For the past couple of months, I’ve been doing a pregnancy workout that involves a couple of pilates-inspired strength sessions. Most of the time, the classes are full of common sense exercises designed to prepare you for pregnancy, childbirth and life with an infant, but the one thing I never really understood was why so much emphasis is placed on wrist health – until now. Last week, after 30 minutes of planks and kettlebells, my left wrist was so painful that I could barely use my hand for days on end.

Carpal tunnel syndrome (CTS) is something most of us associate with laptops and repetitive strains. Ergonomic keyboards and desk set-ups are designed to stop us from developing wrist issues at work, but what you might not know is that pregnancy puts us at increased risk of carpal tunnel – whether we’ve got a crap work set up or not. Hollie Grant, founder of Pilates PT and The Bump Plan, tells Strong Women that CTS is caused by the median nerve (which runs through the wrist – the carpal tunnel) becoming compressed due to swelling. And it’s especially common in the later stages of pregnancy.  

“During pregnancy, the body retains more fluid, and that can cause swelling (oedema). That then puts extra pressure on the carpal tunnel, reducing space for the median nerve to function properly. The third trimester is often when symptoms are at their worst, as fluid retention increases. Additionally, changes in posture, weight distribution and even the way women carry themselves as their bump grows can contribute to increased strain on the wrists.”

My issues are likely something to do with still cycling a fixie bike at 31 weeks – and then trying to hold full planks. I’ve always had sensitive wrists, but on hitting the third trimester, that sensitivity seems to have rocketed. So, does that mean I have to stop planking or give up my bike if I want to be wrist pain-free for the rest of my pregnancy? Grant says it’s all about balance. “Some wrist-loading exercises (such as planks, push-ups, four-point kneeling positions) can worsen symptoms if the wrists are already inflamed. However, that doesn’t mean you should stop training entirely.” In fact, she offers plenty of wrist strengthening exercises as part of her Bump Plan and regularly encourages clients to modify exercises. 

Modify wrist-intensive moves

Instead of a full plank on your hands, try a forearm plank or an elevated plank with hands on a bench or wall to reduce wrist strain. You can also try holding your hand in a fist position (resting on your knuckles) when in contact with the ground to keep the wrist neutral or use dumbbells to elevate the hands off the ground and keep a neutral wrist.

Work on wrist strength

Exercises like wrist curls, grip exercises and resistance band work can help build wrist strength without overloading the carpal tunnel.

Listen to your body

If an exercise worsens symptoms, Grant says that it’s best to adapt it rather than simply pushing through pain. 

Sadly, CTS isn’t always preventable during pregnancy, Grant says, because fluid retention tends to be hormonal. Saying that, you can reduce the risk. 

First off, gentle movement is crucial for keeping circulation going and reducing fluid retention. Think pilates, walking and swimming over very heavy workouts. You don’t want to avoid moving full stop (not least because the benefits of being active for your baby are so huge). Next, it’s worth thinking about your posture. That can become more difficult as pregnancy progresses and your body and centre of gravity change. But Grant says that poor posture – especially rounding through the shoulders as your bump grows – can affect nerve pathways. So, try to dedicate workouts to strengthening the upper body and opening up the chest. Try chest press, dumbbell flys and shoulder press.

Finally, Grant recommends getting to grips with your screen usage. “Holding a phone awkwardly or typing for long periods with poor wrist positioning can make symptoms worse. Taking regular breaks and using supports can help.” 

“The good news is that for most women, CTS resolves itself after birth once fluid levels regulate,” says Grant. However, if you’ve still got months to go before heading off on maternity leave or you’ve got another little person who requires lots of picking up and running about after, having sore wrists for months on end isn’t really an option. Below are Grant’s top tips for stopping symptoms from impacting your daily life ahead of giving birth.

Try wrist splints

Wearing a wrist splint at night can help keep the wrist in a neutral position, reducing pressure on the median nerve.

Schedule in regular hand and wrist mobility exercises

Gentle nerve glides, wrist stretches and grip-strengthening movements can help improve circulation and reduce stiffness.

Elevate your hands 

If swelling is significant, Grant recommends elevating your hands when resting to encourage fluid drainage. That might mean resting them on pillows while you’re watching the TV or having a bit of a stretch every hour when working.

Avoid excessive wrist flexion

If typing or using your phone makes symptoms worse, try adjusting your wrist position to keep it as neutral as possible (or use a keyboard wrist support).

Have a go at cold therapy

We’re not talking cold showers and sea swimming here, but simply applying an ice pack to the wrist for short periods to help reduce swelling.

Seek support if needed

If symptoms become severe or affect daily activities, it’s worth speaking to your GP and asking to be referred to a physiotherapist for further help. 

Images: Getty