Bedrest is limited. There are several simple stretches that mamas can do while on bed rest and we provide them on our free video channel for easy access.

Water. One reason that leg cramps and other symptoms of restless leg syndrome occur is due to dehydration. Adequate water intake is a must for all pregnant women, but especially for pregnant women with restless leg syndrome. Adequate hydration ensures that circulation flows that muscles and soft tissues are well lubricated and that muscle wastes are properly flushed away. But staying hydrated can present an additional problem for Mamas on Bedrest in that the increased fluid intake will result in increased urination. Many mamas try to limit fluid intake which only increases leg cramps, symptoms of restless leg syndrome and can increase the risk of developing a urinary tract infection. Its a delicate balance, but mamas, be sure to drink plenty of water while on bed rest.

Vitamins and Minerals. Most pregnant women are prescribed prenatal vitamins, but many of these vitamins only provide the minimum amounts of vital nutrients necessary to sustain pregnancy and mama and baby may need more. There have recently been several studies and articles published documenting the functional amounts of vitamins and nutrients that are needed to ensure that mama is getting all that she needs to remain healthy, for healthy development of the fetus and to sustain the pregnancy. Mamas with restless leg syndrome may be low on potassium or calcium. While it is not advised that mamas take mega doses of vitamins, ensuring that there is adequate, functional levels of vitamins and minerals will help prevent some of the twitching and discomfort of restless leg syndrome. In addition to prenatal vitamins, mamas may want to add or increase bananas-a good source of potassium-and calcium fortified orange juice and green leafy vegetable (also good sources of calcium) to their diets.

Restless Leg Syndrome can be an annoyance, but it needn’t incapacitate Mamas on Bedrest. Implementing the few tips above can go along way to relief and a bed rest free from leg cramps, twitching and tingling. 

 

Mamas on Bedrest & Beyond would like to thank Tammy Mahan, a contributing writer to Healthline.com, for sharing the perils and pearls of Restless Leg Syndrome with us.