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Navigating exercise during pregnancy: Some prenatal considerations

Carrie Mussbacher, CAT(C), BPE, CSEP-CPT, PPFS

Carrie Mussbacher, CAT(C), BPE, CSEP-CPT, PPFS

Carrie is both a Certified Athletic Therapist and a Personal Trainer, with a specialty in pre/postnatal fitness. After years of working with athletes of all levels and various sports, her focus has shifted to the female athlete, specializing in pre and postnatal fitness and healthcare. In addition to treating patients in Edmonton, she is an avid runner, cross country skier and loves the outdoors. She is a mom of three who is passionate about helping female athletes return to the sports and activities they love, and live a healthy active lifestyle.

Exercise during pregnancy can seem overwhelming for many women and female athletes. There are many questions that arise about what is safe and what is not, as well as how to manage common aches and pains that can develop throughout a pregnancy. Since many women ask these questions as they try to navigate the constant changes to their body, here are a few things to consider.

In general, the benefits of exercise during pregnancy outweigh the risks of being sedentary. It is recommended to do both aerobic and strength/resistance training exercises with a goal of 150 minutes of moderate intensity each week. Some things to remember regarding exercise/physical activity are:

  • It can help reduce the risk of complications during pregnancy such as gestational diabetes, hypertension (high blood pressure), and pre-eclampsia
  • It can help strengthen and support the changing body through the different trimesters
  • Exercise can help prepare the body for labour and delivery, as well as postpartum recovery

In addition to these reasons why you should exercise, there is also a need to understand how to modify and scale workouts based on your needs and the physiological changes during pregnancy. This can help prevent or manage common pregnancy discomforts. For example, there is a high occurrence of what is called diastasis recti abdominis (abdominal separation), or DRA for short. Diastasis recti  is a natural adaptation that commonly occurs to accommodate for the growing uterus, involving stretching of the linea alba between the abdominals. Modifications to core exercises and mindful movements throughout pregnancy can help avoid adding extra stress to the linea alba.

During pregnancy, particularly in the second and third trimesters, there is added weight on the pelvic floor as the uterus increases in weight. High impact exercise such as running, jumping and skipping can add increased load and demand on the pelvic floor. There isn’t a simple answer to when someone should stop these activities. Instead it is important to know how to monitor for symptoms and consider the risk versus reward in doing these particular exercises. If you experience any symptoms of pelvic floor dysfunction during prenatal exercises including pressure, pain, leaking or incontinence, it is time to stop these activities. In addition to exercise modification to avoid negatively impacting the pelvic floor, pelvic floor strengthening and relaxation exercises can also be of benefit. While most women might think of the need to strengthen the pelvic floor especially to help with postpartum recovery, an often overlooked component to pelvic floor function, and labour and delivery is the necessity to relax the pelvic floor. The pelvic floor needs more than just kegels.

Low back pain, and pelvic girdle pain are also common. Sacroiliac (SI) joint pain or symphysis pubis dysfunction (SPD) can create a unique challenge to exercise during pregnancy due to hormonal changes, changes in activity levels, and postural changes. Postural changes in pregnancy can cause decreased rib and thoracic mobility, while hormone changes and the added load from the weight of the baby and uterus can affect the hips and pelvis. Exercise programs that include mobility drills and hip and core strengthening can help support these changes and prepare you for labour and delivery.

Overall, exercise is extremely beneficial for multiple reasons during pregnancy. Monitoring for pain and dysfunction, assessing exercise from a risk versus reward standpoint, and always being ready to modify and adapt exercise, can help exercise feel good. This approach to exercise can keep you exercising throughout pregnancy and have you training for your ultimate goal – the delivery of your baby.

If you are looking for support staying active during your pregnancy, an Athletic Therapist can help.

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