Training through pregnancy

Falling pregnant is an exciting time for women but it can also be a little bit of an overwhelming and daunting time. Our bodies undergo this amazing transformation and I’ll be honest until I started to experience it myself I couldn’t begin to comprehend how some of my clients were feeling through different stages of their pregnancy. 

I think one of the most confusing areas is exercise and training. There is so much information out there about what’s good, what’s bad, what needs to be avoided and unfortunately much of it is conflicting. This blog is aimed at trying to clarify some of the questions around training and exercise while pregnant using a combination of my own experience along with my pre and post natal training.

Can I continue my regular training while I’m pregnant?

The short answer. Yes.

Exercise is very beneficial during pregnancy as it can assist with a whole range of things including preventing excessive weight gain, reducing the risk of Gestational diabetes, reducing the risk and severity of low back pain,  helps maintain physical fitness and may improve symptoms of  depression. 

The level of training through pregnancy will depend on a few things.

Firstly what were you doing for exercise before you fell pregnant? If you were regularly engaging in moderate to high intensity training going into pregnancy you can continue with this style of training as long as you are feeling ok.  

Someone who was more sedentary prior to pregnancy would be encouraged to commence a lower impact exercise program and slowly progress until they reach the recommended  exercise levels for pregnant women which is 150 minutes of moderate intensity exercise per week (20-30 minutes on most days of the week).

One of the biggest realisations I have had in my own pregnancy is that every day is different. One day energy levels are sky high and I felt great training,  the next day a walk around the block can be a mental and physical struggle. My goal has been to just move in some capacity every single day. I often have to remind myself that I feel better afterwards, and this always runs true.

What exercises should I be avoiding?

This is a tricky one to answer as every women will be different based on their training background.I’m going to break it down into trimesters.

1st Trimester (up to week 13) – assuming you are feeling ok, minimal modifications need to be made. Many women are plagued with fatigue, nausea and morning sickness during the initial stages of pregnancy which can make gym workouts more difficult. I would encourage you to listen to your body, there may be days when. you just don’t feel up to lifting weights, instead go for a walk or a swim.

For cardio workout I encourage women to use their exertion levels as a guide. If 10/10 exertion is maximal activity where you can hardly breathe or speak and 0/10 is at rest then you should aim for about a 6/10 which is a moderate level of intensity. This is a better method than heart rate because naturally your heart rate will be higher during pregnancy.

What about abdominal exercises? Personally I felt uncomfortable performing exercises such as sit ups, crunches and leg lowers from quite early on so I discontinued them. It’s very important to distinguish between this type of abdominal exercise and ‘core’ exercises which are of course very important throughout pregnancy.

I would really encourage you to speak to a trainer or physio who has some experience working with pregnant clients to guide you with this.

As you head into the 2nd Trimester (week 13-27) you will start to notice more physical changes in your body. Yep this is when you will ‘POP’. This is seriously the strangest thing. Literally one day I had that awkward bloated pouch around my midline and then the next day I had this round little pregnant belly.

This is the golden period of pregnancy (for most). A time when you may have a surge in your energy levels and a welcome relief from nausea and morning sickness. 

One of the main modifications during this time will be  monitoring (and maybe limiting) exercises that are performed lying flat on your back. (In the past physicians have advised women to  avoid lying on their back because the weight of the baby can put pressure on vena cava which is the main vein which carries blood back to the heart from the lower body). The current guidelines for this vary between different institutions so I think the best approach is to be mindful. If you experience any symptoms such as light headedness, tingling in the legs or general discomfort when on your back then its probably time to modify. You could try performing exercises on a slight incline or just eliminate altogether. At 28 weeks I still feel ok on my back, but every women is different. 

Abdominal exercises such as sit ups, crunches, med ball twists, leg lowers or raises should all be avoided from the second trimester. As previously mentioned ‘core’ based exercises are important and encouraged. If you are unsure I would strongly advice you to seek help from someone that can guide you with what core exercises are suitable at this time. The main concern as you progress into the 2nd trimester is looking for signs of Diastasis Rectus Abdominus which is bulging of the abdominal wall.

For cardio based training again I again would encourage a moderate level of exertion (remember 6/10)

What about running? This  is a much debated topic and unfortunately there is no evidence based time when you should stop running.

I absolutely love running and prior to being pregnant I would run 2-3 x week. I chatted to my womens health physio about when I should stop and her advice to me was when it doesn’t feel right anymore and this is what the general recommendation is. This happened at about week 18-20 when I headed out for my usual loop of Centennial park and it just felt different can’t explain exactly what it was but usually running is zone out time and from that day I didn’t enjoy it as much. That was enough for me to consider alternatives.

The concern with higher impact activities such as running and jumping is the extra stress that is placed on our pelvic floor. This hammock of muscles is already working overtime to support the growing weight of the baby so in my opinion there is really nothing to gain my loading it even more. Instead I’ve traded my weekly runs for walking stairs. It get’s my heart rate up, I still get to be outdoors in the fresh air and because summer is coming I get my daily dose of vitamin D.

Trimester 3 (week 28-40): This is a time of rapid growth and also a time when women probably start to become a little more uncomfortable with general day to day movement. With that in mind the training focus from week 28 onwards is really about maintaining a COMFORTABLE level of movement. 

Modifications with strength training may need to be made purely as a result if your growing abdomen and what feels comfortable.

I touched on it briefly above but It’s very important to start observing and palpating the abdominal wall for signs of Diastasis rectus abdominus during trimester 3. The abdominals have undergone a huge amount of stretch and the rectus abdominus (your 6 pack muscle) can start to pull apart from the midline of the body. How can you tell? Look and feel. Place your hand on your midline at the level of the belly button and above and you are feeling and looking for bulging. If you do have doming of the abdominals that particular exercise should be ceased or adjusted accordingly. Common exercises that may result in doming can include planks, crunches or front loaded positions. 

As an example I regularly used to have cable tricep extension in my program – this is a front loaded exercise. From about 24 weeks I was unable to perform this without getting doming. I have since changed to a single arm version with less weight. This also allows me to use my free hand to monitor my abdominals. 

Its also important to be mindful of common everyday positions and movements that can increase the strain on the abdominals such as sitting up out of bed of off the couch – that’s pretty much an identical movement to a sit up. Protect your precious abdominals and begin to roll onto your side to sit up. All these little small stresses can add up over the course of a day!!

Cardio in trimester 3 will really depend on how the woman is feeling. Many will be happy to let go of their higher intensity training towards the end of their pregnancy. Lower impact alternatives include swimming and walking and will probably be the more favourable options during this time.

This has only really scraped the surface when it comes discussing the journey of exercise through pregnancy but think the take home message from me is that if you are unsure of what you can and can’t do don’t turn to the internet for help. Ask someone who knows what they are doing. 

Em is a certified pre and post natal coach and she can help guide you through some of the confusing should and should not’s of exercise through pregnancy. Feel free to get in touch with me via email activerxphysio@gmail.com or comment below if you have any questions!!

Keep an eye out for more pregnancy related posts over the coming weeks!