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4 Things You Need To Know About Coaching Pregnant Athletes

September 22, 2023 by

Coaches see a lot of different bodies, experience levels, and needs. We are versatile in how we can help, given our own background of education and exposures. 

Pregnancy is something that has typically been either over-simplified, or over-complicated, when it comes to fitness. Coaches want to do no harm, so we often default to telling our clients or members to “do what feels good!” or “listen to your body!” This is understandable, AND our pregnant athletes need more from us. If we can help our clients with knee pain, a back injury, or find modifications for a variety of ability levels, we need to be able to help this next generation of female athletes, because listen, moms make up the majority of our clientele. And if that’s not the case for you yet, it likely will be within the next 5 years.

1. Know what they are predisposed to right now (diastasis recti, incontinence, pelvic organ prolapse) 

We can look at how someone squats and know that if their knee keeps caving in, they may be more likely to have knee pain or an injury. Therefore, we adjust the form and make other strength recommendations proactively. Pregnancy is not an injury; it’s a consideration. No athlete is exempt from core and pelvic health symptoms and experiences, so we have to proactively *understand* what those core and pelvic health considerations are as their body changes, and how exercise influences presentation of symptoms. They WILL have a diastasis during pregnancy - it is how all pregnant bodies adapt to growing the baby. They may experience pelvic pain, pressure, or incontinence due to changing hormones, pressures, and structural changes to their body.

2. Adjust their tendencies 

It’s not just about modifying ab or impact exercises, although that’s a great start, given some of those predispositions.

We have to understand how much tension they hold naturally, and also how much they generate in their lifts and movements (are they gripping their glutes, sucking in their stomach still, etc).

We also have to recognize how they distribute intra-abdominal pressure (are they breath holding and bracing, pushing out into their midline, or down into their pelvic floor?). Noticing these tendencies can help them counter what they typically do, giving more strategies to “listen to your body.” A helpful cue for redistributing pressure is to “breathe into your lats,” or “exhale through the movement.” 

Pressure and tension, for example, have the greatest influence on core and pelvic floor symptoms. Therefore, HOW the exercise is performed matters just as much as the actual exercise selection. 

3. Help adapt exercise variables (not just movements) through pregnancy 

When you understand their predispositions (and potential of symptoms), it will make timing the modifications much more intuitive for you and them! It’s a learning and teaching experience for all. Again, we all know how to modify an exercise, we have a lot of options. Modifying volume, load, frequency, and genre of movement is not always straightforward.

For example, as pregnancy continues, say past 20 weeks when the center of gravity has changed, the belly is bigger, etc., reducing frequency and volume of high impact is advised for preservation of pelvic floor health, and mitigation of potential symptoms (peeing, pressure, pain, etc.)

Additionally, in terms of load, "heavy" is relative; while a pregnant athlete may say, “It’s not heavy" (and it might not be heavy from a muscular perspective for them), it may still create a lot of pressure and force on the core and pelvic floor. For example, a 200 lb squat may not be heavy for them, but it is for their abs and vagina absorbing that force against gravity due to structural and tissue changes. 

4. Be mindful of your commentary 

Once again, pregnant athletes are not fragile, but they are extra susceptible to feeling insecure about their changing body and managing expectations surrounding their experiences, abilities, and all the variables attached to this season. 

It’s so common for coaches to say, “you’re going to bounce right back!", which is said with good intentions, and yet it often fuels the pressure and expectations our athletes place on themselves. 

Another common one is, “birth will be no problem” or “you’ll push that baby right out” 

Birth is uncontrollable, and there are no guarantees for ease of delivery, despite fitness levels. 

We want them to feel empowered without rigid expectations attached to a set outcome. Chances are, they’ve already put a lot of pressure on themselves for what they desire. We have to walk next to them through whatever experience occurs. 

Our goal is to guide them, while providing them the opportunity to make autonomous choices for their body. If they feel dismissed, shamed (even unintentionally), or like we are unwilling to “get them” and what’s ahead, they’ll opt out of our training environment and do their own thing. Knowing how to coach pregnant athletes isn’t just about their physical training, it’s about the mental side of acknowledging the changes, helping them manage expectations and guiding them as a trustworthy resource. 

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