HSS Ask The Experts: Tips for Running While Pregnant

It is important to maintain your physical and cardiovascular health throughout your pregnancy. The American College of Obstetricians and Gynecologists (ACOG) recommends at least 20-30 minutes of exercise a day, 5-7 times a week. Exercise helps to reduce the risk of gestational diabetes, preeclampsia (pregnancy induced high blood pressure), pre-term birth, and having a baby with high birth weight.

In addition, as any person who runs or exercises knows, it can also help to reduce your overall anxiety levels. Having gone through pregnancy myself twice I know there were times that I felt a little anxious about what my new bundle of joy was going to bring me!

First Things First
If you were not a runner before getting pregnant, it is a challenging time to start an activity that requires a lot from your constantly changing body. It may be a better option to start with walking or maintain your current exercise routine (as long as you have clearance from your OB to do so).

If you were a runner before getting pregnant, are having an uncomplicated pregnancy, and your MD gives you the OK, you can safely continue to run through some if not most of your pregnancy. It is also important to maintain your strength training program to support your growing belly and pelvis. This is just as important as your cardiovascular health—you need a strong core and hips to support you while you run.

You should be aware that your running most likely will change. You may not be as fast or be able to run the same distance, and that is OK!  It is very important to listen to your body and not push yourself while you are pregnant. Slow down as needed and give yourself extra recovery days as your body adapts to many musculoskeletal changes.

There are some extra precautions you may want to take into consideration while running during your pregnancy.

The First Trimester
For me, the first trimester with my first child was the hardest during which to keep motivated to exercise. You may find yourself fatigued and nauseous. Exercising can help with both fatigue and nausea but that doesn’t make it any easier to build up the energy to do so. Also, if you are not able to keep food down and keep yourself properly nourished, running is probably not the best idea.

Stay Hydrated: It is very important to stay hydrated while you are running. It may be tempting to cut back, especially if your baby is making a couch out of your bladder and you find yourself making more trips to the bathroom. Resist the temptation! Plain water is best, and you should monitor your hydration. An easy way to keep track is to check the color of your urine—if it’s pale yellow to nearly clear you are good; if it’s darker you need to drink more.

Stay Cool: Wear comfortable, loose-fitting clothes and try to pick cooler times of the day to run outside. If it’s on the hotter side, choose to run indoors. Make sure you are protecting your skin. Like most parts of your body during pregnancy, your skin is more sensitive. It’s best to wear SPF 30 or greater.

Adjust Your Running Gear: Make sure you are wearing proper shoes to support your ankles and arches. Due to the release of the hormone relaxin (which loosens ligaments during pregnancy), your ankles and arches need more support to avoid strains or sprains.

You may notice that your pre-pregnancy sports bra is no longer cutting it in the way of support. Most likely it’s just cutting into you and your ever-changing body. If you can find an adjustable, supportive bra that can expand as you do, you’re less likely to have to buy a bigger size later.

The Second Trimester
Most woman will find that the nausea and fatigue of the first trimester is gone by the second and they have more energy to exercise. That’s great, but just remember that pregnancy is still not the time to push yourself.

Watch Your Heart Rate: Make sure that you’re always able to breathe comfortably. Pre-pregnancy, figure out your heart rate max by subtracting your age from 220. During pregnancy you should be between 60-80% of that number to be safe. Always check with your OB.

Watch Your Balance: . Due to the shift of your center of gravity because of your growing belly, you may find yourself off balance. It is best to pick running paths or trails that are straight and even, without many natural obstacles that may cause a fall, or use a treadmill.

As your pregnancy progresses and relaxin continues to release throughout your body, you may become more aware of your low back, hips, or sacroiliac joint. Maintaining a strong core and hips can help to prevent or alleviate some of this discomfort. You can also try using a pregnancy support belt to take some pressure off these areas.

The Third Trimester
During your third trimester you should continue to be as careful as you were during the first two. Listen to your body and do not push yourself. Most runners (myself included) find themselves slowing down considerably during the third trimester. Once I felt my growing stomach bouncing up and down while I was running, I chose to do a fast walk instead. But if you are feeling good and have the OK from your OB, you can continue running throughout your third trimester.

If you experience any of the following during any part of your pregnancy, you may be pushing too hard and might need to ease up on your exercise routine:

• Exhaustion rather than invigoration after working out
• Pain in your joints or ligaments after a run
• Muscle soreness that exceeds the normal time frame or intensity related to your run
• An increase in your resting heart rate for a longer period post-running

If you experience any of the following, you should stop running and call your OB:

• Dizziness or faintness
• Chest pain, contractions, or vaginal bleeding
• Unusual or persistent pain
• Unusual shortness of breath
• Fluid leaking from your vagina
• Muscle weakness affecting your balance
• Calf pain or swelling

Pregnancy is a beautiful time and for most, a great opportunity to keep your body in shape and healthy. The most important things are not to push yourself and listen to your body. Running will always be there for you when you are ready for it!

Anna Ribaudo PT, DPT, OCS, CAPP-OB, CKTP is the Clinical Supervisor at the HSS Integrative Care Center. She is a certified Orthopedic Clinical Specialist and Certified Kinesio Taping Practitioner and was awarded the Certificate of Achievement in Pregnancy/Postpartum Physical Therapy by the American Physical Therapy Association.