Pregnancy Modifications for CrossFit and Functional Athletes

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Sarah Hughes has been practicing in Seattle for almost 15 years and opened her private practice, Arrow Physical Therapy in 2016. Her specialties include dance medicine, the CrossFit and weightlifting athlete, and conditions of the hip and pelvis such as femoroacetabular impingement and labral tears. In 2017, she began coaching other PTs who wanted to start their own practices, and from there, she co-founded FulDraw Consulting with her partner Dr. Kate Blankshain. Together, they offer coaching, consulting, and several 8-week online business courses for Physical Therapy entrepreneurs. Dr. Hughes earned a BS in exercise science from Gonzaga University and a DPT from the University of Washington. Sarah instructs the remote course, Weightlifting and Functional Fitness Athletes.

Not sure what to tell your pregnant patients when they want to continue to do CrossFit?? Below is a sneak peek into the Weightlifting and Functional Fitness course with some pregnancy modifications for CrossFit and functional fitness athletes:

Start at the “hang” positions: Modify the lifts by starting from the hang position when the belly increases in size, as this makes it harder to lower the barbell to the ground.

Finish in the “power” position: Often pregnant people don’t feel comfortable catching in the squat position. You can still work these barbell movements by catching in power positions.

Forego the barbell: Finally, when the size of the pregnant belly starts to change the bar path (ie. you are swinging that weight way out in front to avoid hitting your bump), consider switching to dumbbells or kettlebells for the Olympic lifts. An improper bar path leads to bad habits and can cause injury.


The biggest thing to note here is that there is no reason to be doing max efforts when you are pregnant. You are not going to be setting any records and the cost/benefit isn’t worth it. However, that is not to say you shouldn’t be lifting. Just be sure that you are managing your breathing and not creating too much pressure with these lifts. You need to be exhaling as you exert effort so as to avoid bearing down into the pelvic floor and abdominals.

 A few specific notes:

When it comes to moving weight overhead, be sure that you are not over-arching your back and instead keeping the weight manageable so that you can maintain the best form
If squatting feels vulnerable because the bottom of the position feels weak, you can squat to a box to limit the range of motion.
You will still be able to strengthen while protecting your body from an unstable position when deadlifting, really think about dialing weight back in order to avoid using a bearing down “Valsava maneuver

If you cannot feel your abs engaging, chances are that they aren’t. You can try side planks perhaps or planks on an elevated surface. At some point, you might just cut them out of your program.

If you have somewhat of a belly, please don’t do burpees. Step out to a plank and back up. You can also do an incline push-up using a bench, plates, or boxes. If you are adding a jump over a barbell or other apparatus consider stepping over to avoid a potential fall and to minimize the impact through the pelvis. If burpees lead to incontinence or an “urge sensation”, modify.

Weightlifting and Functional Fitness Athletes - Remote Course

Course Covers 7Price: $295.00          Experience Level: Beginner          Contact Hours: 9 hours

Course Dates: October 14

Description: This course will review the history and style of Crossfit exercise and Weightlifting, as well as examine the role that therapists must play for these athletes. Common orthopedic issues presented to the clinic will be examined. However, while things like urinary function, pregnancy and postpartum, hip impingement, LBP/pelvic pain, prolapse, and diastasis will be touched on, this will not be a course in addressing pelvic health concerns in these athletes. These topics will be more fully addressed in the course: Pregnancy and Postpartum Considerations for High Intensity Athletics with Emily McElrath.

Labs will introduce and practice the movements of Crossfit and Weightlifting, discussing the points of performance for each movement. The practitioner will not only learn how to speak the language of the athlete but will experience what the movement feels like so that they may help their client to break it down into its components for a sport-specific rehab progression. The goal of this course is to provide a realistic breakdown of what these athletes are doing on a daily basis and to help remove the stigma that this type of exercise is bad for our patients. It will be important to examine the holes in training for these athletes as well as where we are lacking as therapists in our ability to help these individuals. We will also discuss mindset and culture issues such as the use of exercise gear (i.e. straps or a weightlifting belt), body image and the concept of "lifestyle fitness". Finally, we will discuss marketing our practices to these patients.

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