Ask the expert: exercise and inflammation: how, why and what you can do about it

Exercise and Inflammation with pre and post natal specialist trainer Natalie Ferris: everything you need to know about how and why persistent inflammation from the wrong type of exercise can hurt you, plus other common exercise and conception, pregnancy and postpartum questions. Both body and mind. Boys this is for you too!

Modern research is increasingly pointing to chronic inflammation (that usually means a persistent low level immune response click here for more) as being a key player in many chronic particularly modern-day illnesses impacting all aspects of our parenting journey. This is not just related to our bodies, it also relates to our minds too: click here for more.

Important all the time, but particularly when you’re a new parent...

One of the (many) modern sources of inflammation is exercise and it is truly a ‘Goldilocks’ situation. Too much at the wrong time, and too little both can both have a meaningful impact. This is when you need it to be ‘just right’ which can in fact have a very positive effect.

So, what does ‘just right’ look like when it comes to exercise? What is the ‘wrong type’ and how can this affect us? We asked one of our Better Babies expert board advisors Natalie Ferris pre and post natal training specialist for the low-down/all you need to know on this very important topic.

**** Click here for the podcast listen or search Better Babies on all major podcast providers. Alternatively read on for the key highlights ****

What is inflammation? All about the right time and place…

Inflammation can be good, in fact, it is essential for life when it is in the right context. It is part of the body’s defence mechanism against infection and injury. We all know that if we get a cut for example the area will likely get hot and red, this is inflammation and is a symptom of our body’s immune system fighting and signalling to the rest of the body to send reinforcement. Part of this process is the initial ‘first responders’ within our immune system sending out signals also known as cytokines to help. This is great, when it is a not too frequent event, but, the trouble is our bodies are detecting more and more things in our environment as threatening and causing this immune response. The trouble is that this immune response is not without a cost, as there tends to be collateral damage of this type of ‘warfare’ with things like digestive enzymes being spewed out causing damage to our own cells and DNA. When this happens regularly at a low level ie. when it is chronic (which is happening to many of us without even realising) there can be subtle damage mounting up in our bodies. Toxic elements in our environment, food and lifestyle factors can be a cause of this. Especailly not what you want when you’re trying to concieve, are pregnant or have a small person. It is something that modern medical research is increasingly recognising as the first root cause of many major chronic illnesses that we are increasingly experiencing.

When it comes to exercise - the right way it can be anti-inflammatory, the wrong way can make these things worse.

What are some of the main causes of inflammation related to exercise?

On the one hand; exercise is a stress on the body. Muscle building through training heavy is by definition an injury and will illicit an inflammatory response, to build muscle you are creating tears within the muscles themselves. However, with adequate protein and rest they rebuild and they rebuild stronger as they repair. This is not a bad thing in itself, the trouble is when you do this without allowing for adequate nutrition and rest days. Too often (we all know the societal pressure to look a certain way, stress, plus need for quick results) people work out too hard and too often without allowing for proper rest and recovery in between. This can lead to chronic inflammation in the body and potential damage and is something to avoid.

Once again: there is a fine line between a positive and negative inflammatory response. An inflammatory response is good to build up muscle and strength, but, too much can lead to this chronic state of inflammation which is what you dont want. There is a fine line between training hard and over-training.

What do you define as ‘over-training’?

Well firstly it is about listening to your body, your body will tell you, and everyone is different with different thresholds. However, as a general rule, if you’re training very hard five days a week sometimes more than once a day will cause issues unless you are a high level athlete which can come with its own set of problems. It’s pretty simple: you need to give your body time for rest and repair.

Ideal pattern for exercise from an inflammatory perspective?

Depending on your workout routine: two to three days a week of some kind of circuit or resistance is ideal to keep inflammation under control. Ideally you want to alternate between session/rest through the week to aid this recovery. If you do back to back, you can focus on one muscle group one day, give that one a rest the next and focus on another so you do not over-stress a particular area. Ensure that your training split is giving your body adequate rest and time to recover before training again. For full body you ideally need a full day rest in between.

What about no exercise at all?

This is when doing the ‘right’ amount matters. Too little/none at all also causes inflammation within the body, particularly if we are spending long periods of time in a sedentary way (ie. sitting at a desk all day).

How?

You want to build an anti-inflammatory response tolerance in the body. Ideally you want to activate the sympathetic nervous system which helps to increase heart rate, blood pressure and breathing rate and physical exercise activates does just this, particularly if you do it via moderate intensity exercise. Research has consistently shown positive correlation between this type of exercise and optimal immune response (the driver/controller of inflammation). We know that chronic stress also acts as a physical stress on the body and impacts the immune system, exercise can relieve that by release of endorphins and ‘happy hormones’ which can be beneficial - particularly if you’re a new mum which can be a shock to the system, body and mind!

What is ‘moderate exercise’ What is the ideal ‘anti inflammatory exercise’?

Everyone is different, but there is ‘training too much’ and it can in particular impact your ability to concieve. Ideally what you want is something that gets your heart rate up, but not pushing yourself to the limit with very high intensity too often. Ideally keeping up a daily level of activity: walking, swimming etc but very high intensity exercise can cause issues unless you are very used to it. Once in a while is absolutely fine, but, it is the extent you do it and dependent on lifestyle. Having long stressful and sedentary days interspersed with several HITT training sessions (which many modern professionals now do) can lead you into a state of physical stress and chronic inflammation - not what you want at any stage of the journey.

An ‘ideal’ programme:

Taking an ‘average’ person (hard to do as everyone is different!) the ideal mix to manage inflammation is:

1) keeping active and aware, walking where you can, making it part of your daily routine, avoiding the train/Uber/sitting at a desk and just move naturally

2) adding in two to three days of circuit/weight training with rest days in between should be a good time to repair

3) getting your heart rate up for 20-30 minutes a day is ideal

What does ‘getting your heart rate up’ mean and what about if you are pregnant?

When you’re newly pregnant it is ok to get your heart rate up but a good marker is that you want to ensure you can still hold a conversation. Getting too out of breath and your heart rate is too high is to be avoided. For everyone else you want to be 50-75% of your maximum heart rate as a good marker.

What is ‘circuit’ and ‘resistance’ training?

You can make a circuit however intense you want and choose whatever you want. Choose 6-8 exercises and you do all of them in a row and then repeate the exercises 2-3 times or whatever you choose. You can decide the exercises depending on what you want to focus on. Lots of choce and an easy way to do a full body work out.

With weight training. You can choose whatever weight you want - body weight or heavier. It can be in a similar format or a superset ie. where you pick two exercises in a similar muscle group and do them back to back with no rest in between the two exercises.

When you’re pregnant most of the time it is about using body weight but in the right way, or with resistance bands. Once again it depends on your stage of pregnancy and your level of fitness/type of training you are used to doing before you’re pregnant. Click here for more detail.

How do you find what’s ‘right’ for you without having a personal trainer?

There is so much on the internet and it is difficult not to get confused with social media, not everyone is qualified, even very famous ‘fitness influencers’! You can find people with great bodies but not everyone is actually qualified and what has worked for them may not work for you. A properly accredited trainer will show adaptations. YouTube has many of these but check accreditation and most will have this shown and up on their channels so be sure to look for this or do a quick Google search. Be aware that following a video wont be specific to you, wont take in to context your own strengths and vulnerabilities so always listen to your body and bear that in mind when choosing a work out programme.

What do you do as a pre and post natal expert diet and exercise wise?

My diet and exercise has changed a lot over time as I have learnt a lot more about this. I used to be the type of person I would say not to be now! I was training very hard when I first got into fitness and training far too often without adequate rest and recovery. I learnt the hard way and first hand the impact this can have on your body. I was obsessed with the gym and it was my happy place, I was pushing my body to the limits. I have learnt a lot from my journey though and have learnt to listen to my body. You also need adequate nutrition.

What about anti inflammatory food/supplements?

First and foremost you should always aim for nutrients in via your diet. Sometimes it is not possible, if you feel you may be lacking then DHA is an excellent supplement to reduce inflammation in the body. Click here for more. You can also find this in food: fatty fish is a great source. Essential for repair, energy as of course is protein.

Protein is another area to focus on:

There are more challenges getting protein in, not only when it comes to avoiding pitfalls: specifically the way that modern farming impacts animal proteins (added hormones, steroids, antibiotics etc) but also the vegan trend can mean you have to be smart about getting enough complete protein in your diet. There are lots of substitutes: legumes, peas, tofu however you do have to be mindful as it is particularly important when it comes to exercise and repair. Also, when you’re buying a DHA supplement, ensuring that you buy a supplement that sources fish low down the food chain is also crucial to avoid excessive mercury (a known neurotoxin amongst other things). Any supplement that focuses on this (sardines, anchovies, mackerel etc) will clearly state this on the packaging and is something to look out for.

Foods to avoid for inflammation:

Soda, refined carbs, processed meats, sugar and fried foods. Refined Carbs are anything that is not a low GI source - something very processed ie. white bread, white pasta etc and fructose. Sugar really does play havoc with your hormones and is inflammatory - click here for Natalie’s own post on this topic. Focus on fresh herbs and spices: turmeric with a bit of pepper to help absorption is also great.

Click here for a quick summary link to much more detail when it comes to exercise for this time in your life.

Ask the expert: listeners questions! *** NEW PODCAST SECTION ***

Q: Post pregnancy: can’t seem to shift the belly weight in particular, any advice?

A: Firstly it depends on how recently you had the baby. It is quite a task to lose weight very quickly post pregnancy and even without pregnancy you cannot ‘spot reduce’ from particular areas ie. target one area of the body. It is a typical area of course post having a baby that people feel takes time to get back in shape, but you need to remember that it is slow and steady that wins the race, just getting back into a healthy balanced and nutritious path and starting to move every day is a great start. However, it is also important not to put too much pressure on yourself, it wont go back straight away and you are better doing it for the long term and enjoying being a new mum. Added stress in fact can add to persistent weight around the midsection (high cortisol) so avoid putting unnecessary pressure on yourself, if you’re moving every day and eating well that is all you need to do. It is a process.

Q: Post baby how quickly can I start properly exercising?

A: Everyone is different but usually six weeks minimum dependent on your birth/pregnancy but first port of call is to get clearance from your doctor.

Q: How long do you have to wait to start exercising after a C-Section?

A: ‘How long is a piece of string?’ It varies person to person. It is usually longer than for a natural birth as it is major surgery and it is important to remember that although on the outside it may look as though your scar has healed internally can take longer. It has to be a case of starting slowly and building up. Minimum six weeks and speaking to your doctor for clearance. Any personal trainer should ask for clearance from your doctor. Signs to watch out for that it may be too soon: some people don’t feel any discomfort, but it is a delicate time and a major operation so always err on the side of caution and take it slow and build from there. Focus on core strengthening exercises before you start going towards high intensity and impact. Pelvic Floor strengthening is also a major area to prioritise first before you add in.

Q: If i’m trying to get pregnant what type of exercise should I avoid?

A: once again it depends what you’re used to but taking it down a notch particularly if you’re exercising quite intensely is often advisable as well as focusing on getting adequate rest between sessions. You do not want to be in a constant state of stress on the body. HITT work out is ok, now and again with adequate rest, something to avoid too frequently.

Q: best type of exercise during pregnancy?

A: the goal completely changes when you’re pregnant and exercising. It is no longer about any form of aesthetics when you’re pregnant you want to be in physically the healthiest place you can be and prepare your body for the rigorous of birth and having a new baby. Strong posture: lots of postural focus and Posterior chain exercises are great to focus on - that means exercises specifically looking at the back of your body keeping your shoulders up, your hips aligned, nice strong Glutes to support a growing bump. Circulation and blood flow to keep swelling down is another priority, so staying active even if it is just regular walking everyday to feel good. It also depends on the type of exercise you were doing before and not change it up too dramatically. Watching your joints and not locking them out (your joints are more flexible during pregnancy so watch for over stretching).

Q: What about exercising post pregnancy, especially if you’re tired and breastfeeding? It can be a struggle to maintain being exhausted as it is! How do you build up stamina for exercise?

A: Easier said than done but dont put so much pressure on yourself. You are already on a bit of a rollercoaster and if you’re not getting sleep and feel exhausted, you can potentially put yourself under more stress by forcing exercise and that will potentially lead to more cortisol though your body which will deplete you and cause you further imbalances. Somewhat counterproductive! There is always time for it later on - enjoy the time. Gentle exercise when you feel like it is what you should think about, do not add additional pressure as it could be detrimental. Where and when you can. Remember, exercise doesn’t have to be specific. Take the baby out for a walk if it is a nice day, but aside from that, if you do want to exercise it is core and pelvic floor to focus on rather than an intense and exhausting workout. Your hormones will be up and down, especially if you’re not sleeping and breastfeeding, so be careful not to add to this. Remember it is a marathon not a sprint and you need to listen to your body. Adequate nutrition is also essential for energy - click here for more about exercise and breastfeeding. It is particularly important to make sure you’re getting enough nutrition, protein intake, good fats and a healthy mix of the right macros should be the focus. Make sure you’re getting from the best sources, particularly when you’re breastfeeding and choosing animal protein sources. Go organic to avoid some of the common nasties: hormones, pesticides, steroids and antibiotics.

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This article is for informational purposes only. This article is not, nor is it intended to be, a substitute for professional medical advice, diagnosis, or treatment and should never be relied upon for specific medical advice. The information on this website has been developed following years of personal research and from referenced and sourced medical research. Before making any changes we strongly recommend you consult a healthcare professional before you begin.