Training During Pregnancy
Let me start with a simple disclaimer, this is not to be taken as medical advice. While it is based upon the latest scientific evidence around training during pregnancy, it should be understood that everyone is different and therefore will respond with differences during pregnancy. Use what you read below as a source of advisory information only.
Well let's get into it.
There are a huge number of benefits to both aerobic and strength training during pregnancy. A few of them include:
Preventing excess weight gain; due to higher energy expenditure and elevated metabolism post exercise.
Increased recovery postpartum; Starting at a higher functional level means you drop less during the end stages of pregnancy, which results in a quicker return of function.
Decreased risk of gestational diabetes; utilisation of blood glucose and elevated absorption of blood glucose post exercise.
Decreased pain; predominantly back pain due to strength improvements within the postural and ‘core’ musculature.
Decreased risk of C section; mechanism unknown.
The standard exercise recommendations for our population still apply during pregnancy. That is a minimum of 150 minutes of moderate physical activity/week (30 minutes per day most days). Strength training 2-3 days per week with specific modifications as we progress through the trimesters.
Naturally as we progress through the trimesters we will have to make changes to what is safe to do. For this reason I have split the article into 3 sections; 1 for each trimester. Each section will suggest movements that are best to avoid or substitute and what areas on movements would be best to focus upon. Let me just say again that everyone is different so please listen to your body, if something doesn't feel right then don’t ‘push through it’.
TRIMESTER 1 (0-13 Weeks):
The First trimester has the greatest variance in what movements should or shouldn't be performed. This will largely be down to how mum feels as well as her previous training level pre pregnancy. (If someone has never trained before than teaching them complicated movements or moving them through high intensity work won't be necessary to elicit or maintain improvements in strength and fitness)
Generally speaking recommended movements or positions to avoid:
High impact movement such as jumping; think skipping and box jumps.
Avoid stomach lying and prolonged crunching towards the end of trimester.
Movements that can place the stomach at risk of impact eg. Burpee, Bar muscle up, Heights.
Try to keep Heart rate not maximal. While not directly harmful, it does increase the risks of overheating which can then make mum feel pretty poor and less likely to train over subsequent days.
Think Falls risks.
As the hormone relaxin increases towards the end of the trimester be aware that joint laxity will increase so shy away from ballistic movements.
Goals:
Keeping aerobic fitness as high as possible. Mum is now supplying blood and oxygen for 2 now so make aware that previously easy conditioning will now start to feel much more challenging- particularly as we progress through the months.
Maintain as much strength as possible. Begin to place more of a focus on upper body strength/ endurance particularly through the Upper back, Arms and core musculature.
Very few changes usually have to be made throughout the first trimester, but it is a good idea to start recommending a few isolated strength sessions.
This first trimester can be summarised by recommending that you go by how mum feels on each and every day. Again training level will influence much of what was mentioned above. Mum knows her body better than you, so respect that and help them enjoy some safe and targeted fitness.
Trimester 2 (13-28 Weeks):
Recommendations:
All of the same from Trimester 1.
The mum's bump will start to become significantly more evident during this trimester. This means modifications to movements may start to become necessary (again dependent upon the person). Movements that may start to become uncomfortable:
Deadlift: Sub with Sumo Deadlifts or elevated deadlifts. Consider some other option that strengthens the posterior chain.
Squats: Sub with box squats, lunges, sumo squats, front squats.
Rowing: Sub with Bike, sled pushes and pulls.
No back lying exercise.
Avoid crunching style movements.
Cardiovascular intensity will naturally decline due to decreases in cardiac output. Program workouts that keep the heart rate only moderately elevated.
Continue to avoid impact based exercises, including running as you progress through the second trimester.
Overheating ! Do your absolute best to keep the body temp down, they have an increased BMR and higher levels of hormones all of which can greatly elevate body temperature; particularly in response to exercise.
Goals:
Continue to maintain cardiovascular fitness as much as possible. Yes this will be challenging and less the mother to be will become less fit. The goal is to keep them as fit as possible.
Continue to develop upper body strength. Think quite specifically about the muscles and joints that are used most commonly by new mums as well as the common issues that you hear of.
Shoulder issues: Strengthen the upper back and scapula muscles. Think Thoracic extension, scapula retraction, medial rotation and depression. Think shoulder external rotation.
Lower back issues: Strengthen the glutes;both the max and the lateral heads for the side to side stabilisation (think the hip pop and lean many mothers adopt). Strengthen the midline musculature.
Also strengthen the upper arms; particularly in that bent elbow position.
Begin to lightly mobilise the Pecs and the hip flexors to further enhance the ability to strengthen through a full range of motion.
Start to incorporate more pelvic floor specific work, as well as standing isometric work for the global midline - we need to really focus on proper midline engagement with correct lifting mechanics.
Trimester 3 (29 Weeks - Birth):
Recommendations:
All of the previous recommendations still apply within this trimester.
In addition to the previous one we really want to avoid putting the pelvis into unstable positions due to again that hormone relaxin.
Pay more attention to falls risks and anything that may cause risk of bumping the belly.
Very importantly don't stress the soon to be mum out. Create a safe environment before they come in’ once they are in just let them do their workout. They will still let discomfort stop them doing the most harmful thing. Your job is to give them a good, fun and safe workout away from the stresses of the upcoming birth.
Goals:
All of the same goals as in the previous section.
Continue to develop upper body strength.
Continue to encourage movement aerobically to the best of their ability. It can be a great idea to program light intervals with longer rest periods to stop that HR getting too high.
Switch a larger focus to pelvic floor and midline strength.