From Conflicting Advice To Confident Training In Pregnancy

Conflicting rules about pregnancy exercise can make even seasoned athletes second-guess their training. We cut through the noise with a practical framework that honors your history, your symptoms, and your goals—so you can keep moving with confidence. Christina Previtt, pelvic floor physical therapist and researcher, digs into why guidance still conflicts, what the latest research actually supports, and how to use simple guardrails to make smart decisions in real time.

We break down the 150-minutes-plus-strength target, why “some” beats “none” at every step, and how to think about intensity when heart rate naturally runs higher during pregnancy. Runners get a deep dive on comfort strategies: strength training to reduce pelvic floor dysfunction risk, SI belts and compression to offload the pelvis and abdominal wall, and internal bladder supports like Impressa or Uresta for urethral hypermobility. If you’ve been told “don’t lift” or “no squats,” you’ll hear a clearer path: pick movements you can breathe through, brace without pain, and recover from within 24 to 48 hours, and modify when symptoms speak up.

We also reframe diastasis recti. A two-finger gap is often below clinical concern, the linea alba will lengthen to make room for baby, and targeted core work is not off-limits. Learn which exercises actually train the abdominal wall, how to scale without bulging or pain, and why capacity matters more than chasing closure during pregnancy. By the end, you’ll have a steady set of cues, tools, and options to tailor running, lifting, and daily activity across trimesters—without fear or guesswork.

If this Q&A style hits home, tap follow, share with a friend who’s training through pregnancy, and leave a quick review with your top question for part two. Your feedback shapes the next round of topics and helps more active moms find evidence they can use.

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Transcript

New Reddit Q&A Series

Why Pregnancy Exercise Advice Conflicts

A Framework Over Rules

How Much Exercise Is Enough

Belts, Compression, And Supports

Running, Heart Rate, And Safety

Diastasis Recti During Pregnancy

What’s Next And Sign Off

SPEAKER_00 0:08

Hello, everyone, and welcome to the Barbell Mama's podcast. My name is Christina Frevitz. I'm a public floor physical therapist, a researcher in exercise and pregnancy, and a mom of two who have competed in CrossFit, powerlifting, or weightlifting, pregnant, postpartum, or both. In this podcast, we want to talk about the realities of being a mom who loves to exercise. Whether you're a recreational exerciser or an athlete, we want to talk about all of the things that we go through as females going into this motherhood journey. We're going to talk about fertility, pregnancy, and postpartum topics that are relevant to the active individual. While I am a pelvic floor physical therapist, I am not your pelvic floor physical therapist and know that this podcast does not substitute medical advice. All right, come along for this journey with us while we navigate motherhood together. And I can't wait to get started. Hello everyone, and welcome to the Barbo Mamas podcast. Christina Previtt here, and today we are going to be looking at common Reddit threads and answering your questions. I kind of got this idea on the premise of I see those reels about Am I the Asshole? And I always think that they're so great. And of course, they always capture my attention. These are obviously a little bit different because they're going to be specific to pregnancy. Um, but we're gonna do a new series where we're answering common questions and kind of adding into the conversation that's going on on Reddit. Hope you all enjoyed the bonus episode that where we were talking about the CSEP conference. I've been feeling really called lately to do more long form content. I post on social media, but sometimes I always feel like even with my best of intentions and even trying as hard as I can, um, the nuance gets lost a little bit. So um I asked people about long form content, and many see people said the podcast. So obviously, I'm already doing that with this, but I don't know if I'm just gonna do maybe like a separate segment so you guys can choose, and we're gonna have the pregnancy postpartum content and then more general pelvic health content. I haven't really figured it out yet, but uh stay tuned. We're we'll try and uh figure that out. Okay, let's go with number one. Everything about exercise during pregnancy is extremely confusing and contradictory. Amen. Let's chat. I've been doing regular strength training and running for six years. My doctor said you can walk, just not too much. Of course, you won't be lifting any heavy weight. I told her I have actually been continuing with my normal strength training, and she said, Oh, that's fine, just don't do squats. Like, what? How do we get from limiting my walking to it being okay to lift weights? I have done squats that morning and got very scared. So this is an incredible comment and something that I have been pushing my healthcare providers, physiotherapists, occupational therapists, exercise professionals, physicians, family docs, obs, midwives, etc. Where we need to get on the same page. There is an absolutely massive amount of variability, and you're absolutely right that it's so confusing and contradictory. So there's kind of two veins for this. One is that our evidence really is not that old. And I was actually at CSEP, and on one of the days, they were talking about this was a Canadian conference. So they were talking about where and how far we've come with respect to exercise recommendations in pregnancy. And they put up the first document that had um exercise recommendations in it from the Canadian government, and it was in the 1980s. I think it was 1983 or 1984, and it had like hip sways and ankle pumps as recommended exercises. And they kind of went along this journey of how far we've come, and and now we have a lot more um like leeway or a lot more breadth of data, which allows athletes to kind of make more informed decisions. And so I think one of the first things is that there's definitely a knowledge translation gap here where all of our doctors, and this is not every doctor, this is not all physical therapists, but some physical therapists, there's an uncertainty or an a lack of awareness of some of the new data that's coming out. And so podcasts like this, and you know, I am doing some obstetrical grand rounds with some local hospital networks. I get asked to do talks to the military and things like that. And I always try and say yes because a lot of my research and the research of my lab mates, and especially our team, is really pushing the boundaries. Like I was at CSEP and there was a lot of people talking about exercise in the low to moderate intensity range, which is great. But then our lab had posters on contact sports, rock climbing, and high load resistance training. And we were joking that our lab is just like trying to push every single boundary. Um, but because all this evidence is really new, what can happen is as I talked about with like pregnancy physiology and making recommendations on you are pregnant, so you need to take change X, Y, Z. Um, what can happen is that everybody can kind of interpret the research as doing a little bit less or not allowing that much. And it can create recommendations like this. And then if you add in social media, it's also confusing because some people say safe versus unsafe, et cetera. What I think is really important is that we need a framework over a protocol. And I'm gonna try and bulletproof you, not bubble wrap you, unless there's a complication that requires the bubble wrap. And so where I'm hoping that we're gonna go so that we can avoid these types of confusing statements, because you're absolutely right, it's confusing. And then when you do squats, like she said, and then your doctor said, Well, just don't do squats. If something bad did happen, you would blame yourself and say, It was because I did squats, my doctor told me not to, but your doctor was giving you misinformation. And so it's really important that we are educating our healthcare providers, that our healthcare providers are staying up to date with the literature, and then that we are instead of saying these are the rules that you can do and can't do, we always have to have a little bit more nuance in our discussions. And so when we are looking at our framework now, where I hope that we are gonna be in five years, is that your fitness plus how you are feeling in your specific situations in pregnancy are gonna dictate your personalized and individualized exercise recommendations, right? If you were a marathon runner, you're definitely gonna be more likely to be able to do a higher volume of aerobic activity. Maybe running personalized uh education might not feel good if you start getting a pelvic pain or hip pain or something. Um, so one recommendation you may be able to do a ton of aerobic volume, but you're gonna have to cross-train and add a bit more biking or swimming in. And then for some people who don't have that hip pain, they can run all the way up until delivery, right? And so I'm really hoping that we're gonna take that stance, hence the long form content. That isn't the sexy thing to put on social media. Um, but it is really important to have that kind of messaging to our healthcare providers. And I'm really hoping, and it definitely is changing, but as we can see with this Reddit comment, it is not always um that universal that our recommendations are a bit more lenient. Um, but I really hope to get there. And those are some of the things that I know I'm advocating for and working on on a professional level to try and help bring that forward so that we don't get as many people like this who are active. We know that activity is good for you. Keeping up strength training is going to help, especially with the pain of pregnancy and perinatal mood disorders. And we just want to make sure that we're recommending that. So then this goes into the next question. Um, how do I know what an appropriate amount of exercise is while pregnant? Question two. I'm 34 and a first-time mom at nine weeks. And I've heard that working out while pregnant can help a lot with delivery and recovery. How do I know how much exercise is enough? Oh, love this question. It's also really interesting when we are thinking about exercise. That for many moms, being pregnant can be a very strong catalyst to starting an exercise routine in general. And I think that is so cool because we sometimes need that motivation and that accountability and that little baby, and knowing that exercising during pregnancy can have such amazing uh benefits for not only mom and your labor and delivery, but also for baby can be super, super uh motivating. When we're thinking about how much is enough, our pregnancy guidelines, most of them are mimicking our general physical activity guidelines with some considerations um for anybody between the ages of 18 and 64. What I mean by that is that enough, the amount of exercise that's going to incur the highest amount of health benefit is 150 minutes of moderate exercise and two times a week of muscular strengthening and it broken up in any way. What is important, and what I always counsel moms on is that if we look at our data on exercise and reducing sedentary time, so physical activity and reducing sedentary time, anything is going to have a net positive. So if you go from sitting, you know, 10, 11 hours a day and you start breaking up that sedentary time and getting more light physical activity, we're gonna see some of the reductions in risk from the negative consequences of sedentary behavior or sitting too much. If we are doing no moderate physical activity and now we're getting 10 minutes two or three times a week, yeah, we're not hitting that 150 minutes, but we are gonna see a health benefit. Where our data and why the we come to this 150 minutes is the optimal and most significant amount of risk, right? So we're gonna see that the risk is going to drop and it's gonna hit a peak at 150 minutes. After 150 minutes, we do see some continued reduction in risk, but the slope or how much of that reduction is more minimal. And so we come to this conclusion that 150 minutes is what we should be uh approaching or reaching. Right now, our guidelines do not have recommendations, most of them, to vigorous physical activity unless you were participating in vigorous activity prior to pregnancy. Um, I would argue that probably some individuals, just because of heart rate responses in pregnancy are gonna hit what would be considered a vigorous intensity heart rate response, and um, that would be safe. So I wouldn't be concerned and we've kind of debunked this um need for heart rate maxes. Um, but again, this personalized approach is gonna be there. So if in doubt, go with the guideline so that you can get the best health benefit. But also know that even if you aren't hitting those guidelines, anything is better than nothing. And I just love that this poster is wanting to have these conversations in general. Okay. Question three is what are some recommendations for pelvic uh pregnancy belts rather to support running in pregnancy? Brands, where to buy, and I'm 14 weeks today. So this is really interesting, and I might I'm worried about okay. Then the next one's about running too. Um, so looking about pregnancy belts to support running. So let's kind of chat about what we know with pregnancy and running. When it comes to how women can feel with running in pregnancy, pain can be a limiting factor where the weight of baby and the impact of running with the weight of baby and then weight gain in general can make it a little bit tougher on the joints. And so pubic pain, pelvic pain, low back pain, and lower extremity pain can be a reason why towards middle or late pregnancy or at some point in pregnancy, people start thinking about modifying. We just had a paper that came out that looked at um individuals who get over 300 intensity minutes. Um, so it could be 150 minutes of vigorous intensity exercise or 300 minutes of moderate intensity exercise. And if there was any increase in risk for mom or baby from a pregnancy and fetal delivery outcome, the answer was absolutely not. But actually, individuals who are more active tend to, there's a protective effect there. Um, but we did see an increase in diastasis recti postpartum. And I've done a podcast on this where that recommendation is not do not do that level of activity or else you're prone to diastasis recti, but speaks to this need for muscular support or potentially external support to the static tissue, which is what causes diastasis recti. So when thinking about that, the first thing that's going to support your running journey is going to be strength training. When we looked at cross-sectional data in runners and their rates for pelvic floor dysfunction postpartum, what we saw was about a 50% reduction in risk in pelvic floor dysfunction for runners who also did pregnant strength training. So one of the best supports you can do, first of all, is going to be your own muscles and making sure that you are prioritizing strength training if you want to keep running in pregnancy and postpartum. The static piece, and I bring up that diastasis recti paper because this is where that support might come in to try and offload the pelvic floor and the pubic symphysis, the middle joint in the front of your body, um, that bone, and to maybe help with you know belly button pain or discomfort, um, you can use either some sort of pelvic SI joint support or compression garments. Where there's brands, like a lot of people in the US will use a Cirola belt because it's really easy to use and it's relatively inexpensive. Um, I know um the owner of the Fit Splint, Celeste, uh, she's amazing. It has a uh band or strap that goes below the belly and one that goes above. So some people like that a little bit more. Um, I've been playing around with the idea of or the thought of using compression shorts um that kind of applies compression across the belly and across the pelvis as something that could be a support. And so I don't have specific brands, but I do recommend those as options to allow mamas to be to continue running during pregnancy. The other one that I talked about um that I was starting to use before my latest miscarriage was using an internal bladder support. So, especially for my moms who have had multiple vaginal births, um, not that this can happen with other people, but it's definitely more common in that patient population or that mom population, is that they may feel heaviness or more pelvic symptoms when running with subsequent pregnancies because of the change in your anatomy having been pregnant and given birth before. And so one of the things that can cause running-induced pelvic floor dysfunction is urethral hypermobility. And so the movement up and down or more movement of the urethra where P comes out from the bladder and the wall of the vagina is kind of an expected change after a vaginal birth when we look at our kind of pre-post physiology data. Um, but it can make it so that in following pregnancies, you can feel some of these symptoms rather early. And so the one that I used was the poison preza because um you can get it off Amazon. And it basically just looks like a tampon, but when you put it in, it flares out so that it kind of gives a a bit of a support to that wall between the the bladder and the vaginal opening. And then it also can uh tack down a bit or reduce some of that extra movement of the urethra. And for me, this was game changing. Like it just felt like I had a bit of a brace, like a bra for my vagina, and it can be super helpful. And so consider the belt support with pain, consider the Impreza support with pelvic or Uresta or Revive. There's a bunch of different options, or you can go for a full-on pessary, which is uh another type of support for pelvic floor dysfunction. And then the question that is coming into my mind and things that I'm thinking about as a researcher is is there a benefit to preventative bracing or compression? And I don't know the answer to that question, um, but it is an interesting one. And that isn't about, you know, cheating or whatever, but it's more that would be a consideration where you're just respecting the extra stresses that are on your body while pregnant, and then also that empowers and enables you to keep doing the exercise that you enjoy during pregnancy. Okay, so the fourth one um is about running during pregnancy. Hello, lovely ladies. I am six weeks pregnant today with my first ever pregnancy. I'm having an IVF baby, which is so exciting. Um, prior to this IVF cycle, I was running three times a week, uh, following a run up program and probably doing between 25 to 50 kilometers a week plus strength training at the gym two times per week. Amazing. Um, I've kept up my strength training mostly, but have just been for my first run in about a month, and my heart rate was sitting around 150 to 170, average 160, even at a really slow pace. Girl, feel you. Prior to pregnancy, uh, it would have been 150 for that slow of a face. I feel really good now, and I know your heart rate goes up while pregnant. I'm just worried about hurting the baby. Anybody have kept up running, regardless. Thank you, everyone. Okay, um, this is amazing. So, first of all, congratulations. There's a couple of things that I wanted to break down here. Number one is around changes to heart rate with pregnancy. She is in her first trimester as well. So there's a couple of things here. Your resting heart rate will increase when you are pregnant. And the reason for that is that there is a very big change to your blood volume. So as soon as you start to become pregnant, one of the first things that really sparks, of course, baby starting to grow and the placenta starting to develop. But in order to support those changes to your body, your heart and your circulatory system starts to develop more blood cells. And so your blood volume can go up about 30% in pregnancy. And many women notice those changes very, very early. And so, what that can it does is it can create heart rate drift where your resting heart rate increases because your body has to pump more blood around the system. Um, but what I have noticed clinically is that that can also make women look at their heart rates because now people are wearing wearables and they're like, oh my gosh, my heart rate is so high for an activity that is pretty low intensity. And so you can get into this like 150, 160, 170 heart rates and still feel like you're feeling pretty good from a recovery perspective. And then you kind of layer in the fact that we used to have these heart rate targets and people would feel like, oh my gosh, I'm hitting this moderate intensity heart rate zone, and I've barely finished my warmup. And so, one, that experience of, oh my gosh, my heart rate is drifting up a little bit higher, even at the same pace, is super normal because of the way that your heart system is changing in pregnancy. And then the second piece is that you are not hurting your baby at an average heart rate of 160, especially, especially as a seasoned runner, um, that you are going to be able, um, you're gonna be able to sustain that as long as you're feeling good. When I'm educating around exercise and pregnancy, it's always around knowing the clinical buoys. Like if you were running at that pace and you were starting to feel lightheaded or had a headache, or you know, just having a hard time keeping up your uh pay your breathing and you were feeling your breathing was feeling kind of off, or or anything that really would be a warning sign if you were not pregnant, um, those are like the buoys. And then when you're exercising at really high intensities, the only thing that I also counsel, and this is just a clinical recommendation, is that if you're really tired after a big workout, normally when you're pregnant, that post-workout fatigue could just be so much more intense. Um, and so um you just you just want to think about that with respect to the rest of your day. Like, you know, if you're really uh super tired, then um it may make, you know, getting through work or getting through childcare duties or whatever you need to do the rest of your day just a little bit more challenging. And that's when some individuals might self-select or opt to bring down intensity slightly. Um, but it has nothing to do with hurting the baby and has everything to do with just like the logistics and reality of being uh pregnant and a little bit more fatigued and more fatiguable um than when you're in a non-pregnant state. Okay. I'm gonna do one more. These are all amazing. I have a couple more, so I'm gonna think I'm gonna do this as a full uh segment. This is an amazing question. Um, I am wondering, can I close or work on closing my diastasis recti during pregnancy? Oh, so in 2022, after giving birth, I had a four and a half finger gap, which I only managed to reduce to two fingers despite working on my bridges and all other diastasis recti exercises I could find online. Now I'm pregnant again, currently in my first trimester. Can I continue doing these exercises? Although clearly my gap would only get worse. Any issues with doing these exercises during pregnancy itself? Incredible. So this is a great question. So, one, the first thing that I want to comment is going from a four and a half finger gap to a two-finger gap, anything around two fingers for diastasis recti is considered to not hit the clinical threshold for DRA. So diastasis recti is the is classically seen as the distance between your two rectus muscles, the two six-pack muscles on a headlift. And our classic definition of that is that anything two fingers or less is not clinical, clinically relevant diastasis recti. Anything like three-ish is considered mild moderate. And then anything over four is kind of a more severe, significant diastasis recti. There has been a very big change in, especially the clinical spaces. I'm excited to hopefully see this in the research spaces where the finger gap feels very incomplete. Um, diastasis recti was originally post um hypothesized to be an indicator for things like pelvic floor dysfunction and lumbopelvic pain. Um, that has not actually shown to be true in the research. But what diastasis recti has been shown to be is a weakness problem. And if you have an abdominal weakness and a low back weakness, then of course, in some instances, those two things can absolutely feel related. But the biggest variable to both of them and why you can have both of these things simultaneously is a weakness, especially in that core canister. So, for that, the important question around can I work on closing it? Yes and no. So you should and can continue doing core training in pregnancy. In terms of the preventative piece, Nicole Beamish's work, her PhD work when she was at Queen's, showed that those who have persistent challenges with diastasis recti are more likely to have weakness. So they are weaker than those who don't have diastasis recti. And so if you can maintain core strength during pregnancy through doing some of the exercises you have been doing, you can make you start from a better place postpartum. The lengthening of the linea alba is gonna happen in pregnancy, though. Um, and that is because it's a beautiful mechanism that the female body has created in order to make room for baby. And um the recommendations previously a lot had been around your abwall is already under strain, so don't do core. And that thought process has super changed, which is super really exciting. I I'm so glad to see that shift. And so that would be the only thing. The only other thing, and this is just super tiny, but um, bridges don't do anything for diastasis recti because they're not targeting the abdominal wall, they're targeting the posterior chain. Um, though I'm always gonna be uh pro strengthening the whole body. Um, so if we're thinking about specific exercises for diastasis recta, we're obviously looking at uh, or we want so rather we want to be looking at the abwall. All right. I think we're gonna stop there. Next week, we talk about uh stuff with toas to bar, weightlifting modifications, pelvic pain, sciatica, postpartum, c-sections, um, and having a previous uh previous c-section and working out during pregnancy. So many great questions. Um, I love this series. This seems so fun. Um, let me know if you kind of like this kind of hodgepodge of different topics based on Reddit threads. Um, and I'll continue to let you know if we're gonna add other segments to the podcast. All right, have a wonderful week, everyone, and we will see you all next time.