Running Preggers: Diastasis Recti

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.

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

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.

Running Preggers: Vein Popping

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: When you have to go, go!

Running can have some interesting challenges relating to using the bathroom. If you’re a trail runner, this isn’t so much of a problem, although you should be burying or packing out solid waste. In the woods, you can just duck behind a tree. Looking up and down trail before, of course. As a road runner, depending on the time of day when you run, bathroom access is also pretty simple.

When you’re running for two, it’s not that simple. Why would it be? Every bodily system you can think of is altered when you’re pregnant (although I haven’t heard anything about your perception of sound…). It’s very important that you don’t wait to go to the bathroom, number one or number two.

Holding your urine is not just uncomfortable when you’re running, but it can cause infections, even in non-pregnant people. The real problem is the frequency of needing to go pee. Even in early pregnancy, when the baby is smaller than a pea, women will need to go more often. This is because your body increases the amount of blood it pumps and your blood volume, so you’re drinking more water and your kidneys and bladder are working overtime.

Blood volume increases until the third trimester and making sure you’re hydrated throughout the day will continue this pattern of needing to go all the time. And then there’s the baby. As baby grows he/she puts pressure on your bladder making you feel like you have to go even when you don’t have that much in there.

You can be running along enjoying the beautiful day and then bam, you have to go right now. You think, “but I went 15 minutes ago!” doesn’t matter, you have two choices: stop to pee again, or pee your pants. This can make running frustrating at times because jumping into the bushes to pee in a neighborhood is frowned upon. Getting off the treadmill all the time is also frustrating. So, for the potty problems, trails are your best option, in my opinion.

As for number twos, unfortunately, pregnant women don’t have to worry too much about those while they’re running. In fact, most pregnant women wish they had to worry about that when running. Constipation is another lovely side effect of being pregnant. The hormones in our body slows digestion down to a crawl, so the baby can suck as much nutrients out of the food we eat as possible. And then there’s the baby. As baby grows he/she compresses your intestines and shoves most of your organs up into your ribcage further complicating your ability to digest food and move it through your body. All in the name of love.

A maternity belt can help alleviate some of the pressure on your bladder and hopefully you won’t have to go pee, so much. Don’t restrict your water intake to prevent the frequent bathroom stops as tempting as that may be. You could wear very absorbent panties, but they would likely chafe something awful.

Weekly miles: 30 miles this week!

Running Preggers: Trail, road, or treadmill?

Sometimes we don’t have much of a choice about where to run, but some of us are lucky and have many options. Over the last few years, close to 100% of my running has been on trails. It has been amazing, but now I have to adjust back to being more flexible about where I run. I hate having to run anywhere other than in the mountains. I really do. But in reality, I know that there are actually few runners who are able to run exclusively on the trails.

Running while pregnant makes you take a lot more into consideration when you are choosing your running routes. Safety and listening to your body become even more important when you’re pregnant. I’m not saying we runners throw caution to the wind when we’re not pregnant, but when it’s just you, you’re more willing to deal with uncomfortable conditions and slightly higher risks.

During the first trimester, and longer for some women, you must contend with being tired and not feeling well (morning sickness). Both of these can put a huge damper on running, especially, if you have the option of sleeping in later and just running on the treadmill or road instead of driving to the mountains.

Throwing up while running is not something unusual in the ultrarunning world, but it’s also not something we want to deal with during every run either. Choosing a short loop route closer to home or a treadmill when morning sickness is lurking around every corner is more appealing. Then if something goes wrong, you have the option of stopping right away and getting home or at least somewhere more comfortable quickly.

The trails are ideal for the increased urination problem, at least for those who have no qualms about peeing in the woods. Roads make it difficult because you have to plan routes with bathrooms at regular intervals. However, that may not solve the problem. In my experience, there is no predictability to when you will need to go. Sometimes it’s every thirty minutes; sometimes it’s every ten. I can’t seem to make it longer than 45 minutes when running. What’s worse is you may not realize you need to go until you bounce just right and then you have to go RIGHT NOW.

Falling is something you want to think about too. When I wasn’t pregnant, I didn’t like falling, but the chance of falling never stopped me from bombing down the side of a mountain. Now, I think a lot more about the risk of falling a route poses. Early in pregnancy falling is really unlikely to harm the baby. Even into the second trimester, baby has a lot of room to move and is protected by muscles and amniotic fluid. As baby gets bigger, they don’t have anywhere to go to get out of the way of an impact making the risk of falling increase throughout pregnancy. The shift in your center of gravity adds to the likelihood of falling too. As does the instability of your joints because of the hormone relaxin (more on this in another post).

Weather is another thing that plays a bigger roll in deciding on a running route when you’re pregnant. I’ve always said there’s no bad weather, only bad gear, but when you’re pregnant, that’s different. Extreme high and low temperatures have a bigger impact on you when you’re pregnant and ice. Rain shouldn’t be too problematic as long as you stay warm. Ice and snow are another problem entirely (see previous paragraph).

As far as calories go, they get used up quicker the further along you are in your pregnancy. In the first trimester you shouldn’t need to adjust calorie intake. Starting with the second and then throughout the third (and if breastfeeding) you’re going to need more calories, 300-500 extra per day. This could mean taking something small on shorter runs. A two-hour run was no problem without calories for me, now that I’m just past twenty weeks pregnant I’m starting to feel the drag in the last 30 minutes.

Air quality is the one thing runners, along with everyone else, pregnant or not, should take into consideration when deciding where to run. You need your lungs and heart. Running when pollution is thick in the air will increase your risks for health problems in the present and in the future. One thing that the ULTRA research study has uncovered is a higher rate of allergies and exercise induced asthma in endurance runners and one of the hypothesizes is because we’re out in the pollution more than the average person, we develop these types of problems more than others.  When you’re breathing for two, it’s even more important for you bite the bullet and run indoors on a track or treadmill.

I hope you all had a Merry Christmas and will have a Happy New Years!

My running update: I’ve developed a bit of pain in my left knee, which I think is begin caused by all the treadmill running and lack of foam rolling. I’ve backed off my miles this week, but plan to bump them back to the 36 miles as soon as my knee is feeling better.

Running Preggers: Lots of Snot

This is my first post about running while pregnant. I don’t plan on making all my posts about running while pregnant, even as I get further a long in my pregnancy. But, I do plan on throwing them in here every so often.

I know from searching online there’s a lot of personal stories about running while pregnant and what women were running and not running while pregnant. And while all of this is very encouraging and useful, I find that it’s also a little lacking because it doesn’t go into the changes that occur in your body when you’re pregnant and how those change running. So, that’s what I’m hoping to do with my pregnancy posts.

One of the things that began to plague me from early in my pregnancy is the congestion. At first it was only at night. Now at 19 weeks, it’s all the time. The increased congestion is caused by a couple of things. The increased blood volume and hormones. The increased blood volume and estrogen cause swelling in the lining of the nasal passages and that causes more snot. The extra blood also causes the tiny blood vessels in your nose to swell. All of this leads to what has been coined pregnancy rhinitis.

Being congested while you run can be interesting. As your body temperature increases, the snot clogging your noes gets runny, which means you can breathe again, but there’s a cost. It can make your throat sore and irritated because its running down that way or it can make it, so you want to snot rocket all over what ever happens to be to your right or left. For me, that’s another person since I’m running on the treadmill (too much pollution outside). Another pleasant result of the snot beginning to run is then it makes you cough or sneeze.

Pregnancy Rhinitis can begin around eight weeks of pregnancy (yep) and then continue until you deliver the baby. After the baby, it should stop within a few weeks. Having allergies makes things worse of course and the constant stuffy nose can lead to sinus infections.

So what can you do about it? If you start your run all stuffed up, it’s going to make things more interesting when you get going. Using a humidifier at night will keep the drainage action going and help you start your run with clear nasal passages (you have to buy one for the baby anyway, might as well make sure you chose a good one and see how it works). Use saline drops or spray to clear your noes before your run or inhale steam.

If it gets to be too much, contact your doctor or the mother to baby hotline 1 (800) 822-2229 or email them expertinfo@mothertobaby.org They are the experts of what goes through mom’s system and into baby’s. They have tons of research on hand on what medication, vitamins and all sorts of other stuff can be harmful to a baby growing in utero.

I know knowing how much you can run while you’re pregnant is a challenge and it’s all subjective. Let your body tell you how much is okay and be prepared to listen. I’ll post how much I’m running each week at the end of my pregnancy posts, but again how much you should run while pregnant depends on many factors. Make choices best for YOU and YOUR BABY.

Weekly miles: 36, running three days a week.