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Guidelines for Prenatal Fitness

Building Strength from the Inside Out Throughout Pregnancy: Guidelines for Prenatal Fitness

By: Dr. Lindsey Paczkowski, PT

There are books, blogs, workshops all about what to expect when you’re expecting… but there’s little guidance on exercise in the prenatal time besides “listen to your body”. Our hope is to provide you with evidence based guidelines to safely maintain and build strength during pregnancy, for labor and life beyond.

Remember your pregnancy is a time of experiencing the miracle of what the human body can do and create and to have grace in the process that your body is continually changing.

Maintaining a routine of consistent, moderate to somewhat hard level of aerobic exercise (3-4 on RPE scale) throughout pregnancy has been associated with reduced excess fat gain in some studies. A duration of 20-45 minute exercise pending tolerance and prior level of function is a good goal.

The 1st Trimester can be a challenge for many women. With nausea and unanticipated changes with energy and exhaustion this trimester allows for a lot of mindset adjustments more so than the physical changes. Limit efforts of max lifts, competitions or high risk of falling activities. Discontinue use of a weight belt. Modify workouts with reducing reps, rounds, workout times and build in additional rest breaks to accommodate for symptoms of nausea or exhaustion you may be experiencing. Like I mentioned, the first trimester is a lot of mindset adjustments and giving yourself grace. Another consideration for the pregnant athlete is if this is your first pregnancy versus a second or third etc. Do you have a history of or current symptoms of pelvic floor dysfunction? (incontinence, diastasis recti, vaginal or rectal pressure, pelvic pain)

First trimester especially and into pregnancy:

-Avoid hot yoga, hot tubs/saunas and high heat environments
– Water or downhill skiing (risk of falling)
-Contact sports (soccer, softball, basketball, volleyball)
-Scuba Diving

The 2nd Trimester the baby belly is growing, leading into modifications galore for your exercise routine. We recommend seeing a pelvic floor PT for an initial assessment and learning modifications, symptom management strategies to continue to build on throughout your pregnancy to protect your core and pelvic floor. The 2nd trimester is filled with monitoring your symptoms and modifying your exercises as needed. Goal again is for an RPE of 3-4, meaning can you hold a conversation through training?

Modifications include:

-Longer warm ups/cool downs
-Avoid laying directly on back after 1st Trimester, consider a wedge/incline bench
-Switching to an inclined position for prone (belly down) movements (planks, push ups)
-Reduce/eliminate/modify high impact (box jumps, running, jumping rope)
-Set up stance for lifting may need to be adjusted (wider stance such as sumo deadlift, shoulder width stance for squatting)

The 3rd Trimester your body is developing and changing. Use your exercise time for enjoyment and think about “What feels good to you today?” Be mindful of exercises and movements that place more pressure on the pelvic floor, as it is already experiencing higher amounts of stress to the dynamic core system at this point in pregnancy. If possible continue regular exercise to end of pregnancy with respect to your symptoms, interests and energy levels during this stage and see the value in rest & recovery leading up to labor, delivery and the postpartum season.

Modifications include:

-Longer warm ups/cool downs
-Reduce volume/loads
-If experiencing pubic symphysis pain in single leg activities or walking, modify your body positioning with shorter steps, breathing throughout the entire movement or replace movement with a pain free alternative.
-Reduce frequency of training

Warning Signs of when to STOP exercising (at any stage of pregnancy):

-Shortness of breath
-Chest pain
-Rapid or irregular heartbeat
-Headache
-Vaginal heaviness or loss of amniotic fluid
-Dizziness
-Overheating
-Back/hip/pelvic pain
-Joint pain
-Severe fatigue
-Muscle weakness

Pregnancy is a life changing and unique experience to see how amazing the human body is. These guidelines and recommendations are here to provide guidance for a safe, healthy and strong pregnancy.

Interested in personalized programming during your pregnancy or in the postpartum season? Email us at info@iostrengthperformance to get connected with our team to learn more about our options for building movement confidence for new moms, from bump through postpartum. For the woman seeking to live her life strong.

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