I am in my first trimester of pregnancy and I would like to know if there are any precautionary measures I should take before beginning an exercise program?

Many experts advise women who are pregnant and new to the workout world to wait until the start of the second trimester to begin an exercise routine, due to the stress of the nausea and fatigue associated with the first trimester. The upcoming months will be a time of great transition, whether you are experienced or a first time mom. Chances are it will be easier to take those changes in stride when you have nurtured yourself with the benefits of exercise.

Safety Tips

It is important to check with your doctor before continuing or starting an exercise program during pregnancy. Your doctor will base his or her recommendation on your general health and current fitness level. Here is a few safety guidelines to follow.

• Stay cool. Overheating during the first trimester can impair development of the baby’s central nervous system. Do not exercise in hot, humid weather or when you have a fever. Try to forego saunas and hot tubs as well.
  
  
• Keep a moderate pace. Prolonged exercise can divert oxygen in the blood away from the baby. Use the "talk test" to monitor your exertion level. Work out at a pace that allows you to converse without feeling too out of breath.
  
  
• Drink plenty of fluids. Have beverages before, during and after exercise. An easy way to monitor your fluid intake is to check the color of your urine: if it’s clear, you’re fluid level is fine.
  
  
• Go easy. Because your ligaments are more lax during pregnancy, sports injuries are a real concern. Avoid jumping and jarring motions, along with activities that require rapid changes in direction. Make sure your footwear fits properly and provides good traction. Use slow, gentle movements when you stretch. Also, your center of balance will change. Avoid activities that put you at risk for falls, such as biking and downhill skiing.
  
  
• Modify exercises you do lying on your back. After the fourth month, uterine weight can impede blood flow when a woman is on her back, causing dizziness and other serious problems.
  

If you would like to start an exercise routine, first check with your doctor. He or she will take into account your risk factors, changes to your body, and risk to the fetus. You will be given specific instructions on how to safely exercise that involve checking your glucose level, monitoring the frequency of the baby’s movements before and after exercise, and timing exercise to follow meals.


With winter setting in, I am finding myself training outdoors in cooler and cooler weather. My pace feels more difficult to maintain than it did in the summer. Does cold weather effect performance? What can I do to preserve body heat?

Cold weather does indeed hinder athletic performance. Cold muscles contract more slowly and produce less power than warm muscles. In addition, the body is unable to use free fatty acids for fuel to the same extent in the cold as it is in warmer weather. Cold temperatures divert blood flow away from the surface of the body. Unfortunately to the endurance athlete, this is where most of the body fat used for fuel during exercise is located. The result is a reduced availability of free fatty acids for energy. This increases the reliance on limited glycogen stores for fuel during exercise, decreasing aerobic endurance. To combat this, always dress warm and wear your clothing in layers. Take off the layers of your clothing one by one as you begin to sweat. The reason behind this is that you want to stay warm, but you do not want to get your clothing wet with perspiration. As sweat soaks into your clothing, evaporation rapidly removes heat and you become chilled. For improved heat retention in cold weather, exercise in direct sunlight, low wind and low humidity.

I am a 65 year old man and I am experiencing pain in my legs after walking less than a mile. What is causing this pain and what can I do to alleviate the pain?

You may be experiencing claudication. Claudication is pain in the calf, quadriceps, or hamstring muscles that occur after walking a certain distance. The pain stops after a short rest off of your feet. Claudication occurs because not enough blood is flowing to a muscle. The artery that normally supplies blood to the muscle becomes narrow due to atherosclerosis when fatty material (plaque) builds up in the interior walls of the artery, restricting the flow of blood. At rest, enough blood flows to the muscle to meet its needs. During exercise, the working muscle needs more blood and the narrowed vessel is unable to meet the demands.

Along with quitting smoking and lowering cholesterol, an exercise program including some type of aerobic and anaerobic work is helpful against claudication because it stimulates the development of collateral vessels, which will help supply the needed blood to the working muscles.

If you are experiencing these symptoms, seek a medical evaluation quickly. As you can imagine, there are many causes of leg pain, including claudication. If indeed there is a vascular restriction creating the claudication, it could very well be a clot! There are several very accurate methods of evaluating peripheral circulation...so see your doc asap!