Measuring Exertion in Pregnancy! (Without Heart Rate)

While your amazing body grows your baby, you cannot use heart rate for measuring exertion in pregnancy. Read on to find out why, and to learn other options!
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When Measuring Exertion in Pregnancy, Heart Rate is NOT useful.

If you’re a Pelvic Floored Pro, you may have seen my new post on Heart Rate Changes in Pregnancy. That gem went over WHY our heart rate is faster earlier in pregnancy, and slower later in pregnancy. If you’re new, WELCOME!! Check out that post first (it’s a quick read), then come back!

Due to those changes, heart rate is no longer a reliable indicator of ‘how hard’ you are working out when pregnant, and we can’t use it. Luckily there is another option for measuring exertion when working out while pregnant. It’s called the Relative Perceived Exertion, or Rating of Perceived Exertion, but the cool kids call it “the RPE scale.”

Rating of Perceived Exertion

The Rating of Perceived Exertion Scale (RPE) is a way to monitor ‘how hard’ you are working out. Here is a cool summary by the Cleveland Clinic. The original scale was 0-20, but science people found out that 0-10 was easier for ‘real people’ to make sense of.

In essence, it is a scale of 0-10, and my Pelvic Floored Verbiage follows:

0. No Exertion at all. You’re dead, or resting fully.
1. Very Light
2. Light. We can carry on a normal conversation here.
3. Moderate. Think of ‘3 sets of 15-20’ here, as long as you have a nice muscle burn at the end of them. If you don’t have a nice burn at the end, those 3 sets of 15-20 might actually be light.
4. Somewhat Hard. Now we’re breathing heavy, and starting to sweat. Talking is harder.
5. Hard. We can’t talk while we are working out.
7. Very Hard. This is where most of us tend to self-limit our workouts. Not only can we not talk. We can’t really think about anything else than the task at hand.
10. Very, Very, Hard. You are running for your life, and WILL start to throw up if you stay here for much longer.

But isn’t this just ‘my opinion’ of how hard I’m working out?

Yes, and that’s the beauty of it. Many Studies have shown that RPE is a valid and reliable measure for assessing workout intensity. Non-geeks, skip these next few blocks and get to how you adjust your workouts. For my fellow Geeks, here’s a fun read for your spare time:

Lea JWD, O’Driscoll JM, Coleman DA, Wiles JD. Validity and reliability of RPE as a measure of intensity during isometric wall squat exercise. J Clin Transl Res. 2021 Mar 24;7(2):248-256. PMID: 34104828; PMCID: PMC8177844.

The long and short of it is that, yes, it make take you 1-2 practices to guage your RPE, but after that, your RPE does indeed correspond to heart rates of those exertion levels when we’re not pregnant.

So, when we’re pregnant, and can’t use Heart Rate as a marker, we can use the RPE!

Early in Pregnancy, Heart Rates will be elevated.

Here, we might perceive even easy tasks (like walking around the house) as ‘moderately hard’ to ‘hard.’

We can help our heart here in early pregnancy by working out in water, if we have that available to us. The pressure of the water compensates for the looseness in the blood vessels, and helps our heart react more efficiently.

Need ideas? Check out these options from my Instagram Account, @therealpelvicfloored. This water workout includes whole body, another option is mostly legs, this one is mostly arms, and here’s one that let’s you ‘play’ with older kids WHILE you get a workout in!!

Later in Pregnancy, Heart Rates will be lower.

And here is where the RPE scale REALLY matters. Because if you were chained to your heart rate monitor to ‘know’ if you are working hard enough…no matter how hard you work, your heart rate might not increase to those target levels. And if you push, push, PUSH to try to get there, you might injury yourself.

But, by using RPE, you can easily decide when you are working out moderately hard to hard!!

There is no “percentage” that the heart rate will reduce vs pre-pregnancy. In fact, your actual heart rate at ‘moderately hard to hard’ exertions might vary significantly based on temperature, hydration levels.

Hopefully this helps you find different ways of measuring exertion in pregnancy. Now here’s some modifications for later in pregnancy…

Exercise Modifications for Later in Pregnancy

As the heart rate isn’t so reliable here, I do LOVE strength training (all the time), but especially in mid to late pregnancy. You’ll be lugging around beautiful baby in a car seat before too long, so let’s get those arms and legs ready for the challenge! Check back soon for Pelvic Floored Pregnancy Strength Training Courses!!

And, of course, as pregnancy continues, we do want to ensure that our pelvic floor muscles remain RELAXED, so please do make time for some pelvic floor down training after all strength training sessions.

Some of my favorite pelvic floor awareness exercises are here, and down training here (but if you’re preggers, you’ll have to do the down training from a sitting position :).

Thanks for Reading!

And, as always, check out my Pelvic Floored Signature Lecture Series for in-depth training of how your current pelvic floor muscle status could be contributing to your pain, incontinence, constipation, pelvic organ pressure, or sexual dysfunction complaints. The online program, streamable from the privacy of your own home, includes 12 mini lectures, and 12 progressive exercise programs that I developed based upon current research, as well as my 16 years of experience in pelvic health.

A full pelvic floor physical therapy program, for less than the price of one standard in person PT evaluation!

What other motivation do you need? Did I mention that for every 4 courses I sell, I will donate one to a person in need, through my People Before Profits Program. I am so proud of this. By buying my program you are not only helping yourself (or your loved one), but also someone in need.

If buying my program isn’t in the cards right now, no worries! Please join my mailing list to be kept up to date on other free tips for your best pelvic health! My AMAZING blog posts are filled with practical tips for improving your pelvic (and overall) health prenatally, postpartum and beyond! Mailing list subscribers also get exclusive discounts to Pelvic Floored products, and access to subscriber only events!  Don’t miss out!  Sign up Today

Thanks for reading!

xoxo, Dr. Kelly

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