Saturday, January 31, 2009

The Pregnant Triathlete
Information for training as a pregnant triathlete including physiological changes, nutritional and environmental concerns plus certain risks to avoid.

The American Medical Society for Sports Medicine (AMSSM) was formed in 1991 to fill a void that has existed in sports medicine from its earliest beginnings. The founders most recognized and expert sports medicine specialists realized that while there are several physician organizations which support sports medicine, there has not been a forum specific for primary care non-surgical sports medicine physicians.

~Pregnancy is a normal condition.
But can a triathlete continue training during pregnancy and is it safe to do so?
In the absence of complications, pregnant women should follow the Centers for Disease Control and Prevention and the American College of Sports Medicine recommendations of moderate exercise for 30 minutes or more on most, if not all days of the week. The goal of training during pregnancy is to maintain fitness while avoiding fetal distress.

~Physiological ChangesFor endurance athletes who want to continue training during pregnancy, this is great news. However, even though continued exercise is recommended, athletes must still contend with the changing physiology of pregnancy. The increased oxygen consumption of pregnancy will lead to a decline in exercise tolerance. Thus, pregnant athletes should stop exercising when they feel fatigued---they should not try to “train through” fatigue. After the first trimester, the enlarging uterus can cause obstruction of venous return when an athlete is lying on her back, so athletes will have to adjust weight-training and floor exercises appropriately.

~Nutritional Concerns Athletes must also be aware of their nutrition during pregnancy. They should take a pre-natal vitamin and on average, will need an additional 300 calories daily; however, the adequacy of an athlete’s dietary intake is ultimately determined by appropriate weight gain during pregnancy. With adequate nutrition, there is no evidence that training has a detrimental effect on labor or fetal growth. The babies of regularly exercising women appear to tolerate labor well. They also have been shown to have a similar head circumference and length, but lower body fat at birth and at five years of age compared to babies born to non-exercising mothers.

~Environmental Concerns Environmental conditions should be taken into account when exercising. To avoid hyperthermia or risk of relative dehydration, pregnant women should dress appropriately, drink appropriate amounts of fluids, and avoid training in extreme heat.
~Other Risks The highest risk to mother and fetus with exercise is trauma, and this can be minimized by avoiding training in an environment with a high risk of trauma or falling, especially as the woman’s balance changes throughout pregnancy. This includes discontinuing cycling outdoors and avoiding running in slippery or icy conditions or on uneven terrain after the first trimester. As weight increases, and changes in the center of gravity and curvature of the lower spine lead to more discomfort in later pregnancy, swimming and other water-based exercises, such as aqua-jogging, can help an athlete maintain aerobic fitness in a no-impact environment until she is ready to resume biking and running after delivery. There are some contraindications to training during pregnancy, including heart and lung disease and premature labor. Patients with these conditions or any other significant medical problems or pregnancy complications should be under the close supervision of a physician. All pregnant women who desire to continue their training should have regular appointments throughout their pregnancy and consult with their primary care sports medicine physician for any specific questions about their training regimen.
Just a little information!