A BREAKDOWN OF WORKOUTS BASED ON TRIMESTER
by Alison Brunson, PT, DPT, CSCS, PCES
In an earlier blog, I talked about the benefits of staying active while pregnant. Check out that blog here.
Quick Summary of the Benefits of Working Out When Pregnant: exercise will increase your energy levels, improve sleep quality, reduce pregnancy discomfort and prepare your body for labor.
But, what’s important? What exercises should I prioritize? How does each trimester impact or change my training program?
This blog will explain more details about:
(1) Specific areas to focus on during your workout
(2) How each trimester will change the training program
(3) Examples of “a weekly program” for each trimester
And Remember:
If you were lifting weights or running long distances, your body is very much capable of continuing training that way. If you were not so active before pregnancy, it is safe for you and your baby to start a fitness journey, after clearance from your doctor. Overall, my take on this topic is to be active, go on walks, strengthen your muscles, just be cognizant of how you are feeling along the way.
*** Use this as a guide or to give you a few ideas on what may be helpful during your pregnancy. ***
What Are Specific Areas to Focus On?
360* Breathing
This is the foundation of optimal pelvic health.
Inhale: belly AND back AND sides all expand, fully relax pelvic floor
Exhale: contract pelvic floor, “zip up” abdominals starting from lower to upper
Adductors
Strong adductors act like anchors for the pelvis -> giving it support, strength, and stability.
Abdominals
Abdominals coordinate with the pelvic floor to support and stabilize.
Mobility
Stretching is focused on preparing for posture changes throughout the pregnancy & labor prep (extra emphasis on pelvic opening) during the third trimester.
Upper Body
The “forward head, rounded shoulders” posture is common during pregnancy. So, it’s important to (1) work on serratus anterior strength and (2) reduce tightness in the pec minor, upper traps, and levator scap.
Lower Body
Glutes help maintain a neutral pelvis and assist in pelvic floor contractions. During pregnancy, women will “clench” their glutes to help maintain their balance due to the added weight in your bump. That constant tension can cause glute and pelvic floor tightness with subsequent weakness. Be intentional to relax the clench and work on glute strength!
Sample Glute Strength Exercises Progression:
Squats/Deadlifts with light or no weight
Hip Thrusts
Single Leg Deadlift
Single Leg Hip Thrust
Single Leg Lunge Deficits
How Will Each Trimester Change My Training Program?
The First Trimester
Once I learned that I was pregnant, I modified my workout to create a solid foundation for the next several months.
Diaphragmatic Breathing
Practiced 360* breathing in different positions (sitting, standing, sidelying)
Integrated pelvic floor + breathing to prepare for next 9 months
Reframed My Mindset
My goal for the next 9 months: (1) stay active, (2) think long term benefits
Gave myself grace when I felt too tired or too nauseous to be active
Priorities
Hydration & Nutrition.
The Second Trimester
At 20 weeks, I decided to eliminate supine based exercises & avoided over extending belly (e.g., cobra), modified any advanced core work (e.g., leg lifts), monitored my intra-abdominal pressure and watched for diastasis recti
Modify Exercises on Your Back
Some doctors will say it’s probably fine to continue performing exercises on your back because movement while doing an exercise will promote blood flow. But, it’s also easy to modify exercises and I didn’t want to take any risks. So, I modified all exercises after 20 weeks. Talk with your doctor for more information.
Why no prolonged supine exercises?
The growing baby can compress the inferior vena cava vein and reduce the amount of blood passed to the baby. If you experience nausea, dizziness, or breathing issues when supine, change positions immediately.
Modify Daily Activities
Diastasis Recti can be seen with “coning” that occurs between your rectus abdominis, “six pack abs” due to the linea alba thinning out to make room for your baby. As your belly gets bigger, the intra-abdominal pressure will push out into the weakest part of your body. (check out my DR blog for more information)
Example: I changed how I got out of bed by - going on my side first, then pushing up with your arms to sit up. This is reduce the amount of pressure in your abdomen & hopefully reduce “coning”
The Third Trimester
The home stretch: I prioritized mobility work, posture exercises, and lower body strength.
Mobility & Posture Exercises
Focus is to increase scapular strength, mid back mobility, and improve breathing techniques.
Why? Better posture + better breathing = decrease stress on linea alba and pelvic floor
Lower Body Strength
This mainly includes glute/hamstring/adductor strength training.
Be mindful of compensations your body is now making because of the weight of your belly
If you have aches/pains, DR, compensating during an exercise, it might be time to cut back on weight or modify a movement - opt for seated or sidelying positions instead.
Other Priorities
Dehydration can bring on fatigue and contractions - Stay hydrated!
Monitor for signs of prolapse or pelvic floor dysfunction …. which are, feelings of heaviness or difficulty with using the bathroom, & please contact a pelvic health physical therapist
Examples of a Weekly Program Based on Trimester:
*** These are only examples, very rarely did I feel motivated enough to perfectly complete an entire week’s workout routine. ***
REFERENCES
Pregnancy and heart disease. ACOG Practice Bulletin No. 212. American College of Obstetricians and Gynecologists . Obstet Gynecol 2019 ; 133 : e320 – 56
Berghella V, Saccone G. Exercise in pregnancy! Am J Obstet Gynecol 2017;216:335–7
Magro-Malosso ER , Saccone G , Di Tommaso M , Roman A , Berghella V . Exercise during pregnancy and risk of gestational hypertensive disorders: a systematic review and meta-analysis . Acta Obstet Gynecol Scand 2017 ; 96 : 921 – 31
Kolomanska-Boguck D , Mazur-Bialy Al . Physical Activity and the Occurrence of Postnatal Depression-A Systematic Review . Medicine (Kaunas) 2019 ; 55 : 560
(Wang SM , Dezinno P , Maranets I , Berman MR , Caldwell-Andrews AA , Kain ZN . Low back pain during pregnancy: prevalence, risk factors, and outcomes . Obstet Gynecol 2004 ; 104 ( 1 ): 65 – 70)
(Evenson KR, Hesketh KR. Monitoring Physical Activity Intensity During Pregnancy. Am J Lifestyle Med. 2021 Nov 25;17(1):18-31.)
(Berghella V, Saccone G. Exercise in pregnancy! Am J Obstet Gynecol 2017;216:335–7)
(Newtown ER & May L. Adaptation of maternal-fetal physiology to exercise in pregnancy: The basis of guidelines for physical activity in pregnancy. Clinical Medicine Insights. 2017; 10: 1-12)
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