Saturday, March 23, 2013

Exercise During Pregnancy....What I've Done (so far)

Running at 32 weeks
In a future post (in progress), I will discuss general exercise recommendations for pregnant woman. Here I will write about what I did.

To give some background, I've been a runner and marathoner since 2006. (I first became a runner so that I could complete a marathon so the two happened at the same time.) Since 2006 I've completed 13 marathons, so on average 2 a year but in reality I had been escalating my number of marathons in recent years- I did 3 in 2012 and 4 in 2011. My average monthly running mileage varied but was in the 70-100 mile range. I intermittently also lifted weights, did the occasional fitness, weights, or spinning class at the gym. But really, running was my major focus.

In 2012, I began to up the ante a bit by adding in more spinning and learning how to swim with the intention of eventually doing an Ironman. (You may see the theme that I don't do things partway!) My first ever triathlon was the Chicago sprint triathlon in August 2012. Despite barely swimming at all during the swim, I had a great time doing this race with my friend Sara! Immediately after Chicago, I signed up for the Lake Geneva Sprint Triathlon as a redemption race. Two weeks later I found out I was pregnant (thus learning that babybison also did her first triathlon!). Being so early in the pregnancy, I saw absolutely no reason to not do the triathlon, though did acknowledge I should probably take it a bit easier than I otherwise would and drink plenty of water. The Lake Geneva tri was the last time I rode a bike outside during my pregnancy. As I'll note in my general exercise during pregnancy post, avoiding the possibility of falling and causing serious trauma is important. If I loved, loved, loved biking outside I probably would have ridden carefully for a couple more months but it just wasn't important to me and I had to ramp up my running mileage for my fall marathons anyway.

Val's Pregnancy Exercise Rule #1: Cut out activities where you could experience trauma. (biking, downhill skiing, horseback riding, etc-  all carry risk of falls!)

When I found out I was pregnant (we learned at 5 weeks), my race schedule included the Lake Geneva Sprint Tri (week 6), the Des Moines Marathon (11 weeks), and the Outer Banks Marathon (14 weeks). I had toyed with doing the Chicago Marathon as well but wasn't particularly jazzed about it so it was a no brainer to cut that one out (3 marathons in a three week period seemed excessive during pregnancy).  I didn't for a minute consider not doing my two goal marathons. I just knew I'd need to change my goals for the races! The month I learned I was pregnant was actually my biggest running mileage month of the year- 118 miles in September. I had already started my mileage ramp up for my fall marathons, having run 17 miles Labor Day weekend. Sure I read a little bit about endurance running during pregnancy, and the general rules to follow (don't get too hot, make sure to keep the pace conversational) but the question was always how to do it safely not whether I would do it.

Val's Pregnancy Exercise Rule #2: If you were doing it before you got pregnant, you can keep on doing it!

September was a great training month overall with lots of swimming, biking, running (including a 20 miler) and classes at the gym. In October, I definitely tapered and I remember having significant fatigue from weeks 7-10. Like absolutely needing to lay down some afternoons. Like never having been that physically exhausted in my whole life despite sleeping for 9-10 hours every night. Organogenesis will get you. Really, who knew making teeny tiny organs could be so tiring! Plus the (very) mild, (very) minimal, (but still there), low grade nausea made activities less than desirable. There were multiple days where it took all of my motivation (and my desire to maintain my running streak) to get off the couch to run even one mile. But I plugged along and from very early on adopted the rule that I would continue to follow throughout the pregnancy:

Val's Pregnancy Exercise Rule #3: If you feel a symptom or sensation when you are at rest, it is okay to feel that same symptom or sensation while exercising. However if the symptom worsens in frequency or intensity, back off or stop.

Des Moines marathon 11 weeks
During the first trimester, my main symptoms were nausea which often was improved (and definitely never worsened) by running, and this odd sensation of feeling like the baby (or something) was wedged into my right pelvic bone. I have no idea what I was actually feeling, but the beauty of rule #3 is that it doesn't matter all that much what you are feeling as long as it is not exacerbated by exercise. Any woman who thinks she can identify all the sensations she has during pregnancy is either lying to you or to herself because seriously, it's a free for all in there. I mean I had "sensations" from week 5-7 that I was later told must have been increased blood flow in my ovary and uterus. I'm a doctor, a medical doctor, and I had NO IDEA you could feel pregnancy related sensations that early on! Crazy.

Both marathons went well from the pregnant running perspective. You can read the full race reports here (Des Moines) and here (Outer Banks). I actually had a really, really great time in Des Moines- one of my favorite race experiences of all time. I know I could have killed it if I wasn't running pregnant. But I was super careful and even took walking breaks simply for temperature control in the last 6 miles and still pulled out a respectable 4:22.


Outer Banks Marathon 14 weeks

Between the two races (which were just three weeks apart), I only had 5 runs of any significant distance (i.e. 3 miles or more). I was still tired, then I got a terrible cold (which I had during the Outer Banks marathon, yeah, so pregnant and couldn't breathe through my nose for that one!). In November and December the wheels really fell off in terms of my running life and really my exercising in general was not where it should have been. I know the reasons (excuses). First the cold that lasted 2 weeks, then I had an amniocentesis so wasn't supposed to over-exert for a couple days, then we had some scary news about the baby's health (false alarm, she's fine, but it took 3 weeks to get all the tests back) that really rendered both Adam and I pretty non-functional except for the most essential of activities (like work). Plus the pregnancy niggles were really in full bloom and seemed to be new and different every day making it more and more challenging for me to follow exercise rule #3. I seemed to be forever questioning every new sensation racking my brain to remember if it was one I had during rest or a new one that required me to stop. For a few week period, every 3rd work-out ended prematurely because I wasn't sure if I felt okay or not. Very frustrating. Plus the constant having to pee niggle was the PITS! There were multiple 45 minute work-outs where I would pee 4 times, yes every mile. This made running quite unpleasant so I resorted to a good deal of hill walking and started to spin and swim more frequently during this time.

From October to December I was a bit of an exercise sinking ship. I got in a handful of decent runs (at least one a week including a 10 miler at week 22) but running definitely fell off. Then the day of the half-marathon I was shooting for I had another miserable cold. I wasn't going to let that stop me but when I felt all kinds of pelvic sensations on the jog to the start I made the safe choice and went for a 4 mile run with Adam instead.

Luckily, in early January I got back on the exercise bandwagon with the motivation of a second attempt at a 45 in 45 challenge, initially posed my one of my friends on-line. I had completely failed at my first attempt (45 in 4 of 5) in Nov/Dec but decided to give it a second chance as a way to stay motivated (45 in 45). And it worked! While I was a few hours shy of exactly meeting my target, trying for the goal of working out an average of 45 minutes every day for 45 days helped increase my exercise frequency and intensity for the months of January and February, and the motivation is still holding strong now at pregnancy week 32 in mid-March. In addition to the obligatory 1 mile running daily, I averaged at least 1 spin a week, 1 3+ mile run a week, 1 swim a week and 1-2 strength training sessions a week.

Val's Pregnancy Exercise Rule #4: It's never too late to set new ambitious exercise goals even when pregnant!

30 weeks, on my way to the gym
Regarding strength training, I need to thank my husband for his support on this one. He's the one who found the Active Mom's Club, a prenatal and postnatal fitness organization with small group (3 women) training sessions for prenatal women. There are so many rules about which exercises and which positions are acceptable for women at the various stages of pregnancy- to prevent injury, to prevent decreased fetal blood flow, to prevent diastasis recti- so many rules! Training with a small group with a trainer who specializes in pregnant woman took a lot of the guess work out of strength training for me. Plus, it's much more motivating to have a trainer than to do it alone. I've been going once a week and doing the exercises one additional day on my own and I do believe my strength is actually improving during this pregnancy! I've more than maintained.....I've actually gained in the strength department, and when this baby fat (18 lbs of it!) melts away during the first two postpartum months I'm hoping I'll be happily surprised by the muscle that lies beneath:)

Val's Pregnancy Exercise Rule #5: Strength training is the exception to Rule #2.

The third trimester has been generally good to me and the niggles are actually decreasing. The having to pee niggle is all but gone (just 1 break after mile 1 and I can run for another 30 minutes!) There was a week there when I first experienced Braxton-Hicks contractions where I really paid close, close attention to whether the frequency or intensity increased during exercise and since they didn't, I feel confident in managing these during exercise as well. I try to be reasonable, not to be overly anxious, but to always error on the side of caution if I have any questions.

I really lucked out in terms of timing with this pregnancy. Being pregnant from August to May means I won't have to miss the late summer/fall marathon or triathlon season here in the Midwest. I am skipping the Spring marathon season this year (and notably the Big Sur International Marathon since I'll be 38 weeks pregnant), but should be in tip top shape for next Spring's season.

In future posts, I'll write about pregnancy exercise recommendations in general and then about what I would do differently were I to become pregnant again, hoping this can serve as advice to other pregnant wannabe athletes as well as myself if I ever think about doing this again (though I think once is more than enough, thank you very much!)



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