We’re often asked; “Can I run while pregnant?”, “What about Cross Fit?”, “Zumba Class?”. High impact exercise and pregnancy and pelvic floor physiotherapists have had a long and bumpy history. General opinions seem to vary between – “Noooooo! High impact will ruin your pelvic floor” to the opposite extreme of “Girl – you can do ANYTHING while pregnant!”. Some women will fall into either of those two extremes, but most probably do not. What is likely best, is somewhere in between.
What Should I Consider When Deciding About High Impact Exercise and Pregnancy?
There are many things to consider when ddecidig if you should do high impact exercise when pregnant. Most important is the health of the growing baby and mother. You should speak to your obstetrical care provider to rule out any reasons why it might be unsafe for you to exercise.
That being said, the 2019 Canadian guidelines for exercise during pregnancy encourage physical activity and exercise in an uncomplicated pregnancy. (You can find the Guidelines HERE). They recommend accumulating 150 minutes per week, of moderate intensity physical activity. And for good reason! The benefits of exercise during pregnancy include: lower risk of gestational diabetes, high blood pressure, varicose veins, excessive weight gain, blood clots, loss of strength, low back pain, fewer complaints of shortness of breath as well as improved cardiovascular fitness and mental well-being. Women are also encouraged to choose activities that are least likely to lead to falls or abdominal injury.
So Exercise Is Good, But What About My Pelvic Floor?
While the guidelines recommend doing pelvic floor muscle exercises like kegels, they don’t say anything about exercising with pelvic floor symptoms. So, if you do squat jumps, but this causes you to leak urine, what’ should you do?
We like to think that pelvic floor muscles are like other muscles in the body. Some women have very strong pelvic floor muscles throughout their pregnancy. The shape of their pelvis, the size of the growing baby, the health of their pelvic floor prior to becoming pregnant all create a pelvis that can tolerate high impact without any issues. Other women have a less than ideal pelvis for running while pregnant. Some women have weaker muscles, previous pain issues, larger babies, etc., that lead to problems with high impact exercise during pregnancy.
So… What About High Impact Exercise?
In the past recommendations would have ranged from “Sure do what ever you want”, to “No that puts too much strain on your pelvic floor”. But we’ve learned more and now we like to treat each woman individually.
For example, if someone runs consistently prior to becoming pregnant, they are a better candidate to continue running during pregnancy. The Society of Obstetricians and Gynaecologists of Canada (SOGC) does not promote starting a new type of exercise during the first trimester. The SOGC also cautions women about exercising in heat or if there is a risk of fall. So running at noon on a summer day, or on icy sidewalks in January might be bad ideas.
If a pregnant woman starts to experience symptoms of any kind; shortness of breath, increased uterine contractions, dizziness, fatigue, or feelings of being unwell, we ask her to stop exercising and talk to her doctor. But also, if she experiences urinary or fecal incontinence, urinary urgency, low back, pelvic or pubic pain, vaginal heaviness, hemorrhoids, or vaginal varicose veins, then it’s time to re-evaluate the exercise program too. Those symptoms deserve a trip to your local pelvic floor physiotherapist.
The Exception To The Rule
Now, there are the women who experience symptoms like urinary incontinence while running. They would get my recommendation to choose a low-impact activity. But some decide to continue running. Urinary incontinence isn’t a painful symptom, and incontinence pads can be worn during exercise. In this situation, there is very little research investigating if continuing to run will cause any risk to the pelvic floor in the long term. Also, pregnancy can be stressful enough. What about if a pregnant woman uses running as a stress reliever? If the woman’s and baby’s general health is fine then the advantages of continuing to run for mental well-being might outweigh the stress placed on the pelvic floor. The decision is up to the individual at this point.
For now we will continue to encourage pregnant women to evaluate their own individual risks around high impact exercise and pregnancy. We should try to keep women as active as their health allows. All pre-natal exercise plans should be discussed with a patient’s obstetric practitioner. We should all help create more healthy, happy and active pregnancies.
Looking for ways to prepare your core and pelvic floor for delivery? Check out our online course HERE. Designed for both vaginal and cesarean births.
Katie & Eryn