Exercise during pregnancy
You can (and should!) exercise throughout your pregnancy as you are able. You should continue to exercise as you were prior pregnancy BUT modify along the way as your pregnancy progresses to decrease intensity, avoid lying on your back after 14 weeks and avoid any exercises that contribute to pain or discomfort. Any new workouts or exercise regimes should first be cleared with your doctor and/or your pelvic floor physical therapist.
Pregnancy is not the time to set a personal best in fitness. However, exercise has incredible benefits for mom and baby. Exercise during pregnancy can help you sleep better, manage anxiety, maintain cardiovascular health, help prepare your body for childbirth and postpartum recovery. You can continue to exercise (recommended 150 minutes of moderate exercise per week) but pregnancy is not an ideal time to train for a major race or up intensity. Try lower intensity workouts as pregnancy progresses.
What to know before you run
During pregnancy, your body has an increased amount of the hormone Relaxin that causes all your joints to get loosey-goosey, which is a good thing as it allows your pelvic bones to spread with a growing fetus. However, it can lead to instability and pain in your pubic bone and sacroiliac joints and well as instability in your ankle joints, which could potentially lead to falls. Running on a smooth surface, avoiding trails with uneven surfaces, proper footwear, and making sure you have appropriate core stability and balance to minimize the risk of falling.
Consider pelvic support
Compression can be key. If you have prolapse or vulvar varicosities or feel you need to lift your belly up when working out, I recommend using compressive pelvic support. If you have Diastasis Recti, do not use a waist trainer but compression leggings or gentle supports are recommended. You want to ensure they are not too restrictive, and you can breathe adequately.
Breath work is important
I recommend breath work and core work in various positions to get your pelvic floor and deep abs engaged to help maintain stability while running. Strength training is an excellent complement to running but you need to ensure that you are breathing in a way that will limit an excess of pressure on your abdominal wall and pelvic floor, limiting the risk of diastasis recti or pelvic organ prolapse.
Take a squat, for example. We typically breath-hold on the way down into the squat and then use an explosive exhale on the way back up to standing. While this breathing technique might seem beneficial, it can actually be detrimental to an expecting mom. This breath hold significantly increases intra-abdominal pressure. To ensure proper pressure management and activation of the pelvic floor with lifting, we want to always exhale with exertion so engage pelvic floor and deep abdominals before you squat and exhale on the way down and up. This goes for lifting kiddos, groceries, pushing furniture or lifting weights at the gym. This will not only decrease the pressure in our abdomen, but it will also cue our pelvic floor and transversus abdominis (deep core) to activate. This will help stabilize our trunk and pelvis, and limit any unwanted strain on our pelvic floor or abdomen. Ultimately, it will reduce the risk of pelvic organ prolapse and/or diastasis recti.
When to slow down
You want to be able to “hold a conversation” or talk when exercising. If you are breathless, take a break, alternate walking with running, or slow down. You can run up until you give birth as long as you do so safely and comfortably. If you experience any pain, urinary leakage, vaginal bleeding, pressure or heaviness in vagina, or a loss of balance, it’s time to scale back. The best thing you can do though is to work with a Pelvic Floor PT.
When to call a pelvic floor PT
If you feel any sign of pelvic organ prolapse (heaviness, pressure or bulging in the low pelvis), pelvic and/or low back pain, urinary incontinence, vaginal bleeding, or sexual dysfunction, you should stop or modify the activity and check in with your medical provider. Walking is always a great alternative. Your pelvic health physical therapist can assess for the presence of these signs, symptoms, and risk factors, and work with you to develop a plan so that you can meet your running goals. Knowledge is power. Being able to wisely balance risk and reward towards your goals is key. For more fitness and pelvic floor tips during pregnancy, check out my Power Pregnancy and Pelvic Health Program.
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Sara Reardon PT, DPT, WCS is the owner of NOLA Pelvic Health and founder of The Vagina Whisperer, a resource for online pelvic health education and therapy to help women worldwide with pelvic health conditions. She is a board certified women’s health physical therapist with a special interest in treating pelvic pain and pregnancy and postpartum conditions. She is a mom, wife, Saints fan and wanna be yogi.
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