MossRehab

Running While Pregnant? Follow This Expert Advice

By on 04/17/2017

Pregnancy is a time full of excitement and change for mothers to be, but do you have to change your running routine? Running has numerous benefits to mother and baby during pregnancy. With communication and clearance from your physician, many women can continue to participate in the same exercise they enjoyed pre-pregnancy.

General Exercise Recommendations for Uncomplicated Pregnancies:

  • Always check with your practitioner prior to engagement of exercise during pregnancy.
  • Continue to check with provider/physician during follow-up visits for continuation of exercise during pregnancy.
  • Providers/physicians might restrict or prohibit exercise if pregnancy is deemed high-risk or complicated.

Benefits of Running During Pregnancy:

  • Maintenance or improvement in cardiorespiratory endurance, muscle strength, and agility
  • Preventing excessive gestational weight gain
  • Possible decreased risk for gestational diabetes, preeclampsia, risk of cesarean delivery, possible decreased time during first stage of labor

Risks of Running During Pregnancy:

  • Trauma to mother (falls)
  • Hyperthermia (core temperature for mother during first 4-6 weeks should remain less than 102.2 degrees F. to decrease risk of neural tube defects—birth defects of the brain, spine, and/or spinal cord)
  • Dehydration

Do’s:

  • Obtain clearance from provider/physician prior to initiation or continuation of exercise regimen
  • Continue at pre-pregnancy levels of exercise/running, once cleared by practitioner/physician
  • Continue to cross-train
    • Swimming
    • Cycling
    • Strength training—modify to low intensity, low weight (</= 10 pounds, light resistance)
    • Yoga—modify if needed to avoid over-stretching due to increased relaxation in ligaments throughout pregnancy
  • Frequency:
    • Generally, exercise 30 minutes daily, including cross-training, but you might have to decrease the duration or frequency of runs depending on fatigue and how you feel.
    • If initiating exercise, start with 10 minutes walking, increase slowly to 30 minutes per day.
    • If exercising more than 45 minutes, make sure it is a cool environment, or in air conditioning, and increase hydration. Drink plenty of water.
  • Intensity
    • Depends on the individual and prior exercise/fitness levels
      • Begin with low to moderate running, increase intensity gradually, but avoid strenuous or overly vigorous exercise.
      • If already exercising at moderate to vigorous levels, check with your health care provider. Do not over-exert yourself, and anticipate a possible decrease in exercise levels due to anatomical and physiological changes that occur with pregnancy.
      • Monitor with perceived exertion (how much effort you feel you are putting forth)
        • Moderate exercise level should feel “somewhat hard,” vigorous exercise would feel “hard” or “very hard.”
      • Talk Test
        • Moderate level: You should be able to carry on a normal conversation.
        • Vigorous level: If you are unable to carry on normal conversation, with substantial increase in breathing and sweating, you’re going too far.
      • Heart Rate—These are general recommendations, pregnancy recommendations vary and are not widely used.
        • Age less than 20 years: 140-155 beats per minute (BPM)
        • Age 20-29 years: 135-150 BPM
        • Age 30-39 years: 130-145 BPM
        • Age more than 40 years: 125-140 BPM
      • MET’s (a measure of exercise intensity based on oxygen consumption)
        • General recommendation 3-4 MET’s (brisk walking)
        • Intensity may be increased to 6-7 MET’s in well-conditioned mothers (walking 3.5 mph uphill is 6 MET’s)
      • Maintain balance in caloric intake and exercise.
      • Maintain proper hydration as normal pregnancy without exercise requires increased fluid intake. Exercise further increases need for additional fluid intake.

Don’ts:

  • Do not participate in activities with high risk for falls or risk for abdominal trauma.
    • Avoid plyometrics (jump training). Jumping and quick changes in movements can stress joints and increase risk for injury.
  • Over-stretching—Ligaments become more relaxed, placing joints at increased risk for instability and potential injury with over-stretching.
  • Supine exercises (lying on your back) after the 1st trimester—Pregnant women have increased risk for hypotensive episodes—episodes of low blood pressure.
    • Try modifying in quadruped (hands and knees position) for glute strengthening and core strengthening exercises
  • Heavy lifting strength training (> 10 pounds, or heavy resistance bands)
  • Hot temperatures
  • Exercising in temperatures > 90 degrees F.
  • Do not try to achieve peak performance or train for athletic competition while pregnant.

When to Stop Running:

  • Symptoms/warning signs requiring immediate medical follow-up
    • Vaginal bleeding
    • Regular or painful contractions
    • Leakage of amniotic fluid
    • New shortness of breath prior to exertion
    • Dizziness
    • Headache
    • Chest pain
    • Muscle weakness affecting balance
    • Calf pain or swelling

Post-Partum Return to Running:

  • Most anatomical and physiological changes from pregnancy return to pre-pregnancy state in about six weeks after birth. Running may be resumed with medical clearance around this time.
  • Competitive or elite athletes may be able to return sooner with clearance from physician.

Following Cesarean Delivery:

  • Must be cleared by physician due to wound healing, medical complications, pain, surgical complications
    • 1-2 weeks after discharge
      • Walking program (10 min/day multiple times per day), progress as tolerated
      • Stair negotiation as tolerated (may be slow at first)
      • Lifting—nothing heavier than a newborn
    • 3+ weeks after discharge
      • Return to strengthening core and pelvic floor gradually.
      • Pelvis tilts, bridges, Kegel exercises
    • 6+ weeks after discharge
      • Resume pre-pregnancy exercise routines slowly and gradually beginning with low intensity workouts.
      • Aim to follow 30-minute-a-day exercise routine.
      • Abdominal strength will take about 140 days (about 4.5 months) to return to 73-93 percent of original tensile strength

Breast Feeding:

  • No changes in breast milk composition or acceptance of breast milk from infant occur with moderate levels of exertion during exercise.
  • Maximal levels of exertion during exercise are associated with short term (but significant) elevations in lactic acid in breast milk, resulting in less acceptance of milk from infant.
  • Nursing prior to exercise can avoid excessive acidity in breast milk, as well as decreases discomfort in breasts when exercising.

Danielle Olsheski is a physical therapist at MossRehab Outpatient Center in Elkins Park.

(Photo of Danielle by Wes Hilton)

* Artal R. Exercise during pregnancy and the postpartum period. In: UpToDate, Post TW (Ed), UpToDate, Waltham, MA. (Accessed March 31, 2017.)

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