Barbell sports have absolutely exploded in the last 10 years! Women are ditching the 2 lbs dumbbells and embracing the barbell. They are trying to be as strong as possible and going for personal records or PRs.
This is awesome! It is largely to do with the huge rise in popularity of CrossFit.
And then these female athletes get pregnant or have a baby. Then the road BACK to all of these movements seems a bit more foreign.
Women are given so much advice that doesn’t make sense. They’re told things that conflict. They’re told to just “listen to your body” or “go slow”.
Like what does that actually mean?!
In this guide, we are hoping to break that down. Give you the dos, don’ts and what to look out for. The problem is that every woman’s need to scale back during pregnancy will be different. Every woman’s timeline to return to different things postpartum will also be different. We need to do the best we can to give you guideposts, so you know how to navigate your own journey.
First let’s talk about different breathing and bracing strategies female athletes can use. Then we’ll dive into the specifics in pregnancy and postpartum.
Many female athletes, in our opinion, are taught to brace WRONG. We are taught to take in big air, hold our breath and then bear DOWN. We put so much pressure on our pelvic floor when we bear down! That is literally what we do when we want to poop. It isn’t what we want to do when we are lifting.
We teach women to brace IN. What that means is you still take a big breath in and hold your breath. The change is to contract your abs IN not down. It might seem like a small change, but it has massive implications. With 50% of female barbell athletes leaking with heavy lifting, we might need to change our strategy rather than assuming this is just normal.
What are different breathing strategies we can use with lifting?
There are a couple of different ways that we can breathe when lifting. This is true whether you are pregnant, postpartum or have never had a child. They are free breathing, breathing out on exertion, or Valsalva.
- Free Breathing is just not really having a set strategy. You brace and then breathe in and out as needed. This is probably the least talked about strategy for athletes. Using this strategy is fine especially for new lifters who are thinking about so many other things.
- Breathing out with exertion is when we break down the lift and breath out when the movement is hardest. This strategy is talked about most in the pregnant and postpartum space. It is for good reason. Our breath helps to relieve pressure on the pelvic floor. This is so important for a pelvic floor that is more stressed during pregnancy or that is recovering from birth.
- Valsalva is when we hold our breath through the entirety of the lift. We brace into our middle and tighten our core as much as we can. This strategy is best for performance. That is because we get the most amount of tension to push heavier weights. It is what most powerlifters, CrossFit athletes and weightlifters will do.
Think about your breath as a pressure gage.
The easiest way to understand why we use different strategies is with this analogy. Your breath is like a pressure gage. When you hold your breath, the pressure goes up. When you let go of your breath and breathe out, the pressure goes down. You WANT the pressure to go up if you’re trying to lift as heavy as you can. If you want the pressure to go down because you are leaking or having other issues with your pelvic floor, you want to breathe out as you lift.
Valsalva: How most barbell athletes breathe we’re lifting heavy weights and NOT pregnant or postpartum?
When you lift a heavy weight off the ground, you are probably doing a strategy called Valsalva. Valsalva is when you brace your core really tight, hold your breath and then lift up something or move something heavy. The reason why we do this is it makes us STRONGER. It gives us more stiffness around our middle which allows us to push against a weight with more force. This is a very GOOD thing. But there are also things that occur when we are doing a Valsalva that might be a bit hard on a pregnant or postpartum body.
When we Valsalva:
- Our blood pressure goes up for a brief time. It can increase to as much as 200 + mm Hg systolic. Again, this is OKAY but something when we are pregnant, we might think about.
- Our intra-abdominal pressure goes up. This is the amount of tension or force in our belly. This is a GOOD thing from a performance perspective. We use it a lot in our strength training. It helps us move more weight.
- It increases pressure on our core muscles and pelvic floor. This again isn’t a bad thing. Pressure has to go somewhere and usually that is in all directions in our middle. Up is to our diaphragm, back is our spine, forward is our core and down is our pelvic floor. During pregnancy and into postpartum, this is one of the biggest considerations when we think about READINESS to go back to Valsalva. There is already so much extra pressure with weight of baby on the pelvic floor. Postpartum, you are coming back from labor! So much that has happened, and we need to take that into account.
If I have a baby does that mean I can never do a Valsalva again?
NO! Oh my goodness. This went around the social media and internet spaces for so long. If there is not medical reason why you should be free breathing with exercise, then it is 100% possible to go back to holding your breath or wearing a weightlifting belt (a topic for another blog).
The important variable for changing from a breathing through versus a hold your breath pattern with lifting is going to be what pressure your body is ready to handle. There will be more on that further into the blog. But know this now … it IS possible, and we will show you some of the steps how.
It is important to recognize though that there are times in your life where it might not be the best strategy. That is 100% okay and it will be there when your body is ready for it.
Let’s pivot into why this matters when we are thinking about lifting in pregnancy.
We advocate for changing Valsalva to Breathe out on Exertion During pregnancy.
Being pregnant, especially for the first time, is when we start to question everything that we do. We think not about ourselves, but about our baby first and foremost. We evaluate our training program and want to make sure that everything is okay. So first I will say that we have NO research to say that performing a Valsalva or holding your breath with lifting is bad for baby. We have some early research that it does not affect placental blood flow at all.
The reason why we change our breath strategy is for MOM to BE! We change it so that we can manage the changes that are happening in YOUR body during pregnancy to give you the best chance for a fast return postpartum. Your pelvic floor is already strained. We don’t need to layer Valsalva on top of that. That being said… that is YOUR choice. It is not dangerous. Our philosophy at the Barbell Mamas is just to give you the information for you to choose what is best for you.
Valsalva creates a lot of pressure. There is already an increase in pressure because of the growing uterus, placenta and baby. That means we want to try to give our pelvic floor a bit of reprieve and change to a breathe-out strategy.
That does NOT MEAN we don’t brace!! We do brace! You tighten your core and then breathe out on exertion.
** Key concept here is breathing OUT when the lift would be the HARDEST. **
This would be on the push UP against the bar on the squat or the press overhead on the jerk for example. Let’s go through these examples in more depth and detail.
We have two phases in the front or back squat: the eccentric or lengthening phase or the concentric or shortening phase. In general, we breath out as we come out of the hole. The hole is the bottom position of the squat.
Breaking it down it will be…
- Brace core unrack bar (do not hold breath)
- Breath IN as come down
- Breath OUT as come up out of the bottom of the squat.
In the jerk sometimes this can be harder. When we think about Olympic weightlifting, we have a hard time breaking it down. The slower lifts are a bit easier. I often coach my athletes to breathe out the WHOLE lift. That can be done in two ways.
Breaking it down it will be…
- Breath in at the top of the clean or when we take the bar out of the rack
- Breathe out as we dip
- Breathe out as we press overhead
- Breath in on the dip
· Breathe out as we press overhead.
Returning to Different Bracing Strategies Postpartum
Coming back to lifting postpartum is a long process. I’m not going to sugar coat it. It always takes longer than we think it will or want it to. Know that in general, it takes a bit longer if you’ve had a vaginal delivery than if you delivered via cesarian. This is because of the stretch and potential tearing on the perineum when baby was delivered. It is so hard but try to be patient.
Think about coming back postpartum in layers. These layers are
- Breathing freely and increasing load
- Not breathing in and out but not bracing in hard let
- Holding breath/ Valsalva + Bracing Hard
- Adding in a weightlifting belt
We do not pass go on the next layer until we do not have symptoms with the layer before. Symptoms will include pain in the pelvis (well anywhere), a feeling of pressure or bulging in the vaginal opening, leaking of urine, gas from the vagina or anus or stool.
When you try to add a new layer in, start with a lower weight. Think about that pressure gage again. Pressure builds with more load and less free breathing. You can move both of those dials up and down depending on what your body is ready for. The amount of weight you use is going to depend on what you were doing before and during pregnancy, the number of births and pregnancies you have had and the presence of any pelvic floor issues.
When do we know if our bodies aren’t ready for Valsalva?
The symptoms we are looking out for a pain, bulging pressure, leaking, or heaviness. These are all different symptoms of pelvic floor issues. They are signals that we are progressing a bit too quick. It may be because of the amount of work you have done that session or fatigue. There are many different reasons why these symptoms may occur. It can be a part of your healing process if you progress a bit too quickly. Go see a qualified provider if you are unsure of what is happening or what you can do about it.
Getting help from the right provider
A pelvic health physical therapist who knows about lifting can be a huge value add for your exercise routine during pregnancy and as you return postpartum. They are skilled in helping with leaking, pain with intercourse, issues with prolapse and know the pelvic system well to help guide you. If making changes to loading or breathing aren’t helping, I would seek one out and at least get an assessment.
Final Note: Our Hormones Might influence Symptoms
Our menstrual cycle is something we gladly forget about during our pregnancy and into our early postpartum journey. As we get further postpartum, stop exclusively breastfeeding or just with time … we will start getting our period again. That is a good sign of hormone cycling as much as we may hate it. That being said, if you are experiencing pelvic health issues, they can get worse at different parts of your period and it is linked to hormones and not something getting worse. Just something to think about.
Take home Messages:
- Breath is a pressure gage. We take the pressure down when our body isn’t ready for it. We ramp it back up when it is
- We generally coach to not Valsalva during pregnancy but empower women to figure out the best strategy for THEM.
- You CAN Valsalva again postpartum
- You need to return to different loads and bracing strategies when YOUR body is ready for it