Weight-bearing exercise, like running, is a great way to stay fit during pregnancy. However, as pregnancy progresses, the anatomical changes in your body can trigger painful conditions that may sideline your running. A common cause of pain in prenatal runners are strained round ligaments. These are the two thick bands of ligamentous tissue that span from each side of the uterus to the groin. They provide support for the uterus. However, as the fetus grows, the round ligaments can become strained until they have time to adjust.
During periods of round ligament stretching and adjustment, the impact of running can create additional strain, causing discomfort or pain with movement. The pain may start with a sharp pain on one or both sides of your abdomen with movements such as rolling over in bed or twisting to the side, and progress to causing pain during runs. The good news is you can help ease round ligament pain with the following tips.
Invest in a good quality belly support band.
A support band will do exactly that: support those ligaments and alleviate some of the load. The band should be made of breathable and flexible fabric that’s machine washable. It will ideally also feature a Velcro closure that spans the entire width of the band for a secure fit. It should be wide enough to support the lower belly, but not so wide that it cuts into your tummy or is uncomfortable with movement.
Band placement is crucial. To fit the band for the best support, wrap it around your back. Pull the two ends in front and below your belly button. Take a breath in and tighten your tummy as you fasten the Velcro snuggly in front. The band should feel supportive, but not so tight that you can’t move or breathe comfortably. Make sure that the band is below your belly button so that it provides sling-like support for your tummy. You may need to adjust the band during exercise to keep it feeling snug and correctly placed under your tummy.
Switch it up.
Maura Shirey, RN, CPFE, and owner of Bodies for Birth says that some pregnant women find that a belly support band can help them continue running during pregnancy. But, for others, even with a belly support, their round ligament pain is persistent. If that’s the case for you, she suggests determining when your round ligament pain kicks in during a run, and to keep your distance below that duration. But, she says, if your round ligaments hurt from the start of running you may need to switch to non-weight bearing exercises, such as swimming or stationary cycling for a while. Swimming can be a great way to ease up the effect that gravity has on your round ligaments, and time in the water can allow them to rest.
Try modifying your usual routine by mixing it up with a combination of fast walking and running, or splitting between running and non-weight-bearing exercise to see if that helps reduce pain. Most pregnant women find that their round ligament pain ebbs and flows throughout pregnancy. Using these techniques during the week or two after you notice the pain can help keep you moving as your round ligaments adjust.
Strengthen your core.
Your abdominal muscles play a crucial role in providing belly support during pregnancy. But, prenatal anatomical changes can reduce how well those muscles support the abdomen, resulting in more strain on the round ligaments. The large rectus abdominis muscle that spans vertically on either side of your abdomen becomes separated (termed a “diastasis recti”) as the connective tissue that joins the two sides of the muscles thins and widens as the fetus grows. As the distance between the two halves of the recti muscles increases, there’s a loss of support.
Cue the transverse muscle group—it’s located below your belly button and spans across your tummy like a sling. Maintaining strong transverse muscles will help provide belly support throughout your pregnancy, reducing strain on your round ligaments. Check out these transverse and recti muscle isometric exercises that will help strengthen and support your abdominal wall.
Sitting Diaphragmatic Breathing
Start in a comfortable seated position with your back straight. Place your hands on your tummy and take a deep breath in, breathing from your belly. (You should feel it expand outward with your breath).
As you slowly exhale, draw your entire abdomen inward (think of pulling your belly button towards your back). Practice this movement several times and then do five to ten repetitions several times each day.
Breath and Hold
Take a deep breath in. Hold your abdominal muscles tight as you continue to breathe for a count of five. As you become stronger, you can increase the hold duration to ten or more seconds for each repetition. Repeat five to ten times.
Take a deep breath in. As you slowly exhale to the count of ten, incrementally contract your abs tighter as you count. Once you reach ten, slowly inhale, relaxing your abs again in increments as you reach ten. Repeat three to five times.
Ab Contractions with Kegel
For extra credit add a Kegel exercise into the mix to increase your abdominal strength and support. With each exercise, contract your pelvic floor muscles in the same sequence as you contract your ab muscles. This is a more advanced exercise, so it may take time for you to be able to coordinate both a Kegel and abdominal contraction. Start with trying a few Kegels with your belly contraction and continue to add as you become stronger and more coordinated. Repeat three to five times.
Maura encourages any pregnant women who are experiencing round ligament pain to consult with a physical therapist (PT) that specializes in women’s health. A physical therapist can provide exercises and techniques that can target tight round ligaments and work with you on body mechanics that can help prevent further pain.
As with any issues during pregnancy, if pain persists, or is accompanied by cramping that continues even with rest, consult with your health care provider.
Catherine Cram is an exercise physiologist and a leading expert in the field of maternal fitness. Her consulting company, “Prenatal and Postpartum Fitness” specializes in providing the most current maternal exercise information and continuing education courses to health and fitness professionals.