The longstanding recommendation to avoid lifting over 20 pounds during pregnancy is officially not aging well. (To be fair to those using that recommendation, until recently there hasn’t been a very viable competing narrative.) Thankfully, Institute of Clinical Excellence faculty Christina Prevett has recently taken a huge step forward in changing that with her publication in the International Urogynecology Journal titled “Impact of heavy resistance training on pregnancy and postpartum health outcomes” (Link to full text paper).
What does science say about lifting weights while pregnant?
In brief summary, this cross sectional survey evaluated data on pregnancy and postpartum complications in 679 individuals who continued lifting over 80% of their maximum effort. Importantly, the large majority of these individuals were recreational lifters versus elite or professional athletes. The results of this survey directly challenge many long held beliefs or myths surrounding best practice for activity and exercise in during pregnancy, here are just a few of the most important:
- Individuals who continued to perform Olympic weightlifting until delivery DID NOT see any increased risk of pelvic floor issues
- 34% of individuals continued to utilize the Valsalva maneuver and DID NOT see an increased risk for urinary incontinence, anal incontinence, or prolapse
- Participants who maintained pre-pregnancy training levels until delivery reported significantly less reproductive complications than those who ceased training levels prior to delivery
- Diastasis recti was only present in 4% of these individuals who continued lifting heavy during their pregnancy
- Only 14% of these women suffered any subjective symptoms of prolapse
As the saying goes “When you know better, do better”. This data is the first of its kind and demonstrates a couple incredibly important things for expecting mothers considering lifting weights:
- First, lots of women are continuing to perform heavy strength training and olympic lifting during their pregnancy in spite of historical advice to avoid it.
- Second, those that do so DO NOT seem to be suffering deleterious effects in the postpartum period across many domains of pelvic health.
So where do we go from here? Considering the importance of resistance training for both physical and mental health in the female population, it is imperative that expecting mothers understand engaging in these activities DOES NOT put them at increased risk of complications. Simply giving mothers permission to participate in these activities should they choose to do so would be a huge step forward in maternal health and thus an excellent place to start.
As a physical therapist, how can I learn more to help expecting mothers?
For those providers hoping to gain training to specialize in coming alongside mothers in their health and fitness journey, please consider the online and in-person courses offered by the Institute of Clinical Excellence. Our courses are the first of their kind to combine fitness forward principles throughout the entire pregnancy and postpartum journey. You’ll learn all the most current evidence in this space, how to perform internal examination and treatment, as well as spend time in the gym performing and coaching pregnant and postpartum athletes! Find all these courses at www.PTonICE.com.
Prevett C, Kimber ML, Forner L, de Vivo M, Davenport MH. Impact of heavy resistance training on pregnancy and postpartum health outcomes. Int Urogynecol J. 2022 Nov 4. doi: 10.1007/s00192-022-05393-1. Epub ahead of print. PMID: 36331580.