Pregnancy: Exercise Considerations for the Third Trimester
November 20, 2020
The third trimester of pregnancy (28 weeks-birth) brings many physiological and psychological changes that must be taken into consideration when planning your exercise routine. We are going to discuss some of these changes and talk about expectations as well as modifications to make with your exercise routine.
First, let’s set some training goals:
- Keep your activity level comfortable. This is not a time to push, strain, or to make gains.
- Begin to add birth preparation exercises into your routine (a blog post for another day).
- Avoid any exercises that result in bulging or doming of your anterior core.
- Minimize downward pressure on your pelvic floor.
As the baby grows from around 2 pounds to 6-8 pounds by the end of this trimester, maternal weight will increase significantly as well. So don’t let it surprise you if exercise feels more challenging than normal. Increased weight can result in more aches and pain in your joints and can cause difficulty with transitional movements. Consider limiting positional changes in your workout routine. If specific movements result in more joint pain, modify appropriately. Do not push through any pain.
This is a type of contraction that is “normal.” It is characterized by tightness in the abdomen but without pain. For some women, these contractions are barely noticeable, for others, they are strong and force the mom to stop until the contraction eases. If this occurs during your workout routine, pause and allow the contraction to pass, and then continue with your exercise if you feel comfortable.
Sharp Groin Pain
There are many reasons that women experience sharp groin pain or even an electric pain that may shoot down the leg. As the baby grows, the muscles, ligaments, and uterus are continuing to expand to accommodate a growing baby. The baby can also press on a nerve which causes shooting pain. If you experience this type of pain during exercise, pause, and let the pain pass, then continue with your exercise as you feel comfortable.
Low Back Pain and Pelvic Pain
Unfortunately, this is a common finding at this stage of pregnancy. Postural changes, weight gain, and ligamentous laxity can all result in mechanical low back pain and even pelvic pain. If you experience low back or pelvic pain during exercise, try these several things: modify your position, ensure proper alignment, reduce your load, take a rest break, switch to a different exercise. If the pain lingers or will not subside, consider talking to your doctor and request a referral to a physical therapist or another healthcare provider that can assist in helping to manage and even reduce the pain you are experiencing.
During this stage of pregnancy, it is common for pelvic dysfunction (such as incontinence) to disappear. However, it is important to avoid exercises that place increased downward pressure on your pelvic floor. This is especially true if you have a history of pelvic floor dysfunction or if you are currently experiencing dysfunction. For most women, it is sensible to avoid deep, loaded squats and high impact exercises such as box jumps, double unders, and even running. Another way to decrease stress through your pelvic floor is to make time to rest after exercise. It is not the best idea to follow up exercise with hours on your feet running errands. Consider post-workout rest as a form of recovery. Finally, if you experience irritation in your pelvis with long walks, consider taking several shorter walks spread throughout the day.
Fatigue in the third trimester is common and is due to several factors. First of all, the weight of carrying your growing baby can be taxing. It becomes more uncomfortable to sleep through the night; not to mention, frequent trips to the bathroom which also interrupt sleep. It is important to listen to your body. If you are feeling extra fatigued, do not be afraid to modify your routine or to take the extra time to rest.
Diastasis Rectus Abdominis (DRA)
DRA is a separation of the muscles of the abdominal wall, which results in bulging or doming in the midline of your abdomen. This is a normal response to a growing baby and almost 100% of pregnant women have it.
The important thing to remember is to avoid any exercise that causes bulging in your abdomen. Consider removing loaded rectus abdominis exercises such as crunches, sit-ups, and planks from your workout routine, as your linea alba (the fibrous structure that runs down the midline of the abdomen) may no longer be able to support this type of load.
Carpal Tunnel Syndrome (CTS)
Carpal tunnel syndrome results in wrist pain as well as numbness and tingling in the hands or fingers. This is not a contraindication to exercise, but it is something to monitor. Consider asking your healthcare provider about splints you can wear and stretches you can perform to reduce the effects of CTS.
Programming an exercise routine is never a one-size-fits-all process. When choosing the volume and intensity of your exercise, here are other considerations:
- Medical Clearance: Always check with your medical doctor to ensure you are cleared to exercise safely while pregnant.
- Training Level: What kind of training were you doing prior to and even during pregnancy up to this point? Again, this is not a time to make gains. You want to maintain, stay comfortable, and avoid injury.
- Your Pregnancy Experience: No two pregnancies are alike. Listen to your body and avoid comparing yourself to your other pregnant friends.
- Your Goals and Interests: You will often benefit more from choosing exercises you enjoy.
- Time: Your program will depend on the amount of time you can dedicate to it.
The good news is that you can keep moving in the third trimester. This will help you to feel better as you prepare for your baby during these final days.
If you have further questions or are experiencing pain, reach out to us at Physiolete Therapy and Performance. You can call us at 205-409-8060 or email us at [email protected]. We provide complimentary screenings and would love to assist you in any way we can.