Debunking Two Common Myths About Prenatal Exercise

If you’re pregnant and looking to stay physically active, you’ve probably come across a lot of information about exercise during pregnancy, some of which can be confusing or even misleading. In this article, we'll focus on two of the most common misconceptions that frequently appear in searches and provide you with accurate, up-to-date information based on guidelines from the American College of Sports Medicine (ACSM) and the American College of Obstetricians and Gynecologists (ACOG).

Misconception #1: "You shouldn't start exercising if you weren't active before pregnancy"

One of the most persistent myths about prenatal exercise is that if you weren't physically active before pregnancy, you shouldn't start during pregnancy. This misconception can prevent many moms-to-be from reaping the benefits of exercise during pregnancy. Back in the day guidelines were much more conservative out of caution and frankly because the research just hadn’t been done. However, both the American College of Obstetricians and Gynecologists and the American College of Sports Medicine encourage people with uncomplicated pregnancies to engage in regular physical activity, regardless of their pre-pregnancy fitness level. These expert obstetric and exercise organizations are very clear about the benefits of prenatal exercise which include preparing your body for the physical demands of pregnancy and childbirth, better weight management, reduced risk of gestational diabetes, and enhanced mental well-being.

You might find that pregnancy it’s an ideal time for you to start an exercise program. It’s a time in your life when you’re pausing to think about wellness, consider your health, and begin to adapt your habits and schedule. Exercise and physical activity can be incorporated into those thoughts and you can begin to prioritize physical activity as you make changes.

If you are new to exercise or haven’t been exercising consistently, the first step is shifting your mindset. Exercise should be used to support your pregnancy, so past exercise goals or routines may not apply to this stage of your life. Secondly, when you’re ready to get started, you should approach it as a gradual progression. This means little by little you’ll increase the duration of your workouts, the intensity, and the challenge level of exercises. You can begin with as few as 5 minutes of mobility each day and move toward being physically active for 30 minutes most days of the week. 

As always, your healthcare provider should be your resource if you’re concerned that you have complications or contraindications to exercise. However, if you have a healthy and uncomplicated pregnancy, I’d like you to get moving!

Misconception #2: "You should keep your heart rate below 140 bpm while exercising"

Another common misconception is the outdated guideline that pregnant women should keep their heart rate below 140 beats per minute (bpm) while exercising. This advice, once widely promoted, is no longer supported by ACOG or ACSM. No one "target" heart rate is appropriate for all pregnant moms.

Instead, both ACOG and ACSM recommend that pregnant women engage in moderate-intensity exercise, which can be gauged by the "talk test" – being able to carry on a conversation while exercising, but not being able to sing. This level of intensity typically corresponds to a heart rate of 60-80% of your maximum heart rate, which varies depending on your age and fitness level. However, this guidance is not a “maximum” and it is not to create fear of going over that moderate intensity. Many elite athletes work at higher intensities, and research shows that HIIT exercise is safe for moms and babies. So rather than focusing on or fearing the heart rate, or number, focus on getting your body moving at a moderate intensity.

Hopefully, these two misconceptions about prenatal exercise will continue to dissipate so more moms embrace physical activity during pregnancy. By understanding that it's safe and beneficial to start an exercise program during pregnancy, even if you weren't previously active, and by focusing on moderate-intensity exercise rather than a specific heart rate limit, you can confidently use exercise as a tool in your prenatal care plan. Use the power of exercise to feel strong and confident throughout each trimester!

If you’re looking for tips to get started, download 5 Tips to a Strong Core.

The Rise of the Active Mom Movement

If you're reading this, chances are you're part of the powerful movement of moms committed to exercising through pregnancy and beyond. You should feel empowered and proud to be part of this growing revolution. I recently presented at a global conference for the fitness industry and shared information on trends, challenges, and opportunities. I thought you might be interested to see what’s happening in Mom Fitness too!

A Glimpse at Mom Fitness Today

I’ve been fortunate to witness just how many moms are prioritizing physical activity and fitness during and after pregnancy. At Active Mom Fitness in Philadelphia, PA we use functional strength and core training as a tool so that moms can comfortably adapt to the body’s changes during pregnancy and safely return to physical activity after having a baby. It’s evident with apps like Peloton adding natal options, and the number of elite athlete moms competing during and after pregnancy, that exercise and sport during and after pregnancy is here to stay.

Unfortunately, the fitness industry hasn’t quite caught up with this demand. Maternal exercise researchers are moving us forward, but we’ve gone years without sufficient prenatal or postpartum-specific studies to inform exercise programs, especially when it comes to more vigorous activity and sport. There is a recent study that I hope fitness professionals get their hands on. Researchers show that both the mother and the fetus can tolerate high-intensity exercise (they did 10, 1-minute intervals at 90% or more of their maximum heart rate). Of course, every pregnancy is different, and your individual fitness level, abilities, and pelvic floor muscle tolerance matter. But isn't it motivating to see more evidence backing this up so you can feel safe doing the activities you enjoy?? I hope maternal researchers continue to push this field so that moms have evidence-based exercise programs to follow through motherhood.

A stat that I hope improves is that up to 60% of pregnant mamas aren't getting adequate exercise guidance from their doctors. Although doctors are not trained in exercise prescription, with collaboration between obstetricians and qualified pre/postnatal exercise specialists this gap can be closed. Moms don’t deserve to feel overwhelmed and alone navigating exercise through motherhood, we have enough on our plates! The increased awareness through professional athletes competing and moms like yourself demanding more support will help our cause, but there is still work to be done.

It’s Not Easy

Despite this movement toward more exercise and activity through the stages of motherhood, moms face very real barriers. You may have to deal with mixed messages about exercise. One day it's "put your feet up," and the next it's "slay your bounce-back goals!" You have misguided influencer narratives to contend with and old-school thinking to debate.  

One element that I always educate fitness professionals about in my continuing education courses is the fear factor. If you've ever felt intimidated, anxious, or confused about working out during or after pregnancy, you're not alone. For many a difficult conception journey, traumatic birth experience, or even mom guilt can enhance anxiety and fears around exercise and you may need support to navigate those feelings.

And of course, there are always the obvious challenges like fatigue, aches, nausea, and the whole life-changing experience of new motherhood thing. That is where a community like Active Mom Fitness can be helpful. You’re motivated not just by your personal trainer, but getting practical suggestions and support from moms going through the same experience. Additionally, every exercise class or session is designed with those factors in mind. Trust me, as a mom myself and after working with hundreds of moms, “I get it” and I want to help you get through it so that you can exercise until your due date, and feel confident getting back to physical activity after having your baby!

What Was The Point of This Article

I just wanted to let you know that: 

1. If you’re continuing to set goals, seek support, and keep moving then you’re part of this amazing growing movement of Active Moms and you should be proud. 

2. Based on the research, the field of pre/postnatal exercise and sport is growing, but we’re not where we need to be. However, when it comes to healthcare and fitness, work with people who are seeking updated evidence so they can provide you with the best support

3. There will always be challenges. Know it’s a journey through motherhood and it doesn’t have to look perfect. Find someone who can help you navigate the challenges and sift through the noise.

Let’s keep moving, moms! 

If personal or group training doesn’t work for you, know that the self-paced library is building and I’ve taken the approach that I use in the studio and put it into digital step-by-step programs so moms in or outside of Philadelphia, PA have access to quality programs designed just for moms!

If you’re just getting back to exercise after having a baby (6 weeks to 6 years out!) try this self-paced core progression. If you’ve just finished pelvic floor PT, transition back to exercise with this program (2 coaching sessions included!).

The Best Pregnancy Exercises for Beginners

I’m assuming since you’re reading this that you are new to prenatal exercise so let’s take a second to acknowledge the important step you’re taking for the health of you and your baby.

In this article, I want to share with you advice on choosing cardio and strength exercises, but first I have a disclaimer. I don’t like using the word “best” because there is no “best exercise for X trimester”. Every prenatal exercise program should be personalized and exercise selection should be based on your needs and abilities. However, as a beginner, you may not realize what those exercises are or where to begin, so this article is to help get you started so that you can stay physically active during pregnancy. If you haven’t exercised in a while or never have exercised before, this article is for you.

Best Cardio Exercise During Pregnancy

The prenatal exercise guidelines recommend accumulating 150 minutes of moderate activity each week, and aerobic or cardio exercise is one component of physical activity. As a beginner, it’s important to understand intensity and progression. Unless you’ve been told otherwise, I’d recommend moderate-intensity exercise. Rather than relying on your heart rate during pregnancy, determine your intensity based on how hard it feels you’re working. You’re experiencing many cardiovascular changes so heart rate monitoring may not be the most reliable for you. The good news is that research indicates using a scale that measures your perceived exertion correlates well with heart rate zones. Moderate-intensity exercise should feel like you’re overall workload during the workout feels like a 4-5 on the modified Borg scale. You can also consider the talk test. Moderate-intensity exercise should feel like you can talk, but you’re too winded to sing. 

To reap the benefits of aerobic activity you do need to challenge yourself, so keep in mind if you’re walking at a pace of 3mph on the treadmill now and that feels like moderate intensity, as you progress and become more aerobically fit, you may need to increase the speed or incline to reach that same intensity. I say may because as you progress in pregnancy, you also might feel more winded due to the baby taking up more space. This also means that although casual walks are great because moving is important during pregnancy, to receive aerobic benefits your walking intensity needs to be more than a leisurely stroll. 

The other advice I’d give you to determine the best cardio exercise during pregnancy for beginners is to consider the impact level of aerobic exercise. Impact refers to how hard the exercise is on the joints. The harder the exercise on the joints, the more muscle strength is required to endure the impact and prevent injury. Exercises are usually categorized as high or low impact. Running, skiing, gymnastics and jumping are examples of high impact. Walking, yoga, biking, elliptical, and swimming are examples of low-impact activities. 

As a beginner, the best aerobic exercise during pregnancy is low to moderate impact. If you’re inexperienced or haven’t worked out in a while, then pregnancy is not the time to test whether your body can handle high-impact activities. Added pregnancy weight may also make high-impact activities more uncomfortable, so choose an activity that you can do safely and comfortably. 

Best Strength Exercises During Pregnancy

The prenatal exercise guidelines also mention strength training as a component of exercise during pregnancy. Health and fitness organizations generally state that resistance training should be performed on all major muscle groups like the back, chest, quadriceps, and hamstrings twice per week. Although you may want sculpted biceps or triceps, isolating the smaller muscle groups is not the most beneficial goal during pregnancy. Your priority should be to be able to perform all major movement patterns, which target all of the major muscle groups. 

As a beginner, you’ll reap the benefits of an uncomplicated program. An example of this is a full-body circuit performed twice per week. Your circuit should focus on hitting all of the major movement patterns/muscle groups that you need to be able to move well and without pain throughout each trimester. 

Here is an example circuit

• Squat pattern: Body weight squats

• Push pattern: Dumbbell chest press

• Lunge pattern: Forward lunge

• Pull pattern: Supported single-arm dumbbell row

• Hinge (movement at the hips): Glute bridge

• Anti-rotation (keeping your body from being pulled to one side, like when holding a heavy purse in one hand): Pallof press

• Core with pelvic floor: Dumbbell front raise (exhale on the lift while engaging your deep abs toward your spine and lifting your pelvic floor muscles)

Remember there are hundreds of exercises and a variety of ways to structure and select them so feel free to substitute any of them. As you advance, you can vary the exercise by adding more weight, changing the equipment, increasing the reps/time performing the exercise, or going through the circuit for more rounds. 

So in summary, the takeaway points are: 

1. The best aerobic exercise for most moms-to-be is going to be low impact and moderate intensity. 

2. The best prenatal strength program for beginners is one that is full body and covers all of the major muscles/movement patterns, using a resistance that you can perform 10-15 reps without strain or breath holding. 

3. The best prenatal exercises that help you stay active during pregnancy, are ones that you enjoy and are those that you can do consistently and without pain. 

4. Your specific exercise selection should be personalized to meet your needs.

One additional side note based on my experience working with beginner moms during pregnancy, is that I know it can be hard to find the time and energy to perform separate aerobic and strength training sessions. If you have to choose, select resistance training in a format like the circuit mentioned. This will ensure you’re strengthening muscles and allow you to elevate your heart rate at the same time. You can then add walk breaks throughout the day or after dinner to supplement those structured sessions to meet the recommended minimum of 150 minutes each week.

As always, if you need more guidance I’m happy to help. You deserve to feel empowered. Start by downloading the 5 Tips for a Stronger Core During Pregnancy.

How To Start Working Out: Framework for Moms

Whether you’re pregnant and want to begin exercising to have a more comfortable pregnancy or a new mom ready to focus on fitness again, with all of the apps and internet clutter it can be hard to figure out where to begin. That is why I’m sharing the method I developed and have used with hundreds of moms and moms-to-be. It’s called Core, Function & Fitness (CFF). CFF is an approach. It’s a strategy. It’s a guide to help you determine where to begin your fitness journey and a framework to help you prioritize what to focus on during your workouts.

Whether you’re pregnant and want to begin exercising to have a more comfortable pregnancy or a new mom ready to focus on fitness again, with all of the apps and internet clutter it can be hard to figure out where to begin. That is why I’m sharing the method I developed and have used with hundreds of moms and moms-to-be. It’s called Core, Function & Fitness (CFF). CFF is an approach. It’s a strategy. It’s a guide to help you determine where to begin your fitness journey and a framework to help you prioritize what to focus on during your workouts.

The Foundation

During and after pregnancy, the foundation of your fitness program should be core strength and function. Core refers to the 360-degree cylinder from your diaphragm to your pelvic floor, including both abdominal and back muscles. A functional core means that your deep stabilizing muscles activate to support your spine before any movement. A functional core also means, you know how to breathe (exhale on exertion) with movement, and that you’re treating any pelvic floor concerns like tight pelvic floor muscles or urinary incontinence. A strong and functional core will enhance your ability to advance in exercise and will make daily life more comfortable.

If we look at CFF as a pyramid, “core” is the base layer and what you’ll prioritize when you begin an exercise program. This doesn’t mean that core needs to be your only focus, but if you’re short on time or searching for workouts, this will help you strategize and select the correct exercises. If time and energy aren’t an issue you can certainly do workouts that are more than core, but keep in mind that if your core isn’t yet strong and functional, you’ll want to ensure any other formats of exercise you’re choosing don’t require more core strength then you presently have.

For example, if you’re pregnant and beginning an exercise program, you can focus on breathing and engaging your abs with each movement you perform. So if you’re doing squats, lunges, and arm exercises, rather than just going through the motion, you’re exhaling on exertion or engaging the deep abs as you curl the dumbbell during a biceps exercise.

Middle of the Pyramid

So now that you’ve spent some time activating your pelvic floor, deep abs, and using your breath, you’re ready to shift your focus to “function”. The term functional training is a bit trendy so I’ll provide you with my simple definition. Functional training is performing exercises that help you meet the physical demands in your life. This means factoring in the type of job you have, the workouts you plan to do, or the physical demands of caring for your child at different stages. During pregnancy functional training can be performing exercises that help you better adapt to the changes your body is experiencing, like strengthening your back because you’re being pulled forward due to the weight of your breasts and belly. Function is the next step in my model because you should be able to feel good moving through your daily life before setting more lofty fitness goals (for example if your back hurts every time you lift your child, doing an hour spin class maybe shouldn’t be your priority). Functional training also means addressing pain and specific weaknesses. It is easier to attain function when you have a strong core, so for that reason “function” sits on top of the “core” layer in my pyramid.

Top of the Pyramid

You’re ready to move up the pyramid when you have a solid core foundation and you’re functionally moving well during the day and your workouts. “Fitness” is the top piece and refers to goals such as muscle definition, weight loss, sports performance, and running. This is the last step along the CFF progression because you’ll have a better chance of achieving fitness when you effectively know how to engage your core and you know how to perform exercises correctly and without pain. I’ll reiterate that it doesn’t mean that you have to wait to set your fitness goals, but increasing your run distance shouldn’t be the priority before you’ve spent time on the other components. When you move to the top of the pyramid, the idea is that you’ve already set yourself up to achieve your specific fitness goals.

For example, if you do have a goal to run postpartum, you can first focus on making sure your core can support proper running form, and that your pelvic floor muscles can handle the impact and load. Functional training might include single-leg strength activities so that when you do run, your body is better prepared. 

Summary

I developed the Core, Function and Fitness method to help you prioritize your efforts, and make workout selection less overwhelming. The pyramid can also be explained as a pie chart with the percentages of core, function and fitness components shifting as your needs are being met. Maybe you’re starting with core being 80% of the chart because you just had a baby, but after a few months of training, core might then become just 30% and fitness taking the majority. This pie chart is a good visual because it emphasizes that you’re never solely focusing on just one thing. All components are important and will be integrated into your plan.

Whether you like the pyramid or the pie chart, the main point I'm making is that this is a tool that can keep you active through all 40 weeks of pregnancy, and help you feel stronger than ever after having a baby.

Pregnancy Back Pain Explained

It’s estimated that on average 50% of expecting moms suffer from back pain during pregnancy, but some studies show this number as high as 90%. It tends to be highest during the third trimester. This condition might be referred to as pregnancy-related low back pain or pregnancy-related pelvic girdle pain. In this article, I want to explain the causes of pregnancy back pain, provide you with suggestions for relief, and encourage you to use core and strength training as a tool to prevent or reduce back pain as you move through each trimester. Many of the moms I work with keep waiting for back pain to kick in, but with proper preparation and awareness, it never does!

What causes back pain during pregnancy?

• Pregnancy Hormones: During pregnancy, a hormone produced by the placenta called relaxin helps your body relax and stretch. This includes muscles and ligaments around the pelvis to prevent pre-termis uterine contractions and allow your baby to pass through the birth canal during delivery. The relaxation of these ligaments in the pelvis may impact the stability of your spine and pelvis, causing pain. 

• Pregnancy Posture: As your uterus and baby grow, your center of gravity shifts, and you develop more of a curve in your lower back as your pelvis tilts forward. This change of posture called lordosis can increase the stress on the spine and cause back pain.

• Pregnancy Weight Gain: The additional weight gained during pregnancy puts more strain on the muscles and joints, which can result in discomfort, especially at the end of a long day.

Can you prevent back pain during pregnancy?

Based on my personal experience working with moms, it’s a definite yes! Although we can’t control your hormones, we can use strength training and mobility exercises to help your body adapt to the anatomical changes during pregnancy, improve posture, and handle the additional weight/stress. Research shows that core stabilizing exercises can help reduce the risk of lower back pain. During pregnancy your “six-pack abs” called the rectus abdominis lengthen as your belly grows, however, those muscles are not your primary stabilizers. Muscles like your multifidus and transverse abdominis, as well as your glutes, play a major role in core stability, and they can still be strengthened during pregnancy! 

By building body awareness and strengthening key muscle groups, many moms find great relief and even avoid back pain altogether. Keep in mind that your ability to do certain exercises will change as you move through pregnancy so this is not a one size fits all list.

Strengthen

• Transverse abdominis: these muscles act as a corset around your waist. You can activate and strengthen them with exercises like plank variations (wall, shoulder taps, up-downs, etc.), Pilates moves (hundred, side lying leg kick, corkscrew, etc.), or one of my favorites when going against gravity isn’t advised is pallof variations (press, shuffle, etc.)

• Multifidus: This muscle runs along your spine. Exercises like a side hip lift, side plank, bird dog, and bridge march are great ways to activate and strengthen those spinal stabilizers.

• Glutes: This is an oversimplified explanation, but glutes support the stability of your spine and pelvis. Many moms I work with tend to be quad-dominant (front thigh muscle) when doing exercises like lunges and squats. During pregnancy, if your body is constantly being front-loaded and your back and core muscles are being overworked, it is essential to have the assistance of muscles in the back of your body like your glutes. Research tells us that glute exercises combined with back stabilizing exercises are more effective than back stabilizing exercises alone in decreasing back pain. Because the glutes move the hips in different directions and include three different muscles, it’s important to use a variety of exercises. Some of my favorites include side leg lifts using a pilates ball under the hip/rib area to stabilize the pelvis, hip thrusts, seated abduction, and Romanian deadlifts.

Mobilize

It may seem counterintuitive to talk about relaxin AND the need to work on mobility during pregnancy, but as your body changes you’ll need to keep joints mobile and muscles flexible. If you’re experiencing back discomfort, stretches like cat/cow, wagging the tail, pelvic tilts on a stability/yoga ball, and a side stretch can feel good. 

You’ll also want to focus on joints and muscles that aren’t directly involved in the pain area. Because your spine is segmented, tightness and immobility above and below your lower back can impact your level of discomfort, specifically immobility in your thoracic spine (mid back) and hips. 

1. You can use foam rolling to increase mobility in your upper and mid-back. 

2. Try the figure four stretch, hamstring stretches, and a kneeling hip flexor stretch to target the hip area.

A note on lifestyle modifications

Although we’ve focused on the exercise component of reducing your risk of pregnancy back pain, lifestyle modifications can also help prevent discomfort. 

• Ensure you have a supportive bra to support your growing breasts. Supportive shoes are also important, especially if your feet begin to flatten. 

• When you’re sitting, use a lumbar support and try to keep your feet flat on the floor, with knees at hip height. When standing, aim to keep your ribcage stacked over your hips, while also aligning your ears over your shoulders. 

• You’ve heard the term “lift with your legs” to avoid injuring your back. Most people think of squatting in order to do this. However, when you’re pregnant, a squat may not always be comfortable, in which case you can hinge at your hips mimicking the deadlift. This will call on your glutes and hamstrings to support your back.

To close this article, the main takeaway is that although back pain is common, many pregnant moms can prevent it by staying consistent with exercise and being aware of daily life factors. As we continue to learn more about prenatal exercise, specifically strength and core training, I hope the notion that pregnancy has to be miserable begins to fade. Happy training!

If you’re looking for a few more core tips, check out this free download which provides you with 5 strategies for core training during pregnancy.

If you already are experiencing back pain or leaking, consider this FREE 5-day course to gain a better understanding of how to reduce your risk for pain and incontinence.

Taking Care of Your Pelvic Floor During Exercise

You may not have known anything about pelvic floor muscles until pregnancy or after having a baby. Most likely, you’ve heard two things 1) you should do kegels to strengthen them, and 2) problems with these muscles can cause incontinence. 

Those two things are a good start, but I’d love to provide you with a bit more education so that you feel empowered to care for these muscles and/or continue to exercise if you’re dealing with pelvic floor muscle dysfunction. In this post, we’ll talk about where the pelvic floor muscles are located and their function, common problems that can occur, and four ways to engage and protect them during your workout routine.

What are pelvic floor muscles?

Your pelvic floor muscles form a hammock-like layer across the base of your pelvis. They stretch from your pubic bone in the front to your tailbone in the back. I’ve also heard them referred to as a trampoline, which should be taught and durable. Here are a few things to know about their function:

• When these muscles contract, they lift up and support your pelvic organs. 

• When you bear down, like when sneezing or lifting something heavy, the pelvic floor stretches and lengthens to accommodate the pressure created in your abdomen.

• Additionally, your pelvic floor muscles play a role in sexual function. When these muscles are too tight you might experience painful intercourse. Strong functioning pelvic floor muscles can help you achieve greater sensation during orgasms.  

• Pelvic floor muscles play a role in continence, allowing you to have control over elimination, including passing gas. 

• Lastly, they play a role in spinal and pelvic stability as a member of the core muscle-stabilizing team. 

Common Pelvic Floor Issues in Moms

Factors like pregnancy, childbirth, and aging can impact the function of these muscles. They may weaken due to the weight of the uterus, or they may become too tight due to the birthing process. Either way, if they’re not functioning as they should, it can lead to incontinence, prolapse, and impact your core strength. 

Most of you are probably aware of the connection between pelvic floor muscle function and incontinence. Did you know that there are two types of incontinence? 

• Stress incontinence causes leaking of urine when you cough, laugh, sneeze, or during exercises that involve impact, breath holding, or bearing down.  

• Urge incontinence is when you have the sudden urge to urinate and may not be able to hold it. An example often given is that you know you have to use the bathroom and right before you get to the toilet the urge gets stronger and you can’t prevent urinating.

The majority of incontinence for moms is stress urinary incontinence, however, some moms will also struggle with fecal incontinence which is the inability to control bowels. This can happen due to trauma during the delivery process.

Another condition that involves the pelvic floor muscles is pelvic organ prolapse. Because the pelvic floor muscles support your organs, if there is a dysfunction this can cause organs like your uterus or bladder to drop into the vaginal wall. Picture a hammock or trampoline that can’t support the weight of the person on it…it begins to sag toward the ground. In some cases, the organs can extend outside of the vagina.

The good news is that pelvic floor physical therapy is more widely available and we’re learning more about lifestyle changes and exercise that can treat, improve, or help you cope with these conditions. Additionally, qualified exercise professionals should be able to prescribe exercises that support your efforts to improve pelvic floor function.

Four Ways to Engage, Strengthen, and Protect Your Pelvic Floor During Exercise

As I mentioned, either while you’re in pelvic floor physical therapy, or after you’ve been discharged, a qualified exercise professional can help you engage, strengthen, and protect your pelvic floor during strength workouts. Here are a few strategies you can implement during your workouts:

1. Coordinate your breath: Your pelvic floor muscles are the basement of your core, where the diaphragm is the ceiling. The cylinder which is your core will function optimally when both of those muscles work in synergy. When you exhale your pelvic floor muscles are lifted and when you let the breath out your pelvic floor relaxes. The diaphragm should move in the same direction, descending on your inhale and rising on your exhale. Coordination of these two muscles isn’t always easy, especially when movement is involved. However, it’s important enough to master so that you’re not putting excessive pressure on the pelvic floor muscles. 

2. “Close the holes” or "Blow before you go”: I can’t take credit for these terms as I’ve heard them from several pelvic floor physical therapists. The strategy is to engage the pelvic floor muscles right before you’re about to lift something heavy. Imagine closing your anus as if you’re trying to not pass gas. This will activate your pelvic floor right before there is increased abdominal pressure. You can also try “blow before you go”, which means that right before you’re going to lift, you begin the exhale. Again this can help manage pressure pushing down on the pelvic floor muscles.

3. Avoid impact exercises postpartum until you’ve dedicated time to resistance training: The postpartum running guidelines suggest a minimum of 12 weeks of progressive exercise, including resistance training. However, if you’re having symptoms of pelvic floor muscle dysfunction, this may take longer. When you’re ready to add higher impact activities, start with fewer reps and shorter duration. Take your time to progress and build up. You wouldn’t go from lifting a 5-pound dumbbell straight to 50 pounds, would you? It’s worth mentioning that there aren’t prenatal running guidelines and plenty of moms do run during pregnancy, but if you’re noticing symptoms, that may mean your pelvic floor muscles can’t handle the impact and it’s probably best to move to low impact options. 

4. Remember that pelvic floor muscles are muscles: We all understand the concept of challenging a muscle in order to make it stronger and stretching muscles to relax and lengthen. The same goes for pelvic floor muscles. If you have a weak pelvic floor, you don’t want to avoid core training altogether because it’s going to need the challenge of the exercise to get stronger. If you’re not having symptoms, it’s also important to learn how to contract and relax those muscles. The easiest way to do this is by focusing on breath and core stabilization during strength training. If your core muscles are working together, your pelvic floor muscles will maintain/gain strength. If you prefer isolated exercises, you can throw in kegels of different durations (long contractions and quick contractions). 

Education should be empowering. As you learn more about your body, don’t let it cause fear. Research around core stability exercises benefiting the pelvic floor muscles is increasing, which is an incredibly positive thing. So whether you’re experiencing any of the named conditions, or if you’re concerned about atrophy as you age, or if you just want a well-rounded core program, take the time to become familiar with your pelvic floor muscles. 

If you’re ready to put core training to reduce your risk of incontinence and back pain into practice, consider my free 5-day core course.

Happy training!

Pros and Cons of Prenatal Exercise

Prenatal exercise programs are designed to help pregnant moms stay active during pregnancy, while also considering the safety of the baby. There are obvious changes that your body goes through during pregnancy and prenatal exercise takes those into account. Let’s discuss the pros and cons of prenatal exercise, as well as when to start, and how to know if the prenatal program you’re using is a good one.

Positives

• Promotes a healthy pregnancy: Prenatal exercise can help you reduce your risk for more serious conditions like gestational diabetes and pre-eclampsia. It can also help you ease daily complaints like constipation, lack of energy, and back pain.

• Improve Mental Health: Exercise during pregnancy can reduce your risk for prenatal anxiety and depression, and may even decrease your postpartum risk as well.

• Prepare for labor: Outside of the physical strength, mobility and endurance benefits of exercise during pregnancy, by feeling good in your body, you’ll feel more confident going into labor.

• Reduces aches/pains: By strengthening and lengthening the muscles most impacted by pregnancy, your body will move and perform better. You’ll be able to avoid some of the discomforts caused by overused muscles or compensation.

• Improve sleep: Prenatal exercise can help you get a better night of sleep.

• Prenatal Professionals: Instructors or trainers have an understanding of what your body is going through, which can help ease your fears around doing harm to the baby by exercising.

• Social comfort: Not only do you have the camaraderie of other pregnant moms in a prenatal class, but you don’t have to worry about keeping up during a regular fitness class, and you won’t have to constantly ask for modifications.

Negatives

• Potential for heat stress: Your ability to regulate temperature changes during pregnancy. Although, it is unlikely that environmental heat will raise your core temperature to a level of concern, try to avoid exercise in excessively hot/humid weather, hydrate well, and wear breathable clothing to make exercise more enjoyable.

• Access: Finding the opportunity for prenatal-specific exercise might be difficult. It might be that you don’t have any prenatal classes or exercise professionals in your area. If you do, there may be a limited number of them and your schedule may not work with their schedule.

• Individualization: The American College of Sports Medicine prenatal exercise guidelines suggest your program be individualized for your needs during pregnancy. However, if the only training options available are large classes, or workouts led by a trainer unfamiliar with conditions you might have (like pelvic floor dysfunction), then it might be hard to feel like your program is personalized to meet your unique needs.

When should you start?

As far as exercise in general, for most people, the benefits outweigh the risks when it comes to beginning or continuing an exercise program during pregnancy. You might be tempted to wait until you speak with your OB to make sure that exercise is safe for you during pregnancy, which means you might be waiting until you're 8 weeks pregnant. My advice would be if you have concerns or contraindications, then yes, wait until you speak with your healthcare provider. However, if you’re anxious to get started or to continue with exercise and you’ve reviewed the list of safety concerns, you can always message your primary before seeing your OB, just for the reassurance that you’re safe to exercise.

During your first trimester, you may not experience many physical changes so many people assume it is too early to start prenatal-specific exercise. However, if you take into account the hormonal and emotional changes occurring, like fatigue, or stress about whether the exercise you’re choosing is OK for you to be doing, then getting into a prenatal training program earlier rather than later would be beneficial. I also believe it’s never too early to start training the muscles that will be most impacted by pregnancy. For example, you’ll want a strong core, including pelvic floor muscles, and we all know strength gains don’t happen overnight. By starting a program that considers these things, your body will be more prepared for the physical changes to come.

How do you know if your prenatal exercise program is a good one?

When you choose a prenatal exercise program, there are a few key factors to look for. First, you should verify the instructor or trainer’s credentials. Pregnancy comes with hormonal, physical, and emotional changes and the person overseeing the program should have both the education and experience in prenatal fitness. Next, your program should be designed for the pregnant mom, not modified for the pregnant mom. A basketball player doesn’t go into an exercise class with the instructor just providing modifications because of his/her height or wanting to jump higher. Instead, the basketball player has someone designing a program that is specific to their needs. Pregnancy is no different. A prenatal fitness class should look different from your pre-pregnancy class. Strength should focus on functional movements. Core training should include breathing and pelvic floor work. Intensity should vary based on your energy level. Next, a really good prenatal exercise program should allow you to discuss concerns and trimester trends. For example, if you are suffering from pregnancy heartburn, your instructor should know that certain positions might have to be avoided, and be able to give you equally beneficial training options. Lastly, exercise should help you stay active until your due date, meaning it should be a positive addition to your life. If your prenatal program is a stressor or causes you discomfort or fatigue, then it’s not right for you.

Concerned about core strength during pregnancy? FREE DOWNLOAD.

3 Ways Your Baby Benefits From Prenatal Exercise

It can be hard to stay motivated to exercise during pregnancy. Most moms that I work with are driven by wanting to maintain a healthy weight, avoid aches and pains, and prepare for labor and postpartum recovery. However, some of the most overlooked, but really amazing benefits are about the baby. Here are three ways your baby benefits from you being an active mama-to-be:

1. A head start in brain development

   If you exercise even just 20 minutes, three times per week, your baby might get a head start in brain development. Research shows more cerebral activation after birth in babies born to moms that exercised during compared to sedentary moms.

2. Healthy birth weight

   Long term studies show that if you exercise regularly during pregnancy, you’re more likely to have a baby born at a healthy birth weight. Why is this important? A healthy birth weight has been tied to risk reduction later in life for diseases like cardiovascular disease, diabetes and obesity. 

3. Better heart health

   Research shows that babies born to moms that exercise during pregnancy developed stronger hearts. This is indicated by a slower heart rate and heart rate variability. The assumption is that your baby’s heart synchronizes with your during exercises, giving your little one the same cardiovascular benefits as you. 

Personally, I exercised my entire pregnancy but did not end up with the benefit of an easy delivery. After I recovered from my C-section, I was comforted knowing that all of my prenatal workouts still paid off by most importantly enhancing the health of my daughter. So whether you’re trying to get the motivation to go to your prenatal strength group, or processing an unexpected birth, know that your baby benefits from your physical activity. It can be scary exercising during pregnancy, with fear of doing something harmful to the baby. Don’t let lack of guidance be your barrier.

Need a simple starting point? Download 5 Tips for a Stronger Core During Pregnancy.

Do Prenatal Exercise Guidelines Provide Enough Guidance?

Exercise during pregnancy benefits both you and your baby. It’s one of the first decisions you can make for the health of your child. Unfortunately less than 25% of moms-to-be are meeting the physical activity recommendations. The reason? Lack of guidance. Your doctor has probably encouraged you to exercise, and may have even reviewed the prenatal exercise guidelines with you. So why do so many people feel like they don’t have enough guidance to exercise? My assumption is that most moms don’t have the experience to translate the recommendations into practice. At a time when you may be worried about safety, and feel scared that you’re going to do something to harm you or the baby, a little more specificity and support implementing the guidelines can go along way. It’s not necessarily that guidelines don’t provide guidance, but rather more moms need access to professionals that can help them understand how to put them into practice. Let’s take a look and translate the American College of Sports Medicine Prenatal Exercise Guidelines a bit further so that you don’t end up in the 75+% of moms that don’t get enough activity during pregnancy.

Recommendation One: “Accumulate 150 minutes of moderate physical activity each week. Physical Activity is encouraged everyday, but should occur over a minimum of 3 days per week.”

The Breakdown: Moderate refers to intensity. There is no longer a heart rate max. limit during pregnancy. The best way to monitor intensity is to use the Borg Scale, which measures perceived exertion. A moderate intensity generally falls between 12-14 (breathing harder, but can still talk). If you were active before pregnancy, higher intensities may be appropriate, however maximum intensities for most people should be avoided. Suggesting you accumulate 150 minutes means the amount of activity can fluctuate each day, but you’re aiming to total 150.

My Take: Structured Exercise is important, but just as important is not being sedentary. Move more to make your pregnant body feel good. I’ve seen such success with strength training that I’d recommend two days of full body 30-minute strength workouts (more if you enjoy it and have energy), and walking on most other days (around 20-30 min. each day). If you like to do different forms of cardio you can supplement the walking.

Recommendation Two: “A variety of physical activities should be incorporated, both aerobic and resistance in nature, along with yoga and gentle stretching.”

The Breakdown: Aerobic is another word for cardio workouts and refers to workouts that challenge the cardio-respiratory system (walking, dancing, possibly jogging/biking). “Resistance in nature” refers to workouts that use resistance to target muscle strength (bodyweight, free weights, machines, bands, etc.). The guidelines state yoga or gentle stretching because you can usually find prenatal options, but the purpose here is to emphasize lengthening muscles that tend to get tight during pregnancy.

My Take: In terms of resistance training, rather than focusing on training specific muscle groups, emphasize training movement patterns like squats, lunges, hip hinges, push, pull and (anti) rotational movements. This will ensure you’re able to continue to move well as your body changes. The guidelines may give you the impression by using the term “gentle”, that you need to be worried about the type of mobility work you do, but even with the relaxin hormone there isn’t a ton of evidence saying that it will contribute to injury. Yoga is a great option, but for the non-yogis, a dynamic warm up before a strength session, or some targeted stretching at the end of a walk can serve the same purpose. The goal is really to keep your joints moving as they should, despite some muscles being shortened due to the changes in your body while pregnant….hips are usually an area that feels tight for pregnant moms.

Recommendation Three: “Pelvic Floor related exercises (e.g., Kegels) should be performed daily”

The Breakdown:Your pelvic floor muscles are impacted both by hormones, change in function of abdominal muscles, changed breathing, and weight of the baby. Unfortunately most people don’t know much about the pelvic floor until pregnancy, and usually when they experience incontinence. Your pelvic floor muscles can be considered the basement of your core, so to have a functional and strong core during pregnancy, training these muscles can’t be ignored.

My Take: Aiming to daily kegels is a bit unrealistic and not super helpful for most people. However this recommendation is new to the guidelines and a very important addition. More effective than stationary and isolated exercises like kegels, is being able to incorporate both contraction and relaxation of the pelvic floor muscles during movement. I’d prefer people do this during strength training and major movement patterns because that’s when you need to be the most functional. Use kegels to teach yourself what activation of these muscles feels like, and then learn to coordinate activation with breath and movement.

Recommendation Four: “Warm-up and cool-down periods should be included in any Physical Activity regimen”

The Breakdown: Think of a warm-up and cool-down as transition periods. The warm-up should prepare your body for the type of exercise you’re going to do, and the cool-down should help you return to a resting state after working out.

My Take: Your body’s cardiovascular system changes quite a bit during pregnancy. The higher blood volume can mean a higher heart rate. A warm-up and cool-down can help you gradually increase and decrease your heart and respiratory rates, so for those of you that didn’t make much time for that before, you may find it more beneficial during pregnancy. However, you don’t necessarily need a specific routine. If you’re going for a brisk walk, your warm-up might mean starting slow and gradually increasing your pace. If you’re working out first thing in the morning, it might mean a longer period of mobilizing areas that tend to get tight during pregnancy, like back and hips. Your warm-up should mimic your workout and your cool-down should be to bring your body closer to a relaxed, resting state.

Recommendation Five: “Physical Activity programs should be individualized for each woman based on situation, experience, and current health status”

The Breakdown: Avoid any one-size-fits-all fitness advice. Factors like exercise history, pregnancy complications, access to equipment, energy level, and ability to perform strength exercises with good form…it all should be considered in workout selection or program design.

My Take: In reality, fitness should always be individualized, but it’s unrealistic to think everyone can have access to a fitness professional that can customize your program. However, if there is anytime to be thoughtful about exercise, it’s during pregnancy. Exercise can be your most powerful tool in combatting the aches and pains of pregnancy, and feeling strong and confident. Take some time to self-assess your needs and abilities. Don’t get caught up in the internet rabbit hole of Do’s and Don’ts, or best exercises for each trimester. Don’t overcomplicate things. If you aren’t able to seek the support of a prenatal exercise specialist, keep it simple: Walk often, hit the major movement patterns twice per week incorporating pelvic floor work, and stay mobile.

Hopefully, this breakdown has eased some anxiety and motivate you to exercise during pregnancy. Continue to follow this blog for tips or @activemomfitness on Instagram.

5 Things Your Prenatal Fitness Trainer Should be Doing

Trying to navigate prenatal exercise classes and advice can feel overwhelming. Figuring out what is best for your changing body can create feelings of fear, uncertainty and doubt. Information on the internet is often contradictory, and if even you understand the prenatal exercise guidelines, you may not feel confident in implementing them. Whether you’ve worked with a personal trainer before or not, pregnancy is a great time to enlist the additional support you need. In fact, the newest guidelines from the American College of Sports Medicine recommend an individualized program during pregnancy. If you have the access and means to do so, working with a qualified prenatal fitness professional can ensure your program is safe and effective. As a prenatal fitness expert myself, I know the role comes with a lot of responsibility and take that very seriously. So how do you know if the fitness professional you choose is prepared to coach you through pregnancy?

Here are 5 things your prenatal fitness trainer should be doing

1. Assessment: Assessment refers to establishing a baseline in strength, aerobic capacity, and mobility. However, it also includes exercise history, preferences, needs, and injuries. The benefit of working with a personal trainer is customized programming, so at the very minimum, the fitness professional you work with should perform a thorough assessment. As you progress through pregnancy, they should continue to note and evaluate changes in your core function, workout recovery, and daily discomforts.

2. Understand trimester trends: Reading online or scrolling Instagram would make it seem that there are “bad” and “good” exercises for each trimester. This is not the case. Everyone’s needs and abilities during pregnancy vary. The professional you work with should never program exercises based only on your current trimester, nor should they make assumptions about what you’re capable of. However, there are trends during each trimester that they should be aware of, including the fear and fatigue you might feel during the first trimester, or the disturbed sleep or pelvic pressure you might experience in the third trimester. These factors can all influence the workouts they design.

3. Pregnancy continuing education: Hopefully you’ll do your due diligence and select a personal trainer well-trained in exercise science, and one that has taken the extra courses to provide them with prenatal exercise credentials. However, someone working with pregnant people should also have a good, general understanding of pregnancy overall. Heartburn may seem unrelated to exercise, but a professional with an understanding that this is common during pregnancy can coach you on the timing of your meals, or avoid exercises in a position that worsens your reflux.

4. Providing referrals: Prenatal personal trainers or prenatal exercise instructors should be well-trained in prenatal exercise design. They should demonstrate knowledge about the abdominal wall and pelvic floor muscles. However, if you demonstrate any dysfunction or pain they should refer you to the appropriate health professional. This doesn’t mean they shouldn’t work with you, but no matter how knowledgeable they are, it is outside of their scope to diagnose or come up with a treatment plan. They may be certain that your symptoms indicate symphysis pubis dysfunction, but the only support they are qualified to provide is making sure that your exercise program does not exacerbate symptoms, and can help you strengthen and lengthen the muscles that may help you experience less pain. It’s a bonus if they can work in collaboration with the physical therapist you’re referred to so that you receive the most thorough care.

5. Avoiding Promises: If your personal trainer uses words like “fit pregnancy” “bounce back after baby” or “easy delivery”…run! A qualified professional will be focused not on how “toned” your muscles are, but rather how you feel and move so that you can continue to be strong and active through 40 weeks of pregnancy. A qualified professional will design a program that you can stay consistent with and that strengthens/lengthens the muscles most impacted by pregnancy…thus decreasing the chance of delivery complications and possibly reducing the duration of labor. However, they shouldn’t make you any promises about the ease or length of your labor and delivery. Your personal trainer should understand that prenatal exercise can lead to better postpartum recovery, but should never suggest that you’ll “snap back” because the science tells us that tissues take a while to heal and in no way just bounce back.

Beyond those 5 things your personal trainer should be doing there are other factors that you should consider in selecting one to work with, such as convenience, relatability, ability to share information, and trust. The last thing to note is that there is a benefit to working with a personal trainer you’ve worked with before, or working with the same person throughout your entire pregnancy. This leads to a better understanding of the intensity you’re capable of, and someone who knows your ability will probably be less conservative when designing your program. However, you shouldn’t just assume that a personal trainer that you have worked with pre-pregnancy is the most beneficial to you during pregnancy, or the most qualified.

You deserve to feel strong and empowered during pregnancy. Choose someone who will help you use exercise as a tool to be healthy and feel good as you await your baby.

Happy Training! PS. Download 5 Free Tips for a Stronger Core During Pregnancy