Training Characteristics During Pregnancy and Postpartum in the World’s Most Successful Cross Country Skier

Abstract

This case-study investigated the training characteristics, physiological capacity, and body composition of the world’s most successful cross country skier during the 40-week pregnancy, and the 61-week postpartum. Training data was systemized by training form (endurance, strength, and speed), intensity [low- (LIT), moderate- (MIT), and high-intensity training (HIT)], and mode (running, cycling, and skiing/roller skiing). The training volume [mean ± standard deviation (median)] during pregnancy was 12.9 ± 7.3(10.0) h/week in the first- (weeks 1–12), 18.3 ± 2.9(18.0) h/week in the second- (weeks 13–28), and 8.8 ± 4.4(9.6) h/week in the third trimester (weeks 29–40). Endurance training time was distributed into 10.9 ± 6.2(9.9), 15.2 ± 2.3(15.6), and 7.6 ± 3.8(7.9) LIT and 0.4 ± 0.5(0.0), 1.3 ± 0.4(1.4), and 0.7 ± 0.6(0.8) h/week MIT during the three trimesters. Only 2.2 h of HIT was performed during the entire pregnancy. During the first two trimesters, the distribution of exercise modes were approximately the same as pre-pregnancy, but the amount of running was reduced during the third trimester. Training volume during the postpartum periods 1–4 was 6.6 ± 3.8(7.1) (PP1; weeks 1–6), 14.1 ± 3.4(14.3) (PP2; weeks 7–12), 10.6 ± 3.8(10.4) (PP3; weeks 13–18), and 13.6 ± 4.1(14.5) h/week (PP4; weeks 19–24), respectively. Training during PP3 and PP4 was interfered with two fractions in the sacrum, leading to decreased amount of running and MIT/HIT, compensated by increased amounts of cycling. Thereafter, training volume progressively approached the pre-pregnancy values, being 18.0 ± 3.9(18.7) h/week during the general preparation- (weeks 25–44), 17.6 ± 4.4(17.3) h/week during the specific preparation- (weeks 45–53), and 16.9 ± 3.5(17.2) h/week during the competition period (CP; weeks 54–61) leading up to the subsequent world championship. The oxygen uptake at the estimated lactate threshold (LT) decreased to 90% of pre-pregnancy values in the second trimester, but remained to ∼100% in PP3. Body weight and fat-% was higher, while lean body mass and bone mineral density was lower after delivery compared to pre-pregnancy. These measurements gradually changed and were back to ∼pre-pregnancy values during CP. This study indicates that high-level cross country skiers can tolerate high training loads during pregnancy. Although the participant had some postpartum setbacks in her training due to fractures in the sacrum, reduced overall training load, followed by a slower progression and utilization of alternative exercise modes, led to a successful return to competitions.

Performance-Related Physiological and Haematological Changes During Pregnancy and Postpartum in a Well-Trained Cyclist Performing Endurance Training

“…Indicatively, L 4 decreased after a long period of reduced training volume and intensity, despite a greater dilution of blood lactate in the 4% higher BV, but quickly improved with increased volume and intensity. This is in line with a previous study ( Solli and Sandbakk, 2018 ), where VO 2 at the estimated lactate threshold rapidly increased up to- (wk 6–12), and above (wk 13–20) pre-pregnancy values during the postpartum period in a successful Olympic athlete. Overall, this case study suggests some lingering hematological benefits and underlines the positive effect of a quick resumption of LIT with a gradually increasing intensity of training in the first 12 weeks after delivery.…”

“…While the previously estimated risk of premature birth and low birth-weight following high volumes of endurance training during pregnancy, has been rejected ( Haakstad and Bo, 2011 ; Thangaratinam et al, 2012 ; Di Mascio et al, 2016 ), findings indicate an increased abortion risk with very high training volumes and/or HIT during the first weeks after conception ( Hegaard et al, 2016 ). In this context, the total training volume performed during pregnancy in the current case is clearly lower than in a previous study ( Solli and Sandbakk, 2018 ) but showed the same relative reductions in training volume throughout pregnancy as previous studies ( Potteiger et al, 1993 ; Bailey et al, 1998 ; Solli and Sandbakk, 2018 ; Sundgot-Borgen et al, 2019 ). In contrast to these studies, our participant also conducted relatively large amounts of HIT during the first trimester.…”

“…Case studies are therefore valuable tools to gather information about physiological changes and the possible effects of training occurring during pregnancy and postpartum. A recent study reported that the world’s most successful cross-country skier was able to maintain a high training volume during most of her pregnancy, with a gradual reduction of training volume during the third trimester ( Solli and Sandbakk, 2018 ). Her oxygen uptake ( V O 2 ) at the estimated lactate threshold decreased to 95% of absolute pre-pregnancy values in the first trimester and further to 93% in the second trimester.…”

Elite athletes get pregnant, have healthy babies and return to sport early postpartum

“…She trained during pregnancy, gave birth to a healthy baby, won four medals in the subsequent World Championship and became the most successful competitor of all time in the winter Olympics in February 2018. Unfortunately, she experienced two sacral stress fractures during postpartum 11…”

Sports Obstetrics: Implications of Pregnancy in Elite Sportswomen, a Narrative Review

“…More recently, a meta-analysis focusing on health outcomes after pregnancy in elite athletes found very low certainty evidence of no association between pre-pregnancy elite athletic exposure and initiation of breastfeeding postpartum, nor the length of breastfeeding postpartum [ 19 ]. Importantly breastfeeding has been shown to have a deleterious effect on bone mineral density (BMD) due to the loss of calcium from the maternal bone mass [ 73 , 74 ], which may increase the risk of bone stress injury [ 37 , 75 , 76 ]. Whilst the link between breastfeeding and injury is weak, with no evidence of this association among elite athletes, breastfeeding athletes should take precautions to increase impact load gradually, with appropriate muscle strengthening to support a return to impact activities.…”