pregnant runner

Running Preggers: Pelvic floor

Nicole Lowe McBrideLeave a comment

There are three muscles that take the brunt of the stress from pregnancy: the uterus (which is a group of muscles), the rectus abdominis (six pack), and the pelvic floor. It takes the uterus approximately 6-8 weeks to return to it’s normal pre-pregnancy size after the baby is born. We addressed the rectus abdominis in my last post regarding Diastasis Recti.

The pelvic floor muscles are like a sling or hammock that attaches to your pelvic bone and your tail bone. Having a week pelvic floor is not an uncommon thing even in those who have never been pregnant. In fact, men can have problems with their pelvic floor.

Your pelvic floor holds in your uterus, bladder and bowl. Only bladder and bowl in men obviously. Having a strong pelvic floor is important for both pregnant and non-pregnant people. The main symptom of a weak pelvic floor is incontinence or urine leaking, especially, when you cough, sneeze, laugh or during running. You can also have feces leak, but that’s less common. Because this is so common among women, many think it’s normal, but it’s not.

An even more serious issue than leakage is prolapse, which is when one of your organs falls down into your vagina. prolapse has to be corrected with surgery.

Having a strong pelvic floor during pregnancy is obviously important because it holds your uterus inside your pelvis. You should begin doing pelvic floor exercises as soon as you know you are pregnant. In fact, everyone should do them, especially, runners because we can stress our pelvic floor every time we run.

So what are some pelvic floor exercises? First you have to be able to isolate those muscles. The best way to figure out if you are flexing the pelvic floor is to stop the flow of urine. Kegel exercises are the most recommended pelvic floor exercise. A kegel is done by flexing the pelvic floor. Men identify the pelvic floor and do kegels in the same way as women. If you can’t feel your pelvic floor (not unusual after childbirth), use visualization.

You should be doing kegels three times a day, at least. You want to do ten repetitions of two types. First, pull your pelvic floor up and hold for ten seconds, then release for ten seconds. You can shorten the time between each as you get stronger. The second is to flex and release 2 seconds up and 2 seconds relaxed.

Other exercises that work your pelvic floor are:

  1. bridge
  2. clams
  3. hover: sit on your heels with your knees apart rise up and pull your pelvic floor up.
  4. split squats
  5. wall sits
  6. squats.
  7. elevator: pull your pelvic floor up halfway and hold it for 3-5 seconds and then pull it in as much as you can. Release in the same way.

Begin with ten repetitions and two sets. Do these three to four times a week.

When doing pelvic floor exercises it’s important to coordinate with your diaphragm and your rectus abdominus. You should be using your diaphragm to breathe. To make sure you are, lay on your back and place one hand right at the bottom of your ribs and the other hand on your chest. As you inhale it should begin in the bottom of your ribs not in your chest.

You should be relaxing your pelvic floor with each inhalation and contracting your pelvic floor with each exhalation.

You can begin doing kegels a few days after your child being born. If you have stitches you may have to wait a little longer if they cause any pain.

Pelvic floor exercises should be done in a variety of positions including laying down, sitting and standing.

Running Preggers: Diastasis Recti

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This is something I had never heard of before this pregnancy (my third). Diastasis Recti is a condition when the muscles of the abdomen separate, the rectus abdominis (six pack), separate. This usually occurs during pregnancy, however, it can occur because of other conditions. It’s what causes the classic “mamma pouch.” approximately 44% of women have it even at 6 months post partum and 33% at 12 months post partum.

This separation occurs to make more room for your growing uterus, which is exerting pressure on your abdominal wall causing the muscles to bulge forward. It’s not a tear, but a stretching of the linea alba, aka the connective tissue that runs vertically along the midline of your abdominal wall.

Diastasis Recti can cause serious health problems if the separation is large. Most women do not suffer from a large separation. It can cause back pain, pelvic pain, and basically you don’t have anything protecting your organs. It’s fairly easy to check yourself for a larger than normal separation between the abdominal muscles. Here is a video .

How to check for it: lay on your back with your knees bent like your going to do a bridge. Then pull your pelvic floor up and lift your head and shoulders like your doing a crunch. In this position place your fingers on your belly button and move straight up in a line feeling for the separation go three inches above and three inches below the belly button. If the separation is more than one finger widths you have Diastasis Recti. If it’s three fingers you should see a physical therapist.

If it’s two or less, there are some exercises you can do to heal at home. The central component of all of these exercises is the core compression. To do a core compression squeeze your core to draw your belly button in and up toward your spine while doing a forceful exhalation at the same time. Perform your core compression while doing these six exercises:

  1. Cat-cow without the cow
  2. wall sit
  3. single leg lift while lying on your back
  4. Standing inner thigh lift: lift one leg with a slight 45 degree bend in your leg and then move your foot in and up.
  5. side plank
  6. Tricep kickbacks: bend over at the waist and move your arms from 90 degrees to straight. You can use light weights if you have them.

Perform 2-3 sets with 10-12 reps 3-4 times a week. You should see improvement in 8-12 weeks. If you don’t, consider seeing a physical therapist. As always check with your doctor before beginning this program.

Exercises you should avoid are the ones which cause your abdominal muscles to push out (a sure sign that you’re increasing the abdominal pressure). Also any exercises which you cannot perform without arching your lower back off the floor.  These include push-ups, front planks, sit-ups, crunches (anything that has you raise your shoulders and head off the floor), and leg lowers (either seated or laying on your back).

As you recover from pregnancy and child birth, keep in mind that it took nine months to get your body into the shape it’s in and it’s going to take some time to get back to your pre-pregnancy shape. Be patient and be kind.

 

 

Running Preggers: The Weight of It.

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Pregnancy and weight gain go hand and hand obviously. The recommendation for women who are of average weight, BMI of about 18-24%, is to gain between 25-35 lbs during their pregnancy. There are few women, or men, who want to gain an extra 25 lbs. During pregnancy gaining too much or too little has health consequences for both mother and baby.

There’s a certain level of anxiety about gaining weight during pregnancy and the ability to loose it afterward. We all have friends or relatives who never lost the “baby weight” and if they get pregnant again, they put on more weight.

You’re not going to loose all that weight the moment baby is born. Some of it is fat that you’ll slowly work off over the months that follow the birth of your little one. How much fat?

For the average baby and mother the weight distribution is something close to this:

Baby: 8 lbs

Placenta: 2-3 lbs

Amniotic fluid: 2-3 lbs

Breast Tissue: 2-3 lbs

Blood supply: 4 lbs

Larger uterus: 2-5 lbs

Stored fat for delivery and breastfeeding: 5-9 lbs.

So you’re looking at losing somewhere between 12-14 lbs right at birth. Your blood volume will return to normal over the six weeks following birth and your uterus will shrink down over the same period of time. That’s another 6-9 lbs. That leaves you with breast tissue and your store of fat.

If you are planning to breastfeed your baby, you’ll add some weight when your milk comes in (2-3 days after birth of baby), which shouldn’t surprise anyone who has picked up a quart of milk. The average milk capacity of a human female is between 25-35 oz a day. Breastfeeding burns an extra 600-800 calories a day (you should be eating 500 extra calories to maintain your milk supply), which means merely feeding your baby will help you burn of some of that fat store.

You’ll still be wearing your maternity clothes for a while after baby is born, so don’t pack your skinny jeans in your hospital bag as you prepare for the birth of your baby. The important thing is to know this is normal and not to be concerned about it. Your body just created a whole other person inside of it which took nine months. You should give it the same amount of time to lose the weight.

Lugging around an extra 25 lbs is hard work and since it’s not all fat stores, I like to think we’re getting stronger in the process.

Losing weight can be a slow process after baby is born because it’s harder to get to the gym or hit the trails for a run, not only because you have a little one to care for, but because you’re tired. But it’s doable. Give your body time to recover from the most important endurance event in your life.

Running Preggers: To Breathe or not to Breathe

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Remember how great it feels to pull in the fresh air of the mountains until your ribs are at their limit and then to let it out slow just because you can and your lung capacity is impressive as a runner. Well, if you’re in your third trimester of pregnancy (28-40 weeks), you’re missing that ability and those impressive lungs.

Having reached the third trimester, you can see the finish line (even if you’re not ready for it) and you’ll be able to realize those breathing dreams once again and even baby will be expanding their lungs as yours reclaim their glory.

As your uterus grows to it’s max, it pushes on your diaphragm which shifts upwards about 4 centimeters. This also compresses your lungs a bit. This combination means you are not taking in as much air with each breath. To compensate you breathe more slowly. Wait that doesn’t make sense…

The hormone progesterone stimulates your respiratory center in your brain so the air your breath in stays in your lungs longer allowing you to get as much oxygen out of it as you can. There are a few things you can do to help with this feeling of being out of breath all the time.

First, good posture. Make sure your sitting and standing straight. If your hunched over when sitting it’s going to compress your diaphragm and lungs more (and it may keep baby turned sunny side up which is not the optimal position for birth).

Second, keep running and/or exercising. You may have to slow down to compensate for your cramped internal organs. Pregnancy isn’t the time to hit a new personal record anyway. Mostly you want to maintain your fitness level or lose as little as possible. Yoga also helps with it’s use of the breath during poses and it’s breathing exercises.

Third, relax and don’t over do it. Being hyper-vigilant about your breathing is only going to make things worse. Take time to relax each day even if it’s only for ten minutes.

Fourth, if your having trouble with breathing because of congestion try using a humidifier at night. Exercise will also help break up the mucus.

Take heart, your baby is almost ready to be held in your arms rather than in your belly. As baby gets into position to be born, she will drop into your pelvis and you may find it’s easier to breath. This is also called lightening. It usually happens two to four weeks before delivery. If this is not your first child, baby may not drop until right before delivery. As nice as this lightening is on your lungs and diaphragm, it’s not so great for your bladder.

Weekly Miles: My running is very inconsistent at this point. I run on days I feel good and it’s comfortable to run. Other days, baby’s position makes it very uncomfortable. I don’t really track miles. I’m just happy when I’m able to do a little run. Thirty-eight weeks and counting.

Hydrating, It’s Complicated.

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Staying hydrated is essential to being able to sustain a good pace on race day. Too much or too little water can cause serious problems for runners. Maintaining optimal hydration is more complicated than we’d all like.

There are many factors that play a role in your hydration during training and races. We all hear the pervasive message of 8 glasses of 8 oz of water a day, but is that right for everyone? It’s not even close. It’s difficult to calculate exactly how much fluid a person needs each day. Some factors that impact your recommended fluid intake are: the type of food you eat, your activity level, your body fat percentage, and your acclimatization to the heat.

Another recommendation we hear a lot is to drink to thirst, but once again the phrase, “it’s complicated,” rears it’s head. When you’re exercising, especially for extended periods of time, your body may not signal you to drink because of imbalances in your system. You need to be looking at other objective measures such as the amount of fluid you are taking in, the temperature, the color of your urine (we’ll talk about this more in a few paragraphs), and any GI issues you’re having.

You’re unlikely to need to hydrate during a 5k or 10k event. For a 1-2 hour run, you’ll need water, but not electrolytes. If you’re running five plus hours, you’re going to need some form of electrolyte replacement strategy. If you’re between the 2-5 hour range, water is necessary and electrolytes would be helpful but are not necessary like they are after 5-6 hours. Electrolytes are helpful in the 2-5 hour range because they help you hold onto the water you’re consuming rather than it just going straight through you.

 

Most ultrarunners use some type of electrolyte supplement during training and in races. There are lots of options as far as different sports drinks, powders, and tablets/capsules. It’s likely that you’ll want a variety of options when you’re racing because things change and some times something that has worked throughout training suddenly stops working. Sports drinks usually do double duty by providing you with both carbohydrate and electrolytes, so make sure you have options for both when the drink doesn’t work so well. Aid stations typical fare will consist of foods with both carbohydrate and with sodium, the main electrolyte you need, so keep a mental note that you’ve taken in some electrolytes there too.

After a run or a race, there’s no need to ingest a sports drink to replenish your electrolytes. Your body will be able to balance it out within the next 24-48 hours. If you have another run within that time frame, however, drinking a Gatorade is probably a good idea.

One way runners often judge their hydration is through urine color. The problem is there are a lot of things that impact your urine color, so it’s not always the most accurate. You can have clear urine because your body doesn’t have enough electrolytes to hold onto the water so it just spits it back out. The best time to judge hydration with urine color is when you first wake up in the morning because it’s had time to accumulate. The first urine in the morning tells you about your hydration the day before. So if you track your hydration and exercise, you’ll get a good idea of what your body needs for different workouts.

 

 

 

Chasing the Cut Off

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There is almost nothing worse than missing a cut off time during a race. I’ve done it and it sucks and it leaves you wondering what went wrong and looking at all the places where you “know” you should/could have picked up the pace, but couldn’t get out of the mental funk you were in.

Cut offs are not put in place by race directors just to encourage runners to move their butts. They  set an end time for the race for both runners and race staff/volunteers. Race costs can increase when emergency and safety personnel are required to be out there for longer periods of time. It also becomes problematic if there are any road closures or access restrictions put in place due to the race event. Liability increases as participants cognitive and physical abilities diminish with the length of time they are out on the course. And lets face it, we are more cautious about jumping into a race if we think the time lines are not within our ability or we really focus our training to make sure we’re in the best possible condition to make those cut offs.

The ultrarunners who chase cut off times throughout a race are some of the strongest among us. They keep their head in the run and keep moving forward as quickly as they are able too. It takes a significant amount of fortitude and determination to keep going when you’re barely making cut offs. In my personal opinion, ultrarunners who chase cut offs or who are out there for more than two sunrises are stronger than those who finish under 20 hours.

I’ve run sub 24 hour 100 mile events and I’ve run 35 hours and 46 minutes (36 hour time limit) 100 mile events. Give me the 24 hour finish any day. Sure you get a big energy boost when the sun comes up on day two, but after two hours that’s totally gone and putting one foot in front of the other becomes more difficult with each step.

Running a 100 is hard and you’re going to suffer on some level, but the longer you’re out there the more suffering there is and the longer you have to endure it. Runners who chase cut offs are inspiring. They give me strength to push hard when I want to quit because I know they are still out there and I know they are not quitting.

So for all of you who have chased cut offs and those who will chase cut offs in the future, please know, you give us all strength. Don’t give up, a finish is a finish even if you make it by a fraction of a second.

 

Running Preggers: Vein Popping

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Popping veins may be every body builders dream, but as a pregnant runner it’s not something you show your friends with joy and enthusiasm. It’s more along the lines of shock and horror. Varicose veins are another one of those lovely pregnancy symptoms. Not all pregnant women have to deal with them.

Varicose veins appear during pregnancy because your blood volume increases and at the same time the rate at which blood flows from your legs to your pelvis decreases. This increases the pressure on the veins in your lower body and can cause them to become enlarged.

Another contributor to varicose veins is the increase in progestin levels, which dilates veins. The pressure of the uterus on the inferior vena cava, the vein that carries blood from the legs and feet to the heart also adds to the possibility of having vericose veins.

There are a few things you can do to minimize and/or prevent varicose veins during pregnancy. First don’t sit or stand too long. Changing position is your first line of attack. Next is don’t wear high heels (none of you wear them anyway because your runners, right?). Wearing high heels weakens your calf and can shorten (through tightening) your Achilles tendon.

Third, wear compression socks or sleeves on your calves or you can go full out and get maternity support hosiery. Fourth, don’t cross your legs (like you could if you wanted too) during pregnancy. Fifth, elevate your legs every so often to improve circulation. Sixth, sleep on your left side. This takes the pressure off of the inferior vena cava I mentioned earlier.

Finally, exercise. Specifically, running and/or walking. The idea is to have strong calf muscles which promotes good blood flow in the lower legs. Other than these suggestions, there isn’t much you can do about the vein popping while your pregnant.

Varicose veins that appear during pregnancy typically go away within three to twelve months after baby is born. But if they don’t, you’ll be joining the ranks of 1/4th adults in the U.S. who develop them during their life time.

When they don’t go away what’s happened is the small valves within the veins that prevent blood from getting backed up are not working like they should and the blood pools and increases the pressure in the veins. The body then tries to widen the veins to compensate and they end up bulging and thickening.

Varicose veins that don’t go away after pregnancy or that you develop outside of pregnancy should be monitored by a doctor. They can cause achiness, heaviness, throbbing, cramping and swelling in the legs. They are treatable and seeing someone about them sooner is better since they can indicate a more complicated issue.

 

Running Preggers: Baby Belly Support

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A maternity belt is going to be a must have for most running moms-to-be as they near the third trimester. Many women even with the support of a maternity belt decide to stop running during the third trimester because it becomes too uncomfortable. There is no shame in taking a brake during your last weeks of pregnancy ladies.

Keep in mind a belly band and a maternity belt are different. If you’re running, a belly band isn’t going to help support your baby belly. The band allows you to continue to wear your pre pregnancy clothing for a longer time and delays the purchase of maternity clothing. It will cover your belly as your shirt creeps up and it will hold your pants up when you leave them unbuttoned and the zipper more and more down as baby grows.

A maternity belt will help lift some of the baby belly weight up and distribute it more evenly across your back and hips. You can start wearing one whenever you want. I started wearing mine around week 27. I actually tried a bit before then, but found that my belly wasn’t big enough to make any difference. I should have bought a size small rather than a medium, which would have allowed me to wear it sooner.

When you reach the third trimester, baby is about 2 pounds, still pretty small, but over the next 13 weeks baby will add on 4.5-5 pounds, and maybe a little more. Running with a medicine ball attached to your abs that increases in weight every week is tough. Many women begin to feel very tired and have round ligament pain as the uterus grows to its max height and baby’s weight increases. Pelvic pain can be problematic because the hormone relaxin is relaxing those tendons/ligaments holding your pelvis together. You can also have a feeling of increasing downward pressure (not time to exit yet kiddo), which is uncomfortable.

I bought the Gabrialla belt after reading some reviews from other running mamas. Things you want to be aware of when selecting your belt are: first, washability. That thing is going to get sweaty and you’ll want to wash it pretty regularly. Second, regular washing, means you want it to be durable. The third thing to consider is breathability. Being pregnant generates a lot of extra heat, so wearing something around your middle that traps heat in, is not going to work.

The Gabrialla goes around your low back and then under your belly. If you do it up too tight it can push on your bladder. You want it snug and comfortable. My daughter will kick and push at the belt before and after our run, but she is rocked to sleep while we are running. You can wear it over or under your clothing. I wore it over just because I didn’t want to risk any chafing.

I’ve had a few women come and ask me about the maternity  belt when I finish a workout at the gym and I’m always happy to help keep another mom-to-be active and happy.

 

Running Preggers: Clothing issues

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Sure, you can just wear larger sizes of clothes, but who really wants to do that? It’s much more fun to show off that baby bump, especially, at the gym, on the trail, or out running on the road. Show the world pregnant women are strong and fit.

The problem is maternity fitnesswear is kinda expensive and then you’re only going to be wearing it for a few months. Every woman and every pregnancy is different and will change what clothes you need and when you need them. If you’re planning on future pregnancies and/or you have extra money (after all the baby purchases), buy the clothes that make you the most comfortable, even if they are a little pricey.

Depending on how you’re carrying your baby (high or low) changes what you may need. If your carrying low, pants and shorts can become a problem before shirts do. If you carry high, shirts are a problem earlier in your pregnancy. By the end, it’s all going to be a problem though. Shorts with drawstrings and longer shirts may be the most cost-effective solution.

Sports bras are another ball game all together. You’re going to need a larger size and you may need to go up a size after that depending on how things play out. If you’re planning to breastfeed your baby, you’ll want to invest in some nursing sports bras, plus their just a bit more comfortable than normal nursing bras.

Sports bras are expensive especially as the size increases and you need more and more support. No one wants the girls bouncing around and when you’re pregnant it can be painful. If you’re going to be breastfeeding, it is probably worth the extra cost to get the higher quality nursing bras that have good support since you’ll be using them for a while. But, don’t get them too early because once your milk comes in you could go up another size. You’ll want to wait about five days postpartum before you get more than one (because you might want one to wear home after the birth).

What’s a woman to do, when you know your bra size is most likely going to change throughout pregnancy and the sports bras are pricey? Double up. Yep, wear two bras. It does create more heat, which can result in a slight heat rash for some women. But I can get two cheaper bras for less than a really high quality supportive one. If the girls were going to stay that size forever, I’d buy the more expensive one, but they’re not.

Another clothing issue you may be lucky enough to experience is chafing. Your higher body temperature and blood volume make you start sweating earlier in your workouts. Add that to your not so great fitting clothing and you’ll be investing in Body Glide or other anti-chafing cream.

Good luck ladies!

Running miles: I’ve been able to maintain the 3 miles a day at a 10:30 pace. I’m 31 weeks three days pregnant. I’m supplementing with the elliptical or stair master for the rest of my aerobic workout.

Running Preggers: Blood Volume

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As an endurance athlete you already have a higher blood volume. Having higher blood volume reduces heart rate during exercise, delivers more oxygen to hard working muscles, sends more blood to the skin for cooling, and furnishes a reserve supply of internal fluid so that sweat rates can remain high during exercises. Your blood volume begins to increase after just a single exercise session and then reaches its peak within a few weeks.

Aerobic exercise typically reduces your blood pressure and your resting heart rate. But pregnancy increases your heart rate and makes your blood pressure fluctuate. Your resting heart rate can increase by as much as 15-20 percent during pregnancy.

The increase in blood volume due to cardiovascular fitness is much less than the increase seen for pregnant women. Pregnancy increases your blood volume, in fact it increases by as much as fifty percent. You need this extra blood because you’re providing for your growing child. During your first trimester, your blood is going up, but not a lot because the baby is so small and has small needs. By the second trimester, you may experience dizziness or lightheadedness as your body tries to catch up on the need for more blood. By the third trimester all this extra blood can leave you with swelling in your feet and joints.

Additional side effects of increased blood volume in pregnant women can include an increase in body temperature and sweating. All the extra blood volume can make your veins more visible and larger.

Blood volume also accounts for approximately four pounds of the recommended weight gain for a pregnant woman (25-30 lbs). Other fluids, not including the amniotic fluid, like water add another 4 pounds. The amniotic fluid is about two pounds.

That’s a lot of extra fluid floating around in your system by the time you reach the end of your pregnancy.

Weekly Miles: at 30 weeks pregnant, I’m still running but I’ve had to reduce my miles a lot. I run three miles a day at a ten and a half minute mile. Some days are more comfortable than others. I’m supplementing with the various elliptical machines at the gym to maintain my cardiovascular fitness. As the belly has begun to stick out more, the maternity belt works better and is able to reduce the pressure I was feeling in my pelvis while running.

Keep running mamas!