Prevention of Severe Myalgias During Pregnancy
Regular moderate-intensity physical activity, including a combination of aerobic exercise and resistance training at least 3 days per week, is the primary strategy to prevent severe myalgias during pregnancy. 1
Exercise-Based Prevention Strategy
Recommended Exercise Program
Engage in at least 150 minutes per week of moderate-intensity physical activity spread throughout the week, incorporating both aerobic and resistance training activities. 2, 3
Combine aerobic exercise with resistance training, as this combination is more effective than aerobic exercise alone for preventing musculoskeletal issues including muscle spasms. 1
Include yoga and gentle stretching in your routine, as these modalities are particularly beneficial for muscle spasm relief and prevention. 1
Distribute activity over at least 3 days per week rather than concentrating exercise into fewer sessions. 1
Exercise Intensity Guidelines
For previously sedentary women: Start with mild to moderate-intensity exercise and gradually progress. 4
For previously active women: Moderate to high-intensity exercise can be safely continued. 4
Modify activities based on pregnancy stage and individual comfort, reducing intensity if experiencing symptoms but maintaining some level of physical activity. 1
Biomechanical Considerations
Pregnancy-related changes increase myalgia risk through specific mechanisms that exercise helps counteract:
Joint laxity during pregnancy weakens joint stability, increasing demand on stabilizing muscles and potentially contributing to muscle spasm—regular exercise helps maintain muscle strength to compensate. 1
Changes in center of gravity and anterior loading create biomechanical stress, particularly in women who are overweight or obese, making them more susceptible to musculoskeletal pain. 5
Low back pain and pelvic girdle pain are common during pregnancy and may be associated with muscle spasm—exercise has been shown to prevent and manage these conditions. 1, 2
Additional Preventive Measures
Activity Modifications
Avoid heavy lifting and excessive physical workload, as these may increase risk of musculoskeletal problems during pregnancy. 1
Maintain activities of daily living even if medical conditions limit vigorous exercise, as complete bed rest has adverse effects. 5
When to Stop and Seek Care
Immediately stop physical activity and consult a healthcare provider if experiencing:
- Persistent excessive shortness of breath 1
- Severe chest pain 1
- Regular and painful uterine contractions 1
- Vaginal bleeding 1
- Persistent dizziness 1
Evidence for Exercise Benefits
The evidence strongly supports exercise for preventing musculoskeletal pain:
Exercise helps prevent lumbopelvic pain, which is commonly associated with muscle spasm during pregnancy. 2
Regular supervised exercise reduces respiratory illness (including exacerbations that could trigger muscle spasm from coughing) compared to no exercise. 5
Physical activity prevents gestational diabetes, excessive weight gain, and hypertensive disorders—conditions that can indirectly contribute to musculoskeletal problems. 2
No evidence shows exercise increases adverse maternal or perinatal outcomes when performed at appropriate intensity. 2, 4
Common Pitfalls to Avoid
Do not become completely inactive due to fear of harm—inactivity increases risk of adverse pregnancy outcomes including musculoskeletal problems. 5
Do not wait until pain develops to start exercising—prevention through regular activity is more effective than treatment after symptoms appear. 6
Do not assume all pregnant women should avoid exercise—only specific absolute contraindications (severe respiratory disorders, severe heart disease with exercise intolerance, active preterm labor, severe pre-eclampsia, cervical insufficiency) warrant avoiding moderate-vigorous physical activity. 5