fitness training during pregnancy: when to consult a pelvic floor physiotherapist

By Sarah Hull, Co-Owner + Registered Physiotherapist + Pelvic Health Provider

Pregnancy is such a unique and transformative experience in a woman's life, and maintaining a healthy lifestyle is crucial for both the mother and the developing baby. In this blog post I will share some common symptoms that I see with my patients that make me halt or modify exercise. This blog is not meant to intimidate, but rather to make you feel confident in your decision to exercise!

Research shows that exercising 30 minutes a day while pregnant, if cleared by your MD can be extremely beneficial. It is important to note that your body will be going through significant changes during this time. Physiotherapy can help monitor these changes and provide exercises to support these adaptions.

Core Strengthening during Pregnancy

The core is made up of the abdominal, pelvic floor, and hip muscles. These muscles serve as the anchor the body requires while performing daily activities such as transitioning from sit to stand, reaching, lifting, and carrying objects.

A core strengthening program is valuable during pregnancy because it helps to support that anchoring system through all the changes. As the baby develops, it puts the core muscles into a stretched position making it more difficult to contract. For example, think of a chin up, it is considered “cheating” to stay in mid-range rather than lowering all the way down or lifting yourself all the way up to finish the rep. It is noticeably harder to lift your body from a straight hanging position compared to starting halfway up with your elbows bent already. This is because the bicep muscles that bend the elbow are in a lengthened position when you start at the bottom/hanging position for a chin-up. Pregnancy forces the abdominal muscles into a lengthened position, so all the tasks of daily living become noticeable harder. Core strengthening throughout pregnancy helps the muscles adapt to maintain strength during daily activities.

Things to note during core strengthening while pregnant.

o   You should never feel lower back pain or discomfort with core strengthening exercises such as dead-bug, bird-dog, plank, etc.

o   Avoid exercises or movements that create doming or coning in the abdomen

o   You should always feel like you are able to maintain the appropriate position during the exercise (for example, neutral spine in a plank) if you cannot, your core muscles are not strong enough to maintain the position.

-       If any of these occur, it typically means that your abdominal muscles are not controlling the movement, or anchoring the movements like they should, and modifications are required.

Running during Pregnancy

There are many factors influencing one’s ability to run safely while pregnant and in postpartum recovery. While pregnant, it is important to stick to familiar activities and avoid introducing new activity challenges during this time. Pregnancy itself will put demand on your cardiovascular and respiratory systems. Maintaining a “talking pace” and increasing hydration are helpful techniques to help with the increased demand.

If you are in your postpartum recovery, it is important to give yourself ample time for your body to recover. You are at risk of injury if you introduce running earlier than 3 months postpartum. Please note that breastfeeding increases your risk of stress fractures ligament injury while running because of the increased ligament laxity and reduced bone mineral density. You should always have a pelvic floor exam before returning to running.

To run safely during pregnancy and post-partum, here are some key things that I will look at to ensure your pelvic floor is ready:

-       Able to maintain single leg balance without hip drop for 30+ seconds on each side.

-       Able to maintain hip and knee alignment with single leg squat on each side.

-       No symptoms of pelvic organ prolapse while running; heaviness or pressure that typically increases over time (*no prolapse noted on pelvic exam*)

-       No incontinence while running.

-       No spotting noted after a run.

Please start slowly and your body will adapt appropriately!

Engaging in fitness training during pregnancy can offer numerous benefits for both the mother and the developing baby. However, it’s crucial to approach exercise with caution and always consult with a healthcare provider before starting or continuing any fitness program. By paying attention to warning signs and modifying activities based on individual health considerations, pregnant women can safely enjoy the positive effects of exercise throughout this transformative period.

Sarah Hull, Co-Owner + Registered Physiotherapist + Pelvic Health Provider

Sarah graduated with her Masters of Science in Physiotherapy from Queen’s University. She uses a patient-focused approach using hands-on techniques such as manual therapy, soft tissue massage, acupuncture and dry needling. Sarah has taken a strong interest in pelvic health physiotherapy for men and women.

In her spare time, Sarah loves to ski, bake, do spin and HIIT classes, and listen to 80’s music.