Everything You EVER Wanted to Know About Exercising During Pregnancy

Disclaimer: I feel the need to put a disclaimer on this post and let you know I am by no means a medical professional. I am however a mother, certified personal trainer, and yoga instructor. What I am sharing is based on my own research and experience. This post also contains affiliate links. 

I am in my third trimester of pregnancy with my third baby. Never thought I would type that, to see why watch VASECTOMIES, FOSTER PARENTING, & A PREGNANCY TESTOver the last 5 years of being pregnant three times I have learned as much as could about pregnancy and exercise.

I am a certified personal trainer, and yoga instructor, and also a nutrition coach. I also know there are many trainers and fitness professionals in the world who have way more knowledge than I do but don’t have the experience of having been pregnant three times. Here is what I have learned over the last several years about exercising while pregnant.

Your First Pregnancy is NOT the Same as Your Second (or Third)

Your first pregnancy is amazing for many reasons. You can nap when you are tired being one of them. But in all seriousness, during your first pregnancy your body is being stretched for the first time in a new way. Your muscles, ligaments, tendons, organs, and bones have never had the pressure of carrying and holding a baby before.

My first pregnancy I exercised very similarly to how I was exercising before I become pregnant. I adopted the motto “If you were doing it before you were pregnant it is safe to do the same while pregnant“. While this may be true for certain activities I wish I would have had more knowledge of what exactly I was doing to my body.

During my first pregnancy I did lots of yoga. I was already very flexible before pregnancy and with the added hormones I became even more flexible. I don’t think yoga is necessarily a bad way to move while pregnant, but I do think you need to be extra cautious about the poses that you do.

When I became pregnant the second time I was shocked by how my body felt. I was so uncomfortable. I couldn’t do even half of what I had been able do when I was pregnant the first time.

The best way I can describe multiple pregnancies on your body is to think of a deflated balloon. The first time you attempt to blow air into the balloon it will feel like you are going to pass out. The balloon has never been inflated before. The next time it is inflated you don’t have to work as hard.

With the body the same thing happens. The fascia surrounding the muscles, tendons, ligaments, and organs has already been manipulated in the same way previously making it easier to move, which is good and bad. Your body was made to adapt to pregnancy, but if you already have instability in areas of the body they will become even more noticeable and potentially problematic for you.

Hire a Trained Professional

These people are worth the money. Trust me. I spent several months working with a physical therapist after having my second baby and was so sad when I was recovered because I wanted to keep working with him.

While my physical therapist was a male and had obviously never been pregnant he had way more training than a personal trainer and could evaluate the imbalances in my body.

Personal trainers are wonderful. I am certified personal trainer. But our scope of knowledge is limited. We do not have the same training as a physical therapist.

Most insurance plans will cover multiple physical therapy visits. If you have been pregnant and something in your body still does not feel right these are great professionals to go and see.

Diastasis Recti & Healing Your Pelvic Floor after Baby

Women who have given birth – can we just get a moment of silence for all the times we have accidentally peed our pants during a workout. Jump ropes, box jumps, and jumping jacks, I am specifically looking at you. If this is you, there is a solid chance your body has yet to fully recover from having a baby.

Looks can be deceiving. Your tummy might be flat at 6 weeks postpartum but that doesn’t mean that your pelvic floor and abdominal muscles have fully healed.

I mention this because the way you exercise while pregnant can worsen your abdominal separation. Don’t be like me and let your ego get in the way! It isn’t worth it. Again, just because you can do something doesn’t mean that you should.

No matter how many months or even years it has been since having a baby there is hope to heal your pelvic floor and abdominal muscles!I highly recommend the MuTu System for those wanting to heal their core and pelvic floor after giving birth. You can read about my experience with the Mutu System HERE.

Exercises to Avoid While Pregnant

These are the exercises I see recommended by trainers or #fitspo #fitmom Instagrammers that literally make me want to cry. Please, please, please if you are pregnant avoid these exercises. It is only for 9 months of your life and I promise your body will thank you in the years to come.

Even if these exercises can be performed it doesn’t mean that they should. This is a lesson I learned the hard way. Your body is going to change while you are pregnant. Abdominal separation is normal and how you exercise while you are pregnant can improve your recovery after pregnancy.

LUNGES

Most of us, personal trainers included, do not always have perfect form when exercising. For this reason alone, my advice is to avoid lunges after the first trimester. Be very careful with any unilateral exercise, like lunges, during pregnancy because of the risk of low back, hip and knee issues. In my opinion this exercise is not worth the risk of developing imbalances in the body.

Pregnancy Safe Alternative: Squats

Squats are great during pregnancy, just make sure that you have your feet and knees fairly narrow, narrower than you may have done them before, and ensure that you keep your knees in line with your feet. This is to protect your knees and hips, which are more vulnerable during pregnancy because of the horemone relaxin. Also, if you feel too much strain on your back, use a stability ball on a wall for support.

PLANKS & PUSHUPS

Planks and Pushups are beneficial exercises to do, but need to be done mindfully. You can place your hands on a bench, table, stairs, or even against the wall to modify this exercise. Planks should be avoided after the first trimester.

Pushups can be modified during the entire pregnancy. When you look at your midsection while you are doing this you should see more of a gradually rounding. If you see a bulge in the middle elevate your hands further from the floor. There is no shame elevating your pushup.

Pregnancy Safe Alternative: Bird Dog & TRX Chest Press

Bird Dog: Come to a hands and knees position on an exercise mat positioning your knees underneath your hips and the crease of your wrists directly underneath your shoulders. Your fingers should be pointing forward. Engage your core and abdominal muscles. Keep your spine in a neutral position, avoid any excessive sagging or arching. Pull the shoulder blades toward your hips. In this exercise you are attempting to move the opposite arm and leg simultaneously. It is very helpful to use a mirror to help you with form adjustments. Begin by slowly lengthening the left leg until it is long and strong. Lift the leg off the floor until it is at or near parallel to the floor. The leg should not be lifted above hip height. This will help to avoid upward rotation at the hip. That might be enough. If it feels comfortable you can lift the right arm as well. Another option is to lift the leg and arm separately and switch sides.

TRX Chest Press: Grab the handles and take a step forward on one leg. Keeping your body in a straight line and both arms straight, lean froward until your body is at about a 40 degree angle. Bend the elbows and lower your body. Use your arms to push yourself back to the starting position.

trx-chest-press

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SITUPS, CRUNCHES, AND OTHER ABDOMINAL EXERCISES

According to the American Congress of Obstetricians and Gynecologists the average distribution of weight gain during pregnancy is 30 pounds. This increase in weight causes internal pressure inside of the abdominal cavity. The pressure is upward, downward, and outward and is what creates the abdominal separation. The entire core of the body, glutes, ribs, pelvic floor, and the deeper core musculature become unstable.

This can lead to low back pain, pelvic pain, incontinence, prolapse and urinary urgency/frequency. Women who have abdominal separation also tend to have a higher degree of pelvic floor and abdominal pain.

Avoid these all together.

BOX JUMPS

As mentioned before pregnant women release a hormone called Relaxin which causes ligaments to be looser and can affect balance. Therefore, movements such as box jumps should be avoided after the first trimester. Plus they really don’t feel all that great anyway when you are pregnant.

LOWER BODY UNILATERAL MOVEMENTS

Now some trainers will tell you that lower body unilateral movements (lunges, single leg deadlifts, etc.) are an excellent way to train the body while pregnant. Their reason is that these exercises are great stabilizers and improve balance. I do not disagree that these are great exercises, but I cannot recommend them during pregnancy. It is better to keep both feet together and under the hips for improved balance and stability during pregnancy than it is to try and improve your overall balance and stability. Your chance of injury is higher with these types of movements and they should be avoided, especially after the first trimester.

TWISTING MOVEMENTS

Don’t twist or compress your abdomen torso and spine. No twisting yoga poses. Just don’t do it.

RUNNING

I have some friends who can run while they are pregnant. Personally, I feel like my body is falling apart mid stride and the next day I can barely walk. I learned during my second pregnancy that running and pregnancy, at least for me, are not a great combination. Running is very high impact.

The best prenatal exercise routine is to perform exercises that are low impact and will not create further imbalances in your body. Don’t be afraid to lift weights, increase your heart rate, and work up a sweat! These are all great things for you do.

Exercise Intensity, Heart Rate, & Rate of Perceived Exertion

Over the years the recommendations issued by the American College of Obstetrics and Gynecology (ACOG) on pregnancy and exercise intensity have dramatically changed:

  • 1985: The ACOG issues a statement that the maximum heart rate during pregnancy should not exceed 140 beats per minute and women should not participate in strenuous exercise for more than 15 minutes.
  • 1994: A new statement is released removing specific limitations regarding exercise during pregnancy. The ACOG said, ‘‘there is no data in humans to indicate that pregnant women should limit exercise intensity and lower target heart rate because of adverse effects.’’ They still recommended that women avoid exhaustion during exercise.
  • 2002: The ACOG published ‘‘Exercise During Pregnancy and the Postpartum Period: ACOG Committee Opinion 267.’’ In this paper, the ACOG Committee recognizes that ‘‘in the absence of contraindications, pregnant women should be encouraged to engage in regular, moderate intensity physical activity to continue to derive health benefits during their pregnancy as they did prior to their pregnancy.’’

It has been many years since the maximum heart rate during pregnancy was recommended not to exceed 140 beats per minute. If a doctor or trainer tells you otherwise there is a good chance they are sharing outdated information. What you want to be mindful of is not allowing your body to become overheated to the point that it can not cool itself down.

If you regularly exercise with a heart rate monitor you can continue to do so while pregnant or you can evaluate your intensity using the Rate of Perceived Exertion (RPE), or how you feel based on a scale from one to ten. As a general rule, keep your RPE in the 5-6 range during pregnancy workouts.

Your 5-6 RPE pre-pregnancy will not feel the same as your 5-6 while you are pregnant. During pregnancy the body produces more blood and the heart works harder to circulate the excess. The increase in blood is responsible for fatigue, nausea and dizziness during the first trimester.

General Tips for Exercising while Pregnant

Remember to drink plenty of water and stay hydrated before, during, and after exercise. Dealing with dehydration is not fun when you are pregnant. I learned this the hard way with my second pregnant and ended up in the hospital twice.

Find out what works best for you. For me and my third pregnancy this has looked liked swimming laps, incline walking on the treadmill, lifting weights, and stretching.

Once you reach the third trimester be extra cautious and careful with your movements. During your final weeks of pregnancy your uterus is 500 times its normal size. You’re carrying around an extra 20 to 40 pounds, making even the simplest movements a workout. Enter the gym with zero ego to ensure you are as safe as possible.

Properly warm up and cool down as this will help to reduce the risk of injury.

If you feel dizzy or lightheaded at any time discontinue your current activity and give your body time to recover. This will happen sometimes due to increased blood flow.

High risk activities should be avoided. If you road bike avoid the risk of becoming off balanced by finding a indoor cycle class. Any risk or trauma that could potentially happen to the abdomen should be placed on hold until after you deliver.

Be mindful of the amount of time you spend on your back. The added weight of the baby can place more stress on your spine.

Dealing with varicose veins? Be sure to read the following post Varicose Veins & Pregnancy for more on this topic.

Wear comfortable clothes that aren’t overly tight especially around your waist. My favorites include: Lululemon Studio Pants, Lucy Get Going Pants, Reebok Studio Pants, Lululemon Tech Shirts, and Reebok Burnout Shirts.

Hopefully this post was helpful and encouraging to you! Let me know what you think. How was your experience exercising while pregnant?

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The Truth About Diastasis Recti & Healing Your Core

If you did not read last weeks post Prenatal Fitness, Diastasis Recti, & Body After Baby you might want to do that before you read further so you have some background on what it is I am discussing.

Medical Disclaimer: I also feel I need to put a disclaimer on this post and let you know I am by no means a medical professional or a diastasis recti expert. I am however a mother, certified personal trainer, and yoga instructor. What I am sharing is based on my own research and experience.

THE TRUTH ABOUT DIASTASIS RECTI & WHY IT MATTERS

When abdominal separation occurs the rectus abdominis (otherwise lovingly referred to by many as the six-pack muscle) is not the only muscle that is affected. It is however what the majority of people notice. Take a look at this picture of the core musculature.

Core Muscles

Many of these muscles are attached to the same structures. The reason this is important to note is because when a muscle looses its stability it can cause a ripple effect throughout the entire body.

In the case of diastasis recti, the entire core of the body, glutes, ribs, pelvic floor, and the deeper core musculature become unstable. Diastasis recti can lead to low back pain, pelvic pain, incontinence, prolapse and urinary urgency/frequency. Women who have abdominal separation also tend to have a higher degree of pelvic floor and abdominal pain.

Hopefully you are starting to see this is a much bigger issue then just a bulging tummy. Diastasis recti can also alter the function and insertion of the transversus abdominis and external oblique muscles. The transverse abdominis is located under the obliques. It is the deepest abdominal muscle and wraps around your spine for protection and stability. Think of this muscle as your internal girdle. When this muscle is strong and well developed it will tighten and slim your waistline. But when this muscle is weak it will alter the basic function of many other muscles. This alteration in biomechanics and insertion can lead to abdominal trigger points. Trigger points are common causes of urinary urgency, urinary frequency and pelvic pain.

HEALING YOUR CORE

There are many factors that play into healing your body after having a baby. Here is a quick breakdown.

  • By 8-12 weeks postpartum your body has done what it will naturally do on its own. Your uterus has shrunk and whatever amount of abdominal separation you have remaining is most likely where it will stay until you intervene.
  • Adjust your thinking about how you are going to go about healing your body. You need to retrain the muscles that have been affected by birthing your baby. Instead of doing a million sit-ups, which by the way won’t do you any good closing your gap, focus on getting back to the basics. Keep reading to see what program I recommend.
  • While nobody likes to hear it, there are certain factors that will determine your rate of healing such as age, space between pregnancies, weight gain, nutrition, and genetics.
  • Keep in mind that no matter where you are in your post baby journey, maybe you had your baby last week or 10 years ago, there is always a way you can improve. Let me be honest, you might never close your gap completely, but you can always improve it. Don’t give up on yourself.

According to the American Congress of Obstetricians and Gynecologists the average distribution of weight gain during pregnancy is 30 pounds. This increase in weight causes internal pressure inside of the abdominal cavity. The pressure is upward, downward, and outward and is what creates the abdominal separation. Before any exercise this abdominal pressure needs to be addressed. There are several ways you can start addressing the pressure right now by adjusting the alignment of your body.

I am a huge fan and believer in chiropractic care. If you are local and need the name of a great chiropractor go and see Dr. Jason Taylor. He is awesome! Besides seeing a chiropractor there are several things you can do at home to begin to correct your alignment. How we sit, stand, and hold ourselves everyday can be adjusted to begin fixing this pressure.

How to Adjust The Alignment of Your Body
  1. Resist the urge to tuck your tailbone. Tucking your tailbone shortens the muscles in your pelvic floor and creates more upward pressure in your abdominal cavity.
  2. Stop sucking in your tummy. Gasp! I know right! But listen and hear me out. I promise this is not just crazy talk. When we suck in our belly’s everything that was hanging out has to go somewhere. So by sucking in we cause more downward pressure on the pelvic floor and further weaken those muscles.
  3. Relax your shoulders. Try not to hold tension in your upper body. Our entire musculature is interconnected by fascia and when the body becomes tight or tense in one spot it has a direct correlation on another.
  4. No high heels. When we wear high heeled shoes our alignment shifts forward. Elevating your heels places more of your body’s weight on your toes, which causes your body, particularly your pelvis, to tilt forward. To compensate and stay upright, you unconsciously lean backward and overarch your back, creating a posture that can strain your knees, hips, and low back.
  5. Find and work the transverse abdominis. Keep reading to see what program I recommend. I will also do a separate post on why this muscle is so important.
  6. Avoid exercises that open the gap. To see what to avoid read my last post: Prenatal Fitness, Diastasis Recti, & Body After Baby.

There are several programs available that focus on healing diastasis recti. I have looked into many of them. By far the best program that I have found and that I support is the Mutu System. The creator Wendy Powell is simply amazing. This program focuses on retraining the muscles in the body, healing the mommy tummy, and correcting the internal pressure.

You can get a free video with Wendy’s top 10 ab exercises by signing up on her website (top right corner).

The Mutu System offers several different programs, DVD + online training. I have the 12 week online program and love it! It never expires and I am currently doing it right now, even during pregnancy. I will also be doing this program after baby girl is born.

 

I want to thank all of you for reading, commenting, and e-mailing me on this topic. It is nice to know that this information is helpful to you! If you are still wanting more information on diastasis recti please look into Wendy’s program. She is an expert on this topic and has spent years developing the Mutu System to help women reclaim and retrain their bodies after having a baby.

Make sure to share this post with your friends and social network. Let’s get this information out to all the moms we know!

You might also be interested in my Losing The Baby Weight Series! Topics include: Pregnancy & ExerciseWhat to Expect After DeliveryThe First Six WeeksNutrition, and Exercise.

Disclosure: I was so impressed with the Mutu System that I decided to become an affiliate for the program.  

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Prenatal Fitness, Diastasis Recti, & Body After Baby

Can I be honest for a moment? This post is for all you ladies who are thinking about becoming pregnant, are currently pregnant, just had a baby last week, have given birth to a child at any point in your life, or for personal trainers who work with any of the afore mentioned demographics.  I think one of the questions we, as women, all ask ourselves at some point is what is having a baby going to do to my body. This might sound very vain and superficial to some but I think it is an important topic to discuss.

I have seen so many women who have had babies, are working out, eating correctly, and to no fault of their own just can not seem to get rid of their baby belly. So what seems to be the problem? The problem is not from lack of motivation or willpower but from the anatomy of the body after baby.

Let me explain…

RELAXIN (THE HORMONE)

During pregnancy the body releases the hormone relaxin. This hormone peaks at 14 weeks during pregancy and at the time of labor. It allows the stretching of the muscles and ligaments to accommodate the growing baby and prepare the mama’s body for labor and delivery.

Ladies, lets just take a moment of silence and be thankful for how awesome our body’s have been made in order to accomplish such a feat.

(Crickets chirping)

Now that that is over…

Here are several things you may notice thanks to this hormone coursing throughout your body during pregnancy.

  • Increased range of motion. This can be a blessing or an annoyance.
  • Lack of stability and balance in pelvis. Your hips feel off or your back is tighter on one side due to shifting.
  • Ribs may easily shift out of place. The ribs are a joint. With the increased range of motion the joints are more susceptible to misalignments. This is quite painful and can cause a pinched feeling in your back or chest and can also hinder your ability to take deep breaths.

If you are an avid gym-goer or enjoy high and frequent levels of physical activity you may also notice that your tummy does not look quite right and appears to be bulging in plank or pushup position.

I want to focus on the bulging tummy. Or the cone shaped tummy. If you have seen this on yourself or a client you know exactly what I am talking about.

This would be the perfect time to talk anatomy. So let’s discuss.

ANATOMY OF THE ABS

If you have had a baby you might be one of the many women who have no idea that their abdominal muscles have separated and are still separated. Did you know that this could even happen? I had no idea until after I gave birth to Caden. As a personal trainer this was nothing I even learned about in my course work (I will discuss why this is important later).

Take a look at the Rectus Abdominis both before and during pregnancy…

Diastasis-Recti-V3-720x484

The Linea Alba, the connective tissue between the right and left half of the Rectus Abdominis, stretches to accommodate the growing baby. For some women the gap closes naturally on its own. For others the connective tissue has become overly stretched and aggravated that it does not heal properly which leaves the new mama with an unwanted belly bulge months and even years after her bundle of joy has arrived. And for a mama who has multiple pregnancies the gap can become noticeably wider each time.

This gap is known as Diastasis Recti. But before I talk about after the baby let me briefly discuss prenatal exercise and things to keep in mind once you become pregnant.

PRENATAL FITNESS: MODIFICATIONS TO PROTECT YOUR ABS

I am a huge proponent of exercising during pregnancy. If you have been cleared by your doctor to exercise and exercised prior to pregnancy this will be a very beneficial section for you to read. If you want more information on the types of physical activity that are beneficial during pregnancy you can read my post Pregnancy & Exercise.

Certain exercises can aggravate and cause the gap between your Rectus Abdominis to become more severe during pregnancy. I tend to shy away from tons of crunches and situps because they can put more strain on the abdominal wall. I recommend planks or some type of plank variation for all my clients when it comes to programming their workouts.

Planks and Pushups are super beneficial exercises to do, but need to be done mindfully. You can place your hands on a bench, table, stairs, or even against the wall to modify this exercise. When you look at your midsection while you are doing this you should see more of a gradually rounding. If you see a bulge in the middle elevate your hands further from the floor. There is no shame elevating your plank. Protect yourself.

DIASTASIS RECTI/ABDOMINAL SEPARATION AFTER BABY

Congratulations! You have had your baby. Here is a simple way to tell if your muscles are still separated (give yourself a few months to heal before you do this test) and movements to avoid if you find you have abdominal separation.

Diastasis Recti/Abdominal Separation Test
  1. Lie on your back with your knees bent, and the soles of your feet on the floor.
  2. Place one hand behind your head, and the other hand on your abdomen, with your fingertips across your midline-parallel with your waistline- at the level of your belly button.
  3. With your abdominal wall relaxed, gently press your fingertips into your abdomen.
  4. Roll your upper body off the floor into a “crunch,” making sure that your ribcage moves closer to your pelvis.
  5. Move your fingertips back and forth across your midline, feeling for the right and left sides of your rectus abdominis muscle. Test for separation at, above, and below your belly button.
Signs of Diastasis Recti/Abdominal Separation
  • A gap of more than 2 1/2 finger-widths when the rectus abdominis is fully contracted.
  • The gap does not shrink as you contract your abdominal wall.
  • You can see a small mound protruding along the length of you midline.
Some Types of Movement to Avoid
  • Movements where the upper body twists and the arm on that side extends away from the body, such as “triangle pose.”
  • Exercises that require lying backward over a large exercise ball.
  • Yoga postures that stretch the abs, such as “cow pose,” “up-dog,” all backbends, and “belly breathing.”
  • Abdominal exercises that flex the upper spine off the floor or against the force of gravity such as: as crunches, oblique curls, “bicycles,” roll ups/roll downs, etc.
  • Pilates mat and reformer exercises that utilize the “head float” position, upper body flexion, or double leg extension.
  • Any exercise that causes your abdominal wall to bulge out upon exertion.
  • Lifting and carrying very heavy objects.
  • Quadruped exercises without adequate abdominal support.
  • Intense coughing without abdominal support.

This is just a brief explanation on abdominal separation and I would be happy to go into more detail if you have further questions.

BODY AFTER BABY

I am here to show you that you can totally reclaim your body after baby. In fact you can be stronger! Here are a few pictures of me postpartum. I promise I will post pictures after this baby girl is born too.

Belly Before & After Delivery

2-8 Months Postpartum

If anything I hope this post has encouraged you and shed light on what is really going on with your body after being pregnant. It is not that you are not doing enough, it could be that you just didn’t know what was really happening with your body.

For this reason alone if you are working with a personal trainer please make sure they are educated on how a woman’s body works before, during, and after pregnancy. Their lack of education might be hindering your physical transformation. On this same note I want to caution you about Pinterest/YouTube/Facebook/Instagram workouts. While I am all for inspiring others to live healthier lives it is important to point out that those workouts might not be best for someone who has just had a baby or who has abdominal separation. This is why it is so important to have someone who can coach you on your goals who understands and has training in anatomy/physiology and how it relates to human movement. 

For those who have just had or are about to have a baby I highly recommend a Belly Bandit! These are amazing and will help close the abdominal gap after giving birth, allow you to wear your pre-preganacy clothes sooner, and offer you low back support. Seriously go buy one for after the baby is born! You won’t regret it. Just for reference I used a small the first week after I had Caden and sized down to the extra small until I was 6 weeks postpartum.

I also highly recommend the MuTu System for those wanting to heal their core and pelvic floor after giving birth.

You might also be interested in my Losing The Baby Weight Series! Topics include: Pregnancy & ExerciseWhat to Expect After DeliveryThe First Six WeeksNutrition, and Exercise.

Additional Reading: 

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