Excerpt: "Buff Moms"

Jan. 17, 2005 -- -- Sue Fleming began working as a personal trainer 10 years ago. Now she has written a book so she can share her knowledge and help other moms stay in shape.

"Buff Moms: The Complete Guide to Fitness for All Mothers " is part of "Good Morning America's" "Personal Best" series. Read an excerpt from the book posted below.

EXCERPT

Women who exercised regularly during pregnancy may not be capable of their usual workout postpartum. Weight gain and the decline in activity associated with pregnancy contribute to decreased fitness.

Ligament laxity associated with increased levels of relaxin during pregnancy may increase a woman's risk of injury from postpartum exercise. Although relaxin levels return to normal within the first week after delivery, laxity may persist for three months after delivery. Exercise has to be a priority, part of your daily routine. Yes, it takescommitment.

It also takes planning, compromise and loads of flexibility. Keep in mind that staying fit over the long haul is more important than getting into shape right after giving birth. So choose the fitness level appropriate for you. Physical fitness is essential to good health. You owe it to yourself and you owe it to your family.

Benefits for Mom-and-Baby Exercise After Childbirth

Benefits for Mom

Enhances psychological well-being.

Assists with regaining of muscle strength and tone after childbirth.

Reduces back discomfort.

Provides a naturally progressive workout -- mothers get more fit as babies gain weight.

Benefits for Baby

Promotes bonding with Mom.

Stimulation -- babies enjoy the movement, music and watching the video's smiling moms and babies.

Cardiovascular Exercise

With any exercise program, cardiovascular exercise is one of the most importantcomponents of fitness. Cardiovascular fitness is the ability of your lungs, heart and vascular system to efficiently transport oxygen to your muscles.

Aerobic exercise strengthens cardiovascular fitness. Aerobic means "with, or in the presence of, oxygen." Walking, jogging and biking are all examples of aerobic exercises -- exercises that utilize oxygen. Incorporating aerobic exercise into your life will improve your cardiovascular fitness because your body learns to utilize its oxygen supplymore efficiently.

When you utilize oxygen more efficiently, your heart doesn't have to work as hard to pump blood and oxygen throughout your body. This results in a stronger, more efficient heart. Cardiovascular exercise is crucial for maintaining and losing weight. During aerobic exercise, your body expends a lot of energy because you process and utilizemore oxygen. This energy is measured in calories. For every liter of oxygen (or one kilogram of body weight) used during an aerobic activity, the body spends five calories.

The more energy you spend and the longer you exercise, the more oxygen is used and the more calories you will burn. The key is to mix things up and find a form of exercise you like. In the beginning, walking will probably be the only cardiovascular exercise you cando. Slow walks during this initial period will not only help you feel you're getting back into a fitness routine, but will also help you relieve tension and get some fresh air. Don't push yourself -- work to establish a regular routine and keep a steady pace.

A full-fledged return to aerobic activities you participated in pre-pregnancy (or establishing a routine if you're a beginner) usually comes around the four-to-six-week-postpartum period. As you begin to feel better and you start to heal, gradually increase your cardio program and integrate the strength-training exercises that I outline, which target many ofthe major muscle groups.

Buff Exercise Pointers:

Start by consulting your doctor. Once you get his OK, listen to your body. Moms who had a C-section may need additional time to heal.

Resume exercise gradually. Some of the physical changes that took place during pregnancy may persist four to six weeks after delivery. Moderation is the key; progress slowly.

Develop an exercise plan. Think it through before you start.

If you develop severe or chronic pain, vaginal bleeding, faintness, generalized edema, palpitations, nausea, shortness of breath, extreme fatigue or muscle weakness, stop immediately and contact your doctor.

Invest in a good pair of sneakers. Your feet may still be swollen following pregnancy.

Nursing moms may need extra bra support. Make sure your bra fits snugly, whether you're nursing or not.

Drink lots of fluids, preferably water.

Balance your workouts with stretching, cardiovascular work and strength training. Make sure to warm up and cool down properly.

Make exercise a commitment. You're less likely to see results working out one day a week rather than three or four daysa week.

Other Forms of Cardiovascular Activities Include:

JOGGING

Invest in a good pair of running shoes. In the beginning, start with walking. Once you feel stronger (about two to three weeks postpartum), alternate walking with jogging. For example, for every three minutes of walking, alternate with one minute of jogging.

SWIMMING*

BIKING*

A stationary bike can be a relatively economical piece of home exercise equipment. Stationary bikes can cost anywhere from a few hundred to thousands of dollars. One downside is that it only works your lower body. If you have lower back pain, recumbent bikes may be better for you. However, they are a bit easier to use than upright bikes, and you may have to push yourself harder to stay in your target heart rate zone and achieve a beneficial workout. One thing to remember about stationary bikes is that if they will be placed near the baby, consider models equipped with a chain guard and a solid frontwheel that covers the spokes to protect crawling children's fingers. Also, investin a comfortable seat; it makes a world of difference.

* Swimming and biking are excellent postpartum activities because they are non-weight-bearing aerobic exercises that can restore your cardiovascular conditioning without stressing the joints. However, if you had some tissue damage during delivery or had an episiotomy, you may need more time to heal before starting these activities.

AEROBICS CLASSES

Low-impact in the beginning.

YOGA

For those not ready to do more than walk, yoga-based exercise is a great way to help your body and mind get back into shape after having your baby. With practice, positions and movements soon become second nature, enabling you to pick and choose the ones that feel most comfortable. Some of the yoga positions can be done as you are watching TV.

The Physical Benefits of Yoga:

Better circulation of blood and lymph fluids

Better breathing

Improved muscle tone

Greater strength and more flexibility

Less tension and stiffness in your muscles and joints

Relief from minor ailments or aches and pains (especially back pain)

Improved energy levels and less fatigue

Better posture

A positive mental attitude

Increases suppleness

Improves cardiovascular efficiency and overall fitness though it does not involve vigorous exercise

Lowers blood pressure

Balances blood composition

Exercises to Avoid

There are some exercises that should be avoided the first few weeks after having your baby. Ballistic movements (such as bouncing) and deep flexion or extension of joints should be avoided because of the joint tissue laxity that continues after pregnancy.

Jumping, activities that require quick changes of direction and any type of jarring motion should be avoided to prevent possible stretching and dislocation of thesejoints. The knee, hip and back are especially susceptible to injury during the first few weeks after pregnancy. Avoid exercising on hard surfaces such as pavement. Instead, use carpeted surfaces, grass or padded mats.

Try to keep a consistent exercise schedule and give yourself plenty of warm-up, stretching and cool-down time. Although stretching should be done cautiously because of joint laxity, it still should be done every day to regain flexibility.

Avoid exercising in the heat. Hydration is key during this transitional phase of resuming activity. Make your drink choice water, and try to stay away from fruit juices, as they tend to have a lot of sugar.

Monitoring Your Heart Rate

It is important that you monitor your heart rate as you begin to exercise postpartum. This also holds true for veteran moms just starting a fitness program. Consult your doctor on what your target heart rate should be and make sure you don't exceed it.

A heart rate monitor may not be a bad investment to ensure you're not working out too hard. Heart rate monitors are worn on the body while exercising and let you know how many times your heart is beating per minute. You can also check your heart ratemanually. Periodically during your workout, place your index and middle fingers in the groove on the side of your throat. Starting at zero, count how many times your heart beats in six seconds (a clock will help). Add a zero to that number. This is how many times approximately your heart is beating per minute. Keeping track of your heart rate not only ensures that you're not working out too strenuously, but will help you determine if your cardiovascular fitness is improving.

Determining Your Target Heart Rate

Your target heart rate range is the recommended heart rate range for safe and effective participation in aerobic activities. Calculating your target rate requires you to know your resting heart rate (RHR) and to be able to locate and take an accurate pulse check during aerobic activities. Once you've calculated your RHR (count the number of beats youfeel on your wrist or neck for six seconds, starting at zero, and then multiply that number by 10), you can determine your target heart rate zone.

TARGET HEART RATE FORMULA*:

Subtract your age = Your Maximum Heart Rate

Subtract your RHR from MHR = Your Heart Rate Reserve

Multiply your HRR by: x .60 and x .80

Add your RHR to answers above

= your Target Heart Rate

Example: a 30-year-old woman with an RHR of 70 BPM

220 - 30 = 190 (Maximum Heart Rate)

190 - 70 = 120 (Heart Rate Reserve)

120 x .60 = 72 and 120 x .80 = 96

72 + 70 = 142 and 96 + 70 = 166 (Target Heart Rate = 142 to 166 BPM)

* Remember, a doctor may recommend staying in the lower range of the target heart rate for the postpartum mom and the newcomer to fitness.

Creating Your Home Gym

Getting back into your pre-baby shape doesn't have to mean expensive gym memberships. An affordable, simple gym in your own home can make it much easier to keep your new fitness commitments. A home gym really comes in handy when it's not possible to go for a fitness walk or to an exercise class with your baby. A few good pieces of equipment will put you on your way to being a Buff Mom.

The equipment I suggest should cost you no more than $60. However, if you have the space and the extra money, a good machine set up in a convenient spot in your home may inspire you to work out whenever you have some free time. The cost is often no more than that of a one-year gym membership.

The basic machines are treadmills, elliptical trainers, stair-steppers and stationary bikes. However, if you don't want to invest in machines, you can still achieve your fitness goals with some other basic equipment. Make sure your baby is in a secure infant seat, high chair or playpen before beginning your workout. Since you'll be exercising indoors, try to use a fan or open a window to keep you comfortable. You will be able to find all of the following items at your local sporting goods retailer.

Fitness Ball

Tired of doing basic crunches? Then get yourself a fitness ball. This oversize ball, once used for physical rehabilitation, is a staple in every gym. You can do hundreds of core-strengthening exercises with this versatile piece of gear. Strengthening the core muscle groups is especially important for postpartum recovery. The ball is also a great tool for improving pelvic-floor tone. Mothers have also commented that sitting on the ball with baby in arms is very soothing for the child, as it allows gentle, relaxing movement. Make sure you get a ball that comes with a hand pump. The package should cost about $20.

Hand Weights

Hand weights, or dumbbells, are useful when you are able to begin strength-training exercises. I recommend starting off with a set of five-, eight- and 10-pound dumbbells. Hand weights come in many shapes and colors; stick to the less expensive brands. Look around; they should not cost you more than $30.

Mat

A mat is necessary for floor exercises. Find one that is padded. Mats are easy to store and are inexpensive, around $15.

Exercise Bands

Exercise bands can be used in place of dumbbells for certain exercises.

The Program

The following stretching and strength-training suggestions should serve only as a guide as you work toward your fitness goals. Progress slowly and at your own rate. Kegels can be done the first day after labor. Stretching can be done daily as well; however, don't overstretch, and work up to the more complex stretches.

Kegel Exercises

When you were pregnant, no doubt you heard about Kegels. Kegel exercises, named after Dr. Arnold Kegel, were originally developed as a method for controlling incontinence in women following childbirth.

It is now recommended that women do Kegel exercises during and after pregnancy to strengthen the muscles of the pelvic floor. These muscles, which support the urethra, bladder, uterus and rectum, can weaken due to the excess weight of the baby and fluid. Kegel exercises can and should be done daily to strengthen these muscles and help prevent urine leakage. Kegels are also beneficial for toning the abdominals and lower back muscles.

To find these muscles, try stopping and starting the flow of urine. If you can do it, you've found the pelvic-floor muscles. Kegels can be done a few days after childbirth. The effort of doing these exercises daily is well worth the benefits. If you've been leaking a mild to moderate amount of urine following childbirth, chances are that doing Kegel exercises routinely will improve the situation, and perhaps even cure your incontinence. Try to make doing Kegels a habit during certain activities, such as feeding your baby, showering or brushing your teeth, so you're reminded to do them each day. For the first four to six weeks following delivery, leaking a small amount of urine when you cough, laugh or exert yourself is not abnormal. If leaking persists, it's a good idea to seek help from your doctor.

Kegel Exercises:

Squeeze the pelvic-floor muscles, as if you're trying to stop the flow of urine.

Tighten these muscles, holding for 10 seconds, then release.

Repeat 15 to 25 times, four to five times per day.

Other Kegel Variations:

Hold for five seconds, then relax, 12 to 15 times. Don't overdo it!

While sitting in a chair, keep your feet slightly apart and your back straight. Tighten and relax your pelvic-floor muscles, holdingfor five seconds, then releasing.

While sitting on the floor, keep your back flat against a wall and your legs extended in front of you with your feet slightly apart. To the count of five, gradually tighten your pelvic-floor muscles, increasing tension with each count. Slowly release with each count to the starting position.

Stretching

Stretching is an important component to getting back to your pre-baby shape. Gentle stretching is recommended immediately after birth, as long as you didn't have a complicated delivery. Stretching muscles of the lower and upper back and chest can help improve posture. You need to remember, however, that during pregnancy, estrogen and a substancecalled relaxin are released, which have the effect of relaxing ligaments, softening cartilage and widening the pelvic joints due to an increase in synovial fluid.

This fluid actually lubricates the joints of the body, which makes giving birth easier. Combined with other physiological effects, it can predispose you to injury when stretching and exercising if you are not careful. Deep, dynamic stretching is not recommended until the body starts to return to normal, about four to six weeks postpartum.

Try to stretch as many muscle groups as you can daily. If you've had a C-section, do gentle, static stretching and avoid putting too much strain on your abdominals. Never force a stretch; if you experience muscular pain during a stretch, you are pushing yourself too hard. Stretch to the point of mild discomfort and breathe deeply.

Recommended Stretches:

LYING BACK BEND*

This stretch will help strengthen your back. Start slowly and don't force the stretch. Lie on your stomach with your arms at your sides, elbows bent and hands at shoulder level, palms down. Slowly press your body up, keeping your hips touching the floor until you feel resistance in your lower back. Return to the floor; repeat three to five times.

STANDING BACK BEND*

Standing with your feet shoulder width apart, put hands on your lower back, breathe out slowly, arch your back and look up at the ceiling. Don't go back too far; you should not feel any discomfort. Return to the beginning; repeat three to five times.

*Not recommended following C-section.

EXTENDED ARM STRETCH

Interlace your fingers in front of you at shoulder height. Turn your palms outward as you extend your arms forward to feel a stretch in your shoulders, middle of your upper back, arms, hands, fingers and wrists. Hold for 10 to 12 seconds, then relax and repeat.

OVERHEAD ARM STRETCH

Interlace your fingers above your head. Turn your palms upward and push your arms slightly back and up. Feel the stretch in your arms, shoulders and upper back. Hold for 10 to 12 seconds, then repeat. Make sure to breathe deeply.

SHOULDER/NECK STRETCH

To stretch the sides of your neck and tops of your shoulders, stand leaning your head sideways toward your left shoulder as your left hand pulls your right arm down and across, behind your back. Hold for 10 to 12 seconds; repeat on other side. Do each arm twice. This can also be done sitting on the floor or in a chair.

DELTOID STRETCH

Standing, reach your right arm across your chest, fully extended. Pushing your right elbow with your left hand, press your arm into your body. You should feel a stretch in the back of your shoulder, or posterior deltoid. Hold for 12 to 15 seconds, then release. Switch sides and stretch the left shoulder. Do each side twice.

TRICEPS STRETCH

Stand with your feet shoulder width apart. Your arms should be at your sides, palms facing backward. Raise your right arm and bring your forearm behind your head so that your elbow is at a 90-degree angle. Bring your left hand up and over the top of your head, gently pulling the right elbow to point vertically.

Hold your head against your right elbow; your right hand should rest between your shoulder blades. You should feel a stretch along your right triceps. Hold for 12 to 15 seconds, then switch arms. Do each side twice.

STANDING SIDE STRETCH

Stand with your knees slightly bent, and raise your left elbow above your head. With your right hand, gently pull your left elbow behind your head as you bend your torso to the right. Hold an easy stretch for 10 seconds. Repeat on your right side. Keeping your knees bent will help your balance and prevent you from locking your knees.

BEHIND-THE-BACK STRETCH

Standing, raise your left arm over your head, then bend it so that your elbow points to the ceiling and your hand reaches down your back. Bend your right arm behind your back so that your elbow points to the floor and your hand, palm turned outward, reaches up your back toward your left hand. If you're able, grab the fingers of one hand with the other andhold. You may find that you can do one side of the stretch but not the other. Hold for eight to 10 seconds, or as long as you feel comfortable, then repeat on the other side.

Variation: Dangle a towel behind your head with your right hand. With your right arm bent, reach up behind your back with your left hand to hold on to the dangling end of the towel. Gradually move your left hand up the towel, pulling your right arm down, until your hands are touching.

PRAYER STRETCH

Sitting on an exercise mat, place the soles of your feet together, letting your knees drop open to the sides. Reach forward, keeping your head down, and try to grab the front edge of the mat. Pulling with one arm isolates the stretch on either side. You should feel this in your shoulders. By slightly moving your hips in either direction, you can increase or decrease the stretch. Don't strain or try to reach farther than is comfortable. Hold for 10 to 12 seconds; repeat two to three times.

FOREARM AND WRIST STRETCH

Start on all fours. Turn your hands so that your fingers point backward, toward your knees. Keep palms flat as you move your hips backward to stretch the front part of your forearms. Hold for 15 seconds, relax, then repeat.

CAT STRETCH

Get on your hands and knees, with your back straight but relaxed. Exhale and walk your hands backward a few inches and arch your back up and forward into a cat pose. Hold for a count of three, inhale and relax. Repeat three times, adding more repetitions as you feel stronger.

SPINAL TWISTS

Sit on the floor and bend your left leg over your right knee so that your left knee points to the ceiling and your left foot rests on the floor on the outside of your right knee. Then, if it's comfortable, bend your right leg so that your right foot rests at the outside of your left knee.

If you prefer, you may keep your right leg extended in front of you. Keeping your back straight, place your right hand on your left knee and use it as leverage to twist your body to the left. Twist so you can comfortably look over your left shoulder. Repeat on the opposite side. Hold 10 to 12 seconds.

KNEE TO CHEST STRETCH

Lying on your back, pull your right leg toward your chest. For this stretch, keep the back of your head on the floor. Repeat, pulling your left leg toward your chest. Be sure to keep your lower back flat and pressed into the floor. Do each leg twice.

LYING QUADRICEPS STRETCH

Lie on your left side and rest the side of your head in the palm of your left hand. Hold the top of your right foot between the toes and ankle with your right hand. Gently pull the right heel toward the right buttock to stretch the ankle and quads. Hold for 10 to 12 seconds, then repeat with the other leg. Do each leg two to three times.

STANDING QUADRICEPS STRETCH

Standing, maintain your balance by grabbing a chair, table or wall in front of you with your right hand. Bend your left leg backward, holding the top of your left foot with your left hand. Keeping your knees together, bring your left heel to the back of your left buttock. Hold for 10 to 12 seconds, then repeat with the other leg. Do each leg twice.

BENT-LEG HAMSTRING STRETCH

Sitting on a mat, straighten your right leg out in front of you. Bend your left leg out to the side so that the sole of your left foot slightly touches the inside of your right thigh. Slowly bend forward from the hips toward the foot of the straight leg until you feel a slight stretch in your hamstring. Hold for 12 to 15 seconds.

Switch sides and stretch the left leg in the same manner. During this stretch, keep the foot of the straight leg upright with the ankle and toes relaxed. Be sure to keep the quadriceps relaxed. Do not dip your head forward when initiating the stretch. If you cannot easily reach your ankle or foot with your outstretched hands, sling a towel around the sole of your foot, holding the ends in either hand, and pull on the towel to help you stretch forward.

LYING HAMSTRING STRETCH

Lie flat on your back on a mat or carpeted floor. Lift your left leg up perpendicular to the floor. Your right leg should be flat on the floor. Interlock your hands behind your left knee, pulling your leg toward your chest until you feel a stretch in your left hamstring. Hold for 12 to 15 seconds, then repeat with the opposite leg. Do each leg twice.

HIPS AND GROIN STRETCH

Sit with your legs stretched out straight in front of you, a comfortable distance apart. To stretch the inside of your upper legs and hips, slowly lean forward from your hips. Be sure to keep your quadriceps relaxed and your feet upright. Hold for 15 to 20 seconds. Keep your hands out in front of you for balance and stability. Do not lean forward with your head and shoulders. This will cause your hips to move backward and put pressure on your lower back.

The Exercise Plan

The following exercises are recommended if you've had a normal, straightforward birth. Keep it simple; don't overdo it. If you tire, rest and start again the next day. Listen to your body. Some women will be able to advance more quickly than others.

The exercises are outlined by days and weeks. Don't be too concerned about the week; progress as you feel comfortable. Veteran moms just starting an exercise program may start farther into the program (about week 3).

Days 1, 2 and 3

Yes, you may feel up to it!

KEGELS [SEE PAGES 46-47]

You can do these while lying in bed. Slowly contract your pelvic-floor muscles and hold for five seconds, then slowly release. Repeat five to 10 times. Over time, increase repetitions to 50 to 75 per day.

ABDOMINAL TIGHTENING

This very simple exercise can be done in bed, and promotes the process of abdominal healing. Starting this the first few days after labor will help get your abs back to their old shape. Lying on your back, suck in your abdominals and hold for three to five seconds. Release. During the first week, gradually work up to five seconds. Do eight to 10 repetitions and two to three sets daily.

PELVIC TILTS

Lying on your back with knees bent, inhale and suck in your abdomen, pulling in through your belly button. Tighten your buttocks and slowly flatten the small of your back. Hold this position three to five seconds then slowly exhale. Gradually increase the hold to five seconds and progress to doing one exercise eight to 10 times a day by the 10th day.

DEEP BREATHING

Deep abdominal breathing will help you regain strength in your abdominal muscles, and it promotes healing. Each time you take a deep breath, you get oxygen throughout your body while also reinflating your lungs. Lying in bed, bend your knees (if able). Relax your body, allowing your weight to sink into the surface of the bed. Put your hands on your abdomen, close your eyes and be aware of your breathing. Inhale; you will feel your abdomen and hands rise. Stretch your abdominal muscles outward. Hold for a count of five. Exhale, pulling in your abdominal muscles. Hold for another count of five. Repeat three to five times, progressing to doing one repetition 10 times a day by the end of the first week.

ANKLE CIRCLES (TO ENHANCE CIRCULATION)

Make eight to 10 circles with your ankles clockwise, then repeat counterclockwise.Repeat circular pattern three to five times. Do the ankle circles in different positions, such as lying, sitting, etc.

Remainder of the First Week

After the first couple of days, you may feel up to a walk. Some women are able to take a walk while still in the hospital. Just take it slowly and have help nearby. Stretching is also important. Try to do a couple of easy stretches as recommended earlier in this section.

Excerpted with permission from "Buff Moms: The Complete Guide to Fitness for All Mothers," by Sue Fleming. Copyright 2005, Random House.