A few days ago I did my usual trail run near my home. The 7 mile loop gains approximately 1300 ft. and provides gorgeous scenery. I began my run shortly after a male cyclist and passed him within 2 minutes, leaving him far behind me for the duration of the run. Back at the bottom while I was getting into my car he descended and proclaimed his embarrassment at how badly I had beaten him, especially considering he was on a bike. I smiled and shrugged, I didn’t have the heart to tell him “ And I’m in my second trimester of pregnancy”. But internally I felt a little smug.
I have continued to run since the very day I found out I was pregnant. The day I found out was the day immediately before a 22 mile training run, and I frantically called my obstetrician for the final verdict as to whether or not I should continue running at that distance. His advice was concrete. If something was going to happen to the baby, and God forbid I would miscarry, it would not be because of my running, if I was prudent with my heart rate and core temperature. Run to your heart’s content he said. And so I have. Despite intense “all day sickness” (it was not reserved for just morning time my friends), and extreme fatigue, I have continued to run. I have a second place half marathon finish, in addition to a slew of other races under my belt with the baby on board. Granted that my pace has slowed a bit, I continue to run as I desire.
What I have found most startling are some of the judgmental or condescending comments that I have received. In the days leading up to my most recent race, a relay in which I ran 3 legs totaling 18 miles all rated as moderate, I received a menagerie of interesting comments. “Are you sure you should be doing that?”, “Are you really planning on running all of your legs?”. With all due concern for the safety of my unborn child, and under the care of a capable medical team, and with a Doctorate degree in physical therapy and specialty in pre and post natal care in my repertoire, yes, I ran. All of my legs. And this is because I am a runner, and will continue to run with prudence until it is no longer in my or my baby’s best interest. I am not a seasonal fair weather runner, or the girl who picks a fun race and only trains in preparation for the beer at the end. I run in snow, sleet, rain, and sun, from January to December.
As a health care provider, I fully realize that sometime, perhaps soon, there will come a point where my running cadence changes to a walk, and I shift my attention to more low impact activities. I’m certainly not running 22 miles per day at this point, and little by little I will continue to slow down. I’m neither irrational nor hedonistic about my prospects of running too far into my pregnancy. Here are the factors that I will be keeping in mind in the coming months:
- As the pregnancy progresses, the presence of the hormone Relaxin will cause ligaments and tendons to relax, thus increasing the mobility of my joints. This will increase the strain placed on these joints and may begin to result in pain in the joints. It is imperative that a pregnant active woman continue to maintain strength in the hips and decrease running activity when the soreness increases to prevent injury.
- Running mechanics will change due to the above noted factors, thus new patterns are created which are often poor. Thus, all the more reason to continue strengthening and pay attention to the signals the body is giving the runner.
- The baby is suspended in the uterus over the bladder, and all of these structures are supported by the pelvic floor muscles which form a connective sling. As the presence of the fore-mentioned relaxin increases, the tendons that bond the pelvic floor muscles to their bony connection on the pelvis begin to relax as well. The growing weight of the baby challenges these bonds, and can weaken and strain the strength of the tendons. The jostling and impact of running further advance this process, which can lead to incontinence due to pressure on the bladder and decreased pelvic floor muscle support of the bladder. The incontinence symptoms can last after delivery and can become a chronic problem if not addressed. When jostling and a feeling of heaviness in the pelvic floor are noted during running, it is probably time to switch to walking or swimming.
These are some more intricate considerations when determining when to decrease physical activity during pregnancy. These are in addition to the medical considerations set forth by the American Congress of Gynecology (ACOG), outlined in my previous post:
Most important to consider, is that every woman, and every runner is different. If you are a pregnant runner and wish to continue running, discuss any concerns with your physician or midwife. If your highly capable health care provider advises you to run, then run! If you do not feel up to it, do not fret. Your running will be waiting for you when you are ready to return. And if you are not a pregnant person, be supportive of your pregnant runner acquaintance.
Make your day great,