Pregnancy and re-entry into competitive sport
Imke Oelerich • 16. November 2022 • 5 Min.
A scientific and personal perspective
During my first pregnancy I shared a few testimonials with you. I have been thinking for a long time about what relevant and useful information I can share in the course of my second pregnancy and am very happy that a very exciting study was recently published, the results of which I would like to briefly present to you, and then in a second step present my personal experiences.
The study “Impact of Pregnancy in 42 Elite to World-class Runners on Training and Performance Outcomes” published by a group of Canadian researchers (F. Darroch, et al.) was conducted to characterize and quantify the experience of pregnancy in relation to training, injury, and competition outcomes in elite to world-class middle and long distance runners. It is the first study with a significant participant sample of elite female runners to outline training before, during, and after pregnancy, and the first study to statistically analyze race-based performance outcomes before and after pregnancy.
Running circumferences and speeds slowly decrease over the course of pregnancy. The lowest training level in the third trimester was still ~2.3 times higher than the recommended 150 min/week reported in international guidelines, with 300 to 350min of total training per week.
Participants reported a significant decrease in moderate to high-intensity exercise throughout their pregnancy while maintaining low intensities. Running at higher intensities causes significantly higher mechanical stress compared to running at lower intensities. Therefore, pregnant runners can continue their running training at lower speeds or choose “low impact” training to prevent typical low back, pelvic girdle, and pelvic floor injuries as pregnancy progresses.
This study demonstrated that cumulative weekly exercise volume (minutes/week) was nearly maintained throughout pregnancy as cross-training (other sports) increased concurrently with progressively lower running volumes.
Most women returned to running about six weeks after delivery, and they were back to about 80 percent of their pre-pregnancy training load about three months after delivery.
For the first time, using 2,703 race results, the researchers were able to confirm that for the 60% of participants who intended to return to equivalent performance levels after pregnancy, they were able to statistically regain “pre-pregnancy” performance on average in the first one to three years after delivery. 46% of these runners were even able to improve their post-pregnancy performance. In fact, there are reasons that some physiological aspects of pregnancy might positively affect performance, such as increases in blood volume and cardiac output.
However, half of the participants suffered injuries during the first three years, which significantly delayed their return to competitive sports. Most of the injuries were musculoskeletal in nature. The study authors cite returning to competitive sports too quickly as the primary reason, and emphasize the need for professional and individualized support for reentry in terms of mode of delivery, breastfeeding, performance goals, and training requirements.
They recommend multidisciplinary teams consisting of physicians, coaches, physical therapists, nutritionists, strength and conditioning specialists to provide expertise on the stages of conception, pregnancy, postpartum, and return to competitive sports.
The authors recommend that competitive athletes have an open dialogue with their multidisciplinary team during pregnancy and postpartum to create individualized and realistic schedules and progressions. For example, the timeline for returning to training and competition levels after a surgical delivery or cesarean section differs significantly compared to a spontaneous vaginal delivery without complications.
Conclusion of the study
I can confirm the results of the training volumes from my first as well as now progressing second pregnancy. I gradually reduced my running volumes and intensities until I didn’t run at all in the last two months of my first pregnancy. At that time, the baby’s position triggered a nerve in my pelvis and I had severe pain in my pelvis and thigh. On the other hand, I was still able to swim and bike super well and both were possible without any problems until the final delivery.
It is great to see in black and white that it is theoretically possible to return to competitive sports. There are many case studies that confirm this. In practice, however, it can look different. It’s hard to plan for what your baby’s temperament and needs will actually be. I, too, have always set goals for myself post-pregnancy. After many years of triathlon sports, I wanted to fully concentrate on running and like to run my first marathon in a good time after 1.5 years postpartum and thought that I would breastfeed for 6-8 months at the most and then be a bit more flexible again.
I did not take into account the temperament with which our little daughter should come into the world and that she accepted neither bottle nor pacifier nor soother but wanted to be breastfed and only wanted to fall asleep with me, which she also demanded very vehemently. Finally I breastfed her for 19 months and only now at 21 months she slowly accepts it when her daddy puts her to bed. At night, however, I am asked and she still wakes up 3-4 times to check if she can feel safe and secure.
Of course, I imagined it would be easier in the beginning and thought that I would have more time for myself, be able to train in a structured way again faster and participate in events and competitions. Of course I doubted. Of course I was sad at times. Of course I compared myself to other moms who quickly got back into competitive sports and I would be lying if I wasn’t a tiny bit jealous.
BUT I also quickly learned that I can’t control everything in life. All of the can-do craziness and competition that we experience in our everyday lives is something we get to leave behind, and have to leave behind, a little bit with the birth of our child. It is not much that a child needs in the first years, but there should be no lack of love, affection and time from the parents. You can’t imagine how proud we are of our little daughter. She has a mind of her own, she is incredibly assertive and has energy for two. I am happy to accompany her journey and I am sure that great things are waiting for her.
I now manage to do at least 40min of sports a day most of the time during my second pregnancy (often more on weekends).
I enjoy every minute I can spend in my running shoes and I’m sure it will increase again in the coming years.
My goals are not running away 🙂