During pregnancy, your body changes a lot. Weight gain, shifting posture, loose joints, and an evolving shape can all contribute to aches and pains, along with stability issues or risk of injury. This is primarily because of relaxin. It’s pregnancy hormone responsible for relaxing ligaments and arteries throughout the body in order to prepare for labor and delivery, as well as manage increased blood volume. As a pregnant woman, you may consequently experience things like a pulled hamstring, back or hip pain or acid reflux. This is especially true if you’re working out. Our experts explain why pulled muscles are more common throughout pregnancy, and how to keep your muscles safe to avoid strain.
Why are pregnant women more susceptible to pulled muscles?
“There are a handful of reasons why being [pregnant] makes you more susceptible to pain, injury, and pulled muscles,” says Steve Washuta, a certified personal trainer in Savannah, Georgia. “Firstly, there are hormonal changes: hCG, prolactin, estrogen, progesterone, oxytocin, and relaxin. Relaxin will loosen up ligaments and joints around the pelvic region among other things in preparation for the pregnancy. It has also shown to actually widen feet, making women feel less stable, and clumsy when coupled with weight gain and change of body shape.”
Potassium levels are often lower during pregnancy. Without adequate potassium, muscle flexibility is limited.
A growing belly means that your body weight is distributed toward the front, too. This forces lower back and abdominal muscles to overwork. Plus, as the pelvis widens and shifts, says Washuta, a pregnant woman can experience sciatica in the lower back, hips, glutes or legs. This is due to compression on the nerves.
Additionally, potassium levels are often lower during pregnancy, adds Dr. Lisa Folden, a licensed physical therapist and naturopathic lifestyle coach. “Without adequate potassium, muscle flexibility is limited, meaning [that] activities that call upon muscle contractions or muscle lengthening can easily result in a muscle tear, pull, or strain,” she says.
What’s the difference between a pulled muscle and a strained muscle?
Many pregnant women are familiar with round ligament pain. It’s a sharp feeling near the low belly or groin area that normally occurs in the second trimester, due to ligaments that stretch as both baby and belly grow. But, pulled muscles are a little different. They’re more similar to a strained—not sprained—muscle than anything else. Aaptiv Trainer Amanda Butler says pulled muscles happen when a muscle, or the tissue connecting muscle to bone, is overstretched or torn. Conversely, sprains involve stretches or tears in ligaments, which connect bone to bone at your joints.
“A ‘pulled’ muscle typically means that the muscle was stretched beyond its ideal limit,” says Dr. Folden. “In this way, a ‘strained’ muscle can be the exact same as a ‘pulled’ muscle. However, ‘straining’ a muscle can also include injuries that result from an over-contraction of the muscle when the muscle is being used from the shortened position.”
All in all, there are three grades of pulled muscles, notes Washuta:
- Grade one is a slight strain with light swelling, hindered range of motion, minimal pain. It takes two to three weeks to full recovery.
- Grade two is when there’s damage to the muscle, but no rupture, with mild swelling. This one takes four to eight weeks before fully healing.
- Grade three results in severe pain. This is due to a complete rupture of the muscle or tendon, with dark bruising and heavy swelling. There’s no range of motion. You may need surgery for repair.
Where do pulled muscles commonly occur for pregnant women?
As mentioned, many women may feel pulling in the groin area related to round ligament pain. Pulled muscles tend to happen elsewhere, when pregnant women lose their balance, twist an ankle, or strain the lower back and knees. Abdominals and inner thigh muscles are also key targets, says Dr. Kellen Scantlebury of Fit Club Physical Therapy & Sports Performance.
“Pregnant women tend to suffer from pulled muscles in many of the same places as non-pregnant people, like the hamstrings, quadriceps, calves, and low back,” agrees Dr. Folden. “However, one unique pulled muscle that happens often in pregnancy is that of the rectus abdominis (abs or six-pack muscles). This injury occurs when the muscles of the front abdominal wall spread and or split as the uterus grows larger, resulting in diastasis recti.”
How can you protect your body from pulled muscles, especially during exercise while pregnant?
Be mindful that your weight is now front-loaded, says Washuta, meaning that your back muscles are working in overdrive. He recommends seated exercises with back support to allow your back and core muscles to relax. This way you can focus on strengthening specific muscle groups.
Also, it’s best to try to stick to the type of exercise that you’re used to doing pre-pregnancy, with proper modifications, rather than introducing something new or strenuous. Dr. Folden suggests stretching and moving as much as possible. If you think you’ve accidentally pulled a muscle, make an appointment with a physical therapist or your doctor.
“Make sure [that] you do a light warm-up, and avoid jumping into a workout cold,” says Butler. “Mild strains can use the ‘RICE’ approach: rest, ice, compress, and elevate. If it’s more severe, see a doctor to make sure [that] there’s not a fracture. Overall, be mindful of your movements. Just because your range of motion can increase during pregnancy doesn’t mean [that] you should push to your new range of motion. Avoid overstretching and work on strengthening exercises instead.”