Flexibility Training During Pregnancy
Pregnancy Exercise: Flexibility Training during Pregnancy
Flexibility training enables you to adapt more effectively, efficiently, and safely to the many physical changes your spinal alignment and posture, muscle groups, joints, tendons, and ligaments experience during your pregnancy and postpartum periods. (For more information please consult the Physiological Adaptations of Pregnancy page of this web site.) To appreciate the important role of flexibility training during pregnancy, it's helpful to have some knowledge of how muscles function.
How Muscles Function
Muscles function like pulley systems. As one side of the pulley system shortens (a concentric contraction), the opposite muscle group lengthens (an ecentric contraction). For instance, when the front of your thigh, your quadriceps tightens, the back of your thigh, the hamstrings, stretches.
Negative Effects of Inflexibility During Pregnancy
Inflexibility reduces joint range of motion, the functional capacity of opposing muscles groups, and can lead to muscle tears and erosion of joint cartilage. Perhaps more importantly, chronically over tight muscle-groups pull the body out of ideal (neutral) alignment.
Alignment changes of the spine during pregnancy cause specific muscle groups to become too tight. These muscles should be stretched regularly to prevent many common discomforts of pregnancy such as back pain.
Muscle Groups that Need Consistent Stretching during Pregnancy
- Hip flexors; iliopsoas
- Front of the thigh or quadriceps, (particularly the long muscle of the thigh which crosses the hip socket, the rectus femoris)
- Lower back
- Front of the chest; pectorals
- Internal rotators of the shoulders
- Back of the neck and shoulder elevators, (particularly the upper fibers of the trapezius and the rhomboids
Pregnancy Exercise: Benefits that Stretching Provides during Pregnancy
- Counterbalances the biomechanical stresses that pregnancy places on the body.
- Relieves common pregnancy complaints such as back and shoulder pain.
- Reduces excess muscle tension.
- Helps you maintain adequate length in key muscle groups.
- Helps reduce psychological stress.
Inflexibility and Functional Muscular Imbalances
If muscles remain inflexible over long periods of time, a functional muscular imbalance can occur; a syndrome where one side of the pulley system consistently works too hard and becomes too tight or hypertonic, opposing muscle group weakens and atrophies, and becomes hypertonic. Muscular imbalances further pull the body out of ideal alignment. The pattern tends to be self-reinforcing and over time becomes habituated in the nervous system. Alignment problems and associated muscular imbalances are a significant cause of both acute and cumulative stress injuries, muscle spasms and pain, and most back problems.
After pregnancy, the combined effects of altered alignment, a weakened abdominal wall, and ligament laxity leave the body particularly prone to developing to these types of problems.
Typical Example of Postpartum Muscular Imbalance Leading to Pain or Injury
- After pregnancy, heavier breasts and tight chest muscles increase the curve of the upper spine; in fitness lingo what we call a kyphotic posture. In response, the chest caves in, the shoulders internally rotate, and the head slides forward.
- Because the opposing muscles of the upper back (the erector spinae, the mid and lower fibers of the trapezius, and the external rotators of the shoulders) don't have to do their job of upper body support in this posture, they weaken and atrophy.
- Misalignment and muscular imbalance of the shoulder girdle create functional weakness and poor neuromuscular patterning during lifting, carrying. and other activities of daily life. As a result, many new moms experience chronic back, shoulder or neck pain.
- If left untreated, these problems may cause other more serious acute or repetitive stress injuries such as muscle tears, bursitis, arthritis, and disc problems.
Fortunately, these types of problems are not intractable. The key is to stretch overly tight muscles groups at the beginning of your workout. This immediately improves alignment, which in turn improves basic muscle functioning, allows for more effective strength development in opposing muscle groups, and reduces wear and tear on cartilage, tendons, and ligaments. Simple, yet profoundly effective.
Pregnancy Exercise: Stretching Benefits Both the Body and the Mind
In addition to improving your physical well being, stretching can boost your emotional health. Clinical studies of meditation, biofeedback, yoga, and similar relaxation practices have long since established the connection between emotional states and physical health. The increasing popularity of prenatal yoga classes indicates that women are reaping the benefits of flexibility and stress reduction through exercise.
Some of the Mind-Body Benefits of Stretching
- The mind-body connection is a two-way street. Just as stretching helps to align and center the spine, so it also helps you to become more mentally centered and calm.
- Increases your ability to cope effectively with emotional stress.
- Helps you psychologically prepare for childbirth and the transition of adding a new baby into the family.
- Establishes the habit of setting aside time for self-renewal.
Precautions About Ligaments and Stretching During Pregnancy
Ligaments connect bone to bone and function as stabilizers so that joints move only in their proper plane(s) of action. Pregnancy hormones soften and lengthen all of the body's connective tissues including ligaments, enabling the pelvic outlet to ultimately widen when the baby's head moves into the birth canal.
During the last trimester of pregnancy, and for about six months after childbirth, your body's ligaments provide less structural support and are particularly vulnerable to injury making it especially important to practice flexibility exercises with care and sensitivity.
How to Protect Your Ligaments During Stretching
- Always stretch muscles, never ligaments or joints, especially during and after pregnancy.
- If you feel any joint pain or discomfort, modify your position until the discomfort disappears.
- If discomfort continues, or if you have pain or limited range of motion in a joint the next day, drop the stretch from your routine.
- Avoid stretching the sacroiliac joint—especially in positions where the hip is flexed and the thigh is externally rotated—or perform with caution, if at all.
- NEVER try to stretch the joint to try to relieve pain.
If you experience recurring pain on either side of your lower back you should suspect pelvic instability. When in doubt, limit your stretches to those that only move the spine in one plane of action. For instance, perform forward spine flexion without rotation, or side stretches without frontal flexion, or spine rotation without spine flexion. Please consult Preventing Common Pregnancy and Postpartum Discomforts on this Web site for more information about pelvic instability.
Pregnancy Exercise: How to Safely Stretch Muscles
Always stretch the belly of the muscle, never the muscle insertion point (tendon) or joint (ligament). For example, when stretching your calf muscle, you should feel the stretch along the length of the back of your lower leg, not behind your knee, or at the ankle.
Tips for Safe Stretching for Pre-and-Post Natal Women
- Perform all stretches in a slow and controlled manner—no bouncing.
- Only go as far as your body comfortably allows.
- For maximum effectiveness, contract the opposing muscle group as you stretch to work both sides of the pulley system simultaneously. For instance, when stretching the hamstrings, tighten your thigh muscles.
- Breathe deeply and hold the stretch for 20 to 30 seconds. Try to relax excess tension that might occur in other areas of the body.
- Avoid positions that tend to collapse your body weight, or allow your body to give into the force of gravity. Select positions where your spine is supported and long as you stretch.
- After you reach your maximum safe extension, return gradually to your starting position.
Yoga and Pregnancy
Although yoga offers innumerable benefits, this venerable discipline developed long before the science of exercise physiology. Yoga can be excellent for the pregnant woman; however, you need to be mindful of the risks and how to avoid them.
Yoga Positions to Avoid While Pregnant
- All lotus and pre-lotus positions sickle the foot and torque (stretch and twist at the same time) ligaments of the ankle joint—not a good idea in general, but especially dangerous during pregnancy/postpartum, and for those with a history of ankle sprain.
- Yoga poses that stress the lateral (side) ligaments of the knee, especially if the hip socket if not sufficiently flexible, such as pigeon-pose.
- Triangle pose, and straddle type stretches with spine twists may cause or worsen sacroiliac instability.
- Poses that compress the lower back, and/or stretch the abdomen, such as up-dog, back bends, and cow-pose (when performed with the belly slack.)
- Seated poses where the spine is twisted and flexed at the same time.
- During pregnancy, extensive use of belly-breathing, where the abdominal wall is forcefully expanded during inhalation may cause or worsen abdominal separation. Substitute centered-breathing, where the ribcage expands three dimensionally during inhalation. For more information, see Diastasis Recti page of the web site
- Quadruped positions and others that flex the wrist while weight bearing should be done with caution or modified to prevent carpal tunnel syndrome.
- Bikram or other "hot" yoga styles are not recommended during pregnancy. (See the Heat Regulation During Pregnancy page of this web site.)
Many traditional fitness programs fall woefully short on flexibility training, and tend to add on a few stretches at the end of a workout, almost as an afterthought.
The benefits of stretching has recently been called into question due to recent studies that have shown that stretching before an athletic event does not reduce the rate of injury or enhance athletic performance, as had been previously assumed. The press picked up this information, and unfortunately many articles declared that fitness professionals no longer considered stretching important or beneficial. This is an obvious example of how the media can distort facts in the retelling, and disseminates misinformation.
Stretching has indisputable and profound benefits on alignment, neuromuscular functioning, long-term injury prevention, pain relief, healthy aging, and stress reduction.