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Trying to figure out how to exercise safely and effectively can be a challenge especially when you are pregnant. As a prenatal/postpartum certified personal trainer one of my favorite points of prenatal education to teach is recognizing and preventing ‘abdominal coning’.

Understanding how to avoid abdominal coning can be a powerful tool in your pregnancy exercise toolbox. Once you know how to recognize it, you will be able to recognize your body’s messages about the stability of your core. Abdominal coning alerts you when you are putting too much pressure on parts of your body that are already strained just by carrying a baby. The abdominal or core strength of each pregnant person varies widely before getting pregnant and so too does the appearance and frequency of abdominal coning. It is a highly individualized way to monitor your unique exercise journey during pregnancy.

First things first: what is abdominal coning?

Abdominal coning occurs in the middle of the abdomen in line with the belly button. It is characterized by a bulge coming outward from the center of your abdomen causing a pointed or cone shape. It can occur above or below the belly button, or the whole length of the abdomen.

Abdominal coning is caused by an increase of intrabdominal pressure in conjunction with the necessary separation of the abdominal muscles to carry an ever-growing baby. During pregnancy, the rectus abdominis (often referred to as the “six pack muscles”) are stretched apart by the growing uterus. The linea alba is the connective tissue that binds the left and right sides of the rectus abdominis together and it has a crucial role in keeping the integrity of the abdominal wall. The linea alba is also pulled to capacity as the pregnancy progresses.

Why should abdominal coning be avoided?

The main reason abdominal coning should be avoided is that it can worsen the degree of diastasis recti that you experience and carry with you into the postpartum period. Diastasis recti, put simply, is the diagnosis of having separated abdominal muscles and it occurs in multiple degrees or amounts of separation. Diastasis recti is associated with many health issues such as urinary incontinence; back, hip or pelvic pain; painful sexual intercourse and poor posture.

It is common for postpartum women to experience some degree of diastasis recti that can be healed with a gentle return to exercise and specific movements meant to support the healing of the core. For those with a greater degree of diastasis recti, those specific movements become even more important, and a specialized physical therapist can do wonders in helping the recovery process.

Regarding coning, the persistent practice of performing exercises that cause greater strain on the rectus abdominis and linea alba during pregnancy will cause separation beyond what is necessary to facilitate the growth of the baby. This increases the abdominal separation that will need to be healed in the postpartum period.

How does coning feel? And how do I recognize it?

In most cases the feeling of abdominal coning is subtle and not often painful. With some extreme exercises such as a sit up, pressure or strain may be felt. More often though it is not obvious when additional strain to the abdomen is occurring based on sensation alone.

Visually monitoring your abdomen during each exercise for coning becomes paramount to keep the integrity of the core as much as possible during pregnancy. Using a mirror can be beneficial to monitor, especially if you are turned to the side. Ultimately though, it is easiest to look down and observe if your stomach forms a point or a dome in the center while you perform the exercise.

So, I identified abdominal coning while performing an exercise, what do I do now?

Seeing coning does not mean that exercise needs to halt, or that all similar exercises need to be avoided, though it does call for modifications for that movement through changes in weight, positioning or other factors. Most obviously, coning will occur with exercise such as performing a sit up (either intentionally in the gym or in everyday life such as getting out of bed). When an exercise directly stretches the linea alba and rectus abdominis it is best to stop that specific exercise or find another way to perform a movement, such as getting out of bed on your side.

Other types of exercise that can cause coning may not be so obvious. Exercises that increase intrabdominal pressure significantly can also cause coning. Take a pull-up for example. You may be able to do assisted or unassisted pullups until a certain point in pregnancy and then notice coning as you pull yourself up. Adding more weight assistance until the coning disappears may work for a time, but eventually you may need to monitor and switch the exercise with another that targets the same muscles with less strain, such as a lat pull down on a machine, with a band or on the TRX straps.

Push-ups are another example. Once typical push-ups cause coning, dropping to your knees would be the next step. Likely at some point even that will cause coning and the solution to decrease the pressure is to increase the angle of your push-up. Doing a push-up with your hands on a bench, on the TRX straps or standing with your hands on a wall are some good options. Transitioning into an upright chest press machine which similarly works the chest muscles is another option.

Other examples are exercises that may need monitoring include exercises where you are leaning forward such as in deadlifts or bent over rows; exercises where weight is pressed overhead; as well as exercises that require you to be on all fours or in a plank position.

Encouragement for exercise during pregnancy

There is so much good that comes from maintaining an exercise routine during pregnancy! Learning to watch for coning could potentially feel daunting or cause you to want to steer away from strength exercise. To the contrary, however, knowing how to recognize coning in yourself is incredibly freeing as you are able to visually see when an exercise may be pushing your body further than its ready for.

You will be surprised to see how many exercises you will be able to perform with confidence and no hint of coning. As for any exercises that don’t fall into that category, shelf them for now. Know that stepping away or modifying certain exercises while pregnant will ultimately get you back to performing them sooner in the postpartum period. Using the individualized tool of monitoring for abdominal coning is choosing to take an active role in protecting your core during all the transitions of pregnancy.