Second and Third Trimester Exercise Considerations

Calling all pregnant mamas! Check out this supplement that you can take during pregnancy. It’s approved by OBGYNs everywhere and is widely accessible. This supplement can:

• Ease back pain

• Lessen constipation

• Reduce your risk of gestational diabetes, preeclampsia, and cesarean birth

• Improve physical fitness for pregnancy and labor

• Enhance postpartum recovery

• Improve mental health

It’s pretty amazing. And the supplement is called….exercise!

Yes, I know the cheesiness with which I introduce exercise during pregnancy may make you roll your eyes, but it couldn’t be more true. There are so many aspects of pregnancy that are out of our control, but regular exercise is one thing that can be controlled. It has proven to be beneficial to both mom and baby. And while regular exercise is not a proven method to prevent complications, it can greatly reduce your risk and decrease severity if something arises.

In my previous blog post, I outline considerations to make when exercising during your first trimester. All of those considerations remain true in the second and third trimesters. You can read more about those here.

Once you enter your second trimester, you might be feeling a lot less nauseous or fatigued, or you might not. While many moms claim that the second trimester is the best part of pregnancy, there are just as many who continue to feel symptoms that prevent them from experiencing that “second-trimester bliss.”

Personally, I was expecting to feel a huge rush of energy by 13 weeks, which was not the case. I was still exhausted and queasy, but it gradually lessened over time (only to return in the third trimester). So if you have been waiting for the magical second trimester to start exercising, try not to wait too much longer. It’s time to start no matter how far along you are! (Unless, of course, your doctor has told you not to exercise).

As you exercise through your second and third trimesters, here are some additional considerations to make note of:

• Laying flat on your back for exercise might not be a good option anymore. It is possible to start experiencing discomfort in a supine (flat back) position as your baby gets bigger. If you can, incline yourself when doing exercises that require you to be on your back. Otherwise, choose a different exercise altogether. If you are not having symptoms when lying flat on your back for exercises, be sure to clear it with your provider to continue. I recommend rolling to your side in between sets to give yourself a break, and rolling to your side before sitting up.

• Drink plenty of water. Your need for hydration increases greatly during pregnancy, and sweating will exacerbate this. Drinking water also helps hydrate your tissues, which is beneficial during labor.

• Wear a supportive bra to help offload the weight of your breasts as they change throughout pregnancy.

• Monitor your balance. As your center of gravity changes, exercises that might have at one time felt easy can challenge your balance. In some cases, you might want to avoid single leg exercises or hold onto something for balance as needed.

• Avoid exercises that strain your abdominal muscles, such as sit-ups, crunches, Russian twists, or planks. You might be able to continue to plank at an inclined position, but be sure to monitor your abs for signs of diastasis recti. Instead, focus on exercises to strengthen your deep core and transverse abdominals. One exercise I love during pregnancy is bird dogs.

• Monitor for pelvic floor symptoms. If you experience urinary or fecal incontinence, pelvic pain, or back pain, reach out to a pelvic health physical therapist. Addressing this during pregnancy can decrease symptoms and reduce residual impact postpartum.

• Gradually decrease exercise intensity as your body slows down. Yes, your body will slow down as you get closer to your due date! Regressing exercise and decreasing impact are all a normal part of a prenatal workout program. This will allow your body to maintain a sufficient amount of energy and strength for birth, and reduce the risk of injury.

• Incorporate mobility and breathing exercises to help prepare your body for birth. Focus on hip internal rotation, mid-back mobility, and pelvic floor relaxation.

When in doubt, reach out to a prenatal exercise specialist to learn more about how to support your body during pregnancy! Get started to day with my free pregnancy beginner workout today.

Photos courtesy of Amanda Bizarro

Foam Rolling 101

Tight muscles? Feel like you need to stretch all the time? Foam rolling may be the missing piece of your puzzle! 

What is foam rolling? Foam rolling is a form of myofascial release, a technique used on skeletal muscles to decrease tightness and improve blood flow. It applies pressure to the fascia on your muscles using body weight and a foam cylinder. Foam rolling helps promote muscle recovery and improve mobility. And better mobility means improved posture, core strength, and breathing!

Foam rolling is an awesome way to start your warm-up routine. Decreasing muscle tightness before a workout can help us better access specific muscle groups that might have previously been restricted.

Some general guidelines for foam rolling are:

• Apply as much pressure as you feel you can tolerate WITHOUT tensing up. 

• Roll on an area for approximately 10-30 seconds.

• Avoid rolling directly on joints and bones.

• Avoid foam rolling if you are taking medications that could cause excessive bruising, such as blood thinners. (If you are taking any medications and are unsure, just ask your medical providers!)

• If something is injured and you are unsure if there could be a tear or inflammation, do not roll the area.

• This can be demanding on your core. If you notice any doming in your abs, avoid that position until you can manage it without seeing the doming. (What is "doming?" Check out my blog post on diastasis recti!)

• Don’t hold your breath!

You can foam roll so many muscles! Below I outline some of my favorite areas to work on... but keep in mind, the possibilities are endless! 

Piriformis

Sit in a figure-4 position on the foam roller. Turn your hips slightly towards the side of the crossed leg. Roll on your back pocket area (not right on your tailbone).

Hamstrings

Place the foam roller just below your glute. Roll from the top all the way to the back of your knee.

Calves

Roll on the back of your calf muscles. I like to turn my ankles in and out to get the different parts of my calf.

TFL (Tensor Fasciae Latae)

This pesky hip flexor muscle is often very tight! Lower yourself face down onto your foam roller and come slightly on the outside of your thigh. We can do this one leg at a time. You’ll want to roll on the front pocket area of your thigh. (This is not directly in the middle of your quads, but also not on the IT band. It is somewhere in the middle. This takes some maneuvering of your body!

Mid-Back (Thoracic Spine)

I LOVE this for improving mid-back mobility. Start by placing the foam roller on your back, just below the bra line area. Keep your knees bent and feet flat. Support your head and neck by lacing your fingers together and placing them behind your head. Inhale and slowly arch back over the foam roller and stop before your ribs start to flare outward. Exhale as you come back up. Perform this moving in small increments up your spine toward the top of your shoulder blades. Don’t forget to breathe!

Interested in learning more about improving posture, breathing, and core strength? Check out my Core Essentials at-home program and try the first week for FREE! Click the button below to learn more.

Resources:

“Foam Roller Exercises.” Core Exercise Solutions, 26 July 2019, https://www.coreexercisesolutions.com/how-to-use-a-foam-roller/. 

What is Diastasis Recti?

Diastasis Recti is the thinning of the linea alba, which is the connective tissue that runs down the middle of your rectus abdominis muscle (more commonly known as the “6-pack abs.”) This often occurs as a result of pregnancy, but can also occur in women and men due to inefficient breathing, posture, and muscle firing.

This tissue is similar to plastic food wrap. Thinning of the linea alba can occur above the belly button, below the belly, button, around the belly button, or along the entire length from the ribs to the pubic bone.

Diastasis recti is a normal result of pregnancy. A 2015 study showed that 100% of women have a diastasis at their due date, and 39% of them still have one 6 months postpartum. Many women continue to have a diastasis several years later because they were never taught the proper strategies to help heal it! 

Before we dive any further, let's perform a screening to see if you have a diastasis. Check out this video by one of my mentors, Dr. Sarah Duvall, on how to check on your own abdomen. If you think you have a diastasis, don't worry! This is something that can be greatly improved by working on posture, breathing, and core strength. 

A diastasis often causes what we call "doming" or "coning" in your abs. The right side of this image is an example of what that looks like.

The bulging appearance is a result of pressure in your system coming from the inside out. Picture a balloon. As air fills the balloon, the rubber expands 360 degrees to allow even pressure in all directions. As the balloon deflates, there is a natural recoil inward. Because of this even distribution of internal pressure, the balloon can inflate and deflate without issue

Alternatively, if we were to take the balloon and restrict the back half from expanding, all the pressure will go into the front. The pressure will always travel to the path of least resistance. Over time, that rubber in the front is going to become much thinner, weaker, and likely unable to handle the same amount of air.

In this situation, the pressure would be going into the thinned out tissue of the linea alba. If we are constantly allowing that pressure to travel into the front and cause doming, the diastasis will have a very difficult time healing.

This can often become more pronounced with exercises that cause increased pressure in your system, such as crunches or front planks.

So, what can we do? First, I recommend seeking out a local pelvic health physical therapist to get an official assessment. Pelvic PT can help SO much!

Next, we are going to focus on managing pressure in your abs. If we continue to have too much pressure on the linea alba, symptoms will likely continue and prevent the tissue from healing. We will focus on breathing, deep core exercises, posture, and mid-back mobility. Here is one of my favorite breathing exercises you can try!

Additionally, I recommend avoiding exercises that cause doming or coning. Common exercises that cause doming with diastasis recti are crunches, sit-ups, front planks, and push-ups. If these exercises do not cause you to have doming, great! If they do cause doming, you will want to hold off on them until you can better manage your pressure.

If you are ready to get started on the journey to a stronger core, check out my online 4-week program Core Essentials. In just 15 minutes x 3 days a week you will see improvements! Email me at rachel@mamabefit.com if you have any questions.

For further information on diastasis recti, please check out this awesome article by Dr. Anna Hammond, DPT, OCS, CSCS.

Sources: 

Fernandes da Mota, Patrícia Gonçalves et al. “Prevalence and risk factors of diastasis recti abdominis from late pregnancy to 6 months postpartum, and relationship with lumbo-pelvic pain.” Manual therapy vol. 20,1 (2015): 200-5. doi:10.1016/j.math.2014.09.002

Hammond, Dr. Anna. “How to Check for Diastasis Recti.” Core Exercise Solutions, 22 Aug. 2022, https://www.coreexercisesolutions.com/how-to-check-for-diastasis-recti/.