Over the last 38 weeks one of my clients had some big changes happen in her workouts.
She didn’t lose any weight, she GAINED weight, gained inches on her waistline, she decreased her workout volume, she didn’t get her heart rate super jacked up, and she tended to be a little on the slower side sometimes.
This sounds like I’m the worst trainer and dietitian ever!
WRONG – all that happened because she was pregnant and still worked out for the past 38 weeks! She totally rocked the workouts, gained weight at the appropriate weight (2-4 lbs. in the first trimester, and 1-2 lbs. per week after that), modified exercises as required and recommended, and we monitored her heart rate and rate of physical exertion as her pregnancy progressed – all leading up to her final day, only 2 weeks out from her due date.
*Before I go any further in this post I want to make one point perfectly clear – ALWAYS check with your doctor/OB-GYN to make sure you are cleared to exercise during your pregnancy*
Once she was cleared, we were ready to keep on keeping on with the workouts. The changes we made to her exercises and routines slowly evolved over the course of the 38 weeks, but we were able to keep a lot of the exercises the same. The one interesting part of her training was that she did it with a small group, that is normally focussed on weight loss.
Key Point #1: We did NOT focus on weight loss with my client, we did the exact opposite. The group training structure is a healthy mix of mobility, core work, strength and cardiovascular exercise – all things that can be done prenatally, just to a different extent and with some safety modifications. For example, while the rest of the group would be training with some high intensity sprint work/jumping jacks/hills – she would focus more on steady state, much lower impact work – while monitoring rate of exertion and heart rate.
It used to be recommended to not let heart rate rise over 140 bpm during pregnancy, but the latest guidelines have dropped this recommendation . Heart rate does increase by 10-15 bpm during pregnancy to increase blood flow to the baby, so we still did take that into account. Recently, it has become recommended to monitor the RPE, or rate of perceived exertion, and make sure the client is not working out to complete exhaustion. One way I monitored this was to annoyingly constantly ask her questions and see if she could answer without gasping for air in between words. Also, we monitored her body temp by RPE and made sure she was taking plenty of water breaks to stay cool and hydrated.
Key Point #2: We continued to focus on strength training exercises, especially for the hips and posterior chain muscles. As pregnancy progresses, and the belly grows, you often see a greater anterior pelvic tilt.
This can cause extreme strain on the lower back and hips, thus increasing overall discomfort. This also leads to tight hip flexors and potentially weakened glutes. Therefore, we made sure to work on “heavier” sumo deadlifts and hip thrust work. I put heavier in quotes because by no means were we trying to break 1 rep max records, but I know that only 2 weeks ago she was doing deadlifts with a 100 lb. dumbbell from the floor.
We also worked on a lot of core stability and strengthening exercises to keep the abdominal wall strong and sturdy. These included anti-rotation exercises like the Pallof press and standing anti-flexion exercises such as overhead band reaches with a strong emphasis on breathing and postural alignment. We avoided more “traditional” ab exercises like sit ups and crunches due to the stress on the back along with the increased risk of Diastasis Recti (DR).
To quote a very helpful article from http://www.theptdc.com, “A diastasis is the resulting separation of the rectus abdominis muscle bellies as the linea alba becomes stretched. The linea alba can become widened and so the recti muscle bellies are not held as close together as they once were.”
We DID NOT work on any heavy overhead lifts or movements with heavy weights over the torso – bench pressing especially – due to the risk of dropping the weights for obvious reasons. Also, we stayed clear of prolonged time in the supine, or lying face up, position due to the fact that this can decrease blood flow to the little bundle of joy growing inside.
Key Point #3: Focus on myofacial release for tight muscles, not stretching. During pregnancy, there is an increase of the hormone relaxin. This is to aid in the muscles and joints shifting around and to eventually help with delivery. However, this also makes the joints more mobile, and increases the risk for injury. In this case, stretching may not be the best way to help with tight muscles. Foam rolling and trigger point work on the back, glutes, and hips is more appropriate for those tight muscles. The increase in mobility also is another good reason to focus on stability and strength exercises.
Key Point #4: Nutrition – you are NOT “eating for two”. To support a healthy pregnancy, women should consume and extra 200-300 calories, from good sources of protein, fibrous carbohydrates and healthy fats. 200-300 extra calories per day from these food groups is not a whole lot more.
For example, one slice of multi-grain bread with 3-4 oz. of chicken breast and a quarter of sliced avocado is 260 calories – 26g carbs, 11g fat, and 29g protein.
Another example: 1 apple and 1 cup of 2% Fat Greek Yogurt is 266 calories, 39g carbs, 4g fat, 21g protein.
Even with a healthy diet, many doctors and dietitians also recommend a pre-natal vitamin to ensure that all necessary micronutrient intakes are being met.
Foods to avoid during pregnancy include: The most obvious ALCOHOL – NEVER CONSUME ANY ALCOHOL DURING PREGNANCY.
Deli-meats, processed meats (hotdogs, sausages, etc.), raw meats, sushi, due to increased risk for foodborne illnesses.
Another food of concern for pregnant women is fish. Although fish is a low-fat, healthful protein choice, there are certain fish that have elevated levels of methyl mercury or Polychlorinated Biphenyls (PCBs), a pollutant in the environment.
Consuming fish with high levels of methyl mercury during pregnancy has been associated with brain damage and developmental delay for babies. Fish to avoid includes – shark, albacore tuna, swordfish, king mackerel, and tilefish.
Exercise is not only okay during pregnancy, but is highly recommended to prevent complications with birth, increase the health of mother and child, and to help prevent issues postpartum. Cheers to my client for making exercise and health a priority, not only for her, but her baby as well!
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Stay healthy my friends,