Therapeutic physical education (kinesiotherapy) in obstetrics and gynecology. Why do you need therapeutic exercises for pregnant women (examples of exercises) Therapeutic exercises for pregnant women

Childbearing function determines some features in a woman’s physique, the activity of most organs and systems of her body in different periods life. Pregnancy in women lasts about 270-275 days, and such a long stay in a very special state cannot but affect all aspects of a woman’s life, as well as all systems of her body and their functions. The changes that occur in a woman’s body during pregnancy can be divided into two groups: changes aimed at preserving the well-being of the fetus, and changes aimed at preserving the well-being of the mother.

When working with pregnant women, they can be used practically all means of physical therapy: physical exercises (gymnastics, applied sports exercises, games), autogenic training and massage; hardening elements using natural factors (light, air, water); regulation of the daily routine.

All forms of exercise therapy are important: morning hygienic exercises, therapeutic exercises, dosed walking, aerobics, physical exercises in water, fitball, independent exercises for pregnant women according to a given program and periodic monitoring by exercise therapy doctors and an obstetrician-gynecologist.

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All pregnant women are involved in the classes, starting from the first days of their visit to the antenatal clinic and registering them until the moment of birth, but after a mandatory consultation with a physical therapy doctor to identify possible contraindications and individualize the physical therapy program. Classes can be attended by pregnant women with cardiovascular diseases and metabolic diseases (obesity) in the compensation stage.

In the normal course of pregnancy, preference is given to group classes, no more than 6-8 people, approximately the same period of pregnancy and a similar level of physical fitness. To obtain a sufficiently high effect, a course of therapeutic gymnastics (TG) should be at least 10-15 sessions, therefore, it is advisable to start practicing PH no later than 32-34 weeks of pregnancy. In the presence of certain complicating factors that are not a contraindication for exercise therapy (chronic somatic diseases, initial forms of arterial hypertension induced by pregnancy, metabolic diseases, pain in the back and lower extremities due to poor posture, etc.), individual classes using gentle methods.

When performing PH, a variety of starting positions are used - lying on the back and on the side, knee-elbow and knee-wrist, sitting, standing.

Contraindications for prescribing exercise therapy:

Physiotherapy is not contraindicated, but strict individualization of classes is required for the following conditions:

– previous operations in the abdomen and pelvis, including obstetric and gynecological ( C-section, removal of benign formations, etc.);

– post-term pregnancy;

– multiple births;

– delayed fetal development;

– history of eclampsia;

– pain syndromes of the musculoskeletal system accompanying pregnancy;

– dysfunction of the pubic fusion,

– toxicosis easy pregnancy degree of expression;

– neuroses of pregnant women;

– compensated heart defects;

– initial stages of hypertension, bronchial asthma;

– mild forms of chronic nonspecific lung diseases;

– compensated forms of pulmonary tuberculosis in the absence of functional disorders;

– obesity;

– diabetes;

– constipation;

– reflux esophagitis;

- urinary incontinence;

– dilatation of the veins of the lower extremities or hemorrhoidal plexus.

In the development of LH complexes for pregnant women, the period of pregnancy, the functional capabilities of the woman, and the nature of concomitant disorders are taken into account. The LH complex includes general strengthening dynamic exercises for the arms, torso, legs, which improve metabolism, as well as breathing exercises And special exercises to strengthen the abdominal press, long back muscles and muscle-related apparatus of the lower extremities, increasing the elasticity of the perineal muscles. Special relaxation exercises are also required.

A number of authors suggest that pregnant women perform physical exercises using the Joseph method Pilates, developed at the beginning of the 20th century. This exercise system, aimed at training the abdominal muscles, concentrates blood flow around abdominal cavity, strengthens the muscle corset, which the author of the technique called a “framework of strength.”

Newly acquired freedom of movement provides effective work not only the musculoskeletal system, but also the cardiovascular and lymphatic systems, therefore, changes will occur at the cellular level. One of the reasons Pilates is effective is that it restores muscle balance by changing the order in which muscles are used in different movements, training the body to normal, natural movements. This is especially true for pregnant women.

For many pregnant women, the level of cortisol (stress hormone) is unstable, which leads to a deterioration in their well-being and mood. It has been proven that after training using the Pilates method, cortisol levels decrease significantly, endorphins enter the bloodstream and mood improves. Exercises have a positive effect on the level of the hormone testosterone, which is responsible for orientation in space and coordination, so movements become more confident and accurate.

Since the 80s of the twentieth century, they began to be widely used fitball not only in sports schools and fitness clubs, but also in medicine. It has proven itself to be excellent and has become an indispensable assistant in preparing pregnant women for childbirth and directly during childbirth. Fitball has a positive effect on the body as a whole. Acting as a support, the ball allows pregnant women to relax and feel better about their body and perform muscle stretching exercises. Fitball can be practiced with different levels of athletic training at different dates pregnancy. Fitball has virtually no contraindications.

Before starting the main set of exercises on a fitball, it is very important to warm up the body and prepare it. Therefore, elements of self-massage are performed on the head, neck, arms, sternum, lower back, and legs. After this, a complex of joint gymnastics is prescribed, which prepares the joints for greater load, and only after this the main set of exercises is performed to stretch the pectoral muscles, muscles of the spine and legs. At the end of the classes, a set of exercises is performed for general relaxation. Elements of color therapy, auto-training and visualization are used.

Being one of the forms of exercise therapy, hydrokinesitherapy has a number of advantages over training in the gym. A significant role is played by the reduction of the gravity of the human body in water under the influence of the buoyant lifting force of water. So, with a body weight of 70 kg, the weight of a person’s body in water decreases by 7.5 kg. Changing the depth of immersion when performing exercises, including walking, allows you to change the load placed on the woman’s body. Thus, the load on the spine and pelvic bones is reduced, muscle groups that bear increased load due to pregnancy are relaxed. Performing smooth, slow movements that imitate swimming, do not require physical effort and promote complete relaxation and stretching of the muscles of the pelvic floor, perineum and legs.

When carrying out exercise therapy in water, a variety of physical exercises are used, performed at different depths of immersion of a person in water (to the waist, to the shoulders, to the chin). Conduct active and passive exercises with elements of lightening and weighting (with water dumbbells, foam rafts, etc.); exercises with effort at the side; exercises in support against the wall of the pool, against the handrail, against the steps of the pool, with objects and devices (gymnastic sticks, balls of various diameters, etc.); exercises simulating “pure” or mixed hangs; exercises that promote muscle relaxation and stretching of the spine; exercises using mechanotherapeutic devices and devices; breathing exercises; types of walking in water.

Exercises in water have a psychotherapeutic effect: they improve well-being and inspire confidence in a favorable outcome of pregnancy and childbirth.

The water temperature in open-type swimming pools should be 24-26 °C. At this temperature, the hardening effect of hydrokinesitherapy is clearly manifested. Water treatments for pregnant women they are also general strengthening and tonic agents. The water in the pool acts as a light massage, which is very important for muscle trophism. This is one of the components of the beneficial effect of LH in water for varicose veins of the lower extremities.

Indications for prescribing exercise therapy in the pool to pregnant women: normal pregnancy, anemia, hypotension, cardiovascular diseases with heart failure, obesity, neuroses, varicose veins of the lower extremities, chronic diseases of the upper respiratory tract in remission.

Contraindications:

– obstetric: gestational age more than 35-36 weeks, threat of miscarriage at this time, preeclampsia, eclampsia, multiple pregnancy, polyhydramnios, placental insufficiency;

– extragenital: acute and chronic skin diseases, eye diseases, heart failure, condition after infectious diseases and chronic infectious diseases in the presence of bacilli carriage, epilepsy, acute and subacute diseases of the upper respiratory tract, especially with increased sensitivity to chlorine, cholelithiasis and urolithiasis, acute inflammatory diseases of the kidneys and urinary tract.

Classes are conducted by a physical therapy instructor in the presence of a doctor. Classes begin with an introductory part (up to 15 minutes) in the hall, then the group moves to the pool. The first dive occurs at a water temperature of at least 27 °C. The duration of stay in water increases gradually from 5 to 15 minutes, 3-5 minutes each. At each lesson, the volume of exercises performed gradually increases. After leaving the water, the pregnant woman should rest for 10-15 minutes. Each group has 10 classes every other day.

One of the means of exercise therapy that can be used during pregnancy is massage.

Indications for massage: pain syndromes in the back, neck, lumbosacral region, sacroiliac joints, lower extremities, cramps of the calf muscles; mental stress, general fatigue, dizziness, insomnia, headache; signs of mild toxicosis; prevention of the appearance of stretch marks in the area mammary glands, abdomen and thighs; delayed labor; psycho-emotional and physical stress during childbirth; dysfunction of lactation.

The massage is usually performed on the side or while sitting. Lying on your back causes compression of large vessels and nerve trunks in the abdominal and pelvic cavity, so performing a massage on your back is undesirable.

The physical condition of women in labor who have undergone comprehensive preparation for childbirth and who do gymnastics during childbirth, as a rule, is much better than that of others. These women in labor are more manageable during labor, they are much calmer, and their labor activity develops more actively.

So, we can highlight a number of advantages of the beneficial effect of exercise therapy on the body of a pregnant woman, both with and without a history of CS: improvement of blood circulation in all organs and systems; improving the condition of the cardiovascular and respiratory systems; facilitating blood flow in the abdominal cavity and lower extremities (prevention of varicose veins); improvement of metabolism; strengthening all muscles, including the abdominal, pelvic and pelvic floor muscles; improving the state of the nervous system (improving sleep, increasing self-esteem, relieving life stress, fatigue, tension); preparing a pregnant woman to control her breathing during the upcoming birth; quick recovery after childbirth

Educational-research-production complex.

Department of Physical Culture

Therapeutic exercise during pregnancy

Completed by: st-ka gr.21-TM

Buinaya K.M.

Checked by: Lopuseva I.V.

Introduction

The benefits of exercise therapy during pregnancy

Contraindications to exercise during pregnancy

I trimester

II trimester

III trimester

Childbirth rehearsal

Exercise therapy in the postpartum period

List of used literature

Introduction

Pregnancy begins from the moment of fertilization and lasts a long time - about 270-275 days, and such a long stay in a very special state cannot but affect all aspects of a woman’s life, as well as all systems of her body and their functions.

The changes that occur in a woman’s body during pregnancy can be divided into two groups: changes aimed at preserving the well-being of the fetus, and changes aimed at preserving the well-being of the mother. Childbirth is not an easy task, in particular, it is inevitably associated with significant blood loss. The body must be ready to cope with such a load. Actually, the load on a pregnant woman’s body increases by leaps and bounds. Thus, by the time of birth, the weight of the uterus increases by more than 20 times, the volume of the cavity by more than 500 times. From the sixth to eighth week of pregnancy, the mammary glands begin to enlarge, the function of the endocrine glands - the pituitary gland, adrenal glands, and thyroid gland - changes. To meet the growing needs of the fetus for nutrients and oxygen, the blood volume in the mother’s body increases, reaching a maximum of 5300-5500 ml by seven months of pregnancy. The function of the respiratory system is also activated. Under the influence of placental hormones, the bronchi expand, and the passage of air through them increases. Despite the fact that the enlarging uterus increasingly “props up” the diaphragm, the respiratory surface of the lungs does not decrease due to expansion chest. The respiratory rate during pregnancy does not change and is 16-18 breaths per minute, but a larger total volume of air passes through the lungs, which facilitates the elimination of fetal gas exchange products. A double burden falls on the kidneys: they remove from the woman’s body both her own “waste” and the metabolic products of the growing fetus.

During pregnancy (especially in the second half), significant changes occur in the location of the abdominal organs. They are mechanically compressed, which partially impairs blood circulation (causes stagnation of blood in the pelvic vessels). This affects the function of the intestines, primarily the movement of food through the gastrointestinal tract. Intestinal motility decreases, which leads to constipation, exacerbation of hemorrhoids, and swelling of rectal tissue.

The benefits of physical therapy during pregnancy

It can be said without exaggeration that the only way to adapt to increasing loads is by doing physical exercise. This doesn't just apply during pregnancy; This is, so to speak, a general situation. Any person in any situation can adapt to new, additional loads only through training.

In addition, together with the expectant mother, the future child also engages in physical education, and it has now been proven that newborns whose mothers did therapeutic exercises during pregnancy physical development and motor skills are noticeably ahead of their peers, whose mothers preferred a sedentary lifestyle.

There is one more important aspect. It is known that physical exercise is extremely beneficial for the nervous system, and during pregnancy it suffers almost more than anyone else. It is hardly possible to find two women who would experience absolutely the same experiences during this period, but there are some common patterns.

For example, the first trimester of pregnancy is usually characterized to one degree or another by a sharpening of existing character traits: soft, vulnerable, insecure women become even more impressionable, sometimes excessively tearful, and experience anxiety (those women who have a history of miscarriages have already occurred or this pregnancy is not proceeding very well - in this case, the fear of another abortion can become simply obsessive). Powerful women with harsh personalities can become even more aggressive, irritable and demanding.

The second trimester is usually the easiest in terms of psycho-emotional state. The threat of miscarriage decreases, the woman gets used to the new condition and gains some experience of how to be pregnant. In general, many women subsequently remember the fourth to sixth months of pregnancy as the happiest, most prosperous time.

In the last third of pregnancy, emotional storms begin again. Childbirth is approaching, and with it comes fear - women who are about to experience this event for the first time are especially susceptible to it.

Physical exercises performed during pregnancy have a beneficial effect both on the course of pregnancy itself, and on the process of childbirth and the woman’s condition after childbirth.

Contraindications to physical therapy during pregnancy

· for acute diseases and exacerbations chronic diseases;

· in case of decompensation (“failure”) of the functions of any organ systems;

· if the general condition is assessed as “severe” or “moderate”;

· with toxicosis;

· if there is even slight uterine bleeding, or if it happened during a previous pregnancy;

· general serious condition;

I trimester

During this period, the connection between the embryo and the maternal body is still very fragile. Any adverse effects, including intense physical activity (for example, in athletes), can disrupt this connection, and the pregnancy will be terminated.

The excitability and contractility of the uterus decreases somewhat only by the 9-10th week, but still, before the formation of the placenta, that is, until approximately the 12th week of pregnancy, the fetus is not yet connected to the mother by the umbilical cord.

And in the mother’s body there is still complete discord, the processes of excitation and inhibition are misregulated, the parasympathetic nervous system predominates over the sympathetic, which can result in nausea and vomiting, urinary disorders, constipation, and flatulence. Protein and fat metabolism slows down, and carbohydrate metabolism accelerates. The tissue demand for oxygen increases significantly - by the 16th week by about 2.5 times.

In the first trimester, physical therapy helps maintain a woman's Have a good mood(after all, it is at the beginning of pregnancy that increased irritability and sudden mood swings appear). It is very important to master breathing exercises: diaphragmatic, chest, full breathing. Learn relaxation techniques (this will help a lot during childbirth). At the beginning of pregnancy, you need to be careful with the intensity of the load so as not to provoke a miscarriage. During jumping and abdominal swings, tension in the abdominal muscles can lead to an increase in the tone of the uterus and contribute to its contractions, which is extremely undesirable: this can terminate an early pregnancy.

Exercise 1

Squats (lifting on the floor with your fingers).

Goal: To tone the entire body, but especially the legs and inner thighs. When performing, hold on to the back of a chair or wall.

I.p. - standing, legs apart. Toes point outward, arms out to the sides. Breathing is natural.

On the count of one or two: slowly squat down, bending your knees and spreading them slightly to the sides. Don't lift your heels off the floor. No matter how low you sit, it is important to keep your back straight and your knees as far apart as possible. Keep your back straight.

On the count of three or four: tighten your stomach (tighten your abdominal muscles) and, pressing your heels into the floor, slowly straighten your knees. Feel the work of the muscles of the inner thighs.

On a count of five to six: Press your toes and balls of your feet into the floor and slowly lift your heels off the floor. Use your inner thighs and abdominal muscles to keep your body balanced. Keep your back straight. Don't bend your knees. Stay in this position for a while and feel how you have grown.

On a count of seven to eight: Slowly, controlling your stomach and inner thighs, return to the starting position, lowering your heels towards the floor. Repeat the exercise 6 times, alternating with finger lifts on the floor.

Exercise 2

Goal: strengthen the pectoral muscles that support mammary glands, the mass of which increases significantly during this time.

I.p. - basic stance, arms at chest level, palms connected. On the count of one or two: inhale and forcefully press your palms against each other. As you exhale, bring your hands inward toward your chest, keeping your hands tense, turn them inward toward your chest, and relax.

Repeat 8-10 times.

Exercise 3

Circular rotation of the pelvis.

Goal: to tone and stretch the muscles of the whole body, improve blood circulation in the pelvic area.

Etc.. - feet shoulder-width apart, knees bent, hands on the front of the thigh. The situation is stable.

Breathing: voluntary.

Circular rotation of the pelvis to the right, then to the left. Perform 4 rotations. Notice the stretching of the pelvic and thigh muscles.

Exercise 4

Goal: strengthen the oblique abdominal muscles.

The oblique muscles are a natural bandage that supports the growing uterus. Their training eases the load on the lumbar spine and prevents the appearance of stretch marks on the anterior abdominal wall.

I.p. - stand with your feet together, arms apart, you can use support. Standing on your left leg, cross your right leg forward, to the side, and back. Then repeat with your left foot too. Repeat this exercise 4 times with each leg.

Breathing during exercise: voluntary.

Exercise 5

Prevention of the development of varicose veins.

To improve the outflow of blood from the legs, it is necessary to perform - circular movements with the feet, rise and walk on tiptoes, toes, heels, on the outside of the foot, lift the toes from the floor small items.

Exercise 6

Goal: strengthen the muscles of the arms, waist, chest and back.

etc. - sitting on the floor with crossed legs (Turkish style). Back straight, extend your arms straight so that your fingertips touch the floor. Feel that your body weight is evenly distributed between your sit bones. Inhale. Raise your left arm up, tilt your torso to the right. Place your right palm on the floor and allow your right elbow to bend. Keeping your hips on the floor, feel along the left side of your torso, from the tip of your left fingers to your waist. (don't worry if your right elbow doesn't touch the floor - it doesn't matter) Exhale: Tighten your abdominal muscles and return to the rep. Repeat 6 times each side.

In the first trimester of pregnancy, the following tasks can be solved with the help of physical therapy:

· learn proper breathing;

· activate the cardiovascular and respiratory systems, improve blood supply to all organs and tissues;

· normalize the functions of the nervous system;

· increase overall vitality, improve psycho-emotional state.

During this period, a woman can exercise independently, but in the first 12 weeks of the first trimester of pregnancy, strict monitoring of the woman’s condition is necessary, especially on the days corresponding to the expected period of menstruation, since it is at this time that the risk of miscarriage is increased.

Breathing exercises.

1. Abdominal breathing. Lie on your back, place your hands on your stomach. Inhale through the nose, the walls of the abdomen rise, hands lightly press on them.

2. Chest breathing.Lie on your back, place your hands on the hypochondrium, fingertips touching each other. Inhale evenly through the nose, exhale through the mouth. Fingers feel how the ribs move.

. Rapid breathing. Lie on your back, place one hand relaxed on your neck. Breathe shallowly and quickly with your mouth half open. (About how a dog breathes after a tiring run or when it’s hot with his tongue hanging out).

.Breathing according to the yoga system.Take a long, long breath through the nose, first the chest rises, the lungs fill with air, then the stomach expands and tenses. Inhale as much as you can. Exhale through your mouth. The stomach deflates, then the chest drops. Remain without air as long as possible. Can be done standing, sitting, lying down and anywhere.

II trimester

In the second trimester, it would seem that a woman’s body should already adapt to a new state, but everything is not so simple. How can you adapt to something that is growing every day? The pregnancy period of 20-30 weeks is considered the most “stressful” - this is the period of maximum stress on the female body.

Firstly, by the 20th week of pregnancy, the expectant mother has not two (like all people), but three circles of blood circulation. The third circle of blood circulation is mother - fetus. As a result, the heart has to do a lot of extra work.

Blood pressure becomes very unstable; after 20 weeks it has a clear tendency to increase, mainly due to hormonal changes and increased tone of the now sympathetic nervous system.

The viscosity of the blood decreases, the capillaries become more permeable, not only for plasma (the liquid part of the blood), but also for blood cells, and this creates a threat of hemorrhage and poses a danger to both the health of the mother and the life of the fetus.

The kidneys work for two, and the amount of urine increases, and the volume Bladder at the same time it decreases due to compression by the uterus.

All endocrine glands are undergoing a real revolution. The pituitary gland, adrenal glands, and thyroid gland all increase the production of their hormones. Moreover, from the beginning of the second trimester, a woman begins to work another, new endocrine gland - the placenta. It produces additional amounts of female sex hormones - estrogen and progesterone, necessary for the growth of the uterus, mammary glands, and for the regulation of uteroplacental circulation. The placenta also produces a substance called relaxin, which has a strong effect on the musculoskeletal system, in particular, it increases the elasticity of the symphysis pubis and the entire ligamentous system in general.

The profile of the spine changes: lumbar lordosis increases, the angle of inclination of the pelvis increases - and all to make the fetus more comfortable in the womb. True, this also makes it easier for the mother to move around.

The objectives of therapeutic exercises in the second trimester of pregnancy are as follows:

· instill the skills of deep and rhythmic breathing and thereby improve uteroplacental blood circulation (both during and outside of classes);

· strengthen the muscles that will take part in the birth process;

· further increase the tone of the cardiovascular and respiratory systems;

· prevent varicose veins of the lower extremities, as well as constipation.

Gymnastics for pregnant women second trimester exercise No. 3.

Tailor's pose strengthens the back and improves blood circulation in the pelvic organs:

Sit up straight with your feet together. Grab your ankles and press your thighs toward the floor with your elbows. Hold this position for 20 seconds. Relax and repeat a few more times.

2. If it is difficult for you to maintain this position, you can put pillows under your hips or lean on the wall. The back should remain straight.

A cross-legged pose is also possible.

Gymnastics for pregnant women, second trimester, exercise No. 4.

Squats. This type of exercise strengthens the muscles of the hips and back, and gives mobility to the joints. If it is difficult to do squats without support, you can lean on a chair or windowsill.

Using a chair, stand facing it with your feet apart. Leaning on a chair, squat smoothly, spreading your hips to the sides. Hold this position for a few seconds and repeat again.

Without support. Straighten your back and slowly begin to squat, spreading your legs. Secure for a while, relax and repeat again.

III trimester

In the third trimester of pregnancy, the sympathetic nervous system significantly predominates, due to which the woman’s body is, as it were, in a state of constant readiness for the upcoming birth.

The load on the heart continues to increase, and the heart itself acquires a more pronounced horizontal position. In 30% of healthy pregnant women, a functional systolic murmur is heard. The volume of circulating blood increases by the end of pregnancy by 20-30%, while the amount of plasma (liquid part) of the blood increases by 37%, and the number of formed elements (blood cells) by only 17%. This leads to physiological anemia due to blood thinning. In addition, the unborn child “takes away” all the mother’s iron reserves, which is why many pregnant women experience iron deficiency anemia.

Due to the accumulation in the pregnant woman’s body of products of incomplete “combustion” of proteins, fats and carbohydrates, the acid-base balance is disturbed (the body “acidifies”). The oxygen demand of tissues increases fourfold by the end of pregnancy.

The lungs are “pressed” upward by the diaphragm and liver, which is why their movements are limited. Meanwhile, by the 39-40th week of pregnancy, the volume of breathing increases by 40% due to a slight expansion of the lower part of the chest.

In this situation, with the help of therapeutic exercises you can:

· improve blood circulation in the body, reduce congestion;

· stimulate the gastrointestinal tract, intestinal motility;

· if possible, expand the osteo-pelvic ring (“exit” for the child);

· learn to tense muscles without holding your breath.

The load - very moderate in general - should fall mainly on the arms and shoulder girdle, and to a lesser extent on the legs. The amplitude of leg movements, especially flexion at the hip joints, must be limited; bending the body to the sides and turning the body can also only be done “a little,” and bending forward cannot be done at all.

The starting position for most exercises is lying down, sitting, and if standing, then with your hand resting on something, and in any case, neither the starting position nor the exercises themselves should cause discomfort.

Special attention You should pay attention to exercises that will serve you well during childbirth: breathing with tense abdominals, strengthening and increasing the elasticity of the pelvic floor, increasing the mobility of the hip joints and lumbar spine.

Breathing and relaxation

Gymnastics for pregnant women (third trimester) involves performing relaxation exercises. If you learn to breathe correctly during pregnancy, this will help you maintain strength and reduce pain during childbirth. All exercises must first be learned to be performed in a calm atmosphere, where nothing distracts you. Over time, you will be able to relax in any environment.

Gymnastics for pregnant women third trimester exercise No. 1

Relax the body. You need to lie on your side or back, placing pillows or a blanket under your lower back. Tighten your body muscles one by one, starting from your feet and moving higher. This exercise should be performed for 10 minutes, after which the body should be allowed to relax.

You can bend one leg under you and put a bolster or pillow under it. It is very comfortable, especially in late pregnancy, to lie on your side, bending one leg and placing pillows under it. Don't put too many pillows under your head - this will cause your back to curve.

Gymnastics for pregnant women third trimester exercise No. 2.

We control our breathing, learn to relax and calm down, and abstract from the world around us.

Shallow breathing. Use this type of breathing at the peak of a contraction. Do not inhale deeply, fill only the top of your lungs, breathe through your mouth. It is necessary that breathing becomes easier with each breath.

Use deep breathing at the beginning and end of a contraction. You need to completely relax, take a deep breath so that the air fills your lungs completely. Exhale slowly and deliberately. Now inhale as usual.

Sharp exhalation. This type of breathing is used if pushing begins when the uterus is not fully dilated. Take two short breaths, followed by a long, deep exhale.

Gymnastics for pregnant women third trimester exercise No. 3.

Psychological relaxation. Try to calm down, not be nervous and distract yourself. At the same time, you need to breathe evenly and calmly, very smoothly. Remember the pleasant moments of your life, read a poem “to yourself,” mentally write a letter to your future baby.

Childbirth rehearsal

exercise training therapeutic pregnancy

You can start it at different stages of pregnancy, especially since a full rehearsal will require at least 15-20 lessons.

Stage I.“Educating” a pregnant woman (about what she will have to do during childbirth) and developing the skills to perform movements on command, maintain correct posture, training in different ways breathing (thoracic, diaphragmatic, mixed), tension and relaxation of individual muscle groups, self-control of breathing, pulse rate, fetal movement, correct performance of simple gymnastic exercises.

Stage II.Developing motor skills and performing simple gymnastic exercises to overcome difficulties: amplitude and coordination of movements, coordination of breathing with the activity of skeletal muscles. Explaining the meaning of relaxation in childbirth.

Stage III.Developing motor skills in body positions that will have to be taken during childbirth. Training in complexly coordinated tension of some muscles and relaxation of others. Training to concentrate; nurturing self-confidence and concentration of will.

Stage IV.Improving exercises for coordination of movements and overcoming difficulties. No new exercises are being introduced.

Childbirth is a physiological process in which three periods are distinguished: dilation of the cervix, expulsion of the fetus and birth of the placenta.

The period of cervical dilatation begins with rhythmic contractions of the uterine muscles (labor contractions). The first contractions are short-lived (no more than 20-30 seconds) and occur at fairly large time intervals. The body of a woman in labor seems to be training, using the last hours before labor begins. Then the duration of contractions increases to 45 seconds, and the intervals between them gradually decrease (up to 2-3 minutes). As contractions become more frequent, the cervix opens more and more. During contractions, intrauterine pressure increases. Amniotic fluid flows through the slightly opened cervix. The first stage of labor lasts 13-18 hours for first-time mothers and 6-9 hours for women giving birth again. (However, it must be said that in last years There is a noticeable trend towards a decrease in the average duration of labor by approximately 2-4 hours. This is due to psychoprophylactic preparation for childbirth, improvement of methods for preventing protracted labor, the use of drugs that accelerate the dilation of the cervix and enhance the contractile activity of the uterus.) The first period ends with the complete dilation of the cervix.

Should a woman do anything during this period, or is she destined only to “suffer in silence”? Of course, few people suffer “silently,” but is screaming really all that can be done to alleviate your condition?

Of course not. First of all, it is necessary to relax all muscles as much as possible, especially in the intervals between contractions. You need to breathe deeply and only through your nose. From time to time you can get out of bed and walk around a little. It is necessary to empty the bladder in a timely manner, as its overflow disrupts labor and aggravates pain. In addition, it is useful to use some techniques that contribute to the correct and painless course of labor.

First appointment:take deep breaths and exhales from the beginning to the end of each contraction.

Second reception:simultaneously with deep inhalation and exhalation, stroke the lower abdomen with the hands of both hands. Hand movements should be directed outward and upward.

Third trick: thumbs With both hands, press the skin to the inner surface of the iliac crest in the area of ​​both anterior superior spines.

Fourth trick:stroke the skin in the sacrolumbar region; breathe deeply.

Following the complete dilatation of the cervix, the second period begins - the period of expulsion of the fetus. Regular contractions are accompanied by pushing (reflexively occurring contractions of the striated muscles of the abdominal muscles). The second stage of labor lasts no more than 1-2 hours, and for some - only 15-30 minutes and ends, in fact, with the birth of the child.

However, childbirth does not end there. The third period begins - the birth of the placenta. The placenta consists of the placenta, membranes and umbilical cord. Usually, 7-15 minutes after the birth of the child, the woman begins to experience contractions and pushing again, as a result of which the placenta is expelled. In this case, as a rule, there is no longer any pain.

Exercise therapy in the postpartum period

So, the woman’s body did a colossal job - it carried and gave birth to a child. Now we need to go back to normal life.

When leaving the maternity hospital, some women look as if they were not pregnant a week ago, while others look as if they still have not given birth. The secret of such inequality is very simple: the former obediently attended physical therapy classes held in the postpartum ward, while the latter did not. The objectives of exercise therapy in the postpartum period are: to improve blood circulation in the pelvis, abdominal and thoracic cavities and lower extremities; promote active contractions of the uterus, ensuring its correct involution; help regulate bowel and bladder function; improve cardiovascular, respiratory and digestive systems; strengthen and strengthen the muscles and ligaments of the abdominal wall and pelvic floor; strengthen the musculoskeletal system, ensuring restoration of normal posture and prevention of flat feet; improve emotional state, sleep and appetite, activate metabolism.

Contraindications to prescribing exercise therapy after childbirth: body temperature above 37.5°C; complications of the postpartum period (endometritis, thrombophlebitis, mastitis); severe anemia due to large blood loss during childbirth; bleeding after childbirth; difficult, prolonged, debilitating labor; preeclampsia or eclampsia during childbirth; suffered severe gestosis; progressive failure of blood circulation, kidneys, liver; severe subcutaneous emphysema; III degree perineal ruptures; postpartum psychosis; cardiovascular insufficiency of the third degree.

Before starting therapeutic exercises, it is necessary to carefully examine the condition of the lower extremities. Varicose veins veins, pain, fever require medical consultation for thrombophlebitis. At inflammatory diseases exercises are prescribed after the condition has normalized (the temperature has dropped to normal and there is no pain).

If there are sutures in the perineum after perineotomy or its rupture, exercises with abduction of the legs are excluded for 5-6 days. For third-degree perineal ruptures, therapeutic exercises are performed according to methods for postoperative patients.

During the normal course of the postpartum period, classes are carried out in a group method. Complications of the postpartum period require the use of individual classes.

Therapeutic gymnastics must begin as early as possible, since in the first days after childbirth, the restructuring of the body occurs most actively. After a relatively easy birth, therapeutic exercises can be started from the 1st day, after a difficult one - from the 2nd day after birth.

Therapeutic gymnastics classes begin with general developmental exercises in combination with breathing exercises. They mainly use elementary exercises for the upper and lower extremities, exercises for raising the pelvis. Later, exercises are prescribed to strengthen the abdominal muscles of the pelvic floor. The load is increased gradually. Exercises are done at a calm, slow, and then at an average pace. The duration of classes in the first days is 15-20 minutes, in subsequent days up to 30-35 minutes.

In the first 2 days, therapeutic exercises are performed while lying in bed, in the next 2 days - in a sitting position.

On the 1st day after birth, all physical exercises are performed from the starting position lying on your back.

Moving fingers and toes.

Sipping. Raise your arms above your head and pull your toes inhale. Return to the starting position - exhale.

Curling your fingers into a fist.

Pronation and supination of the hands and at the same time rotation of the feet outward and inward.

Bending the legs at the knee and hip joints with support on the feet.

Raising the pelvis with support on the feet and shoulder blades.

Deep differentiated breathing (thoracic, abdominal, mixed) with self-control.

The entire procedure of postpartum therapeutic exercises consists of 8-12 exercises and lasts an average of 20 minutes. Massage of the limbs is indicated to improve peripheral circulation.

On the 2-3rd day after birth, the exercise therapy complex includes exercises that enhance peripheral blood circulation, diaphragmatic breathing, reducing congestion in the abdominal cavity and pelvic cavity, muscle relaxation exercises, and exercises for the abdominal muscles. These may be the same exercises that the postpartum woman performed on day 1, but their amplitude and pace increase slightly. Circular movements with your hands are useful, normalizing lactation and activating pulmonary ventilation. From the 2nd day after birth, the woman should squeeze the rectal sphincter more intensely. To activate blood circulation in the pelvic organs, outward circular movements of the hips are indicated (with straight and bent legs), but if there were no serious ruptures of the perineum.

On the 4-5th day after birth, the load gradually increases, mainly as a result of the introduction of new exercises for the abdominal and pelvic floor muscles and an increase in the number of repetitions of previous exercises. Add the starting position lying on your stomach, knee-wrist or knee-elbow position.

In subsequent days, when the uterus decreases, most physical exercises are performed from the starting position in a standing position. These are turns and bends of the body to the sides, circular movements of the pelvis, half squats, movements of the straight leg forward, to the side and back, standing on the toes, etc. They are necessary to restore posture. When performing physical exercises, pay attention to the rhythm and depth of breathing. Postpartum gymnastics procedures are usually carried out 0.5 hours after feeding the baby. If you have pain in the muscles of the back, pelvic girdle, or a history of significant lordosis, you should be extremely careful when using exercises for the abdominal muscles with your legs raised low above the bed (for example, “scissors”, “bicycle”). Such exercises cause lordosis of the lumbar spine and its stabilization, especially with weak abdominal muscles. In addition, some straining during such exercises can increase the separation of the abdominal muscles.

The high likelihood of injuries to the lumbar spine after pregnancy due to irrational lifting of heavy objects, including lifting a child, requires avoidance of forward bending, especially in combination with simultaneous rotation of the torso.

To restore sufficiently full performance of the back and abdominal muscles, daily systematic training is required for 2-3 months.

List of used literature

Therapeutic physical culture: textbook. for university students V.I. Dubrovsky. - 3rd ed. VLADOS, 2004. - 623.

Therapeutic physical education: Textbook for the Institute of Physics. culture Under the general editorship. S.N.Popova. Physical education and sport, 1988. - 270.

Physical culture: Textbook for secondary professionals. education N. V. Reshetnikov, Yu. L. Kislitsyn. Mastery, 2002.

Physical culture: Textbook for universities I.S. Barchukov. - UNITY, 2003. - 254.

Tags: Therapeutic exercise during pregnancy Abstract Tourism

Modern life is a continuous movement forward. From all sides we are urged to hurry and learn everything new and unknown. When a woman learns about an “interesting” situation, the instinct of self-preservation forces her to stop and slow down. However, pregnancy is by no means a painful condition, but rather a chance to get to know your body from a new perspective. You shouldn’t give up active recreation and your favorite gymnastics activities. It is necessary to find a middle ground and get great pleasure, sharing it between two.

Pregnancy is not a reason to give up physical activity!

Movement is life. Exercise for pregnant women helps improve general condition, increases tone and improves blood circulation. Those who were actively involved in sports before pregnancy should not stop training, citing unreasonable fears. A wise decision would be to select a suitable load. What exercises can pregnant women do?

Get ready to exercise: morning set of exercises

A successful start to the day will have a beneficial effect on its continuation and successful outcome. Do exercises in the morning - good habit healthy people. In fact, if the expectant mother regularly performed morning exercises before conception, then she can safely continue in the same spirit during pregnancy.

Morning exercises for pregnant women may consist of the following exercises:

• warming up joints and tendons;
• turns and tilts of the body and head;
• swing your legs and arms;
• squats;
• exercises with fitball.

Pregnant women should avoid speed running, strength exercises and general overexertion. On early stages when implantation occurs ovum into the wall of the uterus, running can cause complications. Fast jogging can also harm those who are a few weeks away from giving birth. The result of rash actions can be placental abruption and premature birth.

Strength exercises lead to weakening of the pelvic floor muscles, which can lead to cervical insufficiency and chronic miscarriage for young women. Too intense power training(with heavy lifting) before pregnancy also lead to insufficiency of the pelvic floor muscles. Young girls who are planning to get pregnant in the future should definitely take this circumstance into account.

Excessively exhausting exercises lead to overwork of the body. Long-term exercise programs, too intense cardio loads and endurance exercises are not recommended. In everything you need to know when to stop. The expected effect will be achieved by proper gymnastics for pregnant women; a video on how to perform exercises at home will help coordinate movements and get rid of common mistakes.

Positional gymnastics exercises

Positional gymnastics for pregnant women is a set of static exercises that are performed in cycles, while the body is in fixed positions - poses. Such exercises for pregnant women are suitable at any stage. Their main feature is the presence of an initial pose and the absence of sudden movements, which makes the choice in favor of a positional form of gymnastics for pregnant women obvious. The video demonstrates the correct execution of the complex.

Let's look at the most common poses:

• butterfly pose;
• cat pose;
• frog pose;
• tumbler pose;
• tree pose.

In the butterfly pose, the muscles of the pelvis and inner thighs are trained and strengthened. You need to take a sitting position, bend your knees and slowly pull your feet towards each other. Next, you need to grab both feet with your hands and pull them towards the perineum, slowly, with jerky movements. When your legs, bent at the knees, form a butterfly, you need to fix the position and make smooth swings with both knees up and down 15–20 times. While performing the exercises, you can apply light pressure to your knees, pressing them to the floor.

The cat pose is aimed at relaxing and warming up the muscle group that supports the spine. You need to take a position on all fours, resting your palms and knees on the floor, keeping your spine parallel to the floor. Next, while inhaling, bend the spine in an arc downwards - the chest protrudes, the pelvis stretches to the top. After 2-3 seconds, exhaling, arch your back upward. In this case, the middle of the spine stretches up, and the head and pelvis go down. Repeat the exercise cycle 10 times.

The “frog” exercise (pictured) trains those muscles of the legs and perineum that will soon take an active part in the birth process. You need to squat down, spreading your hips as wide as possible. The knees are directed in different directions. Then they fasten their hands together, and rest their elbows on the spread knees, pressing on them, thereby spreading them wider. The exercise should be performed 10–15 times with smooth, progressive movements until slight trembling occurs in the legs.

The tumbler pose trains the vestibular apparatus, as well as the muscles of the perineum and abdomen. To perform the exercise you will need a mat. You need to sit on the floor, straightening your legs forward and spreading them as wide as possible. Next, raise your arms up, keeping your spine straight. As you exhale, bend towards right leg, hold on for a second. Then, while inhaling, return to the starting position. Repeat the combination for the left leg. The complex can be repeated 5–10 times, without making sudden movements and monitoring uniform breathing.

The positional tree exercise is designed to train the muscles of the back and pelvis, as well as improve body coordination. Standing on the floor, you need to spread your legs wide apart, your feet should be shoulder-width apart. The arms are relaxed parallel to the body. As you exhale, raise your left hand up and reach your knee with your right palm. Turn your head and look at your left palm for a few seconds. Inhale and return to the starting position, changing hands. The exercise cycle can be repeated 5–10 times, without making sudden movements and keeping your back straight.

Fitness and aerobics: pros and cons

Fitness classes are designed to correct the silhouette of the figure and increase muscle tone. Aerobics is a set of exercises to saturate the body with oxygen and improve lung ventilation. Both sports involve alternating intense and calmer movements.

Reasons why fitness and aerobics are necessary for women in an “interesting” position:

• strengthening the muscles of the whole body;
• improving blood circulation;
• saturating the body with oxygen;
• stabilization of emotional and psychological state, stress resistance;
• strengthening immunity;
• improvement of metabolism and skin condition;
• prevention of congestion, hemorrhoids and edema;
• maintaining normal weight;
• physical preparation of the necessary muscle groups for the upcoming birth.

Important Areas: Abdominal Exercises and Stretching

Abdominal exercises cause the most concern among pregnant women. This question comes up especially often from those who were constantly involved in sports before pregnancy. According to doctors and fitness instructors, if a woman has kept her muscles in good shape, then she can safely work out her abdominal muscles even after conception has occurred. The number of approaches and intensity of the workout will differ.

It is prohibited to pump up the press:

• in early pregnancy;
• in the presence of uterine tone;
• if there bloody issues and pain in the lower abdomen;
• with the threat of miscarriage and pathologies of placenta previa.

Stretching exercises have a positive effect on a woman's overall fitness. To improve muscle elasticity, positional gymnastics is well suited (we recommend reading: positional gymnastics for pregnant women in the 3rd trimester). It does not include intense loads, but special poses “cat”, “butterfly”, “frog” and others that ideally stretch the desired muscle groups.

Preparing for childbirth physically and mentally is the best thing an expectant mother can do for her baby. Trained muscles and good stretch guarantee relief of the birth process and reduce the possibility of birth injuries.

What exercises are contraindicated for pregnant women?

A woman’s body is controlled by hormones that affect the condition of joints, muscle tissue and blood vessels. Metabolism and water-salt balance change, heart rate and the speed of blood movement through the vessels increase. What types of exercise should the expectant mother avoid in each trimester?

In the first trimester

The first three months of pregnancy are the period of formation of all the vital organs of the child, fixation of the fertilized egg in the uterine cavity and complete restructuring of the female body. During the 1st trimester, it is recommended to avoid the following sports exercises:

• abdominal trainers;
• strength training;
• lifting loads;
• endurance exercises;
• long-term cardio training.

Don't forget that during the first 12 weeks of pregnancy, a woman's immune system goes through difficult times. Implementation foreign body– the process is long and energy-consuming; you should not further deplete the body’s reserves with unjustified loads.

In the second trimester

The second trimester is characterized by some stabilization of the pregnant woman’s condition. Toxicosis is over, the time of intensive growth of the fetus in the mother's womb begins. The number is increasing amniotic fluid, the placenta has formed and is growing along with the fetus, the belly has become larger. The center of gravity of the pregnant woman’s body shifts, clumsiness appears in her movements. List of prohibited exercises:

• twisting;
• stand on one leg;
• speed running;
• intense high jumps.

In the third trimester

The last trimester is the longest and hardest for expectant mother. The time has come for swelling, back pain, shortness of breath and congestion. Exacerbation of these symptoms is an indication for exercise therapy for pregnant women. Physical therapy cannot be done at home. Most often when antenatal clinics and clinics have exercise therapy rooms, where a pregnant woman will be referred by a local therapist or an observing gynecologist.

Most exercises for exercise, which were acceptable in the 1st and 2nd trimester, are prohibited during the last 13 weeks. What remains are breathing exercises, exercises with a fitball, positional and therapeutic therapy.

When is any physical activity contraindicated for a pregnant woman?

Performing moderate-intensity exercise during pregnancy benefits both the woman and the baby. However, physical exercise, even positional therapy and physical exercises, do not always have a positive effect on the health of a pregnant woman. Conditions and diseases in which exercise is strictly prohibited:

• diabetes mellitus, ARVI;
• spotting, uterine hypertonicity, threat of miscarriage;
• low attached placenta, constant nagging pain in the lower abdomen;
• severe toxicosis in the early stages and late gestosis.
• iron deficiency anemia of pregnant women;
• unstable blood pressure;
• multiple pregnancy;
• chronic diseases in the acute stage;
• pathological deviations in the course of pregnancy.

Doctors recommend that women who have already had cases refrain from exercising at home spontaneous miscarriages. You cannot independently treat those who suffer from heart defects and have problems with intracranial pressure.

Pregnancy is not a disease, and therefore it is even useful to engage in physical therapy in this situation. Thanks to properly selected exercises, you can not only restore tone, but also prepare the body for the upcoming birth.

If a pregnant woman regularly performs therapeutic exercises, then:

• pain in the legs, pelvis and lower back will go away;
• blood circulation will improve, thereby avoiding swelling and constipation;
• there will be less urge to urinate;
• the tone will be normal, thereby preparing the body for childbirth;
• sleep will become calm and breathing will be uniform;
• weakness will become less than in those pregnant women who do not do gymnastics at all;
• the mood will be better.

What are the differences between exercise therapy for pregnant women and regular physical education?

Exercise therapy for pregnant women differs from simple gymnastics in that during such exercises certain muscles are intensively tensed. A method is allowed in which no harm will be caused to either the fetus or the mother.

In addition, the exercises differ from each other depending on how far along the pregnancy the woman is. One group of exercises is implemented for the beginning of pregnancy, the other for the middle and last stages.

Also, the division of exercises can be different:

• up to 16 weeks of pregnancy;
• from 17 to 24 weeks;
• from 25 to 32 weeks;
• from 33 to 36 weeks.

At the end of gestation, the exercises should be light; breathing exercises, walking down the street or swimming in the pool are quite suitable.

Length and regularity of classes

Physical therapy during pregnancy should be carried out according to the rules determining the frequency and intensity of training.

Rules	How are classes conducted?
Consistency of training	It will be quite acceptable to do physical therapy 3 times a week for up to 30 minutes. The rest of the time, classes can be compensated in other ways, for example, walking down the street, water activities in the pool.
Length of training time	It is important that classes take place continuously throughout pregnancy.
Training structure	The structure of classes should consist of several stages: warm-up, which consists of light stretching and breathing exercises; the main part is that you first need to work with the muscles and joints that are located in the limbs, lower back and pelvic part, for approximately 15 minutes; hitch lies in another group breathing exercises and easier relaxation, 5 minutes is enough.
Heaviness	At the initial stage, the main load should take no more than 5 minutes, with a gradual increase to 15 minutes.
Coordination of well-being	Due to the fact that every woman’s body is individual, it means that there cannot be a single set of training for everyone. If suddenly during exercise you feel any discomfort, you need to stop. After the break, you can continue training, but at a more average rhythm.
Speed ​​of movement	All sharp exercises are excluded, otherwise there may be a danger for both the fetus and the expectant mother.

Contraindications

Physical therapy during pregnancy may be completely contraindicated following cases:

Class Rules

Exist important rules that must be observed during physical therapy:

• It is recommended to exercise on an empty stomach, a maximum of 3 hours should pass after eating;
• It is recommended to practice in comfortable and durable shoes and comfortable clothes;
• The surface of the floor for training should not be slippery; it is safer to train on a rubber mat.

1st trimester

Technique:

2nd trimester

Technique:

3rd trimester

Technique:

Prohibited exercises during pregnancy

Adhering to a healthy lifestyle during pregnancy is not only possible, but also necessary.

However, it is worth considering which exercises or activities are completely prohibited:

General strengthening physical education for pregnant women in the first trimester

Therapeutic physical training, even at the beginning of pregnancy, requires care. The main thing is to try not to overstrain the body.

You can use the following set of exercises:

1. walking on level ground for 10 minutes;
2. spread your legs, place your arms at your sides, you need to turn your torso left and right;
3. put your hands on the back of your head, connect your elbows in front of your face, and spread them to the sides, do this many times;
4. bent arms place your elbows down on your chest, spread them to the sides, repeat;
5. Having settled down on your side, lean your elbows on the floor with one hand and straighten your other hand towards the top. So you need to pull your knees towards your stomach and straighten them to the starting position.

A set of general exercises in the second trimester of pregnancy

The middle of pregnancy is the most favorable stage, since by this time the body has already adapted to the changes, toxicosis is no longer a concern, and the belly is not yet completely huge.

You can perform gymnastics to the fullest extent:

Classical physical education in the third trimester

Discomfort during pregnancy begins to appear when the last trimester approaches, for example, your back may hurt, your stomach makes it difficult to move, and your head is full of upcoming troubles.

In this case, you shouldn’t give up training, you can simply change the course of training, choose an easier workout:

If suddenly in the last trimester a pregnant woman experiences swelling or appears excess weight, there is no need to be sad. Special physical training will help to quickly solve these problems, thanks to which you can do without the use of medications.

When choosing a set of exercises, it is necessary to take into account the duration of pregnancy, so that the complexity and load of the exercises can be adjusted at different stages of gestation.

Pool exercises: a set of exercises

You can strengthen the health of the expectant mother, as well as train your breathing and relax your muscles by doing exercises in the pool.

Thanks to them, pregnancy will develop safely:

"Warm-up":

• in a horizontal position, grab the sides, gradually spread your legs to the sides, connect, do this up to 10 times. Then bend your knees one by one and straighten them;
• turn your back to the side, hold on to it with your hands, and with your feet make movements reminiscent of breaststroke swimming;
• with your back to the side, raise and straighten your legs, spread them wide and lower them, cross your legs and try to lift them above the water;
• stand with your front to the side, holding onto it, rest your feet against the wall of the pool, try to bend and straighten your legs.

"Strengthening and support":

Localized exercises

Physical therapy during pregnancy will help eliminate discomfort in different parts of the body through localized exercises.

For the neck

A set of workouts for the neck:

For the back

Exercises for the back should be performed at the beginning and in the middle of pregnancy, since it is this part of the body that will have the hardest time last date due to the increasing burden.

These could be the following exercises:

These exercises, if performed correctly and moderately, will help pregnant women cope with pain in the lumbar area. Although the most important criterion in these exercises is considered to be strengthening the muscles of the spine and back.

For legs

Just 3 exercises will help eliminate leg fatigue during pregnancy and avoid possible discomfort. These exercises are also a preventive measure against seizures. You should try to do them every day in a different sequence, for 10 minutes.

Exercise "swing":

1. you need to rest your hands against the wall or you can hold on to the back of a chair;
2. straighten your back and squeeze your gluteal muscles;
3. rise on your toes, shoulders and body need to be relaxed;
4. stay in this position for 10 seconds;
5. gradually lower yourself without touching your heels to the floor;
6. do this up to 10 times.

Monkey Grip Exercise:

1. you need to sit on the floor, rest your hands behind you, your back should be tilted;
2. stretch your limbs in front of you;
3. in this pose you need to grab a pencil with your toes, do not bend your legs;
4. in this position, try to touch the floor with your toes;
5. take a break;
6. perform the exercise up to 10 times.

Exercise “dream circle”:

For hands

Side fly exercise:

1. You need to take dumbbells in your hands, lean forward slightly, bring the dumbbells together in front of you, start the exercise by stopping the dumbbells completely;
2. raise the dumbbells no higher than your shoulders, while turning your wrists slightly, as if you were pouring water from a jug;
3. as you exhale, lower your arms down;
4. repeat up to 15 times, with a break;
5. The weight of dumbbells should not exceed 2 kg.

Overhead Elbow Extension Exercise:

For the stomach and back

To perform the exercise, you need to position yourself on the floor so that your heels are under your buttocks, your knees and hips need to be brought closer to each other. You need to stretch your arms in front of you and slowly lean forward, while trying to reach your forehead to the floor. Gradually return to your previous position.

Combination of exercise therapy and massage for pain in the neck and back

Physical therapy during pregnancy together with massage will help:

• strengthen the body;
• improve blood circulation, respiratory system, metabolism;
• strengthen the muscles that are involved in labor activity;
• increase the elasticity of the muscles involved in childbirth;
• increase the mobility of the pelvic joints, spine, hip joints;
• learn proper breathing;
• prevent complications.

How to do a massage correctly

Massage must be performed according to the rules that need to be taken into account:

Every pregnant woman can engage in physical therapy, she just has to want it. You can perform special exercises both at home and in fitness clubs together with a personal trainer. Thanks to gymnastics during pregnancy, you can eliminate many ailments.

Article format: Vladimir the Great

Video about physical therapy during pregnancy

A set of exercises during pregnancy:

Exercise therapy during pregnancy

Pregnancy causes changes in all body systems: nervous, cardiovascular, respiratory, digestive and others.

In the first half of pregnancy, there may be symptoms of toxicosis with nausea, vomiting, and perversion of taste.

Exercise during pregnancy

Physical exercise is indicated for normal pregnancy, as well as for pregnant women with diseases of the cardiovascular system in the compensation stage.

diseases with elevated body temperature;

pronounced toxicosis;

nephropathy;

preeclampsia;

eclampsia;

uterine bleeding;

recurrent miscarriage;

history of stillbirth with Rh-negative factor;

concomitant diseases for which exercise therapy is contraindicated.

Gymnastics method

It is advisable to divide the entire period of study into three time periods (trimesters): 1-16, 17-32, 32-40 weeks. This makes it easier to assemble groups for classes in antenatal clinics.

Tasks for weeks 1-16: to instill skills in regular exercise, teach how to perform physical exercises, and correct breathing. Promote the normal development of pregnancy, increase the functionality of the body, strengthen the musculoskeletal system, cardiovascular, respiratory and other systems.

Tasks for weeks 17-32: improve conditions for the full development of the fetus, strengthen the abdominal and perineal muscles, increase endurance, improve posture, and help prevent venous stagnation.

Classes include general strengthening exercises for the arms, legs, torso, breathing and special exercises for strengthening the abdominal muscles, back muscles, feet, and increasing the extensibility of the perineum. To strengthen the abdominal press while standing, twists and bends of the torso are used. In the supine position - imitation of riding a bicycle (“bicycle”), crossing the legs (“scissors”), raising the leg(s), writing numbers and drawing figures with raised straight legs.

To increase the extensibility of the perineum, exercises are used with maximum abduction, bending the legs, folding the soles together and spreading the knees. These exercises are carried out from various IPs: in a standing position - squats, legs wide apart (feet parallel); lying on your side - maximum abduction of the leg.

Exercises are dosed taking into account the functional state of the body, using the simplest indices and functional tests. This allows patients to be divided into three groups (Table 16).

Approximate sets of exercises for pregnant women

Complex 1. Exercises for pregnant women (17-32 weeks, weak group)

Slow walking, free, even breathing (2 minutes).

Raise your arms up through your sides, rise on your toes - inhale, return to IP - exhale (4-6 times).

IP - standing, legs shoulder-width apart, arms along the body

Turn your torso to the right, spread your arms wide in front of your chest - inhale; return to IP - exhale (alternately to the right and left, 3-4 times in each direction).

IP - standing by a chair, legs apart

Take a breath; sit down, leaning on the back of a chair - exhale; rise - inhale, standing - exhale (4-6 times).

Make semicircular movements to the side alternately with one and the other leg (3-4 times).

Lunge forward, arm forward, bending either the right or left leg (3-4 times).

Shift the center of gravity of the body alternately to the right and left (5-6 times).

Table 16. Features of the LH technique in three groups of pregnant women

Group of pregnant women

IP for performing exercises

standing; sitting on a chair, floor; lying on your back

standing; sitting on a chair, floor; lying on your back, side; on all fours

Total number of exercises

Number of repetitions of each exercise, times

Lesson duration, min

Duration of pauses between individual exercises, s

The ratio of general strengthening and breathing exercises

Exercise amplitude

Moderate

Maximum

Exercise pace

Slow

Slow

Slow and medium

Additional muscle effort (use of various gymnastic apparatus)

A number of exercises are performed with dumbbells, medicine ball (1-2 kg), with a stick

A number of exercises are performed with dumbbells, medicine ball (1-2 kg)

Brief description of gymnastic exercises

Simple, relatively easy exercises for the limbs and torso (raising, bending and abducting arms and legs, bending, turning the body, etc.)

Simple and complex exercises for arms and legs or other medium muscle groups at the same time

Combined and complex exercises simultaneously for different medium and large muscle groups

IP - standing, legs apart, arms hanging freely

Free breathing exercises (8-10 times).

IP - sitting on the floor, legs straight, hands clasped

Raise your hands - inhale; bend over and stretch your arms forward, turning your palms outward - exhale; return to IP - inhale; sitting, relaxing the muscles - exhale (6-8 times).

IP - lying on your back

Inhale, rise up, resting your forearms on the floor, exhale; return to IP - inhale; lying down - exhale (4-6 times).

Imitation of riding a bicycle with bent legs (30 s).

“Scissors” - cross leg movements (30 s).

Alternately lift and move to the side one or the other leg (3-4 times with each leg).

Slow deep breathing (6-8 times).

IP - standing on all fours

Raise your left arm forward and right leg back - inhale; return to IP - exhale (4-6 times).

IP - kneeling

Sit on your heels - inhale; kneel down - exhale (6-8 times).

IP - standing, legs apart, hands on the belt

Take a breath; bend to the right - exhale; straighten up - inhale; standing - exhale (3-4 times in each direction).

Slow walking - breathing evenly (2 minutes).

Legs apart, arms along the body. Raise your arms through the front up - inhale; lower through the sides and relax the muscles - exhale (4-6 times).

Complex 2. Exercises for pregnant women (32-40th week, weak group)

Walk at a slow pace, breathing evenly (2 minutes).

Feet are shoulder-width apart, arms along the body. Raise your right hand up, take your left hand back - inhale; IP - exhale. Repeat the exercise, changing the direction of arm movement (3-4 times).

Legs spread wide apart, hands on waist. Take a breath; bend to the right, raise your right hand - exhale, return to IP - inhale (3-4 times in each direction).

IP - lying on your back, legs bent, feet resting on the floor

Take a breath; raise the pelvis and retract the anus - exhale; return to IP - inhale, lying down - exhale.

IP - lying on your back, hands under your head, legs straight

Inhale, raise your legs straight - exhale; spread your legs - inhale; bring down - exhale, lower - inhale; lying down - exhale (4-6 times).

IP - lying on your side

Retract your right arm and leg - inhale; return to IP - exhale. Repeat the exercises first on the right, then on the left side (4-6 times).

IP - standing on all fours

Take a breath; bend your back up, lower your head - exhale; bend your back down, shake your head - inhale (4-6 times).

IP - standing, legs slightly apart, arms down

Take a breath; tilt your torso and, straightening your arms forward, stretch - exhale; return to IP - inhale; standing - exhale (4-6 times).

Spread your arms - inhale, return to IP - exhale (4-6 times).

Walk slowly, breathing evenly (2 minutes).

Alternately shaking relaxed arms and legs, breathing evenly (1 min).

Exercise therapy in the postpartum period

After childbirth, a restructuring occurs in a woman’s body. The muscles involved in the birth act are overstretched and flabby (the abdominal and pelvic floor muscles), the ligamentous apparatus of the pelvic organs is weakened, the condition of the uterus, the functional state of the cardiovascular and respiratory systems, and the musculoskeletal system are changed.

Indications for prescribing physical exercises:

acute thrombophlebitis;

endometritis;

preeclampsia or eclampsia during childbirth;

progressive circulatory failure;

temperature above 37.5 °C;

bleeding during and after childbirth;

III degree perineal ruptures;

general serious condition;

all diseases for which exercise therapy is contraindicated.

Tasks and exercise therapy:

promote reverse contraction of the uterus and overstretched abdominal muscles;

strengthen the abdominal and pelvic floor muscles;

improve bowel and bladder function;

improve the functional state of the cardiovascular and respiratory systems.

The method of using physical exercises consists of using general strengthening, special and breathing exercises:

1st day after birth: IP - lying down. Exercises are used for small and large muscles of the arms and legs in flexion and extension, circular movements and lifting the pelvis. Repeatedly throughout the day, you should arbitrarily contract the rectal sphincter (retract the anus). The entire postpartum procedure consists of 12-14 exercises, lasting 20 minutes. Foot massage is indicated.

2nd day after birth: IP - the same. These exercises are repeated, but the amplitude is increased and cross movements of the legs and outward circular movements of the hips are recommended. These movements should not cause pain if there were ruptures of the soft tissues of the birth canal during childbirth. To increase lactation and improve pulmonary ventilation, circular movements of the arms are advisable; the rectal sphincter should be contracted more intensively.

3rd day after birth: most of the class is spent standing. They use turns and bends of the body to the sides, circular movements of the pelvis, and half-squats. The procedures are carried out 0.5 hours after feeding the baby.

In the following days, various exercises for the legs are performed in the IP lying down: imitation of cycling, cross-circular exercises, twisting in the opposite direction. Exercises that stretch the perineum are not used - these exercises were necessary only during pregnancy.

Classes are conducted in a group method, individual - for complicated postpartum period.

Special exercises for postpartum women, postpartum period

IP - lying on your back

Vigorous clenching of fists and flexion - extension of the feet; breathing is uniform (1 min).

Raise your hands - inhale, lower them - exhale (6 times).

Alternating leg bending; when bending the leg - inhale, when straightening - exhale (5-6 times).

Bending your arms and clenching your fists - inhale; return to IP - exhale (4-5 times).

Bend your legs and lift your pelvis. Bend your legs, place your feet firmly on the bed - inhale; raise the pelvis - exhale; lower the pelvis - inhale; straighten your legs - exhale (6 times).

Blow on the suspended strips of paper (4 times).

Hand movements imitating boxer punches, breathing evenly (1 min).

Alternately raising straight legs - inhale, lowering - exhale (6 times).

Circular movements with raised straight arms, uniform breathing (1 min).

Cross movements with raised straight legs (“scissors”), uniform breathing (1 min).

Deep belly breathing (1 min).

Alternate shaking with raised arms and legs, breathing evenly (1.5 min).

Deep “belly breathing” and retraction of the anus (1 min).

Circular movements with a straightened leg, breathing evenly (4 times).

Raising hands - inhale; return to IP - exhale (6 times).

Alternate flexion - extension of the feet, uniform breathing (1 min).

Calm deep breathing (1 min).

With functional urinary incontinence, it is necessary to perform a special exercise many times throughout the day - voluntarily contracting the levator ani muscle. It is also recommended to train the bladder sphincter - stop the stream several times with some effort during natural urination. General strengthening physical exercises are important.

Exercise therapy for chronic inflammatory diseases of the female genital organs

Inflammatory diseases most often occur in at a young age and when chronic, they can lead to infertility. This process represents a long chain reaction, the trigger of which in most cases is a microbial pathogen. Subsequently, the microbial factor loses its leading importance and the pathogenesis of the disease is dominated by local and general organic and functional disorders. The allergic factor is of particular importance. The entire body is involved in the process, metabolism is disrupted, and significant deviations occur in the endocrine, nervous, cardiovascular and other systems.

Pain during exacerbation leads to limitation of motor activity, signs of hypokinesia and physical inactivity develop, manifested by weakness of the abdominal muscles, poor circulation, and congestion in the pelvic and abdominal cavities.

Indications for exercise therapy:

chronic salpingoophoritis;

incorrect positions of the uterus: fixed or subfixed retroversion, retroflexion (retrodeviation):

as a result of an inflammatory process,

caused by pelvic peritoneal adhesions,

accompanied by dysfunction of the large intestine and bladder;

infantilism (genital), uterine hypoplasia;

ovarian dysfunction as a consequence of the inflammatory process of the female genital organs;

pelvic peritoneal adhesions as a result of an inflammatory process or surgery on the uterus and appendages.

P r o t i v e d i n c a t i o n :

acute and subacute diseases of the female genital organs;

sactosalpinx;

vesico-intestinal-vaginal fistulas;

malignant neoplasms;

benign formations of the uterus and appendages;

menstrual dysfunction such as menometrorrhagia.

Tasks and exercise therapy:

carry out a general strengthening, health-improving effect on the body, increase physical performance,

improve blood and lymph circulation in the pelvic organs;

help restore mobility and normal relationships of the pelvic organs;

strengthen the ligamentous apparatus of the uterus, abdominal muscles, pelvic floor, promote stimulation of damaged links endocrine system, metabolic processes, improving the function of the cardiovascular system,

influence the central mechanisms of nervous regulation, help improve the motor-evacuation function of the intestine.

Therapeutic gymnastics can be carried out twice a day (the main lesson is in the hall, conducted by a methodologist and an independent lesson is in the ward). The procedures are carried out using a small group (3-4 women) and group (8-9) method. When treated in outpatient settings, patients are taught therapeutic exercises for independent studies at home, twice a day.

During menstruation, which is not accompanied by severe pain in the lower abdomen and heavy bleeding, the procedures are not canceled, but during this period the load on the abdominal muscles should be reduced, and exercises for the muscle groups of the upper and lower extremities should be used to a greater extent.

In the introductory period, the load should be given, alternating its increase with decrease (avoiding a significant increase in the middle of the lesson). Subsequently, as patients adapt to physical activity, the LH procedure is built according to the type of 2-3-vertex curve, which is achieved by uniform distribution of load exercises throughout the procedure.

One of the leading objectives of the method of therapeutic exercises for chronic salpingoophoritis is to improve blood and lymph circulation in the pelvic organs. For this purpose, the following exercises are used.

Exercises that involve large muscle groups close to the pelvic organs

Muscles of the hip region and thigh muscles (iliopsoas, gluteal, external and internal obturator muscles, piriformis and quadratus femoris, pectineus, tender, long, short, adductor minor and major muscles, quadriceps, biceps femoris, etc.) . These muscle groups carry out movements in the hip joint, which are possible in three planes: sagittal (flexion and extension); frontal (abduction and adduction); vertical (rotation) and circular movements in the hip joint. In addition, these muscles pull the hips towards the body and, when the hips are stationary, bend the pelvis along with the body forward and to the sides.

Lower back muscles (quadratus lumborum) and abdominal muscles (external and internal obliques, transverse, rectus abdominis, pyramidalis). The abdominal muscles surround the abdominal cavity and put pressure on the insides contained within, forming the so-called abdominal press. Thanks to the tone of the abdominal muscles, the internal organs are held in their position. These muscles are involved in the movement of the spine and torso, performing its flexion, bending, turning and rotation.

The third large muscle group is the muscles of the perineum, which, covered with fascia, form the genitourinary and pelvic diaphragms. When the pelvic floor muscles contract, the genital gap closes.

If the pelvic floor muscles are in good functional condition, they provide sufficient resistance to the abdominal press, as a result of which the woman’s internal genital organs maintain their normal position. With functional inferiority of the pelvic floor muscles, the resistance to intra-abdominal pressure decreases and the increase in the latter during effort can be so pronounced that the uterine ligaments cannot counteract the pressure in the abdominal cavity and hold the uterus in its normal position.

Vigorous work of all these muscle groups improves blood supply to the pelvic area, promotes stretching and breaking of adhesions resulting from the inflammatory process.

In order to improve blood circulation in the pelvic organs, you should also use different kinds walking: simple and complicated in different directions, walking with high knees, with alternating crossing of legs (cross step), lunging forward, in a half-squat, etc.

Much attention is paid to diaphragmatic breathing, which helps to activate blood circulation in the abdominal organs and regulate intra-abdominal pressure. Training the abdominal muscles helps strengthen the ligamentous apparatus of the uterus due to the connection with it through the transverse and oblique abdominal muscles. Along with this, exercises that strengthen the abdominal muscles have a stimulating effect on intestinal function. The use of special exercises against the background of general developmental exercises helps restore trophism in the pelvic area, stimulating both general and local metabolic processes.

The physical exercises used must be differentiated taking into account the anatomical and topographic relationships of the pelvic organs.

In the method of therapeutic exercises for chronic salpingoophoritis without displacement of the uterus, any IP is used: standing, sitting, lying (on the back, on the side, on the stomach), on the knees, hanging, various types of walking.

When the uterus is displaced, physical exercises should help transition it to its normal physiological position. This can be achieved by using such IP of the body, in which the uterus, due to its gravity, will strive to take a normal position.

If there is a backward bend of the uterus, it is necessary that special physical exercises and IP during their implementation contribute to the transfer of the resultant force of intra-abdominal pressure in the anterior surface of the uterus to the posterior one. These starting positions include: knee-wrist, knee-elbow, plantar-wrist, plantar-elbow and lying face down. When performing physical exercises in the indicated IPs, the pressure on the uterus from the abdominal organs weakens due to the movement of intestinal loops to the diaphragm, and the high position of the pelvis is a favorable moment for returning the uterus, due to its heaviness, to its normal position.

In the presence of a sharp bend of the uterus forward, only IP lying on the back is used, in which the force of abdominal pressure and the weight of neighboring organs (bladder, intestinal loops) fall on the anterior surface of the uterus, thereby contributing to its deviation back. They mainly use exercises for the abdominal muscles, strengthening which helps to increase the tone of the uterus and its ligaments.

When the uterus deviates to the side, exercises are introduced, mainly in the PI lying on the side opposite to the deviation, which helps to stretch the round ligaments of the uterus, which have lost their tone as a result of the inflammatory process and the formation of adhesions. Regression of the uterus with this displacement occurs due to its movement under its own weight, as well as as a result of training the oblique abdominal muscles on the side of the deviation.

The amount of physical activity during procedures is dosed taking into account functional capabilities.

There are two groups of patients:

Group I - physically stronger, more trained;

Group II - those unable to perform heavy physical activity, weak.

Introductory period

In group I patients, during the introductory period of the course of treatment, exercises are used for various muscle groups of the body and limbs in flexion, extension, abduction, adduction, rotation, bending, turning; exercises with resistance, weights; simple and complicated walking, squats; relaxation exercises, which are introduced after exercises on large muscle groups and weight training exercises. In order to teach proper breathing, static breathing exercises are used (1:3). The pace of the exercises is average. The range of motion is full. The duration of rest pauses is determined by subjective tolerance to physical activity. Not only extracardiac circulatory factors are mobilized, but also gradual training of the central circulatory apparatus is carried out, and special exercises are gradually included. The duration of the procedure in the introductory period is from 25-30 minutes.

In the introductory period, patients of group II use mainly simple gymnastic exercises for the muscles of the upper and lower extremities, and simple walking. Depending on the degree of decrease in physical performance, exercises are performed with a limited range of movements, at a slow pace with frequent pauses for rest. Breathing exercises of a static nature -1:3. They influence only extracardiac circulatory factors. The duration of classes for this group of patients in the introductory period is 15-20 minutes.

Special influences are not used in the introductory period, or with a moderate decrease in physical performance, elements of training are introduced with a special exercise (Table 17).

Main and final periods

In group I patients, in the main period, breathing exercises of a static and dynamic nature are used in a ratio of 1:4. Carry out special effects and training of the circulatory system. Complex gymnastic exercises are used with full range of motion, number of repetitions up to 10-12 times. Use exercises aimed at training the muscle groups of the thigh, lumbosacral region, abdominals, and pelvic floor; exercises that cause fluctuations in intra-abdominal pressure; exercises at the gymnastic wall; exercises with resistance, weights; various types of walking, outdoor games, running. The load is brought to submaximal values. The duration of the procedure is up to 40-45 minutes in the main and final periods.

Table 17. Approximate scheme of the therapeutic exercises procedure for patients with chronic salpingo-oophoritis (introductory period of the course of treatment) Contents of the procedure Purpose of the procedure

Guidelines

Group 1 (physically weaker)

Group II (physically stronger)

Introductory section

IP - standing, sitting, lying down.

Elementary gymnastic exercises for muscle groups of the upper and lower extremities. Breathing exercises of a static nature. Combined exercises for the limbs or walking in combination with exercises for the arms and legs; order exercises and formations

Gradual involvement of the body in physical activity. General strengthening effects. Learning proper full breathing.

Stimulation of peripheral circulation

Depending on the degree of decrease in physical performance, exercises are performed either with a limited range of motion or with a full range of motion at a slow pace with frequent pauses for rest. Breathing exercises of a static nature. Use only elementary gymnastic exercises for muscle groups of the upper and lower extremities, ordinal exercises, formations

Exercises are performed at an average pace with a full range of movements. Breathing exercises of a static nature. In addition to basic gymnastic exercises, combined exercises for the limbs, walking in combination with exercises for the arms and legs, ordinal exercises and formations are used.

Main section

IP - standing, sitting, kneeling, lying down, special IP for displacement of the uterine body.

Exercises for various muscle groups of the body and limbs in flexion, extension, abduction, adduction, rotation, bending, turning.

Gradual increase in load. Mobilization of extracardiac circulatory factors. Gradual training of the central circulatory apparatus. Exposure to increase blood pressure during hypotension. Full breathing training and developing the skills of combining breathing with movement.

When choosing an IP, be sure to study the pelvic cavity: if any IP is normal; in case of deviation of the abdomen, knee-elbow, knee-suture-elbow, plantar-hand, lying on the side; in case of sudden maneuver, sitting with emphasis on your hands, on the side - standing, lying on your side, against your stomach and special IP, using

When choosing an IP, the position of the body of the uterus must be taken into account; in this position of the body of the uterus, special IPs are possible (lying on the carpal, knee-thoracic, infra-spinal), as well as standing, standing on the anterior knee - lying on the back, behind the back; in case of deviation in the opposite direction, lying on the side in case of posterior deviation of the uterus

Exercises with resistance, weights. Breathing exercises of a static and dynamic nature. Relaxation exercises. Coordination and game exercises. Walking simple and complicated