Breathe.
Such a simple task that is hardwired into our brains the moment we arrive in the world until our last moments. For some, this is something they never really need to pay attention to, but as a pregnant athlete, breath becomes our accountability partner, our pain reliever, and our healer. This is one of the most common things I see pushed to the wayside during pregnancy and during athletics and rarely addressed or talked about. When ignored, this can cause a whole slew of problems that can linger for much longer than we would like.
First things first, as a pregnant athlete, the main thing you need to make sure of is that you are in fact, breathing. Continued, controlled respiration is what helps us maintain a steady heart rate, ensure continued oxygen flow to our tissues, and more importantly our baby.
Talk Test: Luckily, the age-old rule of keeping your heart rate below 140 BPM during exercise is out the door. During my first pregnancy, there were times just going up a flight of stairs would send my heart rate higher than this so I was glad to know this wasn’t a hard and fast rule. What is now recommended is the “Talk Test”. During your exercise of choice, you want to make sure you can carry on a conversation. If you find yourself unable to speak, this means heart rate is too high, breath is too few and far between and most likely, the baby is not getting the oxygen it needs.
If you find yourself doubled over, hands on your knees, gasping for breath, then most likely, you are breaking this rule. Conversely, those that are apprehensive about exercise and tend to shy away from it, know that the “talk-test” has a caveat, that is yes, you should be able to talk, but not able to sing! We do want our heart rates up (as there are so many benefits to us and our babies of aerobic training) enough where we can still talk, but could not sing.
Find yourself a workout buddy to help keep you accountable if needed. Talk, carry on a conversation. Don’t be fearful of sweating or breathing hard, but just make sure you can still get a sentence out.
What the therapy world has come to in the past years is it’s not about “what” exercises you are doing that cause thing like diastasis recti or prolapse but “how” you are doing them. Women that have issues tend to have poor pressure management strategies for their abdomens.
Most of us, when we go to pick something heavy up off of the floor perform what is called a “Valsalva maneuver” or a breath hold. We go down, take a breath in, tighten our bellies/backs and then lift. This physiologically increases pressure in our cores to add stabilization. This is what is taught during Crossfit Level 1 certification (coaches training) and what is common advice in most weight rooms to make sure athletes are stable throughout their middles. Try it I dare you. Imagine a squat, bicep curl, deadlift etc. In a normal person, this strategy can be okay and is an acceptable way to stabilize through our bellies as we perform a heavy lift. But with a changing belly and a growing uterus, this strategy can cause many problems now and in the future. By performing a Valsalva or a breath hold, we are putting extra stress on our abdomen and pelvic floor which can manifest itself in things such as excessive diastasis recti, pelvic organ prolapse or incontinence.
So what we have learned to do, is make sure we are managing pressure (not allowing a great buildup of pressure in our stomachs) by pairing our work with a functional breath or a piston breath (coined by PT Julie Weibe). Simply put, we want to make sure we exhale as we lift.
If we pair our lift with the “exhale” portion of our respiratory cycle, we can be sure that we are tight through our bellies (we are stable and supported) as well as pressure is leaving through our mouths as opposed to breath holding which causes an exponential increase in pressure!
Examples:
Inhale, relax as I lower down to my barbell. Exhale, draw my belly in and lift the barbell up.
Inhale, relax as I lower myself down to the ground. Exhale, draw in and push me up to complete a push-up.
Inhale, relax as I allow my Pilates reformer to lower down into a squat. Exhale, draw in and push through my legs as the springs and machine give me resistance.
Using this breath strategy is a great way to keep you accountable and is appropriate for so many reasons.
Making sure breathing occurs during exercise keeps tension low not only through our bellies and pelvic floor but all of our muscles. Storing up tension during workouts can contribute to pain and discomfort, less sleep and when the time comes, poor relaxation strategies during labor and delivery. Using breath and meditation before bed and as the due date approaches help to prep the mind and body for birth.
I consistently program diaphragmatic breathing, deep breathing and visualization for every single patient (pregnant or not) for pain control and relaxation.
So breathe. Breathe deep. Pair your breath with your work to ensure you are protecting the tissues most stressed during pregnancy. Don’t allow small breath-holds to creep up on you throughout your pregnancy, wreaking havoc on your stomach and instilling poor habits for your future.
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