Full Squat During Pregnancy - to Do or not to Do

Full Squat During Pregnancy- To Do or Not To Do- by Jacqueline Gradish, BSc., Medical Exercise Specialist

 Doing a full squat exercise when you are not pregnant is recommended for people with healthy backs.  Squatting is a primal developmental stage for babies and is a precursor to standing and walking, on the other hand, what if you are pregnant, what type of squats should you do and in what range.  Many birthing classes recommend performing a full squat or a partner assisted full squat for a natural delivery.  I have studied many fitness articles that indicate to avoid “deep knee bending”, a full squat, while pregnant.  So what should you do during your fitness routine?  This article will attempt to answer this.

As your pregnancy progresses your pelvis is opening and widening almost like a book from the front of your pubis symphasis.  This makes more space and allows for your growing uterus to house the baby.   This growth puts more strain on your pelvic floor muscles.  As you squat to neutral where your knees are at 90 degrees to the floor the pressure of your uterus increases on your pelvic floor muscles and your pelvis tilts anteriorly.   If you were to squat lower you are at risk of going into a compromising anterior pelvic tilt position due to the extra front load of your protruding belly and your relatively inefficient abdominal muscles, this can put undue strain on your back.    As your belly grows you have to place your feet further than hip distance apart to perform a full squat otherwise you would get stuck and jam your belly.  At a 90 degree squat your knee ligaments are at their least stable position, and due to relaxin your joint stability can be further compromised.   So what do you do, compromise your back, feel extra pelvic floor strain, or squat to where your knee joint is least stable with your legs at 90 degrees to the floor. 

Pros for Full Squat

Doing a full squat allows you to use your gluteus maximus (the behind) thru its full range.  During pregnancy the tone in your glut muscles increases in a standing position to allow you to stand upright.  Constant low grade firing in this limited range causes your gluts to become tight.  You would naturally squat to 90 degrees to sit in a chair giving some strength in that range, but it is still limited.  Performing a full squat keeps your gluts strong in their full range and can help counteract tightness.   Working thru your full squat range will prevent you from pausing at 90 degrees where your knee joint is least stable as well.  Performing a full squat during pregnancy helps relax the pelvis and provides pressure for waist elimination which can help prevent constipation and haemorrhoids.  Using a full squat for a birthing position may reduce the need for an episiotomy or the use of forceps.

Cons for Full Squat

A full squat is very metabolically demanding, so make sure you replenish your food store after performing this.   You may become lightheaded during this move.  The majority of people have muscle imbalances and are unable to maintain neutral spine position.  Performing a full squat with an imbalance can further pull on your pelvis to one side and may exacerbate pelvic shearing forces in the pubis symphasis (front join of your pelvis) and put strain on your sacroiliac joint.   The stress on your pelvic floor muscles increases you need to be cautious not to overstrain them.   Most women in Western culture are not attuned to performing a full squat, so performing this move is dependent on the fitness level of the exerciser.  You can perform a full squat using the stability ball against the wall to help keep you from pitching forward. 

Conclusion

Since you should not use excessive external weight during your full squat and you are in controlled environment knee stability should not be the major issue that you base your decision on, but a history of knee issues is a key factor. 

Performing a full squat will potentially increase the stress on your pelvic floor muscles, exacerbate pelvic shearing and could put more strain on your back due to anterior pelvic tilt and compromised abdominal muscles.   These symptoms will be increased if your baby bump has just gone through a growth spurt.  For the small percentage of women who were performing a full squat exercise with neutral spine before you were pregnant, keep it up during your pregnancy, as long as you are comfortable.  This exercise is great if you can perform it correctly, but a very small percentage of women would be able to complete this task.

If you are confident you do not have a muscle imbalance and can maintain neutral spine, do not suffer from any pelvic shearing forces and have particularly strong pelvic floor musculature you can perform a full squat.  This is an ideal exercise for fitness and to prepare you for labour.

A mid range squat still allows you to perform exercise, work in your most functional range to sit on a chair, and will not put your pelvis, back and pelvic musculature thru undue stress.  But this squat is not an optimal as it does not train you for labour or birth.  This exercise is a good alternative.

The  type of squat most commonly recommended  for Western Culture women during pregnancy is a full range stability ball squat.    The inability to maintain neutral spine or lack of practice of full squat in western culture should not be factors with this exercise as your back is supported on the ball.  You will work your gluts through their full range of motion preventing tonic muscles while standing.  A full stability ball squat puts your knee joint in its most stable position as well as opening the birthing canal and helps with other pregnancy related issues such as constipation and haemorrhoids.  Work yourself up to the full range stability ball squat squeezing your pelvic floor during the exercise to avoid straining these muscles.

If your fitness level is moderate and you have never performed a full squat before start with half range squats and work your way up to a full squat in time for your delivery if this is your goal for squatting.

References

Exercises for Pregnancy: squatting associated content

ObGyn/Pregnancy issues: Squats in prenatal class-Helene Byrne

Alwyn Cosgrove – Full Squat Article T-Nation