Pre-pregnancy training, conditioning, information and recommendations29 March 2012
The first trimester (weeks 1-12)
The physiological changes that occur in this period include vascular underfill. Vascular underfill is where the blood vessels expand in width (vasodilate); this naturally occurs to supply sufficient oxygen to the baby. The problem at this stage is that the blood itself has not changed in supply, so the blood volume lags behind, which basically means the blood is slow moving around the body as it has to slowly move through these big vessels whereas before it could flow very quickly and be pumped along nicely.
This lack in blood volume causes our blood pressure to drop considerably because the pressure in the system has been reduced drastically due to these new large vessels and small amounts (in comparison) of blood. Therefore the mum-to-be will feel very tired during this stage and may experience nausea or light-headedness getting up and down quickly, so this has to be taken into account for training purposes.
Mum will also get tired quickly for a second reason. As above we mentioned that blood pressure drops because mum’s heart will want to naturally raise the pressure and supply nutrients through blood to the foetus. It forces the heart to beat harder and faster than usual so, for that reason, mum may feel fatigued relatively quickly.
When exercising in this first trimester my recommendations are:
- Keep hydrated before, after and especially during session
- Have plenty of breaks
- Never exercise to exhaustion, only to exercise failure, when technique becomes inhibited
- Don’t train if you ever feel over tired…listen to the body; it’s a sign to rest.
Here’s three good exercises that I recommend in this first trimester – each exercise mum should start with one set of 12 repetitions, and gradually build up to three sets. If mum wants to supplement these resistance exercises with Cardiovascular Training I would recommend just walking or swimming for 20 minutes at a time and gradually increasing the duration.
1. Step over Squat
This exercise can be done at home using a broomstick across the chest, held in place with the elbows up and out to keep a nice tall posture to look after the back, encourages a good thoracic (upper back) extension, which will help relieve low back pain/stress, and help with good posture.
The exercise focuses primarily on the hips and whilst strengthening butt and legs, its hidden beauty is that it takes the hips into rotation, which allows the pelvis to be strong, free and mobile in its most restricted plane of motion (transverse plane). This will also reduce a lot of lumbar spine torsion or stress. Fix the left foot on the floor. Take the right foot and step forward and in towards the front foot so it makes a “T” shape. The whole body should now be facing to the left, apart from your originally fixed left foot.
Now with the right foot step out and behind the body taking it to about 4 o’clock. Imagine your fixed left foot is 12 o’clock, so your right foot comes back and rotates 180 degrees and is now behind and to the right of the body. Once stepped to 4 o’clock squat down as far as feels comfortable, stand up and repeat for 12 repetitions. Repeat on the opposite side but this time with the right foot fixed. When it rotates back it will go to the 8 o’clock position to mirror what we did before for symmetry.
2. Reverse Lunge with Overhead reach
Use body weights or maybe some small hand held items (one in each hand). Now step backwards with the right foot (nice lunge stride back to stretch the hip) landing on the ball of the foot and with the heel up off of the floor. Whilst the step back is being executed simultaneously take both arms straight up and forward over the head to really stretch, load and condition the abdominals and also the generally tight hip flexors that will make mum feel a lot more comfortable when walking, standing in everyday functional tasks. Do 12 repetitions and then change legs repeating the same pattern with the arms going forward and overhead.
3. Press Up with a Twist
Sounds gruelling…but remember it can be regressed if needs be and built up as fitness increases. The most comfortable option would be stood against a wall, arm’s length back with hands shoulder width apart and pressed against said wall.
The next option is down on the floor on all fours, or if you really want to jazz it up and progress intensity full length on the floor with hands under shoulders as you push your upper body off the ground and keep your feet on floor; this time your knees are up and extended into the press up.
Once you’re in the start position take your left leg under the body and as far over to the right as possible and now execute the press up for 12 repetitions. This facilitates a fantastic chain reaction sequence from the floor up into the top of the spine, which gives lots of rotational motion to all joints in the body including the spine, scapula and hips whist, at the same time, achieving the press up’s desired function of working the chest and arm muscles but with the added bonus of huge core/abdominal activation. Once completed change sides and repeat.
The second trimester (weeks 13-27)
The physiological changes this time are that:
- The body has now adjusted to vascular underfill and a hormone called Progesterone has communicated with the kidneys to keep fluids, nutrients and salts from being lost so the blood has now caught up and filled the mum’s internal systems to fuel both her and baby with oxygen and nutrients.
- Blood volume and pressure have now normalised and the Heart Rate is brought back down so energy levels for mum are now generally higher.
- The new change in this trimester is that a second hormone is released into the mix called Relaxin.
- Relaxin’s role is to provide laxity and more range of motion to two joints in particular – the Sacro-Iliac Joint (base of the spine where the pelvis and spine form a joint at the back of the pelvis) and the Pubic Symphysis where the pelvis meets at the front left and right where the baby’s first passage from the mother to the outside world occurs.
- This is done to aid joint relaxation for the mother to take the stress off the ligaments and joints whilst giving birth.
- The downside to this is that there is an inherently obvious lack of joint stability, so mum is vulnerable to torsion or even breaks and fractures.
- This can be combatted by sensible exercise.
- My recommendations in this phase include no heavy weights, no high impact exercises because of joint laxity and keeping a sensible range of motion.
Recommended exercises for this trimester should be performed three times for 12 repetitions and can be supplemented with light walking and swimming if mum desires.
1. Deadlift Rotation to standing Extension and Rotation
Take a broom onto the top of the chest, keeping elbows up and out again to encourage the lift of the chest and good extension through to the top of the spine. Bending from the hips (not the spine), rotate your right shoulder as close as comfortable down and towards your left knee, pause momentarily and slowly come up and back taking the right shoulder up as high as possible and rotate to the right whilst extending.
This exercise is fantastic for the hips, the butt, the spine and the abdominals – all of which are vital areas of focus and attention for mums.
2. Side step lunge with Lateral side bend
Simply start with feet shoulder width apart and facing forward. Take comfortable steps to your right keeping the lunging foot facing forward and, at the same time, bring your right arm up and over the head towards the left hip. Again, this is fantastic for the same culprits as before (butt, hips, spine and abdominals) but in a different plane of motion. The body moves in three planes and needs to be conditioned in them all.
3. Press Up with Extension
Simply perform a press up but whilst on the decent phase (downward phase) of the exercise, lift your chin and look directly up and forward to a comfortable range for the neck. At the same time lift one leg back and up like a donkey kicking action. Then, as you push up off the floor, look back down with the head and allow the leg to lower down. Remember to swap legs up with every repetition, and perform six on each side (12 in total). This is an excellent core, spine and upper body exercise.
The third trimester (weeks 28-40)
Physiological changes are complete at this stage but it is a time of concern where regular midwife check-ups are advised and things such as high blood pressure and excessive or abnormal foetal growth can be detrimental to both mother and child.
So my advice here is to exercise sensibly, have regular breaks, meet with your midwife as often as possible, avoid exercising in humid/hot conditions, keep hydrated and do not train if tired or lethargic.
66% of women suffer from Diastasis Recti. This is where the abdominal wall splits right down the middle length ways and gets pulled outwards (much like a torn curtain) – this happens to women who do not train and if this occurs it never repairs itself and has been linked with on-going low back pain after the pregnancy.
Exercise suggestions here are again three sets of 12 repetitions, and walking and swimming are permitted.
1. See-Saw to Tuck
On all fours, take your right elbow under the body towards your left knee. Bring the left knee in towards the subsequent right elbow as close as possible to each other and then take both in the opposite direction (forward for the arm and backwards for the leg). Keep high and stretch into both, bringing a nice lengthening into the abdominals and a great spinal extension from the top down through the moving arm and the bottom up through leg lifting. Repeat each side 12 times, slowly and controlled.
2. Mini Step Matrix
Keep your left foot on the floor. With your right foot, step forward as far as feels comfortable and return. Then, step sideways with your right foot, keeping the foot facing forward – step as far as feels ok and return. Then, with the right foot, step and rotate behind the body to a comfortable range and return. This is fantastic for the hips, thighs and buttocks.
3. T rotations
On all fours take the right arm up and rotate behind and up towards the ceiling above the head as far as feels ok and return. Now do the same with the left hand and repeat 12 times on each side. This exercise is great for the spine, abdominals and upper body strength.
The above are recommendations on exercises for each trimester for a pregnant lady who does not go to the gym to do at home. If you are a gym user and want advice seek advice from a qualified Pre/Post Natal Pregnancy Level 3 Trainer.
My recommendations are great for all muscles that aid birth i.e. pelvic floor, abdominals, glutes and hip musculature and those around the spine that control stability and have to deal with the weight of the baby pulling them forward.
They look after joint motion in all three planes, which relieve stress in localised areas such as the low back and spreads and dissipates forces all over turning muscles and keep the mum-to-be functioning and enjoying life and pregnancy to the max.
Having done these exercises, mum is conditioned and fit for pregnancy, whilst pain free and able to enjoy pregnancy. And baby has the safest, most effective passageway into the real world and he/she will have the greatest chance of being born fit and healthy and having the best immune system due to mum’s training and less chance of illness and disease.