Injury across the lifespan: pregnancy

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A look at pregnancy to understand how it can alter a woman’s injury risk profile.

Until recently, society told pregnant women to rest. Exercise is a bad idea, they said. 

Happily, we’re moving beyond this faulty advice and, these days, movement and exercise are mightily encouraged in pregnancy. 

Current guidelines on prenatal exercise recommend that healthy women with uncomplicated pregnancies aim for 150 minutes of moderate-intensity physical activity and two days of strength training per week. Pregnant women who previously trained at high-intensity can keep going as they were, so long as they feel okay and have no complications.

We should say, also, that prenatal exercise is not associated with miscarriage, preterm delivery or a small baby. However, it’s also true that the majority of miscarriages do happen in the first trimester of pregnancy so it’s a personal choice – ideally one made in consultations with experts – whether to dial back exercise or not. 

It’s personal, it’s a choice

The advice to exercise during pregnancy is good advice. Exercise when pregnant is the gift that keeps giving. The problem is the lack of smarts in putting that advice to work. Less than 8% of personal trainers (and even fewer netball coaches) hold the right credentials to rightly support pregnant women who want to train. 

And as much as generic advice can be helpful, every pregnant woman is a unique mix of circumstances, medical conditions, symptoms, experiences, abilities, mental health … 

So staying safe in netball and in exercise in general while pregnant is relative. Activity has to be tailored to the individual – who she is and where she’s at.

Change = risk

Pregnancy means profound changes to the body. An obvious point, but each change can add a new dimension of risk. For example, a pregnant woman carries extra weight around, but that weight continues to increase; meaning her centre of balance is constantly shifting. 

This changeable centre of balance can warp her awareness of her space, her body and even her ability. The potential to miscalculate a movement is greater and because her joints are looser – a by-product of increased oestrogen in pregnancy – there’s an altogether heightened risk of falls, slips, jerks, and bumps. 

To add to those balance woes, a pregnant woman’s stance width increases and her step length decreases. Each new such adaptation to her usual gait can impact her movement. 

Basically, her sense of normal is abnormal and continually changing; so extra care is required throughout the pregnancy timeline to gauge where she’s at and mitigate risk at all times.

Breasts and feet, bras and shoes

Moving northwards, a woman’s breasts grow when pregnant. Good breast support via a well-fitting sports bra is a good idea forever, but in pregnancy it’s even more of a non-negotiable if you plan to exercise.

Not only will good breast support help with balance issues, a sports bra will dial back the risk of breast injuries. Sports bras do that as a rule, but during pregnancy – when breasts are more likely to be sore, sensitive or painful – wearing one is essential. Here’s more on why sports bras are wonderful things in sport, in life, in pregnancy … 

Further into pregnancy, swollen ankles and feet may come into play. Again, this could further affect balance but also comfort, pure and simple. 

Like a good sports bra, the right choice in footwear – female-fitting trainers that are maximally supportive – will help to keep things balanced and comfortable, and diminish the risk of ankle injuries. You may need a new pair of shoes, but the investment will be worth it as your feet will stay their different size and shape well into motherhood.

We’ve much more on sports shoes here. 

Pelvic floors and mental health

It initially seems odd grouping pelvic floor and mental health together, but stay with us while we show how they connect. 

But first the physical. The pelvic floor takes on a new significance during pregnancy. Even if a woman hasn’t ever before worried about her pelvic floor, that’ll probably change in pregnancy as the strains and stresses of a developing baby bear down. 

These stresses and strains can cause leaking, wind, pain and discomfort. Constipation, too, though not a pelvic floor issue itself, can further damage and weaken the pelvic floor as it causes stretching beyond the safe bounds. 

Sure, pelvic floor issues aren’t injuries per se, but they can be a stepping stone to worse. 

Imagine pregnancy leads to frequent urination and leaking. In a sport like netball, leaking on court poses a small danger to your physical safety – slipping and falling for example – but that’s much less likely than the potential mental damage.

Leaking is embarrassing. It’s a reason to stay off-court. It’s a reason to obsess about bathroom-planning. It’s a reason to underhydrate. Women who leak, pregnant or not, find different strategies to cope, but it’s a painfully distracting mission. 

Obsessing about leaking (or not leaking) takes a woman’s focus away from where it should be: her, on court, enjoying netball and benefitting from the mental and physical nourishment of the sport she loves. 

So during pregnancy (and ideally before), pelvic floor exercise is more essential than ever to build up resilience against symptoms and to prepare for what’s ahead. Here’s a reminder of our recommended technique.

The mental health injury

We have an article dedicated to pregnant women’s mental health but, for now, it should be noted that one in five women will be diagnosed with a mental health issue either in pregnancy or year one of motherhood. It’s a vulnerable time. 

Among pregnant women’s key concerns as they relate to sport and exercise are the lack of confidence in the body and what it can do, the belief (rightly or wrongly) that people talk to and treat them differently, and the major changes in her appearance. 

It’s a shaky time for her confidence, and research suggests previously active women are more likely to drift away from sport and exercise than active men once they become parents.

Exercise is an obvious benefit in terms of physical health, but its positives for mental health and one’s sense of belonging and community take on even more prominence during pregnancy. 

None of us want a pregnant teammate to feel disillusioned from the sport she loves. So even if she decided she doesn’t want to participate in the physical aspects of netball – and that’s a fair and personal choice she can make – teammates can rally round to ensure she keeps up the nourishing social aspects of netball. 

This has value to her mental health today, but it can also help to ensure she doesn’t cut ties with the sport she loves further down the line.