Exercise in Pregnancy: Strategies to manage symptoms, part 2

Updated: Feb 25, 2020

Last week, we talked about postural strategies you can use in exercise during pregnancy. Check it out HERE.

Today, I want to dive into some strategies related to your breath and the core and pelvic floor connection with movement.

Before completely giving up on certain exercises all together, there are often some different strategies you can try to see if the exercise feels better when performed in a different way. Sometimes all it takes is doing it differently.

Remember (especially in pregnancy) that something may feel great one day, but not so much the next, so going with the flow and learning HOW to listen to your body can be very helpful. (If you haven’t yet, check out THIS blog on exercise in pregnancy and how to approach it.)

Before diving into these strategies, I want to remind you of a few examples of when you will want to modify or change up your movement:

  • ANY amount of unintentional leaking (urine or feces)

  • Pelvic pain or pressure

  • Heaviness or a bulge feeling in the vagina

  • Coning or doming along the midline of the abdomen

  • Pulling sensations in the abdomen

  • Rib pain

  • Pain during or after exercise (back, hips, pelvic, belly)

Once you have some awareness of how you carry yourself throughout the day and what your tendencies are (more on this here), it can be helpful to learn how you breathe (or hold your breath) during the day and throughout workouts.

Our breathing is very much connected to our core and pelvic floor function, so if you begin experiencing any symptoms, practicing some different breathing strategies can be useful. Our breath plays a large role in pressure management throughout our core system, so it can have an effect on symptoms if not managed well. As with everything else, there is no right or wrong way to breathe, but there can be some better options for you if one way tends to elicit symptoms.

During pregnancy, the growing baby, extra blood volume, and overall changes to our bodies can change how we are breathing. As the baby continues to grow and push things around in the abdominal cavity, it can make it a bit harder for the core and pelvic floor to work together as well as it did prior to pregnancy which also affects our breathing tendencies.

Here are a few things to start considering about your own breathing tendencies:

Are you holding your breath throughout the day? If so, when?

Are you holding your breath during certain lifts or exercises?

Can you pay attention to how you are breathing during an exercise that doesn’t feel great? When are you inhaling and exhaling on those movements?

Can you tell what your core muscles are doing while you breathe in those exercises? (Are they contracting in, pushing out, etc.?)

Note that any these tendencies aren't bad things, but knowing what you are currently doing can be helpful in determining some other things to try out.

Before going into different ways to change up how you are breathing, it can be helpful to have a basic understanding of how your breathing affects the coordination of the core and pelvic floor muscles:

  • With an inhale, the diaphragm moves downwards, relaxing the abdomen and pelvic floor (for many, it can be difficult to fully relax because of being used to/told to suck it in constantly, however, this part is very important for quality breathing and pressure management).

  • With an exhale, the diaphragm moves upwards and the pelvic floor and transverse abdominal muscles gently contract (this is where strength and stability is created).

Image used with permission from Burrell Education.

This is an automatic process that occurs in your body, but changes during pregnancy can make this connection more difficult and sometimes requires bringing more awareness to it in the