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6 Tips for Safe Exercise During Pregnancy From a Physical Therapist

6 Tips for Safe Exercise During Pregnancy From a Physical Therapist

Whether you’ve always been into fitness or you barely get out for walks, it’s perfectly normal to wonder what and how much exercise to do when you’re pregnant. For starters, we’re happy to reassure you that working out regularly throughout pregnancy can be hugely beneficial for the majority of birthing individuals. From boosting mood and energy, to reducing pregnancy-related pain and complications (including gestational diabetes, pre-eclampsia, and high blood pressure), to building stamina for labor and delivery, the benefits of exercise with a bump are truly amazing. As a pelvic floor physical therapist who specializes in treating pregnant and postpartum individuals, I’ve helped hundreds of patients find the right exercises for their body and their goals. Below are some of my top tips to keep you moving safely and effectively


TIP #1: Check-in with your OBGYN. Really.


This tip is so obvious, you’ll be tempted to skip right past it, but hear me out. It really is important that you talk to your OBGYN about exercise. This is true for two reasons.


One, while most pregnant individuals can stay active without any problems, there is a checklist of conditions that can make exercise riskier. The American College of Obstetricians and Gynecologists (ACOG), lists the following conditions that can make exercise unsafe:

-You have pregnancy-induced high blood pressure or preeclampsia
-You’re carrying twins or multiples and are at risk for preterm labor
-You have placenta previa later in pregnancy (26+ weeks) 
-Your water has broken or you’re having preterm labor
-A surgical stitch or cerclage has been placed on your cervix  to prevent preterm birth
-You have heart or lung disease
-You have severe anemia


    For some of these, you’ll know right away if it applies to you (e.g. if you’re carrying multiples). But for others, you’ll need your doctor to confirm. For example, your doctor can check your iron levels to determine if you have anemia and get an updated high blood pressure reading.


    Second, talking to your OBGYN about exercise can be empowering. They can give you peace of mind that, yes, exercise is great for you. They can also share helpful resources based on the activity you enjoy, like the best pregnancy yoga teacher in town or the fitness center that organizes pregnancy walking groups.


    So during your next well-visit, be sure to bring up the topic of exercise, tell your OBGYN what type of workout you plan to do, and get their input.

    Tip #2: Know your goal, then work toward it slowly.


    It’s generally recommended that pregnant individuals aim for 150 minutes of moderate-intensity (see below for what counts as ‘moderate’) aerobic activity each week. If that sounds like a lot, consider that you can split that 150 minutes up, any way you like. 


    What 150 mins of activity can look like:

    -30 mins every weekday
    -20-25 mins, 7 days/week
    -15 mins on weekdays + 30-40 mins on Saturday & Sunday


      If you haven’t been getting much exercise, you can start small (for example by walking 10 minutes a day, 3x/week) and add on 5 minutes every week, if and when that feels comfortable. When it comes to movement, every little bit counts.

      Tip #3: Exercise at moderate intensity.


      How do you know if you’re exercising at moderate intensity? In the simplest terms, you want to be breathing a bit heavier than usual, but not so heavy that you can’t talk comfortably. While there are situations when more intense exercise can be helpful, moderate-intensity exercise is best during pregnancy. 


      As you’re exercising, give yourself this “talk-sing test” often:


      -Can I sing comfortably? If you can belt out your favorite song during a workout without running out of breath, you’re probably exercising at low-intensity and could benefit from picking up the pace or adding a little more weight or reps.

      -Can I talk comfortably? If you’re breathing a bit heavy but can still carry on a conversation, you’re in a good spot. Try to maintain this. If you can’t talk comfortably, reduce your pace or otherwise adjust your workout to lower the intensity.

        From boosting mood and energy, to reducing pregnancy-related pain and complications (including gestational diabetes, pre-eclampsia, and high blood pressure), to building stamina for labor and delivery, the benefits of exercise with a bump are truly amazing.

        Tip #4: See a physical therapist to get the best exercises for you.


        Every body is different. As your body changes with pregnancy, certain muscles will become weak, while others will become tight and overworked (it’s also possible for a muscle to be both weak and tight). And every exercise or activity you do can either push your muscles further out of balance — which puts you on a path to pain and injury — or help bring them back into balance. 


        Working with a pelvic floor physical therapist, especially a pelvic floor physical therapist who specializes in pregnancy, will ensure that you’re doing the best type of exercise for your body. 


        A pelvic floor PT can not only assess your entire body and prescribe a safe and effective workout that’s just right for you, they can also help you prepare for the intense demands of labor and delivery and learn to push effectively. Research shows that working with a pelvic floor PT can reduce the time you spend in labor.

        Seeing a pelvic floor PT doesn’t have to be time-consuming or expensive. Clinics like Origin offer virtual care covered by insurance, so you can get affordable care right at home.

        Tip #5: Avoid activities that are known to be unsafe for pregnancy.


        It’s just common sense, but anyone who is pregnant should avoid sports or activities that could cause them to fall or increase the risk of impact to their abdomen. We’re talking about anything from soccer and boxing to skiing and sky-diving. 


        It’s also best to avoid exercising in extreme heat at any time during pregnancy (say no to outdoor activities on super hot days and skip the hot yoga or pilates) or doing anything that could obviously increase your chance of injury. The last thing you want in the delivery room is a cast on your arm or a pulled muscle in your hip. 


        Now for some less obvious things to avoid: 

        -Exercising while lying on your back after the first trimester
        -Exercises that compress or overly strain your abdominal muscles after the first trimester (sit-ups, lying on your stomach, or lifting weights with both arms overhead, for example)
        -Stretches that cause a lot of uneven strain in your pelvis, or increase pain or discomfort in your low back.


          It can be hard to know if an exercise strains your abdominal muscles or pelvis. Working with a pelvic floor physical therapist is the best way to make sure. 


          Last, but not least, if you notice any of the following warning signs, stop exercising immediately and call your OBGYN:

          -Dizziness or the feeling that you might faint
          -Shortness of breath before exercise
          -Chest pain
          -Abdominal pain
          -Painful uterine contractions
          -Blood or other fluid coming from your vagina
          -Calf pain or swelling 
          -Muscle weakness that affects your balance

            Tip #6: Start with simple, familiar activities.


            If you’re not sure where to start when it comes to pregnancy exercise, I like to recommend walking, riding a stationary bike, water workouts in a pool, pregnancy-safe yoga or pilates, and/or resistance training with weights or resistance bands. ACOG lists these activities as generally safe for pregnancy. 


            Ideally, you’d have a menu of safe activities and exercises that you can pick from, depending on how your muscles feel, your energy level, and what you’re in the mood for.


            If you’re not interested in doing any of these things or if there’s a different activity that you’re interested in, you have options! There are many, many activities that are safe and beneficial for pregnancy. And some potentially risky activities may also be modified with the guidance of a healthcare professional to make them safer. 


            Don’t hesitate to talk with your OBGYN about your exercise wishlist or connect with a physical therapist who specializes in pregnancy and can customize every aspect of your workout.

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            Dr. Ashley Rawlins, PT, DPT

            Dr. Ashley Rawlins, PT, DPT, Clinical Learning & Development Lead at Origin.
            About Origin: We’re on a mission to make pelvic floor physical therapy the standard of care for women and individuals with vaginal anatomy, at every stage of life. With in-person visits available in CA and TX, and virtual care and coaching offered nationwide, our highly-trained and compassionate clinical team is healing pelvic floors from coast-to-coast.

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