4 Pearls Of Wisdom For The Newly Pregnant Athlete
So what, really are the do's and don'ts for those first 12 weeks in pregnancy and is there much we should be aware of if we're the kind of person that loves to redline with frequency?
Bet you didn't see this one coming!
Aren't we now talking about doing more than ever as a pregnant athlete?
Yup. Which is fab, right? But we still have a few areas which we need to change up - just a few.
It's time to debunk the fact from the fiction about what REALLY are the high intensity functional exercises you shouldn't do in pregnancy, and WHY.
This is no longer a race. Don't be tempted to ever choose intensity over integrity of movement - you're now working out with different principles in mind. Your goals for exercise should now be about feeling good, maintaining your fitness levels and muscle mass, maintaining good posture, creating or maintaining superhero pelvic floor control and keeping gestational diabetes at bay.
Pregnant women have a higher basal resting heart rate, so now you're pregnant it might spike to a higher heart rate quicker than you're used to.
Athletic women can also be quite competitive, with themselves if not with others. Discomfort has also become quite the norm in modern exercise and oftentimes pushing through discomfort is seen as an achievement.
What's more, clinical studies have suggested that athletes are notoriously poor at subjectively rating their own exertion because they're used to feeling uncomfortable, so we recommend objective monitoring to tell you how how hard you're pushing.
As a result, I suggest wearing a heart rate monitor. Garmin, MyZone, Polar, and now even FitBit and Apple Watch have all been clinically validated as accurate HR monitors.
Pair this advice with using the Talk Test - being able to comfortably hold a conversation during workouts - which is sound advice through your whole pregnancy.
Although it's been proven that it's safe to spend short periods at higher intensities I wouldn't recommend hanging maxed out for a whole workout. Your body will always make sure it protects your baby's homeostatic environment before it protects you (blood supply and nourishment) so a massively intense workout in pregnancy might leave you feeling rubbish and depleted for the rest of the day. Not a great idea in our books.
DOMs (delayed onset muscle soreness) - and don't mean a bit of an ache post-workout, we mean hobbling around after a massive leg day, or being unable to go down the stairs comfortably - means you've been lifting or exercising to the point of breaking and building new fibres. These symptoms are largely present after a very high volume of reps or after some very heavy lifting. Although we're often very proud of this feeling when we're not pregnant, I don't recommend it in pregnancy - it encourages an inflammatory response which can make you feel crappy, can alter our sleep patterns and also makes the next day training a bit of a write-off.
All not great pregnancy training behaviour in our books.
You're something like 3 x more likely to have a fall when you're pregnant. That just goes to show how 'off' your spatial awareness and balance is when you have a bun in the oven.
Careful to all those 'butt-winkers' at the bottom of a squat - keep it high enough that you retain pelvic control. Turn it into a box-squat if you can't be sure. Also, are you a bum-clencher? Diane Lee - the women's pelvic health guru - has a lot to say about these and it's very common in athletes. When you're standing still, or rising from a squat or a deadlift do you find you overly squeeze your butt? Many athletic folk have this tendency and it leads to hyperextension at the front of the hip which puts extra strain on the low back. Get someone to check for you. This will only get worse in pregnancy so nip that in the bud now.
Common pregnancy injury areas to be mindful of if your posture isn't spot-on are back and neck injuries, exacerbation of pelvic girdle issues and compromise to that sacred pelvic floor.
Common movements where it all goes wrong: deadlift, back squat (perhaps sub it out for a front squat in the third trimester or do box-squats), kipping - a technique reserved for racing (which can force you into a backbend and can stretch the abdominal wall unnecessarily) and olympic lifts (your centre of gravity and your bar path will change - is it worth having to completely relearn how to lift again postpartum?)
Eve, Fi and Laura demonstrate great posture with their lifts
It’s time to change up the dialogue here. It actually stands in your favour postpartum if you don’t let your abs go to waste for 9 months. It is becoming more and more accepted advice now that forward flexion movements from the hip, like: crunches, sit ups, leg lifts can be continued to some extent. These may regress as your bump grows, and there might become a time where you don’t want to or it’s physically too difficult or uncomfortable, but the message is don’t be afraid of these movements anymore.
So, if you’re loving gentle crunches into your third trimester, that’s great. Equally if you prefer the more pilates-style core movements like pallof presses, side planks and bird-dogs, that’s great too. We don’t have any research to suggest either have any impact on the size of your postpartum separation later on.
Soft Coning VS Hard Coning
It’s been feared for decades but what we know from the latest research is coning isn’t as bad as we thought. In fact we have no research to suggest that coning in pregnancy impacts the diastasis we’ll have postpartum. And we have new research to suggest that athletes who do include abdominal exercises in their pregnancy training, don’t end up with worse diastasis postpartum (Thodorsen et al, 2024).
In fact some brains think a bit of soft coning is a form of ‘tension’ which can keep the linea alba strong. Either way, we still think ‘hard’ coning, which is when we touch the tent shape and it’s very solid isn’t a great thing to be doing regularly. Hard coning can be a sign that that area is under a lot of strain. Use your judgement when you think it’s time to cut out a certain movement if you think you might be hard coning or overcooking it a bit.
And it should go without saying that if it's uncomfortable or you can't comfortably execute the abdominal exercise in question that's the time to switch it for something else.
Breathe out for all exertion or lifts in pregnancy? No to Valsalva? Yep we taught this not long ago too. But now we're of the thinking that actually everyone's pelvic floor is different - some of us can Valsalva/breath hold through pregnancy, others might need to stop.
Valsalva is a weightlifting technique where you breath-hold and stack your core before completing a heavy lift. It's a very effective technique in improving one's ability to lift heavy load and protect your spine using intra-abdominal pressure. This is an area under big scrutiny right now by researchers, who are now starting to suggest that Valsalva in pregnancy weightlifting is not necessarily a threat to your pelvic floor (Prevett, Forner, Davenport, et al 2023).
Researchers found that individuals who did or didn't use the valsalva manourver in their pregnancy training had similar pelvic floor outcomes postpartum - there was no significant impact from those who used breath-holding techniques. Prevett (2024) has also found that there is no significant impact to a pregnant lifter's cardiovascular system including transient changes to blood pressure.
This is fab news for the lifters amongst us and an incredibly development in the field of research in this area. At Hatch we too agree, that for lifters who are experienced and have the ability to BRACE with their pelvic floor at the same time as carrying out a lift, Valsalva or not, should continue with confidence.
There are a few things to consider alongside this.
Don't forget technique.
This isn't license to go for your next 1RM. Lifting loads that require breath holding might mean you're going for max-out or submaximal loads - please refer to point 3 of this blog. As a pregnant woman your joints can be naturally more injury-prone. Even if it might be ok for your pelvic floor, if you're lifting something you might potentially miss, or might have to lift with a poor technique to achieve it, it's not worth it. We want you to enjoy training injury-free and tweak-free for your entire pregnancy. Which might mean lifting more achievable loads.
I think it also needs to be mentioned that if you're not an experienced lifter, you might not really know what it means to brace with your pelvic floor when lifting something heavy. It could be your pelvic floor doesn't switch on whenever you need it. This could certainly be the case with anyone experiencing pelvic floor dysfunction, i.e. leaking, heaviness or pain down there.
In these cases, I recommend breathing out through larger efforts instead of breath-holding, and trying for a nice pelvic floor squeeze to engage those muscles and focus on getting them more 'automatic' for your pregnancy lifting journey. It would be also a recommendation to visit a women's health physio who could coach you towards lifting with an improved technique so you can enjoy this form of training throughout your pregnancy without removing it entirely.
The important thing to take from this is to choose what's right for you.
A final and very important note on Valsalva, breath holding and bracing with your pelvic floor.
Ensure, if you've been training in this way, it's just as important to learn to Valsalva with a release of your pelvic floor when you're not training. This is more of a 'bearing down' feeling - like doing a poo. And THIS is a technique you're going to need when you give birth, so as part of your training, ensure you're capable of achieving both!
Do you have a history of leaking on cough, sneeze, run, jump, laugh or lift? Do you have irregular bowel habits? Do you have a long history of very heavy or painful periods (i.e. endometriosis)? Are you currently working through any bodily aches/pains or injuries?
If you answer yes to any of the above it might be worth checking in with your women's health physiotherapist before continuing to run in pregnancy. They will be able to address some of your concerns and might be able to help you address any pelvic floor dysfunction.
If you're symptom-free, we also recommend (as a gold standard) to get a Pregnancy MOT with a physio to be sure your pelvic floor is in top shape to run in pregnancy. Ask them to take a measurement called a GH+PB. This is a measurement of your pelvic floor which should, ideally, be under 7cm if you want to run without increasing any risk of pelvic organ prolapse.
This measurement typically elongates/lengthens throughout your pregnancy, to allow for vaginal delivery, so just be mindful that your pelvic floor in later pregnancy is going to be more mobile and potentially a bit more vulnerable in later pregnancy. More on this later.
Understandably, women's health physio assessments aren't easily accessed by all. So as a rule of thumb - if you have experienced, or do experience any leaking, dragging, bulging, or heaviness in your bladder or vaginal areas when you run this is your cue to take it to low impact for now.
Ah pelvic girdle pain (PGP) can be the pits. PGP can happen for a number of reasons and it's often very multi-faceted. We know it's not as simple as 'an unstable pelvis due to Relaxin hormone. This is more of a old-wives-tale. We do know there's likely to be a very strong inflammatory component to it, and contributing factors such as prior history of trauma/injury and concurrent periods of elevated stress or anxiety can also pay a huge part. What that means is working with your body to reduce triggering movements, to keep mobile, and not fear 'instability' but to work with your body to help it through.
Sometimes flare-ups can take 24hrs to show themselves so try to identify what exercises you did the day before that may have exacerbated things.
Good news is PGP can be massively helped with a women's health physio and nearly always resolves after delivery, so get yourself a silly calendar and start striking off those days.
Avoiding this is now very outdated.
The basic no-go guidelines are there for sleeping or spending a prolonged period of time there, which can potentially compromise the blood flow in the major arteries and veins that run through the abdominal cavity.
If it's for exercise alone and you don't have any symptoms of dizziness, nausea, shortness of breath or pain then you're fine to keep on going (e.g bridging/hip thrusts which can be fab for pelvic floor, low back and core).
1. Exercises for time - instead choose movement quality and having energy for your day
2. Severe DOMS inducing volume
3. Any exercise which compromises your posture or form
4. Abdominal exercises that feel uncomfortable or cause repetitive HARD coning - but remember to keep training your core muscles through pregnancy
5. A singular lifting/breath rule for pregnancy - choose YOUR option
6. High Impact exercises if you have pelvic floor dysfunction
7. Split stance/single leg work if you have pelvic girdle pain
8. Avoiding exercises on your back (they're ok)!
9. Training through pain, dizziness, nausea or feelings of malaise
Hope it's been helpful :)
P.S. Are you in our Facebook Group and do you know about our Pregnancy Training Programmes?
Kat, Hatch Founder & Women's Health Physio
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