It happens to everyone once in a while. You step wrong and twist your ankle. You lift something too heavy and strain a muscle. Or you don’t even know what you did, but now a muscle or a joint hurts.
But pulling a muscle or straining a ligament or tendon can happen during your pregnancy. In fact, it is even more likely to happen now. Pregnancy causes physical changes in your body that make you more prone to a joint or muscle injury and can even make you a bit clumsier.
Why is this? During your pregnancy, your body starts making a hormone called relaxin that softens the ligaments in your pelvis in preparation for childbirth. But relaxin works on all your ligaments, not just the ones in your pelvis, which means that your joints are a bit looser. You are more likely to turn your ankle or pull a ligament as your pregnancy progresses. The hormone progesterone also plays a role in softening up your ligaments.
You are a bit clumsier because your center of gravity, which is the spot in your body where your weight is centered, changes as your pregnancy advances and your abdomen starts to stick out. This means that you are more likely to lose your balance and fall.
You’re also putting on weight as your pregnancy continues. Your joints and muscles haven’t gotten used to carrying the extra weight around. There is more impact with each step you take, which is enough to start feeling it in your knees and hips.
If you factor in a bit of brain fog and the distractions of having a lot on your mind, it all adds up to an increased risk of straining a muscle, twisting a joint, or worse, falling down.
How to Avoid a Muscle or Ligament Strain
Early in your pregnancy, you can safely stick to your regular exercise program. Getting a good amount of exercise is excellent both for you and your baby. The U.S. Department of Health and Human Services recommends that healthy women get at least 2.5 hours of moderate-intensity aerobic exercise each week.
If you have been an active person before your pregnancy, your body is used to your workout even if it is something that another person might consider intense, such as long-distance running or weightlifting. But make sure to talk over your exercise routine with your obstetrician or midwife.
But as your pregnancy progresses and your center of gravity changes, you might want to reconsider parts of your regular activities. Be aware that you are at greater risk of losing your balance or pulling a muscle because you stopped yourself from falling. A sport like tennis, with its stops and starts and changes of direction on the court may increase your risk of an injury, especially as your body starts to create relaxin and your ligaments and tendons loosen. The same goes for a high-impact exercise such as running, or sports that can involve contact, like soccer and lacrosse.
In your third trimester, you might want to switch to a workout consisting of low-impact exercise to put less stress on your joints. You’ve put on weight during your pregnancy and what had been OK for your hips and knees before your pregnancy may not be OK now. You can get your heart rate up without putting as much stress with low-impact exercise, which includes walking, swimming, water aerobics, yoga, and Pilates.
Warming up before your workout is more important than ever during your pregnancy. Do some mild stretches to get your muscles going before your workout. You might warm up for a longer time now to make sure your joints and muscles are ready for your workout.
Another piece of advice: Take your time and be mindful of what you are doing while you exercise. You are more likely to hurt yourself if you rush around in a state of distraction.
What to Do for a Muscle Pull or Sore Joint
If you do pull a muscle or twist your ankle and are mildly to moderately sore, take it easy. Rest the affected area and elevate it, such as by putting your foot or leg up.
If you feel you need to take a pain reliever, talk to your healthcare provider first. In general, acetaminophen (Tylenol) is safe to take during pregnancy for an occasional problem like a sore joint.
If the pain is severe, or if it starts to get worse, call your healthcare provider immediately.
If you fall during your pregnancy, it isn’t usually a cause for worry. Your uterus is made to protect your baby and keep it safe. A slip or a fall early in pregnancy is not usually a problem. Talk to your health care provider at your next visit.
Later in pregnancy–the last half of the second trimester and the third trimester–a fall can be a more serious matter. If you have fallen, call your healthcare provider and describe what happened and any symptoms that you may have. If you’ve fallen and then have any vaginal bleeding, abdominal pain, or uterine contractions, call your healthcare provider immediately.