PREGNANT AND SPINNING, SKIING OR TENNIS ANYONE?
or How to modify these "high risk" sports for pregnancy.
By Birgitta Lauren

Both the latest ACOG prenatal exercise guidelines and common sense will tell most pregnant women not to participate in sports that could cause trauma or a fall. According to the ACOG committee opinion January 2002; "Generally, participation in a wide range of recreational activities appears to be safe during pregnancy; however, each sport should be reviewed individually for its potential risk, and activities with a high risk of falling or those with a high risk of abdominal trauma should be avoided during pregnancy." Skiing, spinning and tennis would definitely fall (no pun intended) into that category for almost all women. However, as always there are exceptions to the rule; professional athletes and otherwise very well trained women may still be able to continue their favorite sport, at least for a while. Many athletic women either get frustrated if told they can't continue what they love doing, or are too scared to if they don't know how to proceed safely. Athletes that need to keep their "sport specific" muscles in shape to be able to resume postpartum, must learn how to modify their routine. None of these sports are for any beginner, novice or sporadic pregnant exerciser, but if you practice your sport religiously 3-6 times a week and are extremely fit, how do you continue to enjoy and reap the benefits from your sport without jeopardizing your pregnancy?

SPINNING: A present client of mine, Robyn of Malibu (due in October), a mother of 4 year old twins, and an avid 5 days a week spinner, was thrilled to pieces when I told her that "- of course you can continue spinning" . You should have seen her happy face! She had been afraid that she wouldn't be able (allowed) to do her favorite class. But after we determined that she did not experience any problems or had any risk concerns (at 8 weeks), she felt very comfortable on the bicycle, the exercise room was cool and well ventilated, she had plenty of water to drink, her instructor was well informed of her pregnancy, and that she would listen to her body through out her pregnancy and be open to any modifications (including quitting) I felt that it was fine and appropriate for Robyn to continue her spinning in addition to her workouts with me. Sometimes making someone change to a sport that they don't enjoy, may make them miserable and possibly quit all exercise. A much worse scenario. -" Spinning really helped me get through the first two trimesters. It got the blood flowing and I felt great the whole day. It made the first 6 months a lot easier." Says Robyn.
As Robyn's belly grew her spinning changed; with the feed back she gave me, we lowered her seat gradually and raised the handle bars until she was almost sitting up straight. She continued spinning until 25 weeks when it got too difficult. She does miss it, so to keep her "spinning muscles" in shape, her workouts now includes stationary recumbent bicycling and "cycling" movements in the deep end of the pool, lunges and circular movements with resistance.
Spinning is a great low impact cardiovascular exercise, that as long as you are accustomed to it, have no risk factors, adjust the knob to your level of difficulty, avoid getting out of breath, rest when you need to, hydrate, and the room is cool can be enjoyed for as long as you feel comfortable doing it.

SKIING: This is not a sport for beginners or vacation-skier. Even if you are an avid skier, you must put your ego and/or thrill seeking away. You must avoid steep and difficult slopes as the mildest fall could shake things up and jeopardize your pregnancy. Stay on the green, maybe the blue slopes and avoid busy times to prevent someone else from skiing into you and be very careful.
Altitude is another problem; do not ski at higher than 6000 feet according to ACOG. (Many California mountains are OK). Ski only if you are able to ski several times a week; do not go on sporadic ski vacations. Avoid altitudes above 8,500 feet altogether. There is 45% less oxygen in the air at 9,000 feet like in the Aspen village; oxygen is what makes your baby grow and develop. Women that live in high altitudes have a high incidence of premature delivery, low birth weight, birth defects and stillbirths. I know Christy Brinkley got married at 4 months pregnant, on top of a mountain in Vail, Colorado once - I wouldn't recommend it. Taking all of this into consideration, you may be able to continue skiing at modified intensities until your 12-16th week or so.
To keep you skiing muscles in shape, modifications and substitutes after can include; slide training, indoor ski machines, isometric squats, balance exercises, drills and plyometric ski moves in a pool.

TENNIS: Tennis and other racquet sports demand speed, agility, technique, balance, coordination and endurance. No talents of which most pregnant women possess. Though tennis can be strenuous, it's a lot of stop-n-start and not purely aerobic. Since there is always a risk that a ball may hit your belly, only very well-trained players should play, and in that case should play several times a week.
-" I played doubles tennis until the last week" says Marianne of Los Angeles, 35, mother of a 4-week old boy and two older children, -"and I resumed playing 2.5 weeks postpartum. I played three times a week and paid close attention to my body during the game, as I was very aware of my limitations. I didn't run down some balls. There were some moves I wasn't going to make. I was very careful and would never have played singles."
With her modifications, Marianne was able to play all the way through, but most tennis players' stop in the 5th or 6th month as balance and coordination declines. But for as long as you do play, or anyone dares play with you, slowing down to play "doubles" is a safer bet.

Avoid

• any competition - keep it light, there will be plenty of time to beat your opponent(s) after you have your baby…
  
• modify the "ready stance" to avoid crowding your belly,
  
• lunging or over stretching for balls (modify your serve),
  
• fast moves,
  
• playing on hot days or in a badly ventilated indoor court,
  

Do

• drink plenty of water,
  
• warm up & cool down properly to avoid injury & in addition; work-out to
  
• strengthen quads, hamstrings, calves, inner thighs to protect hips, knees and ankles,
  
• strengthen rotator cuff muscles to protect your shoulders,
  
• stretch after each tennis game and workout.
  
• to replenish, eat healthy and a sufficient amount of food, and take your prenatal vitamins with folic acid.

If and when you need to give it up, make sure to keep your "tennis muscles" in shape. Try playing toy-racquet games in the pool and simulate "tennis moves" both in the pool and the gym; do supported squats and lunges, grab a small dumbbell and simulate your serve, forehand and backhand.
These recommendations go for all other racquet sports as well.

Summary: You must be a well-trained athlete, be free of any risk factors and have your caregiver's permission for these sports. Pay very careful attention and listen to your body as you participate in these or similar sports. Modify, modify and modify as you see fit…. and you should able to enjoy your favorite sport for quite some time. You may get stares and comments from friends, family and others, but as long as you feel comfortable you may continue. Use this motto: If it feels good, it is good. If it doesn't - modify or quit. I can't remember how many times my friends and even some clients comment with: - "you let her spin (play tennis or whatever) when she's pregnant?!!"
Some doctors are tough to convince, but pregnant women are not as fragile as long thought. Maybe a tad uncoordinated…. but given the chance and with plenty of modifications, pregnant women can be very fit and strong - how else are we the ones able to create a new life?

ACOG committee opinion No. 267 January 2002
Exercising through your pregnancy, James f. Clapp III MD - Human Kinetics 1998
Exercise in Pregnancy, Raul Artal MD - Williams & Wilkins 199

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