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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 pregnancy and postpartum chapters.

It can be helpful to practice this while on hands and knees, sitting, or lying down before incorporating it into more movement.

Let’s take a light weight back squat as an example. You feel pretty good lowering into the squat, but as soon as you get to the bottom, you feel a lot of pelvic pressure and a complete loss of stability. You notice that you were holding your breath. So instead of allowing the natural process of a pelvic floor contraction to occur, you may have actually been pushing that pressure (generated by holding your breath) downwards towards your pelvic floor which resulted in that loss of stability and created the pelvic pressure.

From there, you could try inhaling before you begin the squat, then exhaling throughout the full range of motion (lowering and coming back up). Think about a *gentle* pelvic floor contraction as you are exhaling.

If you don’t notice much of a change, you can try inhaling as you descend then exhaling right before coming up out of the bottom (again, a gentle contraction with the exhale).

That extra support created by the exhale and gentle contraction may be all that you need to reduce the symptoms you were having before.

When we are using our breath for more stability, we want any intra-abdominal pressure that we generate to be evenly distributed throughout the whole core; vs. it just pushing downwards into the pelvic floor or outwards towards the abdomen.

Remember that there isn’t one right way to breathe or move; try out different positions and breathing strategies to find what works best for you!

Want more info on what strategies will be best for you and your journey? Fill out this form to schedule a FREE call with me to discuss how you can best navigate exercise in pregnancy!

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