Running During Pregnancy

There is possibly no activity more freeing than lacing up your shoes and heading out for a run! We train many (prior, current, and future!) runners at The Lotus Method and strive to support each woman in building the capacity to enjoy the benefits of running. Running during pregnancy can be fine, but there are a few things that are often not considered when determining the pros and cons of running. 

The American Congress of Obstetrics and Gynecologists advise that pregnant women who habitually engage in vigorous-intensity aerobic activity (ie, the equivalent of running or jogging) or who are highly active “can continue physical activity during pregnancy and the postpartum period, provided that they remain healthy and discuss with their health care provider how and when activity should be adjusted over time” (Department of Health and Human Services, 2008). 

The ACOG does not speak directly about our biggest concern regarding running during pregnancy....

The biggest consideration we are thinking about when deciding whether running is the best choice for pregnancy is the health and function of the pelvic floor. During pregnancy, the extra weight from the baby (and everything that comes with him/her!) is placed on your pelvic floor, a basket-like structure of musculature and connective tissue that lines the base of the pelvis. The pelvic floor provides structure and support to our bodies, aids in continence, and plays an important role in birth, and sex, as well. Along with having to manage the extra load of our bodies due to pregnancy, the pelvic floor's ligaments become softer and more relaxed in response to the changing hormonal landscape of pregnancy. 

What this adds up to is a pelvic floor that may not be able to meet the high impact demand of running. As a result, running may put us at an increased risk of pelvic floor dysfunction, including incontinence and prolapse, which may persist well after the immediate postpartum period. 

For this reason, we typically don't encourage running during pregnancy after the first trimester for most women. 

If running is something you're unwilling to give up beyond the first trimester (we totally get it!), we highly recommend seeking the expertise of a Pelvic Floor Physical Therapist (PFPT) who can give you a better idea of your unique situation. It may be that your pelvic floor is coping well to meet the demands of running and you might be able to stay in the game longer! 

What we really want to think about when we're deciding if running is an activity we want to continue to do throughout our pregnancy is the big picture and our long-term health. If there is a chance that running during pregnancy will predispose us to conditions that have longterm implications (and may even prevent us from running in the future), is it worth it? When there are so many other activities that will get our heart rates up and make us feel good, we're not so sure! 

So, what can you can do in lieu of running? Lots of things!

With all of these activities, follow a few simple guidelines:

-Keep your rate of perceived exertion (how hard you feel you're working) at a level where you can still speak a sentence, or 13-14 (somewhat hard) on a scale from 0-20. It's no longer considered necessary to monitor your heart rate (unless you have a preexisting condition). 

-Avoid activities that increase your risk of falling. 

-Watch out for symptoms of heaviness, pressure, dragging, and bulging in the pelvic floor. Leaking is another sign that the pelvic floor is overwhelmed by the activity being placed on it. Adapting the strategy in which you do the activity causing symptoms may be all you need to continue with the activity - you don't necessarily need to give it up!

-Consider:

  • Uphill walking 
  • Swimming
  • Spinning (keeping your tailbone untucked can help your inner core unit do its job best) 
  • Climbing stairs

And our personal favorite: 

  • Lift weights/resistance train faster! Keep your rest intervals shorter and work in a circuit format to reap the benefits of strength training and cardiovascular endurance. Check out the video below on how to turn up the intensity on simple strength training exercises without having to contend with the impact of running. 

Running will still be there for you if you prioritize the well-being of your body (especially your pelvic floor) and take your time during pregnancy and postpartum to focus on activities that take this transformative period into consideration. 

When the time comes to return to running postpartum, be sure to check out our tips on how to safely and effectively work back up to it. We also offer a Return to Running workshop! Keep your eyes on this space for more details. 

How to Get and Stay Strong to the Core During Pregnancy!

Core training during pregnancy is one of the topics that comes up most frequently when we are first beginning to discuss exercise with new members. Many women have questions about what they can or can't do to work their middles, how or when they should modify the exercises they've previously done, and what the goal is when training the core during pregnancy. A quick google search will show you everything from "avoid all core exercise!" to Instagram pages of women at 9 months pregnant during planks and crunches. How are you supposed to know what's appropriate for your body and your pregnancy?!

First...a note on what we're talking about when we say "core":

In most fitness spheres, the word "core" is used synonymously with "abs". Generally, when most people think of core training, they think of training the rectus abdominis (our "six pack" muscle), the obliques, maybe even the transversus abdominis, by doing exercises like crunches, planks, side planks, mountain climbers, or exercises believed to specifically "target" the "core". 

We'd like to change that discussion and specify what, exactly, we're referring to when we talk about "core" training. 

Picture an apple that you've eaten down to the seeds. What remains is the inner structure that helps to support the parts you aren't able to get through (the stem, the seeds, etc.). The more superficial apple bits you ate to get to the core were the rectus abdominis and the obliques and what's left is the "core". When we discuss your core, we're talking about these four muscles: the diaphragm, the transversus abdominis, the multifidus, and the pelvic floor muscles (there are actually several PF muscles, but for the purpose of this, we'll lump them together). If you picture a can of soda, the diaphragm is the top of the can, the transversus abdominis wraps around the middle, the multifidus is the back of the can, and the pelvic floor muscles make of the bottom. These four muscles work together to create dynamic stability and anticipate movement throughout the rest of the body. They are directly involved in respiration and the stability and mobility of our trunk. 

The other thing to know about the core is that, obviously, our babies end up taking space within them. This means that just the presence of pregnancy will shift the balance of the muscles in the core. No fear, though! We can still make efforts to ensure these muscles work as effectively and efficiently as possible throughout the duration of pregnancy. 

So, now that we understand what it is we're talking about when we say "core", let's talk about what you need to know about core training during pregnancy:

1.) Yes, We Absolutely Need to be Training Our Core During Pregnancy!

Now that we have a better understanding of what it is we're talking about when we say "core", it should be clear that it would actually be impossible not to train our cores! We need to train our cores to help our entire body function well and stay strong and adaptable to the demands of pregnancy and motherhood. 

2.) Use Your Breath and Alignment to Facilitate Optimal Core Function

A rib-over-hip alignment will place the elements of your core stacked on top of each other. Imagine a straw: the straw that is straight up and down is going to move a thick milkshake more than the bent straw. Imagine your trunk alignment in a similar way. Keeping your ribcage (where you diaphragm lives) over your pelvis (where your pelvic floor lives) allows these two to interact more effectively. In addition, the way you breathe will influence the function of the core. When you inhale, think about expanding through the ribcage, relaxing your pelvic floor, and softening your belly. When you exhale, the pelvic floor recoils, there's a gentle engagement from the transversus abdominis, and the ribcage will move back in. When you're lifting something heavy, you made need more awareness of the lifting of your pelvic floor (meaning, you would more actively try to "lift" up an object using the muscles of your vagina/anus). You'll want your exhale to begin your movement and continue throughout the entire concentric motion (usually described as the "challenging" part of an exercise. For instance, coming up from the bottom of a squat would be the concentric portion of the exercise. The eccentric portion is the lowering into the bottom of the squat, which is when (in most cases), you'd focus on inhaling. You would also want to prioritize keeping your rib cage over your pelvis during the entire range of motion of the squat. Using this strategy will help you keep your core doing its job as effectively as possible. 

3.) But what about my abs?!?!?!

Yes, your rectus abdominis and your obliques are important too! During pregnancy, they also stretch to accommodate your baby. Many exercises that attempt to focus specifically on these muscles (crunches, sit-ups, Russian twists, planks and plank variations) aren't the ideal choice for pregnancy. As a woman progresses through the weeks of pregnancy, crunches/sit ups (and all the variations!) will likely start to feel weird. One reason is that the action of a crunch is condensing the space available to your baby. Another reason could be that the motion increases the potential for excessive pressure on the pelvic floor. In addition, there's potential for putting excessive strain on the linea alba, the connective tissue that lines the center of our abdominal muscles, which may increase the potential for exacerbating a diastasis recti. We recommend holding off on crunches, sit-ups, twists with flexion (like a Russian twist) during pregnancy. Exercises where the trunk stays stable (like a plank/push up/hanging knee raise) may or may be appropriate, depending on your stage of pregnancy and how your core is functioning. How do you know what to modify? Look for doming of the abdomen, pain or pressure through the trunk/pelvis, or anything that feels "weird" or "off". 

4.) Think About the Big Picture

Instead of thinking about how the abs will get trained during pregnancy, realize that all the muscles of our bodies work together as a team. Instead of focusing on what specific muscles are doing and training each of them individually, think about the tasks you're asking your body to achieve and the movements your body makes. When we think about movement this way, we realize that all the muscles of the trunk are involved in a squat, in a deadlift, in a push up, etc. There may be times when we want to specifically think about the muscles we're using, but the majority of our training can revolve around bigger, compound movements, instead of isolated exercises. Your (inner and outer!) core is functioning during everything you do. We don't need a 30-minute "abs" class to "blast our cores". We need to move efficiently and functionally, before, during, and after pregnancy! This might feel like a big shift in thinking, but we promise it will make your training more effective and keep your training time down so that you can achieve the results you want in less time. 

So, what does core training look like at The Lotus Method? 

Here's a sample circuit:

Suitcase Deadlifts

Pallof Press

TRX Rows

Standing Woodchop

With these four example exercises and by using a breathing and alignment strategy that prioritizes our core function, we're able to get a total body, including our core!!, training session. Your personal training program will look different (based on your needs), but remember to think big picture, modify moves that no longer serve you, prioritize the function of your inner core unit, and have fun! Your pregnancy training will help set up the foundation for postpartum healing and an eventual return to full function and fitness. 

For more information, check out these blog posts:

http://www.juliewiebept.com/fitness/core-conversations-the-anticipatory-vs-reactive-core/

Exercising during pregnancy

How to exercise during pregnancy doesn't need to be a complicated mystery, even though it can seem confusing to know what to and what not to do. The internet is rife with suggestions and many fitness instructors and trainers have not received adequate information on what to be aware of during the pre- and postnatal chapter. Have no fear, The Lotus Method informational blog series is here! We'll be posting to help educate, empower, and demystify training through motherhood. 

Gone are the days where pregnant women were viewed as fragile. It has now become common knowledge that physical activity benefits both mama and baby (woohoo!) but there is still quite a bit of discussion on what exercise is most beneficial. As is true for many things, the answer here is "it depends!" 

What is your objective? 

A few great goals to strive for with exercise prenatally:

  • Maintain function and fitness throughout the duration of pregnancy
  • Prepare for labor/delivery
  • Prepare for the impending challenges of motherhood

At The Lotus Method, our focus is strength training. Here's why:

  • Resistance training enables mamas-to-be to maintain strength throughout their bodies by prioritizing movement patterns and muscles that allow for the body (including the ever-important inner core unit) to function optimally throughout the trimesters, making life inside and outside the gym easier and more enjoyable.
  • Prepare for the hard work of labor 
  • Motherhood is repetitive, physical, and demanding. Babies don't stay little for long and with them comes a lot of gear! Being able to manuever an infant in a carseat (without waking them from that precious nap you've been waiting for!!) is a lot more challenging than it may initially seem. In order to be up for the challenge, we strength train!

Strength training may initially seem intimidating but it's not all barbells and bros. We highly recommend seeking the expertise of an exercise professional you trust (like us!) to show you the ropes, but if you're unable to, here are a few tips to help you strength train as effectively as possible:

1.) Keep it simple. Focus on major muscle groups, and basic human movements. Simple sessions with squats, hinges (deadlifts), pulls (rows), rotations (woodchops), etc. can yield great results! Instead of getting caught up in the latest and greatest exercise in a magazine, stick to the basics. 

2.) Prioritize great form and utilize a strategy that takes your core into consideration. Your inner core unit is made up of your diaphragm, your multifidus, your transverse abdominis, and your pelvic floor. You can picture them as a canister. We want to keep our canister as stacked as we can and we want our breath to encourage these teammates of the core to work together! On inhale, our diaphragm descends, our rib cage expands, our belly softens, and our pelvic floor softens. On exhale, our pelvic floor lifts, our bellies generate gentle tension, and our diaphragm ascends. During your strength training exercises, you're going to work to keep your diaphragm stacked over your pelvic floor (which means your ribs will be stacked over your hips) and you're going to exhale with (and just before) the exertion (the "hard" part) of the exercise. For example, in the squat: inhale and soften your belly as you descend, begin your exhale just before you begin to come back up and continue that exhale until you get to the top. Throughout, keep your rib cage and pelvis aligned. It may take some practice! For more information, please check out this program, created by renowned women's health PT, Julie Wiebe: http://www.juliewiebept.com/product/the-pelvic-floor-piston-foundation-for-fitness-2/

3.) Emphasize exercises that will support you through pregnancy, back off exercise that cause you to strain. Every pregnancy is different and so there are no hard and fast rules about what exercises will or won't be appropriate throughout the duration of one's pregnancy. A good rule of them is that any exercise that forces you to hold your breath is likely too challenging. Consider reducing the amount of weight you're lifting or switch to a slightly easier version to see if you can return to your breath (as described above). Another thing to look out for is doming or ridging along the middle of your belly. This is indicative of a core that is unable to manage the amount of pressure being exerted and is a good reason to regress or eliminate the exercise. This is what we watch for during planks or push ups as our clients progress throughout their pregnancies and it's a reason we recommend eliminating crunches, sit-ups, double leg lowers and raises during pregnancy. 

4.) Easy on the impact. During pregnancy, there's a significant load placed on the pelvic floor. when we add impact (from jumping, running, etc.), we're asking a lot from our bodies to be able to stabilize and receive that force from above. As baby gets bigger, it's possible that, over time, the demand becomes greater than our bodies can handle and excessive impact from exercise could increase our risk of pelvic floor dysfunction. We generally recommend hanging up your running shoes after the first trimester, but if running is something you're truly hoping to continue longer into your pregnancy, we feel it's essential to work with a pelvic floor physical therapist who can give specific feedback and guidelines.

5.) Stop if you feel any of the following symptoms: pain, pressure (especially in the vagina), bleeding, lightheadedness, fluid leakage (urine or otherwise), anything else that strikes you as odd or abnormal. Follow up with your doctor to verify that everything is still A-OK before continuing. 

6.) Vary your workouts according to how you're feeling and where you are in your pregnancy. Your exercise routine in your first trimester may not look that much different than your pre-pregnancy workouts, but it may not be appropriate for your third trimester. Along with generally slowing down as you near the end of your pregnancy, you'll likely find that certain positions or movements aren't as accessible as they used to be. The push ups you blasted through at week 9 may now be causing some abdominal ridging at week 23; best to swap out the push ups for a standing cable chest press or incline/wall push up, for instance. 

Every woman is different, every pregnancy is different, every woman's pregnancy workouts should be different, too! 

For more individualized information, reach out to us to schedule an assessment session!