What to consider if you want to run during your pregnancy

This is an all too common question women ask when they first learn that they have become pregnant. At least among women who are interested in staying healthy during pregnancy. It can be frustrating for anyone who has to put a hold on their fitness or running routine. With a pregnancy, unlike an injury, the thought of having to give up 9+ months can be daunting considering how hard it can be to jump back into a routine after just a few weeks.

In 2008, the U.S. Department of Health and Human Services issued physical activity guidelines.  They stated that If you have an uncomplicated pregnancy and you have been engaging in vigorous activity, you “can continue physical activity during pregnancy and the postpartum period, provided that you remain healthy and discuss with your health care provider how and when activity should be adjusted over time” [1] this document also stated that pregnant women should perform 150 minutes of moderate to intense aerobic exercise spread across each week [1]. So what does this tell us? Well, it doesn’t mean you can’t run so it’s not a no. But this also isn’t giving you an absolute green light either, so not a yes either. So I want to break it down further for you so you can make the most informed decision in regards to you and your growing baby’s health.

In order to make this decision there are a few things to consider:

1. How is your cardiovascular fitness
2. Have you already been running/lifting prior to your pregnancy?
3. Has your doctor permitted you for exercise?
4. Do you have any pelvic floor or musculoskeletal issues?
5. Do you know all of the signs and symptoms that you need to look for if you do decide to run while pregnant?
6. Are you eating enough?

How is your cardiovascular fitness?

If you’re not already a runner then this may not be the best time to pick up the habit. Your body is going through many changes. The amount of stress you are placing on your cardiovascular system may be excessive. This is because blood volume can increase by as much as 40% during the 1st  trimester and more than 50% by the 3rd trimester.

The work your heart needs to perform (cardiac output) with this increase of blood volume can increase by up to 50% which will, in turn, increase the load of your cardiorespiratory system [2]. These alterations to the body are made to provide blood supply to your baby. A seasoned runner may already have the ability to adapt quickly to these changes. But if you are someone who is sedentary prior to pregnancy then you may be placing too much pressure on your system to maintain safety for you and your baby.

Have you been running/weightlifting before your pregnancy?

There’s also the issue of your joints and musculature. A seasoned runner has already built up the musculature and has accustomed its joints to the impact of running. They are able to support new changes in their body such as a weakened abdominal section and well… the weight of a growing baby inside them. To sum it up, if you have not ran/jogged before your pregnancy, then you may actually do much more harm than good to your joints, lower back, and pelvic floor. Remember your baby is growing quickly. If you haven’t worked on strengthening your support muscles then you may find it difficult to support the rapid increase in weight. This isn’t like gaining extra body fat, which you are also likely to gain.

I will point out that there are no current studies that I can find that have tested whether or not it is safe or unsafe for a pregnant woman to run and when they should start, this makes sense as it would be unethical to perform such a study asking sedentary women to begin running or jogging after becoming pregnant at any stage. So please use common sense and check with your healthcare provider prior to running.

Has your doctor permitted you for exercise?

You are going to run into all kinds of people through your pregnancy. And you will soon find out that everyone has an opinion. I urge you to take it all in with a grain of salt. It is very important for your health and your baby’s health that you listen to your doctor.

 Now, of course, not everyone is perfect. So, if you have an issue with what your doctor says or you find something, he/she said is suspect, then consider getting a second opinion.

This is your baby. Don’t be afraid to be bold and ask questions. If you have been running, you have every right to ask your doctor if there is any reason, he/she feels you need to stop. And of course, you should always discuss past and present medical conditions

Do you have any pelvic floor or musculoskeletal issues?

There are many injuries that might prevent you from running. It is likely that if you already know about them that you haven’t been running anyway. So, assuming that you are in the category of women that have not been running prior to pregnancy due to a musculoskeletal injury, it’s probably not wise to begin now. I would recommend something more of a brisk walk in the attempt to meet that 150 minutes per week that we discussed earlier.

However, if you have such injuries (pelvic floor pain, lower back pain, carpal tunnel syndrome or knee pain) and you have been managing it well and have been running prior to pregnancy, I would still recommend that you speak with your doctor before continuing. Remember as your baby grows your weight distribution will change. This can, in turn, change your stride without you even noticing. So, all the techniques you may have learned while running prior to pregnancy can go straight out the window. If you are adamant about continuing with an injury please seek advice from a certified professional who can take a look at your running stride and make corrections as you progress through your pregnancy. And of course, consult your doctor.

The best advice I could give you is to find something with less impact, like swimming, bicycling, or weight training.

You may also have some pelvic floor issues that might prevent you from running. Some of these include leaking when you cough, sneeze, run, or laugh. This could be an indication of weak pelvic floor musculature. This may need to be addressed prior to running as your pelvic floor will become an important factor in the support of your baby and later delivery. Also, ask yourself if you have heaviness in the peritoneum. And lastly, is this your first pregnancy. If you have had a pregnancy before then you may need to consider the trauma to your pelvic floor caused by your last pregnancy, if there was any. If you have experienced any of these issues I urge you to please seek guidance from a pelvic health physical therapist before running.

Remember your body is going through changes and may exaggerate any injuries you may or may not know you have or even injuries that you thought were long gone. The causes of this sudden change in aggravation can be due to, gaining weight, change in center of gravity, sleep issues, balance changes, and core musculature (your abdominal muscles are stretching and your linea alba becomes lax which can cause diastasis recti. Click here for more information on how to heal your diastasis recti to name a few.

If you are having joint pain, consider seeking treatment so you may continue to run. If you are unable to manage the pain still, then you may have to decide to stop running.

The choice is yours.

If running is your way of life and is your social outlet. Don’t be afraid to ask your friends if they mind going at your pace. You may be surprised at how many women will actually consider a slower-paced run for the sake of conversation and friendship. If not, then get creative. Maybe ride a bike alongside them. Remember it’s not forever and you can return to your normal running routine later.

Do you know all of the signs and symptoms that you need to look for if you do decide to run while pregnant?

Finally, and we have covered most of the earlier in this passage. But I want to reiterate my point. Be aware of the signs and symptoms of muscular-skeletal or pelvic floor injuries. These injuries include joint pain; leaking of urine and feces (incontinence); leaking of blood or clear fluid (seek medical attention immediately if you see this); bulging or stretching between the two halves of your rectus abdominis muscle or 6 pack (the linea alba); chest pain, headaches, dizziness, calf pain or swelling; shortness of breath prior to exertion (these all require medical follow up). [7]

Are you eating enough and are you eating right?

Finally, I want to briefly talk about nutrition. As you may already know the food you put in your body is now being shared by your baby. As your baby grows you will need to consume more calories. I will cover healthy nutrition planning in another post. But for now, I want you to grasp the fact that a fitness program, like running, requires a lot of energy, the energy that you will obtain from your food.

The very same food that you are now sharing with your baby. So not only are you needing to increase your caloric intake to support you and your baby. You also need the right amount of calories to support your fitness as well.  If you are concerned about gaining access to the right foods or the right amount of food for the needs of your body, your baby, and your fitness routine, then you may want to consider changing the intensity of your routine.

Summary

Running is considered safe during pregnancy as long as there are no complications. Women with muscular-skeletal or pelvic floor injuries regardless of past running experience should consult with their doctor or pelvic floor physical therapist prior to running during pregnancy. It is acceptable to continue vigorous activity during pregnancy if you are already accustomed to it. For everyone else seek medical advice before starting a brand-new routine during your pregnancy. Consider following the guidelines of 150 minutes per week. This might equate to a brisk walk until after your pregnancy. Fitness is still important to your pregnancy and all things must be considered for safety purposes

I hope you found this article helpful. If you are interested in a fitness program designed for pregnant women, I would love to work with you. You can reach me through the messaging system here or through my facebook business page.

References:

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[1] American Congress of Obstetricians and Gynecologists, Physical Activity and Exercise During Pregnancy and the Postpartum Period, https://www.acog.org/Resources-And-Publications/Committee-Opinions/Committee-on-Obstetric-Practice/Physical-Activity-and-Exercise-During-Pregnancy-and-the-Postpartum-Period

[2] Bø K, et al. Exercise and pregnancy in recreational and elite athletes: 2016 evidence summary from the IOC expert group meeting, Lausanne. Part 1-exercise in women planning pregnancy and those who are pregnant, British Journal of Sports Medicine, 2016, https://www.ncbi.nlm.nih.gov/pubmed/27127296

[3] Sports Medicine Australia (SMA), Exercise in pregnancy and the postpartum period Position Statement, 2016, https://www.researchgate.net/publication/308106170_Sports_Medicine_Australia_SMA_’Exercise_in_pregnancy_and_the_postpartum_period’_Position_Statement

[4] Kuhrt K, Harmon M, Hezelgrave N L, Seed P T, Shennan A H, Is recreational running associated with earlier delivery and lower birth weight in women who continue to run during pregnancy? An international retrospective cohort study of running habits of 1293 female runners during pregnancy, BMJ Open Sport Exerc Med, April 2018, https://www.ncbi.nlm.nih.gov/pubmed/29644086

[5] Tenforde A S, Toth K E S, Langen E, Fredericson M, Sainani K L, Running habits of competitive runners during pregnancy and breastfeeding, Sports Health, March 2015, https://www.ncbi.nlm.nih.gov/pubmed/25984264

[6] Salvesen K Å, Hem E, Sundgot-Borgen J, Fetal wellbeing may be compromised during strenuous exercise among pregnant elite athletes, British Journal of Sports Medicine, 2012, https://www.ncbi.nlm.nih.gov/pubmed/21393257

[7]Marike H, Is it OK to Run While Pregnant (4 Important Considerations), Girls Gone Strong, August 2019 https://www.girlsgonestrong.com/blog/pregnancy/is-it-ok-to-run-while-pregnant-4-important-considerations/