What Does “Listen to Your Body” Even Mean?

“Absolutely! You can keep doing CrossFit during pregnancy. Just listen to your body and keep at a conversational pace”- The advice my OB gave me during my first trimester when I questioned how pregnancy impacted my athletic hobbies. When pushed a little further, she said “well, don’t do anything aggressive - like train for a marathon”. Okay. No worries. Running a marathon isn’t anywhere on my to-do list.

This is common advice received from medical providers in regards to pregnancy or postpartum fitness. I don’t hold it against my OB that this is the advice she gives. Her interests in my health aren’t related to what I’m squatting or what my Fran time is. She’s looking at a bigger picture and is more interested in the healthy development of my baby, and how I progress through pregnancy, delivery, and recover postpartum.

Her concerns may seem basic to the athletic crowd, but she’s not a physical therapist or trainer and the functionality of my core and pelvic floor in the gym are a little past of the scope of her concerns. Can OBs do better? Can they start mentioning PFPT to patients? I hope so. I hope with each mom that asks for a referral, they start to consider suggesting that automatically.

But for now, we have to look elsewhere to understand what listening to our body means. In reality, pregnancy is a confusing time to be told this, because nothing feels normal. So is how I’m feeling normal? Or is it my body saying “hey! We gotta switch things up!”

Pain

Anytime you feel pain (pregnant, postpartum, neither) you should take that as a signal that something isn’t right. If your knee hurt every time you performed a squat, you’d probably stop squatting. Maybe you’d adjust your stance, lighten the load, ask a coach to check out for any funky movement, or maybe you’d even get an appointment with a PT. The same goes for pain signals during pregnancy. Common areas of pain or discomfort during pregnancy are the low back and pelvis. While you may be able to re-strategize or remove movements from your training, it’s also advised to get an appointment with a PFPT and address the problem sooner rather than later.

Pressure

Pressure management is something to pay attention to during pregnancy as well as postpartum. During pregnancy this allows us to start familiarizing ourselves with strategies for postpartum rehab, as well as to help mitigate risks of pelvic floor injury. Pressure may be felt downward through the pelvic floor and vagina, or outward towards the linea alba.

Heaviness

A third common symptom felt during pregnancy is heaviness. This can be felt as a bulging or the feeling of a tampon falling out. If you have this feeling, keep a note of whether it occurred during certain movements, or after certain workouts, or is constant.

Leaking

There are a variety of categories regarding leaking or incontinence, including stress induced or urge incontinence, but the common theme is that just because it is common doesn’t necessarily mean it has to be your normal. This is a big one that our mother’s and grandmother’s have told us is just part of pregnancy and motherhood, but, resources are more readily available now and if this is a regular occurrence there is help. Seek out PFPT, or a qualified coach to help address the symptom and understand how to stay dry during your day to day life as well as workouts.

Coning/Doming

Thanks to social media and the visibility of this symptom, it is becoming widely recognized in the women’s fitness world as a sign to stop doing certain exercises. However, you don’t always need to stop completely. Coning (the outward bulging at the linea alba) is a signal of mismanaged abdominal pressure. This may look like a mountain ridge down the midline, or as more of a dome similar to a bread loaf. Rather than just stop the movement indefinitely, first assess. Can you find a different way to manage your intra abdominal pressure? Can you change the range of motion?

This symptom can sometimes be seen in daily life during activities such as getting off the couch, or even leaning back in the shower to rinse hair. These aren’t the times that it’s overly concerning to a P&PA coach. If you are coning during every pullup, every pushup, every squat, and we’ve assessed breathing strategies, then maybe we reduce that outward pressure by modifying to a different movement.

Why do we care about these symptoms?

During pregnancy the goal is to preserve core integrity, and mitigate potential for pelvic floor injury, while keeping you engaged in activities you enjoy. These symptoms are signals of mismanaged intra abdominal pressure, which can be a contributing factor in longer term injuries of the pelvic floor and core such as a lingering diastasis recti, prolapse, and incontinence. These injuries or dysfunction are unpredictable. Two moms can train exactly the same and one may have a diastasis recti that closes with little rehab, and the other may work months to regain functionality. We can’t control our genetic makeup or what will happen during labor. How we train is an area we can control. By training smarter and recognizing these signals we can preserve, prehab, and build a foundation of knowledge for rehab.

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Ok, I have one of these symptoms, what do I do now?

So you listened to your body and it threw up a hand to say “Hey, something needs to change!”. What do you do now? You assess. Are you always symptomatic or only during certain movements? Is it every time or only under fatigue? Can you change how you approach a movement? Or do you need to put this movement on the shelf for a bit? Are there alternative options?

Who is on your team? Have you worked with a pelvic floor physical therapist? (www.pelvicguru.com has a huge directory of qualified PTs) What about a qualified coach? A coach can bridge the gap between your PT exercises, rehabilitation, rebuilding, and getting you back to regular training in the gym. A coach can help keep your workouts varied, appropriate, and aligned with your goals while taking into account your pregnancy considerations. A coach can assist in building short term and long term strategies to mitigate risk during pregnancy, or rebuild postpartum.

I provide remote training services to athletes during whatever stage they’re in of pregnancy or postpartum. These services range from one time consults to help understand how and when to modify workouts as it pertains to their individual pregnancy or recovery, all the way to fully individualized programming to progress towards their goals.

If you’d like to discuss options or have questions, reach out to me at coachamyboyle@gmail.com, send me a message on instagram @coach.amyboyle, or book a call.