Exercise Considerations During Pregnancy from a Pelvic Health Specialist
Are you pregnant and confused about what you should and shouldn’t be doing in the gym? Worried you’re overdoing it? Worried you’re not doing enough? Worried about your technique? Wondering if what you used to do is still safe? You’re not alone! There is so much confusion and misinformation out there on this matter. This blog will help to clear the air and answer these burning questions!
Aside from some obvious contraindications such as extended laying on your back or abdomen later in pregnancy, exercise during this phase of a woman’s life does not necessarily need to be drastically different than what she was doing before (given some modifications towards 3rd trimester). Everyone’s strength, flexibility, cardiovascular, and pelvic floor baseline is so different, and that is why there is no single answer to this question. For example, with adequate core strength and control, an individual may be able to continue planks throughout the majority of their pregnancy, whereas someone with less experience or inadequate core recruitment strategies may need to modify them quite early in their pregnancy! This is why it’s so important to get assessed and work with a specialist PT who can safely guide you through each stage. Although there is no “one-size fits all” approach, there are some key things to keep in mind that will let you know it’s time to modify. Check out the list below!
When to Modify Your Activity During Pregnancy:
- Abdominal doming/coning. This phenomenon usually occurs later in pregnancy. You may notice a bulge or tenting in the middle of your abdomen when sitting up to get out of bed for example. It also commonly shows up in exercises such as planks, sit-ups, and pull-ups. Doming or coning occurs when intra-abdominal pressure is not managed correctly. Basically, the deeper core stabilizing muscles (transverse abdominus, pelvic floor, diaphragm and multifidi) are not working in balance with the obliques and rectus abdominus (main “ab” muscles), the latter becoming dominant. This doming ends up putting a lot of pressure on the linea alba, the connective tissue that connects both sides of our abdomen and can worsen an abdominal separation or create pelvic floor dysfunction. We want to assess how well each individual is managing force throughout their core and modify the exercise, or try more effective core recruitment strategies, as needed!
- Pelvic or back pain. Another sign that an exercise is either too much load on the pelvis, too challenging right now, or is not being done correctly. As we progress through pregnancy our bodies continue to change and it’s important to be constantly re-evaluating whether your workouts are still working for you.
- Urinary leakage. Leakage is a sign your pelvic floor may not be strong enough or coordinated enough to control the pressure during an exercise. This is a sign to modify, making the exercise easier and more appropriate for your pelvic floor’s current capacity! Don’t be fooled into assuming your pelvic floor is weak. We often see pelvic floor muscles that are too tight, creating weakness, as they are not able to contract appropriately with all that tension! Before you start doing kegels, always check in with a pelvic health PT.
- Breath holding. It is important to avoid breath holding or “Valsalva”. There are a couple of different reasons people do this. First off, if an exercise is too hard, people often either hold their breath to help stabilize, or forget to breathe. Second, higher impact and heavier exercises like Olympic weight lifting, sometimes require breath-holding in order to effectively brace your core and move the load safely. While it is appropriate in these cases, breath holding is not recommended during pregnancy as it puts a lot of pressure on your pelvis and its contents (think – organs).
- No longer feeling confident in your ability to complete the exercise correctly. As we progress through pregnancy, our bodies and our minds may no longer feel good about working out like we used to or doing certain exercises. Higher impact and higher intensity stuff can downright feel uncomfortable! As can many different positions and movements. If you don’t feel comfortable or safe doing an activity – that is enough to stop! Especially without the guidance of a specialist!