Q&A with physio-therapist Jane Simons

Jane Simons is a physiotherapist who has been running core stability classes for women for 25 years. She currently works at the Royal Hospital for Women in Randwick. Jane is passionate about exercise and women’s health and has written widely on the subject.

Jane answered some questions about exercise and pregnancy for The M Word. You can find out more about Jane and her classes at her website.

Jane Simmons

Courtesy of Jane Simons

What attracted you to working with exercise in pregnancy?

Physiotherapy is the mother of exercise prescription, a wonderful career and has been my greatest teacher. Pregnancy brings about the most dramatic physical and emotional transformation in a woman’s life and there is so much adaptation needed to meet these changes. For many years, I have had the privilege of enhancing my knowledge, learning from women and passing on this knowledge.

How have attitudes about exercise in pregnancy changed over time?  

Coming from the period where labouring women were not even encouraged to get off the “labour table” to current childbirth practices, there has been an equal shift in attitudes towards pregnancy exercise. The issue is that most of the normal muscular-skeletal changes of pregnancy, the problems, aches and pains, do indeed revert once pregnancy is over. One word of caution: the pelvic floor can be irreversibly stretched in some extreme cases with certain exercises, but this needs a separate conversation on its own.

The “pregnancy exercise attitude spectrum” today varies from treating pregnancy as if it were not there (and doing what they normally do regarding exercise), to those who are concerned out of fear of what they can or cannot do.

I am concerned with the latter end of the pregnancy exercise attitude spectrum as it includes the very real-and not simply fearful, breaches from normality that bring discomfort, pain or frank disability in these three trimesters. Those at the other end of the spectrum may indeed “get away with it” by exercising to any limit they desire and indeed I say good luck to you, well done but I believe they may be few and far between.

Nature has a way of saying “slow down (put your modelling career on hold)”. Adapt your attitude to fitness as your body adapts. There is the rest of your life to catch up, once your baby becomes a three year old!

Are there any exercises pregnant women should avoid?

Ballistic, fast movements in my opinion do not teach the exerciser how to protect and brace during movement in order to support loosening joints, and in a nutshell, these are the kind of exercises I believe are not great for pregnancy.

The main culprit here is any form of running or jogging. The Continence Foundation recommends not running in pregnancy or for a year following birth as this puts the pelvic floor at risk.

How can regular exercise benefit pregnant women? Does it make a difference whether a woman is pregnant with her first or second/third baby?

Regular exercise is vital for every human on earth. Pregnant women who have a good baseline level of fitness are then able to maintain this throughout those growing nine months, adapting to their increasing weight, changing body awareness and softening pelvic floor muscles. Multiples, or women having their second or subsequent child have an accumulated vulnerability of their pelvic muscles and joints, combined with the doubling of weight lifting (carrying toddlers and paraphernalia), and seem to need pregnancy exercise guidance even more.

What myths and misconceptions have you encountered about exercise in pregnancy? Where do you think they come from?

I am a bit loath to answer this question as I feel comfortable with the exercises I prescribe and prefer not to critique others. But as expected there is an “however”. I do get asked questions about other forms of exercise but to be honest unless I see what is being done I really cannot comment on the precautions or dangers. This is too open-ended a question. 

A simple statement made very often is “I have sciatica”. Sciatica is nerve root compression from the spine and mimics the pathway of sacroiliac pelvic pain. So in 99% of cases this is SIJ pain and not spine pain. A lot can be done to manage this pain.

Carpal Tunnel syndrome, pins and needles in the hands and wrists, can be managed with exercise, so don’t avoid using the hands – another myth.

A golden oldie is that stretching arms up above the head is bad in pregnancy. Not so. Another one: “You cannot get stronger in pregnancy.” With supervised pregnancy exercise you can improve overall body strength, especially the core group.

Be wary of the belief that you can do anything in your pregnancy. As stated previously there are some who “get away with it” but do so at their own behest. Be wary of anyone pushing you beyond your capability, know that they are there to monitor each and everyone in the class and be confident they know the remedy if anything becomes painful. The credentials of those guiding you in pregnancy exercise are key. To me, comprehensive professional training combined with several years (at the least) of obstetric experience, are a base line “must have” for those teaching pregnancy exercise.

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