Pregnancy Fitness: Finding what Works
As featured in Mamatoga Pregnancy and Newborn Issue Spring 2016.
Mamas, we live in an exciting time.
When strong is the new skinny and fitness is an essential accessory to the modern woman’s life, exercising during pregnancy is a natural progression for healthy-minded mamas.
With exercise classes and training opportunities for expectant mothers popping up on a regular basis, how do you decide what’s best for you and your blooming babe?
Not only is exercise during pregnancy encouraged by the American College of Obstetricians and Gynecologists (ACOG), but the December 2015 guidelines cited strength training, Pilates, and jogging among the activities that are “safe to continue.”
Research has shown that women who continue to exercise during pregnancy are less likely to have excessive weight gain, gestational diabetes, or require intervention during labor and birth.
Babies of active mothers tend to experience less stress and complications during labor, maintain a healthy body composition, and actually perform better on standardized intelligence tests through early childhood.
Here are my top 5 tips for staying fit during pregnancy:
1. Check your ego at the door. There is nothing wrong with breaking a sweat when exercising, but don’t be surprised if you need to slow down and modify certain exercises. Pregnancy is not the time to compete with others or yourself. You will have the rest of your life to run that marathon or deadlift 200lbs!
What intensity should you maintain? Although some medical professionals still cite heartrate guidelines from 1985 (not to exceed 140bpm), a much more reliable measure of intensity is the Rate of Perceived Exertion (RPE). On that scale, 7 is classified as “very, very light” and 19 is “very, very hard”. During pregnancy, your perceived exertion, or how hard you are working,should remain between 13 to 14 or “somewhat hard”. More simply, you should be able to talk fairly comfortably while doing your exercise of choice.2.
2. Continue to Train your Core. A strong core prior to pregnancy will help with a faster recovery and can prevent back, pelvis, and hip pain. Maintaining strong core muscles during pregnancy is not about crunches and planks! These muscles are key in stabilizing your posture as your belly grows and your lumbar, or lower back, curve becomes more exaggerated. It’s best to avoid exercises that involve lifting your head off the floor (such as crunches and Pilates “hundreds”), and movements that put extra stress on your rectus abdominals or “6-pack” muscles.
Diastasis Recti is a separation of the abdominal muscles down the line of tissue called the Linea Alba that affects approximately 3 out of 4 women during pregnancy. Engaging the rectus, or "6-pack," muscles by performing exercises such as front planks, sit-ups, crunches, leg lifts and the like can worsen the separation, which may lead to tissue damage, lower back pain, and may require rehabilitation and/or physical therapy postpartum.
The best core exercises during pregnancy include glute bridges, Pallof Press, farmer walks, reverse planks, and diaphragmatic breathing.
3. Breathe Well. Correct breathing technique is essential! Always inhale on the easier part of an exercise (“breathe in to prepare”) and gently exhale during the more difficult part (“exhale on exertion”). Avoid holding your breath or forceful exhalation, which is also referred to as a Valsalva maneuver. This can cause sudden changes in blood pressure which may lead to dizziness or fainting.
Belly breathing or diaphragmatic breathing is a fantastic way to engage your pelvic floor and core muscles simultaneously.
Try this: picture your belly as a balloon. Inhale slowly and quietly through your nose to “inflate the balloon” and engage your diaphragm. Send your belly button away from your spine and allow your rib cage to expand, while keeping the shoulders still and send the breath as low in the abdomen as possible. At full capacity, exhale, and “deflate the balloon” through a slow, controlled breath out of your nose.
Efficient breathing is the body’s natural coping method for stress and pain and good technique can be extremely helpful during labor.
4. Lift Weights. Women who maintain strength and fitness levels during pregnancy not only have less aches and pains during pregnancy but they also have quicker recoveries and less physical complications during the postpartum period. Lifting weights is an excellent way to maintain and improve stability and posture, and to support the extra weight you will be carrying. Yes, you may need to decrease your weights towards the end of your pregnancy, but this is completely normal. Ensure you are following a program that is designed for pregnancy and can be modified every trimester as necessary.
5. Train with a Purpose: When you walk into the gym or outside to exercise, know what you want to achieve. Stay strong and unless you are a competitive endurance athlete, keep cardio to 20-30 minutes 3-5 days a week (or even less if you are doing intervals). Full body strength movements can absolutely be prioritized over exercises that only train one muscle at a time. Explore your options, find your focus and go for it!
You may find at certain points in your pregnancy, you have less energy and less motivation to work out. Use your drive and your time wisely.
When you need a rest day, take it. Remember, you are making a baby!
26 September 2016
Check Yourself (before you wreck yourself).
“All clear to get back to exercise!”
Ah these precious, long-awaited words.
You had your baby and you’ve been poking at your soft, squishy belly for 6 weeks, chomping at the bit to get back to your exercise routine. You are ready to get back to what you were doing before pregnancy; group classes, weights, ab routines and maybe even some cardio sessions are calling your name to drop the baby weight and get your body back.
Does that sound familiar?
If so, pump the breaks and read on (I promise it will be worth your time).
You just built a human (that’s amazing), carried it in your uterus (which, by the end, has grown to fill your entire abdomen), then gave birth either through a very small hole or through a deep incision.
Pregnancy and birth are no joke. And your recovery shouldn’t be either.
Like any other major medical event, there are some physical factors to consider before getting back to your normal activities. However, because child birth is so commonplace, most women are not cautioned appropriately. This often results in both short and long term issues. These issues can include, but are not limited to, incontinence (involuntarily peeing or pooping), pelvic organ prolapse (when your pelvic organs fall out of place), diastasis recti (abdominal muscle separation resulting in weakness, dysfunction, and/or a tummy pooch), delayed fat loss, and more.
Whether you were very active during pregnancy or sat on the couch for 9 months, you must recover and rehabilitate no matter who you are or where you are coming from.
Here are 5 recovery tips you can start working on immediately:
1. Keep rolling. Remember that roll you did to get your huge pregnant belly out of bed? Keep doing that. Why? Your abdominal muscles (and the surrounding tissues) stretched to 1.5x the length they were before pregnancy and they need some time to realign as they shorten and begin to strengthen again. You should roll (out of bed, off the floor, and even out of chairs/couches) for at least 12 weeks or longer.
2. Reset your posture. Your spine changes a lot during pregnancy and often, so does your muscle structure. The lumbar curve (at your lower back) becomes much deeper and many women also experience rounded shoulders, lower back pain, mid-back pain, pelvic pain. Try feeding your baby lying down and holding him higher up on your shoulder so it’s easier to stay upright during every day activities. Back to work already? Get a lumbar support for your desk chair or sit on a stability ball so you’re less likely to slouch. A chiropractor trained to work with postpartum mamas can also be a huge help.
3. Check your breathing. Pregnancy causes a bunch of breathing changes, and often new moms use a shallow, inefficient breathing strategy that does not integrate the diaphragm and uses only a fraction of the lung capacity. Try this: lay down on your back and take some deep breaths. Does your rib cage rise and travel closer to your head? If so, you’re probably doing it wrong. Inhale and fill your rib cage (forward, back, and sides alike). Visualize your belly like a balloon so that when you inhale, “inflate” and fill your belly and when you exhale, “deflate” and quietly expel all your air. This practice is called belly breathing and will engage your diaphragm (big breathing muscle) which will go a long way in including your abdominal and pelvic floor muscles as a cohesive unit. When you get good at this (it takes some practice), add in a Kegel at the end of your exhale.
4. Fix your pelvic floor. Oof. Here’s the doozy. Firstly, what is the pelvic floor? It consists of 33 muscles (including the vagina and rectum) that act as the “floor” to your internal organs. Simply by that principle, you can see why pelvic floor trauma and weakness can create some serious issues. If you’re familiar with Kegels, they are the most basic way to strengthen your pelvic floor. To locate your pelvic floor muscles, contract/squeeze the muscles you would use to stop the flow of pee and poop. (If you cannot engage your pelvic floor muscles, I would strongly recommend locating a women’s health physical therapist for an assessment.)
The type of birth you had will have some influence on the way you recover:
If you had a Caesarian Section, it’s essential to address the scar. Scar massage is not difficult to learn, and can be immensely helpful in preventing inhibited muscle function, and in preventing adhesions from forming under the scar. Adhesions are internal bands of scar tissue that attach from the scar to the internal organs. They can be painful and severe adhesions may require surgical removal. There are many helpful scar massage technique tutorials online, but it advisable to receive instruction from a physical therapist or other experienced medical professional. Additionally, you may find painful or “stuck” areas in your quad muscles that require some release techniques such as foam rolling or massage.
If you had a vaginal birth and experienced tearing (sometimes described as 1st to 4th degree), an episiotomy, and/or intervention or assistance during delivery (suction, forceps), the healing process may take several months. I would strongly recommend a phased return to exercise complete with a consultation and assessment by a physical therapist specializing in the pelvic floor.
If you had a vaginal birth without intervention (suction, forceps, episiotomy) and minimal to no tearing, your recovery may be more straightforward. You may feel like yourself “down there” sooner than those who have had trauma and/or intervention. I would recommend getting a pelvic floor assessment by a physical therapist within the first 6-12 weeks postpartum to ensure all is healing and functioning well.
5. Phase the Return to Exercise. Jumping back into your workout routine with both feet is not the answer to regaining your fitness postpartum. If your core and pelvic floor muscles are not recovered and functioning well, you are building a house on sand. Create a strong foundation with rehabilitative exercises that will integrate the abdominal, pelvic floor, and glute (bum) muscles.
a. Limit weights, HIIT, and endurance training. These methods of training put excessive strain on the recovering muscles. Additionally, exercise that contributes extra stress to the body’s normal levels will inhibit its ability to control the production of cortisol, also known as the stress hormone. Erratic cortisol levels (brought on by lack of sleep, emotional and mental stressors, etc.) may inhibit fat loss and internal healing.
b. Stop crunching. Crunches, sit-ups, and planks will not give you a flat tummy postpartum. In fact, these movements may actually cause weakened and dysfunctional abdominal muscles. During the first 3-6 months postpartum, if you are strengthening the core muscles in a supine (laying) position, keep your head and shoulders on the floor.
c. Keep perspective. This phased return to exercise is temporary. Returning to full health postpartum depends almost entirely on your body’s ability to recover. Rest, hydration, good nutrition, and mindful movement will go a long way in rebuilding a healthy, fit and strong version of yourself.
Nora Matthew is the founder of Pregna-Fit LLC, a company built on the premise that mothers are strong, determined, and selfless beings who deserve and have the capacity to care for and accept themselves to live life well. Pregna-Fit LLC prides itself in producing safe and effective workouts, holistic nutritional advice, and positive life coaching for women who are trying to conceive, pregnant, and postpartum.
For more information, visit http://pregnafit.com or Instagram: @pregnancy_fitness
14 August 2015
Stop trying to get your pre-baby body back.
Postpartum is a time of extreme highs and lows. Every 24 hour period can bring hundreds of different emotions and often they are totally inexplicable. In the months following birth, you can definitely chalk much of this up to hormones. The sudden fall in estrogen and progesterone alone can make an even temper a thing of the past.
That being said, every woman is different.
Everyone will react to the postpartum period in a different way, and that’s ok!
As a trainer and a mom myself, I know the insecurity, doubt, and inner conflict that can follow child birth. Women are bombarded by images of models and actresses flaunting their perfect beach-worthy tummies less than a month after giving birth.
Is that real?
While many moms know that having a perfect dimple-less body postpartum is unlikely and unattainable for most (especially for #2 and beyond), we all want to feel confidence or at least experience what our bodies were like before baby.
Let me put it into the perspective of a sports injury. Say you’re a competitive runner and you break your foot. You have a cast on for a couple months so it can heal unhindered. The cast is removed and you are sent to physical therapy to regain movement, strength, and function in your foot. You return to running a little bit at a time. What will happen if you go run a race on the way home from getting your cast removed? You get the gist.
Child birth is not an “injury,” per se, but it is one of the most physically, emotionally, and - some would say – spiritually challenging events that can happen to a woman. Because the wounds are not visible in everyday life, those on the outside sometimes forget what a mom has gone through. It’s no wonder that proper recovery is often overlooked by doctors, nurses, midwives, and moms themselves. Why should women pretend like child birth was a walk in the park?
Rest, recovery, and rehabilitation should be words we hear postpartum.
So where do we start in changing this perspective?
LET’S STOP TALKING ABOUT GETTING OUR PRE-BABY BODIES BACK.
My body will never be “pre-baby” again. Nor should it be! What an absolutely miraculous feat it has accomplished – a feat that first needs to be acknowledge in my own head and in my own heart. Every stretch mark is a reminder of my little miracles and although we may be told they are not aesthetically pleasing and we may spend 5 minutes every night rubbing cocoa butter on them, they are part of what made our experience ours.
“Alright,” you’re thinking. “But I still want to be able to wear a bikini and not wear a maxi dress all day at the beach in 95 degrees.”
Even if you or someone you know is at her “pre-baby” weight (lucky duck), no woman will say that her body is the same. Aside from the very obvious changes “down under,” your uterus needs weeks (or months) to go back down to its starting size and your boobs (breastfeeding moms, especially) are giant and/or not your own anymore and don’t even get me started on the rounded shoulders and sad, droopy bum!
So, if we can’t get our “pre-baby” bodies back, what should we be doing?
Here’s my step-by-step guide for getting, for lack of a better term, “in shape” postpartum:
When will you feel “normal” again? It will happen. Not immediately. Be honest with yourself and you will progress.
Deep breath, mama, you can do this!
If you need some more guidance, check out these sites and/or email me at email@example.com.
Jessie Mundell (pre/postnatal trainer)
Debra Goodman (women's health physical therapist)
OptiMUM Health (trainer & mom)
If you know of any more helpful sites, please let me know and I’ll add them to the list.