3rd Trimester Pregnancy Considerations for Exercise AdaptationsApril 2nd, 2020
In the 3rd trimester of pregnancy there are heaps of benefits from exercise, such as improved mood and sleep, decreased levels of stress, strength is created to support the ever changing frame of the mother’s body, it prepares the mother for the birthing experience, it can alleviate aches and pains, and generally improves sense of well being.
Precautions need to be taken so that both mother and child are safe, ideally exercise should make you feel better, rather than potentially cause injury or complications. It is so easy to make these changes so that the mother can still reap all the positives and benefits of exercise.
Considerations for Exercise
- The risk of falling should always be considered. In the 3rd trimester the center of gravity has changed, body weight has increased, uneven loading of where the weight is now distributed, proprioception is altered, hormone changes that control the ligamentous and muscular functions can confuse what feels normal, all increasing risk of falling. High impact exercises should be changed to low impact and sports such as skiing should be avoided.
- Another consideration is pelvic floor pressure. There is an increase of downward pressure on the pelvic floor during certain physical activities, such as high impact, when this adds to the pressure caused by the baby it can cause pelvic floor dysfunction (prolapse and/or incontinence, which NO ONE wants in their life). Deep squats, as an example, can cause excessive pressure on the perineum, so reducing the range or weight used can help prevent harm here.
- Abdominal wall pressure occurs when there is too much pressure across the whole of the front of the bump, and can cause the abdominal wall to split (diastasis recti). And although there is a high chance this will happen towards the end of pregnancy for many woman anyway, it is still best to avoid doing things that feel heavy in the front of the stomach, or creates a bulge in the front of the abdominal wall, such as planks and press ups.
- Avoid anything that causes pain or causes a change to technique to avoid discomfort felt. The best thing to do if discomfort is noticed is to stop what you are doing, change the range of motion / weight being used / angle at which the movement is occurring / change the exercise altogether.
- Avoid laying supine (on the back) IF it causes dizziness, nausea, numbness, tingling or other symptoms. If you experience those symptoms then roll on to your side and cease the exercise, as the baby’s weight may be pressing on a nerve or blood vessel. If you do not experience any of these symptoms then it is still okay to exercise on your back.
- Avoid overexertion, this could be from lifting heavy weights or working to such a high intensity that you can’t speak properly. Lifting heavy weights increases the possibility of poor form that can put unnecessary strain on the body, so stick with a weight that you can move well. This is subjective though, what is light for one person can be heavy for another, the pregnant lady will know more about what feels right for her, so never judge another or even yourself.
- If the movement requires a change to technique, rather than positioning, then consider whether it needs to be done at all. For example if performing an Olympic Weightlifting clean, the technique needs to be changed to avoid the bump. This then create an incorrect movement pattern, so the wrong muscles are used, which can lead to injury, and the barbell could hit the abdomen if it’s miss judged. Therefore, it’s worth avoiding the movement with a barbell, maybe replace with a dumbbell or leave altogether.
- Avoid holding your breath as this causes too much pressure on the abdominal wall.
Adaptations to Cardio exercise
- Change running to gentle jogging if you’ve been running before and through your pregnancy, or fast walking on flat or up hill.
- Light sled pushing and pulling is safe and effective, just don’t brace, hold your breath or over exert yourself.
- Choose indoor cycling over outdoor cycling or indoor rowing, as these both have a higher risk of falling.
- Remove all high impact exercises such as jumping.
- Sprints can be done on an indoor bike or incline walking, not running.
- Replace burpees with alternate incline push up (against wall) and squats.
- Replace box jumps with step ups or lateral step ups.
- Replace lateral speed skaters with curtsy lunges.
- Replace mountain climbers with standing controlled high knee marches.
Adaptations to Strength exercise
- Glute Bridge – raise the shoulders on a bench or bosu ball.
- Plank – raise hands on a higher surface or on knees. If it feels too heavy on your front, stop.
- Bent Over Rows – replace bent over rows with standing or seated rows from a cable machine or resistance band.
- Push Ups – raise hands unless it feels too heavy on the abdominals, or use a seated chest press machine or a standing push with cables or resistance band.
- Squats – reduce range and/or reduce weight.
- Replace barbell cleans and snatches with dumbbells or kettlebells.
- Generally reduce the weight and make sure you breath out on exertion.
- Keep strengthening the posterior of the body to support the bump.
Adaptations to Core exercises
- Avoid crunches.
- Replace planks with incline planks.
- Standing Palof presses with a resistance band or cable machine are an effective anti-rotation exercise.
- Slow and controlled mountain climbers with the hands raised as high as needed, to work hip flexion with a neutral spine.
- Suitcase carry, including up and down stairs to strengthen anti-lateral flexion.
- To work rotation ensure that the hips rotate with the torso, so a standing resistance band rotation is effective.
- Look for bulging in the belly (linea alba) and stop immediately if this happens.
Adaptations for yoga
- Standing strengthening postures like warrior 2, and balances such as tree pose are great for strengthening hips and legs.
- Avoid balances where it is not easy to stabilize if you loose balance.
- Avoid balances like dancers pose if the loading on the linea alba is too much.
- Butterfly pose, wide legged forward fold and frog pose are great for preparing the body for child birth.
- Cat / cow and pelvic tilts are great to relive back tension.
- Focus on stretching lower back, so childs pose is great for this.
- Avoid holding breath in breathing work and in poses.
- Avoid inversions like headstands, but gentle ones like forward folds, bridges and childs pose still okay if you do not get light headed.
- Avoid over extension of the spine, so keep backbends small and focus more on using the strength in the back of the body.
The most important thing to do is to listen to you intuition, if it doesn’t feel right, don’t do it.
For help and guidance please feel free to ask.