There are no official guidelines for flexibility training during pregnancy, and many resources are conservative. However, we know that regular physical activity is beneficial during pregnancy. While specific advice from your OBGYN will always trump generic guidelines, the Australian Department of Health promotes the WHO (World Health Organisation) recommendations for exercise during pregnancy being; physical activity most days totalling 2.5-5 hours (moderate-intensity exercise) or 1.25-2.5 hours (vigorous-intensity exercise) a week (or a combination), with strength training at least 2x a week.
Read more here:
https://www.health.gov.au/health-topics/physical-activity-and-exercise/pregnancy
Cardiovascular and strength-based training will be the most beneficial forms of exercise during pregnancy, but what if you *enjoy* flexibility training and want to continue this training during your pregnancy? Is flexibility training during pregnancy dangerous?
Flexibility training, in general, is fairly low-risk (read more about that here). There is no risk of contact or collision (such as in team sports), and it tends to be low impact, low load, and low risk of falling. However, like any form of exercise, there is risk, which increases during pregnancy.
Musculoskeletal pain and injury risk
This is probably the biggest risk training flexibility during pregnancy. This risk is elevated for many reasons:
- Increased fatigue, poor sleep, changes in nutrition, compromised training recovery.
- Increased weight, changes in posture and centre of mass, reduced proprioception and balance, and relative changes in strength.
- Release of the hormone relaxin during the first trimester and for eight weeks post-birth. This hormone is responsible for preparing the birth canal to stretch and deform to allow the birth of the babies head. It causes all of the joints and ligaments in the body to become more elastic, meaning less stable and at greater risk of injury.
While a sprain or strain may seem relatively minor, your ability to manage your symptoms will be significantly compromised when pregnant, and you may not fully recover until after birth.
To reduce the risk:
- Reduce the load and intensity of your training. Increase your recovery between sessions.
- Support your joints with props, particularly in longer holds.
- Move-in and out of positions with control.
- Avoid stretches that are precarious and require a lot of strength, control and balance to execute.
Neural compromise and sensitivity
Its fairly common for people to experience neural compromise during pregnancy due to increased swelling, fluid retention and reduced blood supply to peripheral nerves. Carpal tunnel syndrome is the most common, and presents with pain, numbness, and weakness of the thumb and first two fingers, usually worse at night. You may notice increased nerve symptoms in other areas when stretching during pregnancy, particularly if you have previously injured a peripheral nerve (e.g. had an episode of sciatica). Nerve injuries are particularly unpleasant and often don’t resolve entirely until after birth.
To reduce the risk:
- Avoid neural tensioning stretches (eg wushu bounces).
- Reduce the length of static stretches, under a minute, is a good time. This limits the time the blood supply to a nerve is potentially reduced.
- Come out of any stretch that causes progressive tingling or numbness.
- Move around in between exercises.
Cardiovascular compromise
The cardiovascular system is less efficient during pregnancy due to;
- Comparatively less blood volume to body mass.
- Reduced lung capacity due to changes in posture (effecting rib cage movement) and abdominal organs encroaching into the rib cavity.
- Changes in blood pressure.
- Less effective return of blood to the heart
- Increase cardiovascular requirements (growth and development of womb and foetus)
Cardiovascular compromise usually presents with fatigue, shortness of breath on exertion, and swelling of peripheries. If the system is sufficiently compromised, you will feel light-headed, dizzy and may lose consciousness.
People are generally advised to sleep on their backs after the first trimester due to the risk of the growing uterus applying direct pressure onto the vena cave, the main blood vessel that returns blood to the heart. However, for most people, it’s fine to lie on your back for short periods to complete exercises. Being awake, moving, and only being in the position for a short time reduces any risk of compromise.
To reduce the risk:
- Only spend short periods on your back after your first trimester and move out of this position if you feel short of breath, light-headed or dizzy. Propping your back with a wedge of 20-30 deg will elevate this risk.
- Ensure that you are well hydrated.
- Take breaks to ensure you maintain your breathing at a comfortable level (you should be able to speak a full sentence).
- Rest if you feel dizzy and light-headed.
Pelvic floor overload
There is a real risk of overloading the pelvic floor when pregnant, predominantly due to extra weight applying pressure to the top of the pelvic floor and compromised core function. This is why people are encouraged to participate in pelvic floor and general bodyweight strengthening rather than weighted strength. Overloading pelvic floor muscles during pregnancy may result in leaking, pain and difficulties regaining continence post-birth.
To reduce the risk:
- Reduce the load of your strength exercises.
- Seek the guidance of a pelvic floor physiotherapist, especially if you have concerns about continence and other pelvic floor functions.
Pregnancy and Flexibility Training Summary:
-Follow the advice of your OBGYN.
-Listen to your body. Adapt your training to how you feel.
- Reduce the load and intensity of your training. Increase your recovery between sessions.
- Support your joints with props, particularly in longer holds.
- Avoid stretches that are precarious and require a lot of strength, control and balance to execute.
-Avoid neural tensioning stretches (eg wushu bounces).
- Reduce the length of static stretches; under a minute is a good time.
- Come out of any stretch that causes progressive tingling or numbness.
- Only spend short periods on your back after your first trimester and move out of this position if you feel short of breath, light-headed or dizzy.
- Ensure that you are well hydrated.
- Take breaks to ensure you maintain your breathing at a comfortable level (you should be able to speak a complete sentence).
- Rest if you feel dizzy and light-headed.
- Seek the guidance of a pelvic floor physiotherapist, especially if you have concerns about continence and other pelvic floor functions.
What is ok:
- Strengthening through range.
- Bodyweight strengthening.
- Shorthold supported stretching.
- Nerve flossing.
- Things that feel good.
