Physiological changes to your body, how you might be feeling and how to adapt your exercises
Changes to your body & how you might be feeling in trimester two
Like anything in pregnancy, if it doesn't feel right speak with your doctor or maternity nurse. I am not a doctor and will stay firmly in my lane of personal training, however I hope I can shed a bit of light on WHY you might be feeling the way you do. I advise that you read the first blog about trimester one before reading this one too!
Nausea & excessive tiredness should begin to subside - This is great news all round and you should really be feeling more energetic now. The only thing to be mindful of however, is that you will fatigue quicker during exercise due to the pressure on the circulatory and musculoskeletal systems making sure mother and baby get oxygen, so don't go mad with heavy weights and keep it moderate!
Bump & boobs beginning to grow - You may finally be seeing your bump growing and developing which is so exciting, alongside this you may get enlarged breasts from growing breast tissue making room for the milk. You may also find that your centre of gravity is beginning to shift slightly as your bump and breasts grow, this will be mainly towards the end of trimester two and into the third.
Weight gain - this is TOTALLY NORMAL your weight begins to increase significantly from trimester two with the growing baby, blood stores, necessary maternal fat stores, fluids and breast tissue as well, so its normal for the scales to start going up at this stage! This helpful video from the NHS explains in more detail about pregnancy weight gain
Maternal Heart Rate increases by 10-20bpm - What does this mean? It doesn't mean increased blood pressure, just blood volume (so the amount of blood in your body) begins to significantly increase in trimester two so this means there is more to pump around the body, and therefore more pressure on the circulatory system - hence the increased heart rate!
You sweat even faster - Yep, even faster than in trimester one. Your sweat threshold has lowered again as your body’s way of regulating your temperature so you don't overheat . Make sure you increase water intake and rest periods!
Increased breathlessness - This can be due to quite a few things because of all the amazing things your cardiovascular and respiratory systems are doing through pregnancy, so if you’re feeling this way decrease your intensity in this trimester. Always use the TALK TEST to ensure you can hold a conversation throughout exercising and avoid breath holding and breathing properly through the eccentric and concentric phases of a movement. Decrease the weight if you find yourself holding your breath!
Water retention may be beginning to start - As the growing womb puts pressure on the blood vessels in the body, this can mean that there is a slightly reduced blood flow to extremities - as in your hands and feet. It is important to warm up and cool down for longer periods of time in trimester two to ensure blood and fluids circulate around the body, too and and away from all extremities.
Relaxin - As per in trimester one but also during trimester two you may find that you have indigestion, reflux and heartburn. This is because relaxin not only relaxes your skeletal muscles, but also relaxes smooth muscle tissue like your airways, making them a little 'sluggish'. This can also lead to constipation as the intestine relaxes so make sure you are taking in adequate fibre in your diet and you’re not straining when you go to the toilet. Straining not only puts pressure on the pelvic floor girdle, but also can be a cause of haemorrhoids.
Pelvic Girdle Pain (PGP), typically Pubic Symphysis Syndrome (PSS) - This can occur in trimester one but is more common from trimester two. Pelvic Girdle Pain is an umbrella term for all things that are sore in your pelvis. There are many reasons why so many women experience pelvic girdle pain of some sort in pregnancy. It can be hormone related (oestrogen and progesterone balances) but also due to the relaxin present in the body during pregnancy, and at heightened levels from trimester two onwards, the joints in your pelvis become, for want of a better word ‘looser’ and more supple. Pain or discomfort felt is your body’s way of telling you not to move the way you are currently moving, so for example if you getting it whilst walking, take more gentle, shorter strides. It can also be caused by the changes in your centre of gravity as the baby bump and breasts grow, making minimal to large changes in your posture so and your pelvis is being moved in a different way. There are many other causes, so it's best to seek medical advice if you are finding it particularly debilitating. The HSE website have some great exercises to relieve the pain which can be found here
Pelvic Floor - Throughout trimester two, as the baby grows, you may be feeling ‘heavy’ sensation in the pelvic area. It is so important to keep training your pelvic floor through Kegel exercises throughout this trimester. If you are finding that you are leaking during moderate to light exercise, ensure you reduce the resistance, impact and intensity.
Non-specific back pain - Back pain (especially lower back) is very common from trimester two onwards as the baby bump and breasts are getting bigger and heavier. In turn this can create small postural deviations and subsequently can cause back pain. It's important to keep your core and back muscles strong to help alleviate this pain, because the core is 360 degrees, it is NOT just the front and sides of the body but the back too. Never push through back pain, rest, lower the weight or move onto a different exercise.
Exercise adaptations in trimester two
Your energy levels might be back up! - You may have more energy now, however it is not the time to push yourself for PBs or go too heavy with resistance. Keep it moderate, remember the baby bump and breast tissue weighs something too, you have your own built in resistance!
Its important to monitor and adjust your intensity accordingly - As previously mentioned, the TALK TEST is a great way to monitor intensity. Keeping the resistance down from heavy to moderate, or even moderate to light will help here too. You may have more energy but you don't want to put too much undue pressure on the body which is already working hard for mummy and baby.
It is recommended that pregnancy women do 15-30 mins of exercise and not pushing to fatigue - The HSE and NHS both recommend pregnant women do 150 minutes of exercise per week. This equates to 5 x 30 minute sessions per week, or 10 x 15 minute sessions per week (including walking). The NHS then say two sessions a week of strength/resistance type training is advisable. This can be bodyweight or with moderate to light weights. This poster is a great visual of how exercise is recommended in pregnancy:
Avoid supine (lying flat on your back) positions - This is down to the individual and the bump size, but science behind avoiding this position is because as the uterus grows, it can push down on the vena cava (a main vein taking blood to the heart) and can reduce blood flow. This can subsequently make the mother feel quite light headed so change position to seated or propped up on a cushion, chair to avoid feeling this way.
Advised to do seated, kneeling and standing positions - Firstly this keeps your head above the stomach, if you are suffering from indigestion, nausea or reflux, bending over or lying down can aggravate this. Seated, kneeling and standing are also stable positions and less likely to fall and bump the bump!
Avoid prone (lying on your front) position - again this is down to the individual, you may not have a bump until much later in the second trimester, however for obvious reasons its recommended from trimester two to not to lie on your front during exercise to avoid squishing the bump! Do modified burpees or place a hand on a bench/chair for support or come into all 4s
Use a suspension trainer (eg. TRX), wall or a chair for support, if needed - this is particularly prevalent during any single leg work like lunges, a chair is great to use as support if you’re feeling off balance.
Use moderate to light weights when resistance training - This is to not put undue pressure on the cardiovascular system or pelvic floor, but also by having a slightly lighter weight will reduce the likelihood of breath holding which typically happens when lifting heavy weights
Keep repetition ranges/sets the same as you did in trimester one - Just increase rest periods so you can take on more water and your body and heart rate can recover between sets
Longer warm ups and cool downs - As mentioned earlier, there an increased volume of blood in the body, therefore it takes longer to pump all the blood around the body and longer for the body to warm up - simple!
Longer cool downs - As mentioned before, this helps to stop pooling and reduces the likelihood of water retention, but wont necessarily prevent it
Increased Beats Per Minute (BPM) - As the maternal heart rate is beating faster (10-20bpm more at rest than when not pregnant) you wont need to push as hard to get the same results, so again, adjust the intensity accordingly.
PSS & PGP - Having pelvic pain doesn't mean stop exercising altogether, in fact a lot of women find exercise can relieve symptoms of PSS & PGP. Yoga, pregnancy pilates and mobility & stretch work can also help to relieve symptoms. When working out, try and avoid anything that involves abduction so moving a leg away from the midline of the body, such as a side lunge or lateral leg raise. Try staying static, so static lunges or split squats.
HIIT and running - Same as in trimester one, if you have been doing it priory to pregnancy and throughout trimester one, you can generally continue to do it through trimester two with modifications (see trimester one for more details on these) but continue to approach with caution due to increased relaxin levels and joint instability, as well as the risk of falling during jumping/explosive exercises.
Changes in your centre of gravity and posture - this can make some women feel a little off balance, this is because the baby bump and breasts have changed your normal posture to a more forward (anterior pelvic tilt) or compensated with a backwards tilt (posterior pelvic tilt). Again work on keeping your posture neutral by strengthening muscles regions that commonly weaken (see trimester one for advice on this). Also if you notice that you do have an anterior tilted pelvis, I would strongly suggest avoiding overhead presses in a standing position as this can exacerbate these postural changes in the lower back and can cause back pain and other areas of soreness.
Activities to avoid - See trimester one for a list of these. From trimester two the bump will begin to be visible, so be careful with machines that could again put the bump at risk such as the rowing machine. Change this for a different cardio machine or if you’re looking for resistance training, try a one or two point dumbbell row using a bench/chair for support.
Isometric holds - Like in trimester one, these are generally safe to do but only for a short period of time so if you were performing something like the plank, reduce the time down to about 5 seconds or perform on your knees for a modification
Breathing through the movement - To avoid holding your breath during exercise, inhale on the eccentric phase and exhale on concentric phase of the movement. So using a squat as an example, as you squat down, inhale, as you stand back up, exhale and engage the core and glutes to power you through the move.
Core - Its important to work the core throughout pregnancy, but avoid anything that creates intra-abdominal pressure such as long plank holds, crunches, sit ups etc. Stick to seated, kneeling, side lying, standing, all 4s or box core work.
Preparing for later trimesters and postnatally
Core activation through breath work - definitely time to start it if you haven't already. Using your breath to engage the core is not only an excellent workout for the core, but it keeps the muscles working but your core to mind connection strong. Combine this with deep diaphragmatic breathing and you'll reap the rewards postnatally.
Focus on keeping strength in areas that typically weaken - as our belly grows more through trimester two, our centre of gravity shifts forward which means some muscles 'switch off' working as hard in everyday tasks such as walking, some new ones 'switch on'. The most common areas of weakness are your back, core, glutes & hamstrings, so work on keeping them strong and a good posture will help with this.
Stretch muscles that get tighter - this is commonly the hip flexors, chest area, quadriceps, and parts of your back. Stretching in the cool down will help to relieve any tightness
Work that pelvic floor - it's never too late to start your Kegel exercises. You can incorporate them into your workout so they don't feel like an added thing to think about in the day. I’ll be showing some exercises you can do to help in the coming weeks. Email me at georgydillonpt@gmail.com if you want more information on pelvic floor exercises
Interval training - This may sound a little 'out there', but its a great way to prepare the body for things like labour as its time of intense work and times of catching your breath. Try 30 seconds of work with 30 seconds of rest, as the pregnancy progresses, reduce the work time and increase the rest time.
It goes without saying this is just my advice, and if anything doesn't feel right - stop, move on and change it up and always here for questions of queries. Feel free to email me. Hope this helps you mummas and keep up the amazing work! Any questions or queries, email me at georgydillonpt@gmail.com