Baby Bumps and Barbells

Many active women wish to continue their lifestyle even through pregnancy.  Aerobic activity and resistance training are fantastic for maintaining fitness while keeping the baby healthy.  Of course, always consult your doctor after becoming pregnant to make sure that it is safe to exercise at various intensities.

 There are endless physiological changes during pregnancy that effect your body’s response to exercise.  The pregnant women has 30-50% higher cardiac output, meaning the amount of blood pumped by the heart each minute is greater when pregnant.  Due to this change, your heart rate during exercise will not be a reliable indicator of exercise intensity.  The amount of air inhaled and exhaled in one minute is also increased by 50%.  Therefore, the best way to judge exercise intensity will be how it feels to you.  A useful scale that is popular in the medical world is called the Borg Rating of Perceived Exertion Scale (pictured right).  The moderate exercise will fall in the range of 11-12 while the vigorous exercise should be kept around 14-15.  Again, we want to avoid exhaustion but still challenge the cardiovascular, musculoskeletal and respiratory systems.  Another major change is the flood of the hormone relaxin throughout the body that relaxes the ligaments and allows for greater ranges of motion.  Thus, with any activity it is essential to maintain a safe range of motion.  Free falling in the bottom of the squat where your calves meet your butt is not a great idea.  Or pushing a little further in a stretch should be avoided!  

The general guidelines are to accumulate at least 20 minutes of moderate intensity almost every day of the week.  For those of you who look for more intense activity, 3-5 days of vigorous activity is suggested for 20-60 minutes per bout.  ​​

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Baby Bumps & Barbells guidelines:

• Continue to exercise just as you did before the pregnancy.  It is suggested that continuing to workout at the same intensity is still safe.  If you were not active before, an exercise routine will undoubtedly benefit you and the baby but you will want to maintain a low intensity, staying around the 9-11 range.
• Avoid performing exercises laying on your back, specifically in the second and third trimesters.  This position could put pressure on important vessels as well as can challenge your breathing.
• Do not exercise to exhaustion.  Remember, you cannot rely on heart rate alone!
• If it hurts or is uncomfortable, stop doing it.  This seems obvious, but I thought it was worth emphasizing.
• Any aerobic and resistance training using large muscle groups will be beneficial.  (walking, hiking, jogging/running, swimming, cycling, rowing, dancing, rope skipping, etc)
• As the baby bump grows, modifying exercises will be necessary.  Some ideas include substituting a barbell for dumbbells, low step ups or squat to box instead of box jumps, and ring rows instead of pull ups.
• Continuing to run, swim and row is safe as long as you and the baby are healthy and comfortable.

Targeted Strengthening
As the baby bump grows and the center of mass is moved forward, your posture will be affected.  The lumbar lordosis, or curve of the low back, will increase drastically throughout the pregnancy.  Often times, your thoracic spine will flatten.  Although postural changes are expected and normal, it is important to continue to maintain the best posture possible.  Continuing upper body strength training and focusing on proper posture are key.
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Another group of muscles that is greatly affected during pregnancy is the posterior chain.  I’m talking specifically about the glutes and the hamstrings.  Any barbell work to strengthen these areas should be continued throughout, keeping the baby bumps and barbells guidelines in mind. Lunges and squats remain some of the best and most simple workouts to target the posterior chain with little risk.  
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Birddog- if achieving this position proves to be too difficult, you can keep your knees down and extended just one arm at a time.  Then you can progress to extending just one leg at a time before combining for an arm and a leg simultaneously.

Safe Stretching
As mentioned earlier, pregnant women are inherently more bendy than they were pre-pregnancy so stretching may seem unwarranted.  However, most of these stretches are aimed at relieving areas of pain or tension from the growing bump and new posture.

​Child’s pose- as the baby bump grows, this can be modified by having your arms and hands out-stretched on a workout ball, chair, or any other elevated surface.  A large ball will give you the option of small rotations right and left with your arms to feel the stretch intensified along your sides.

Seated Hamstring Stretch- as the bump grows it may be necessary to use a bed sheet wrapped across the bottom of the foot and held with the hands.

Hip flexor stretch- while standing at the bottom of a staircase, place the lead foot two or three steps up.  Keeping the back leg on the bottom with a slight bend in the knee, shift the weight forward to the lead foot to the point that you feel a comfortable stretch in the front of you trailing hip.
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Cat Cow- a great way to stretch the lower back and get the thoracic spine moving throughout the entire pregnancy.

Pigeon- if you are unable to achieve or maintain this position, adding a firm pillow under the upper thigh of the back leg and buttock area of the front leg may be more comfortable.

Deep Squat- a great stretch for your hips and pelvic floor during the pregnancy.  **Caution – in the third trimester, ask your doctor before trying this stretch as it may induce labor **

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Remaining active will lead to a healthier and happier pregnancy.  Keeping the posterior chain strong can ward off back pain for mom while exercise activity increases blood flow for the baby.  Remember, it is important to always listen to your body and consult healthcare professionals when questions arise.

Thanks for reading!
-Dr. Jackie, PT, DPT, CSCS

​References
R Artal, M O’Toole. Guidelines of the American College of Obstetricians and Gynecologists for exercise during pregnancy and the postpartum period.
Photos:  FitPregnancy.com, tfwropestone.com, fusionwellness.com, themusicmommy.com, alimcwilliams.com, momjunction.com