Running Strong through the Trimesters: A Therapist’s Perspective

I run to feel good, both physically and mentally; therefore, I needed running even more during pregnancy. But running while my body was (and still is) constantly changing presents some new challenges. Here’s a guide of some helpful tips to avoid running into any problems.

SAFETY FIRST

Take it Slow

Let’s start with the usual disclaimer: make sure you are cleared by your doctor (obstetrician/midwife/gynecologist) before beginning an exercise program. There are a number of medical and obstetric conditions that may make exercise unsafe during pregnancy.

With that out of the way, the current guideline for exercise during pregnancy calls for about 30 minutes of moderate intensity exercise, most days of the week (as per the American College of Obstetricians and Gynecologists). Fortunately, running is an activity that allows you to moderate the effort you put forth. You may be a seasoned runner, aware of how hard you feel you’re working and able to regulate on your own. Or, your doctor might want you to wear a heart rate monitor and stay within a certain range. As for me and my slightly competitive nature, I needed additional external factors to slow me down. I ran with my dog so that his incessant need to stop and smell the roses would force me to take rest breaks, or I chose a running partner who was slower than my current pace (shown below at 34 weeks gestation, with my 60 year old dad).  

Staying out of the red zone is important because your blood volume is increasing tremendously (from 30-50% as early as 16 weeks gestation), causing your heart rate to be higher than normal even at rest. And if you’re like me, your iron stores haven’t necessarily caught up with the increased red blood cells, so your risk of anemia is increased. Add to that your difficulty breathing now that your rib cage has expanded and your diaphragm is less efficient (it’s stretched out and contracting against more resistance), and you’re likely to find yourself short of breath way earlier than usual. So, go for your run, but be prepared to slow down and incorporate intervals of walking.

Don’t Overheat

If you’re in warmer climates or it’s summertime in the city, be especially cautious to not overheat, which could be harmful for your developing baby. I usually like to get a tan while I run, but soon I found more comfort in taking routes that were shady instead of sunny. The thought of carrying a water bottle with the weight I had already gained seemed preposterous, so I memorized all the water fountains along the route as well. If you have retained fluid during your pregnancy, and have found that your hands or feet are swollen on the regular, keep this in mind. Dehydration will come on sooner (especially if you skipped your normal glass of water pre-run so that you could last a little longer without a bathroom break.) By my third trimester, during the heat of the summer, I kept all my runs close to home, sometimes just circling the park next to my apartment, just in case.

PREVENTION

Do Your Kegels

It was early on in the second trimester that pressure built on the pelvic floor and the pelvis started to stretch and change, which meant leakage, first with sneezing and then with running. I had to up my kegel game immediately. I ran with a liner at first, but I caution you that you must change out of your running clothes pretty immediately after your workout, as UTI risk is higher during pregnancy. I recommend a pretty solid kegel routine as soon as you become pregnant (some apps even let you track your sets and reps), but make sure that you’re holding the kegel for 5-10 seconds at a time for improved endurance. I would try to focus on my pelvic floor contraction during the first half mile for good strengthening practice under running conditions and was able to get rid of my leakage in about one month. If you need more help on this front or aren’t sure you’re doing them correctly, check in with us.

Strengthening Rules Still Apply

Logically, it’s fair to say that your joints now think that you’re going out for your usual jog while wearing a weighted vest. This is not something most people do voluntarily to enhance their training, and for good reason. An increase in one pound of body weight multiples by 3-4 times that amount when you are running, and it will take its toll on your joints. So strengthening is even more important now than it was even before. Keep up your squats and lunges throughout the pregnancy to ensure support for the knees and hips as you gain weight. I chose to stick with my usual HIIT classes (high intensity interval training) with the support of some solid teachers (check out the great team below) and a number of modifications to make it a MIIT class (moderate intensity interval training). 

Recover Well, Stretch With Caution

Recovery is more important for the same reason, mostly by means of rest and refueling. If you were an avid stretcher or just love to feel flexible, this is where you might need to hold back. With your ligaments being looser than ever, stretch with caution as it’s easier now to “over-stretch.” Keep it gentle with a minimal intensity stretch instead of moderate. I had to change my usual runner’s lunge stretch for my hip flexors to more conservative quad stretches, since it started to make me feel a little unstable (more on that later).

GEAR

Invest in a New Sports Bra

First trimester feels a bit like all the other runs you’ve done while at peak-PMS. Mostly your boobs hurt and you feel bloated. Over the course of the pregnancy, you may need to invest in a new sports bra, the same as you will with your other bras to accommodate the change in size. Mostly, my bras made it feel hard to breathe because they were too tight against my expanding rib cage (which can widen up to 3-4 inches over the pregnancy). I ended up doubling up on some older, looser sports bras to stay supported and comfortable at the same time.

Consider an SI Belt

If you have a history of sacroiliac (SI) joint pain or low back pain, are feeling excessive movement in your pelvis while running, or are dealing with some SI joint, or sciatica symptoms now that you’re pregnant, consider wearing an SI belt (with extender strap) while running to decrease shear forces on your pelvis. I love the Serola belt and keep one in my office in case you want to do a trial run before you purchase. Just make sure to read the instructions to make sure you’re wearing it at just the right level.

Check Your Shoes

My old posterior tibialis tendonitis (an inflammation of the tendon that runs along the inside of the ankle) said hello during second trimester. Since the ligaments of your feet are also stretching, your lower leg muscles will be working overtime to stabilize your ankle as your foot hits the ground. If you notice your feet are expanding or you start to feel pain in the arches of your feet, considering switching out your neutral or minimal shoe to a stability shoe for some more extrinsic support. I threw my old orthotics into my running sneakers and it remedied the situation immediately. Couple that with a shortened stride to reduce joint loading and you should be on your way to safely running in trimester three.

Suffice it to say that being a good body-listener becomes more important than ever, especially since you’re listening for two. If you’ve been cleared to exercise but just want a little more guidance, if you are struggling with feelings of heaviness or incontinence, or if you are having any pain, don’t hesitate to reach out. Zion’s physical therapists specialize in treating both prenatal clients AND orthopedic cases, so rest assured that we can put the pieces together in a way that works for you and helps you keep exercising safely throughout your pregnancy.

REZIST class with Gino Caccavale

REZIST class with Gino Caccavale

walnut beach 5k with dad

walnut beach 5k with dad

ironstrength class with dr. Jordan Metzl (and guest Edem tsakpoe)

ironstrength class with dr. Jordan Metzl (and guest Edem tsakpoe)

Training: The Importance of Rest

THE IMPORTANCE OF REST

Contributed by Guest Blogger, Coach Mikael Hanson
www.enhancesports.com

I wanted to begin with a discussion on the importance of rest – an area that I see over-looked all too much and which is increasingly important especially as we get older. 

In my twenties recovery came easy and rest days, well those were few and far between and in my opinion for the weak minded. I used to become overcome with guilt for skipping a training day. Even when I was sick, I lived by the mantra that somewhere, someone is training and when you meet them in competition, they will beat you. They say, with age comes wisdom. I no longer feel guilty for missing an occasional workout, and realize that some of my best performances have come after a period of forced rest. It may have taken two decades of lessons, but I now look forward to my recovery days and it is not uncommon for me to string together back-to-back rest days. The forty-something me is also much more in tune with my body.  I take my resting heart rate and check my body weight every morning, looking for those early warning signs of not being properly recovered (perhaps bordering on obsessive-compulsive behavior).

SLEEP

As someone who has battled with the debilitating affects of insomnia I know all to well what a lack of sleep can do to not only one’s performance but also to their state of mind. Former professional triathlete and now endurance coach, Wes Hobson, believes one should not train unless they got a minimum of 6 hours of continuous sleep the night before - if that were the case, I would have had to skip the last half decade of training!

Living in New York City, one complaint I constantly hear from many of my athletes is their inability to get enough sleep. Work commitments, quality family time, training, recovery, all take their toll on us amateur athletes. A close look at the training regimen for any professional endurance athlete will invariably include at least 8 hours of sleep each night PLUS a nap. Now if we could all do that, I think most of us would be able to elevate our performances!

I have battled sleep troubles for years and knew I really needed to focus on my own sleep routine if I wished to stay competitive on the racing scene as well as just plain healthy as a person with a family. This is one of the reasons I have my athletes keep track of their own sleep patterns and resting heart rates as part of their training log - to help them identify when they have not gotten enough rest and need to take it easy!

As for how much sleep one needs - that is a very individual thing. Here are some tips to help you sleep or at least find a relaxed state:

  • Caffeine - Yes, the lifeblood of endurance athletes - but try to go decaf after 3pm!
  • Sugar - Ever see how your kid acts after a post-dinner cupcake? Well - we are the same and some extra sugar in the blood stream will keep you up!
  • Alcohol - No, a glass of wine or beer before bed DOES NOT help you sleep!
  • Dinner - Avoid eating late and spicy meals and you will find falling asleep a tad easier!
  • Environment - Make sure where you sleep is dark and try to avoid reading or watching TV in bed as you want the bed to represent a place to sleep in your mind.
  • Relaxation - Can't seem to leave work at the office? Try writing down the exact things weighing on your mind on a pad of paper before bed and get into a routine of relaxation before you sleep - a few minutes of stretching and deep breathing from the diaphragm will help!
  • Natural sleep aids - Valerian root and melatonin are both natural sleep aids that do help some (myself not included and be warned that Valerian root has a very distinctive smell!). Also magnesium is said to help open up the capillaries and can help you relax at night. Avoid taking your vitamins at night (better taken in the AM). One of my favorites - a nice hot bath before bed works wonders!

SIGNS OF OVER TRAINING

Over-training is a word endurance athletes hear a great deal and is something no longer isolated to the ranks of Pro athletes. Even us amateurs can fall victim to over-training, especially when trying to balance training and racing with a family and full time job. Over-training should not be confused with another term thrown out by the endurance world, over-reaching. Signs associated with over-training syndrome include:

  • Extended decreased performance
  • Elevated resting heart rate
  • Significant change in body weight (either up or down can be a sign)
  • Difficulty sleeping (perhaps a source of recent insomnia?)
  • Prolonged muscle soreness
  • Frequent illness or onset of colds
  • Low energy level and motivation (especially toward training)
  • Mood swings
  • Decreased appetite
  • Several poor workouts in a row

Besides training, several other non-exercise related factors can contribute to the onset of over-training; poor eating and hydration habits (before, during and after exercise), recent illness or injury (and resuming training without being fully recovered), poor sleep habits, travel and jet lag, are among the most common non-exercise contributors to over-training. Add to this list psychological stresses like death of a loved one, new addition to the family, stress at work or financial problems and you can see just how quickly over-training syndrome can sneak up on an athlete.

Over-reaching can be a normal aspect of one’s training regimen. To over-reach is when one ‘overloads’ their training volume over a brief period in hopes of seeing significant results in a shorter period of time. Pushing one’s body to this higher limit of activity (but not going into the over-trained zone), allows for the body to enter a super-compensation mode, where upon recovery your overall fitness level is much higher than before. The key factor for over-reaching to work is pairing it with proper recovery (without, you risk over-training).

While over-reaching may take several days to a week or more to fully feel like your old self again depending on the training load, over-training can take months to fully recover from. What is the remedy for over-training? Try simple, old-fashioned rest. Put the cycling or running shoes in the closet, skip some races and just chill. Let your body recover, so you can come back fresh and strong!

Top 10 Ways to Prepare for the Corporate Challenge

You signed up for the Corporate Challenge…. Now what!?

Top 10 Things to Do

10. Invest in a new pair of running shoes - running shoes typically last about 6 months

9. Write down a goal for the race - for example, finish time, don’t walk, have fun, high five spectators

8. Foam roll - most gyms have foam rollers, if not it’s $10 on Amazon..happy muscles = better running

7. Sleep more - our bodies recover from hard work while we sleep

6. Hydrate - drink water alone or with electrolytes often throughout day especially if you are drinking coffee and/or alcohol

5. Go for a run in the evening - the race is a 7pm or later start, acclimate to evening conditions

4. Practice fueling before a run so you know what to eat pre race - usually bland items, simple carbs

3. Look at a course map so you know where to expect ascents, descents, and flat terrain

2. Find a buddy to train with

1. Enjoy the process - exercise is fun! And even more satisfying when you achieve a goal!

- Amanda Scheer, DPT