CategoriesFemale Training personal training

A Thoughtful and Reflective Discussion On Postpartum Training

My son, Julian, was born January 31, 2017.

Four days later my wife, Lisa, accompanied me to the gym.

The workout wasn’t anything crazy. There were no burpees, no deadlifts, no squats; hell I don’t even think there was a barbell involved.

If anything, the field trip served as more of a rendezvous back to normalcy for us.

Our world had just been knocked the fuck upside down during the previous 96 hours, and, after the shellacking we had been taking, a lifetime in Azkaban would have seemed a better alternative.

So yeah, heading to the gym, even for 20 minutes, was exactly what we (she) needed.

It was an oasis for us.

Copyright: realstock / 123RF Stock Photo

That Time the Internet Got All Judgy On Us

Lisa’s first postpartum workout, if you want to call it a workout, wasn’t anything to write home about. I think I had her do some deadbugs, side planks, a few Pallof Presses, bodyweight step-ups, and, yeah, okay, there was a barbell involved…

…she did some light bicep curls.

To her credit Lisa trained all throughout her pregnancy.

While no where near the same intensity she was accustomed to, she deadlifted, swung kettlebells, performed hip thrusts, and even used natural progressive overload (her growing tummy) to crank out her chin-ups.

 

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A post shared by Tony Gentilcore (@tonygentilcore)

At the same time, she remained cognizant it was imperative she listen to her body. If at any point something felt off or “wonky” she stopped and we made the appropriate adjustments.

I wholeheartedly believe that it was her dedication and diligence to strength train throughout her pregnancy which resulted in a smooth and seamless birth.1

NOTE: For a more detailed article expounding my approach and thought processes on the topic of women and strength training through pregnancy go HERE.

Fast forward several weeks and I posted this video on my Instagram page of Lisa hitting a bench press personal record:

During her maternity leave we took advantage of having more time to workout together, and I was proud of her for staying proactive during this time.

She listened to her doctor, she listened to her body, and she was able to regain (some) of her pre-baby strength levels rather quickly (in no small part because she stayed consistent with it during her pregnancy).

I say “some” because we made it a point of not pushing the envelope with other movements such as deadlifts and squats.

Nevertheless, there was a woman who chimed in with her own concerned, if not bordering on scathing remarks and comments on the matter.

“It takes a lot longer than 2-3 weeks to retrain the postnatal core! And wouldn’t she still be bleeding at this stage? That’s an open wound that needs time to heal/ and she needs lots of rest to repair her DRA and PFM tissues, especially if there’s additional birth trauma. I would get her to see a women’s health physio or pelvic PT first, if you care about her recovery. What postnatal courses have you done?”

Oh-no-she-didn’t.

It was all I could not to go into an all-out Beyonce “Lemonade’esque” rage.

“I DON’T CARE ABOUT HER RECOVERY?”grabs baseball bat.

“WHO SAID ANYTHING ABOUT 2-3 WEEKS?!” smashes windshield.

via GIPHY

But I didn’t do that.

In the woman’s defense what she (probably) read and saw was some meathead bragging about his wife hitting a heavy bench press a few weeks postpartum.

How could she have known that in the weeks leading up to that Lisa had also been performing a plethora of diaphragmatic/positional breathing drills, deadbugs, birddogs, carries, hip stability drills, and many other exercises that don’t equate to near the engagement on social media as a bench press?

#mostboringexerciseever

#actuallymaybethisismoreboring…zzzzzzzzzzzz

 

I kindly reiterated that Lisa was cleared by her doctor, that she had been taking things slow up until that point, had been using appropriate progressions, and that she had a pretty smart strength coach (and the world’s #23rd ranked tickle fighter) in her corner writing her programs.

The same woman also stated:

“There’s nothing badass about being a victim to the social pressure to get your body back, it’s stupid really.”

Given no one ever came close to mentioning anything about social pressure or being a victim, at the time, I didn’t have much of a response. She was likely projecting based of experiences in her past, and I chose to ignore it.2

I mean, my wife’s been lifting weights since she was 13 years old, it’s part of her DNA. What’s more, we were engaged in an activity we enjoyed doing together (working out), and she really loves benching, why should I have to defend that?

However, upon further reflection I could see where this woman was/is coming from.

Don’t get me wrong: I still feel there was an exorbitant and egregious amount of “assuming” on this woman’s end.

Like, who in the flying fucks of fucks was she to assume we didn’t take all the precautions in the world? But, deep breaths Tony, I could see how my initial post may have been triggering and come across as a bit too braggadocious.

Moreover, I can see how the message could have been misconstrued.

As oxymoronic as it sounds (and this is likely why this particular woman called me out), women that exercise through their pregnancy are often at MORE risk for postpartum issues. Many feel pressure to head to the gym as soon as possible after giving birth because they actually feel “okay.”

To be clear: This was not the case with my wife. It had everything to do with not wanting to throw an ax into her face from cabin fever.

However, this mentality can often lead to dire circumstances because their body is still healing. Just because someone may want to perform kipping pull-ups paired with sandbag carries through a grenade field for AMRAP doesn’t mean you should.

You CAN still exercise postpartum, but it’s important, nay, crucial, to respect the notion that your body still needs time to “catch up.”

I guess maybe I should have said that from the get go when I originally posted that video of Lisa bench pressing.

That said, it was something the woman said in her initial comment to me that really struck a chord:

“What postnatal courses have you done?

Shit.

None.

Now, I’m not an idiot.

I understand, to the best of my Y chromosome having abilities, the intricacies that coincide with helping a woman train through her pregnancy, as well as how delicate matters are in the months postpartum.

The first few months are all about rebuilding the base (specifically to address the pelvic floor and diaphragm, to get the “core” connected, working, and to progress from there).

After that, a person’s capabilities and foundation matter more than whatever time frame it takes to get them deadlifting appreciable weight again.

As far as the BIG no-no’s to avoid immediately postpartum:

  • Plyometrics – burpees (please, stop), jumping, stairs, and running.
  • Anything coming close to max-effort loading.
  • Front abdominal exercises (planks, sit-ups, push-ups, leg lifts, or anything that makes the abdominals bulge anteriorly or uses the core to support a lot of bodyweight).
  • FWIW: Any sort of Fight Club is out of the question during this time as well.

I’m also aware that the postpartum “phase” doesn’t just refer to weeks or even months. Women can present with postpartum issues years after the fact, and it’s imperative to respect that and know how to assess and program accordingly.

But, to go back to the woman’s comment (what postnatal course have you taken?) that was a massive mea culpa.

I had taken none.

She got me there.

At that point I felt it was my responsibility to remedy the situation.

And that’s what I did (and am still doing).

Pregnancy & Postpartum Corrective Exercise Specialist 2.0

In recent years whenever I am asked by other health/fitness professionals what course I’d recommend they look into my immediate answer is Dr. Sarah Duvall’s PCES course.

It’s without hesitation the most valuable continuing education resource I’ve come across in the past four years, and it’s also had the most impact on my own coaching.

Every pregnancy is different.

Every woman who is postpartum is different.

There are a LOT of women out there and you WILL undoubtedly need to know this information and know how to apply it.

As it happens, Sarah just revamped the entire course: PCES 2.0

  • 34 hours of content loaded with a tsunami of lectures, videos, and case studies.
  • CEUs available
  • Save $150 off the regular price through Wednesday (2/24). Access to the course CLOSES on March 5th.
  • FYI: Payment plans available.

This course will teach and show you the appropriate assessments/screens to use as well as the corrective strategies to implement to address everything from pelvic floor dysfunction to incontinence to rectus diastasis. In addition, and this is what I dig the most about Sarah’s approach, is that strength training can and should be a part of the process.

Remember: You only have till midnight on 2/24 to SAVE $150 and access to the course shuts down on 3/5.

👉 Click HERE 👈

CategoriesStuff to Read While You're Pretending to Work Uncategorized

Stuff To Read While You’re Pretending To Work: 1/19/18

Man am I in a funk. This has never happened before, but I’m struggling to come up with content to write.

I can’t say for sure, but it “may” have something to do with a soon-to-be one-year old that’s growing more and more mobile by the day.1.

In any case I apologize for my lack of writing prowess. Rest assured I’ll be making a comeback sooner or later.

Onto this week’s list….

Copyright: wamsler / 123RF Stock Photo

BUT FIRST…

1) Mark Fisher Fitness Presents: Motivate & Movement LAB

I’ve had the honor of presenting at two previous iterations of the Motivate & Movement LAB (the brainchild of MFF’s Harold Gibbons) and it’s unequivocally one of the most unique events in the fitness industry.

Think: TED Talk, but with deadlifts and lots of f-bombs.

Anyways, the next LAB is this coming February, and will feature myself, Dan John, Pete Dupuis, my wife (Dr. Lisa Lewis), and several of the MFF coaching staff including Brian Patrick Murphy and Amanda Wheeler.

2) Appearance on the All About Fitness Podcast

Host Pete McCall does a superb job with this podcast and keeps things light and entertaining.

In this episode I discuss my journey towards my 600 lb deadlift.

You can go HERE (Episode 85) or HERE (Episode 85) via iTunes.

3) Postpartum Corrective Exercise Specialist

I’ll go a head and say it: I feel this is one of the single most important courses I have ever taken.

If you train women it behooves you to understand the intricacies surrounding this topic: pelvic floor dysfunction, prolapse, incontinence, etc.

Dr. Sarah Duvall covers everything from assessment/screening to corrective exercise (tons of attention to proper breathing mechanics) to training considerations immediately postpartum (1-4 weeks) onward to a year plus.

What’s more, what I truly dig about Sarah’s approach is that she advocates women to eventually “lift shit to fix shit” (my words, not hers). Sooooo, there’s that.

FYI: Use the coupon code TONYG at checkout for an additional $50 off your purchase.2

Stuff To Read While You’re Pretending To Work

10 Nuggets, Tips and Tricks on Energy System Training – Mike Robertson

Per the usual Mike takes a rather complicated topic and dumbs it down for us peons. I REALLY liked his breakdown on the differences in adaptations between aerobic training and anaerobic, and how it’s the former (aerobic) that will likely help with better progress in the weight-room.

Does It Matter If You Can Deep Squat? – Travis Pollen

The deep squat screen can tell you a lot about a person. It can tell you his or her’s ability to achieve adequate ankle dorsiflexion, as well as much hip mobility, thoracic extension, and shoulder flexion they have.

About the only thing is doesn’t tell you is their favorite installment in the Fast & Furious franchise.

But what does the deep squat really tell us? Travis sheds some light.

Everything You Need to Know About Recovering – Dr. Mike Israetel

Very comprehensive article that covers a litany of popular recovery strategies:

– Those that work well

– Those about which science is uncertain

– Those that don’t seem to work as planned or much at all.

Social Media Shenanigans

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CategoriesFemale Training

One Year Postpartum: Are There Any Special Training Considerations?

The short answer is a resounding yes.

A lot of articles and information directed towards postpartum women cover the initial weeks and months after giving birth. That’s awesome. But what about one year after? Five years?

As Dr. Sarah Duvall, creator of Postpartum Corrective Exercise Specialist, mentions below in today’s guest post: once postpartum, always postpartum.

PCES is an outstanding course, and one I’m currently going through now. It’s only being offered for another week, with a special offer for TG.com readers below.

Enjoy!

Copyright: vadymvdrobot / 123RF Stock Photo

Are there any special considerations for training a woman that is over a year postpartum?

For this question we need to ask ourselves, “does the postpartum period end at an arbitrary time?”

In some cases, yes.

Time does have a positive impact and in other cases, no. So, let’s take a look at when time matters and when it doesn’t.

In the early stages postpartum women are still dealing with excessive ligament laxity that was needed to help get the baby out. Most women notice a decrease in the laxity by 4-6 months postpartum but for those that continue to breastfeed, the laxity can continue well over a year.

This matters because laxity creates instability and increases vulnerability to injury, especially in the pelvic floor.

So, being further along postpartum is a real win for not having to worry about the extra ligament laxity.

Most of the stories I hear from patients about post-delivery prolapse development happen in this one-year window. There is still a chance of women getting prolapse outside this time frame, but thankfully, the chances go down with the recovery time.

Why does this matter?

Women should take it slow getting back into impact exercise that could place an unnecessary strain on the pelvic floor while it’s still healing. (This goes for C-Section ladies as well!)

Incontinence or leaking during exercise is another one of those pesky issues that a significant number of women complain about and we often associate with having a baby. A survey taken among women that experience leaking showed that women with no leaking three months after delivery had a 30% chance of experiencing leaking twelve years later.

This is a significant number!

Now we’re talking about a woman who decides to get in shape and head to the gym and all of a sudden she is experiencing this pelvic floor issue she never had before.

Why does this happen?

I think it’s a breakdown of the system. An accumulative effect, if you will.

When proper steps aren’t taken postpartum to ensure complete pelvic floor recovery, our system can form compensations. Sometimes these compensations can take years to show up. Much like many preventable chronic injuries throughout the body.

The same thing can happen with the core. If 100% of women that go into delivery have a diastasis, then checking for it should be a routine part of any initial visit. Pregnancy pushes women into poor movement patterns.

The large amount of weight in the front causes a posterior weight shift and lengthened abdominals.

Because of this weight shift, women will often end up with tight paraspinals and a hinge point at the T12-L1 junction. This can cause back pain and tightness as well as perpetuating a poor breathing system that prevents complete core recovery.

Along with this weight shift, the baby itself pushes up on the diaphragm continuing to shut down deep breathing. Proper breathing is the foundation for core and pelvic floor recovery.

These postural compensations can stay with women for the rest of their lives unless someone gives them the right corrective exercises to break these patterns. Checking for a diastasis and asking key questions about pelvic floor health should be high on the priority list for a woman at any stage postpartum.

Check out this video for a couple key posture tips that help promote diastasis healing.

 

Bottom line, once a woman is postpartum she is always postpartum.

Being pregnant increases her risk of pelvic floor issues, diastasis and postural changes.

These risks are not limited to the first year or even the first five years postpartum. These are issues that affect many women for the rest of their lives. The good thing is that with a little knowledge we can do something about it. These women can have hope for healing at any stage in life.

Postpartum Corrective Exercise Specialist (Special Offer For TG Readers Only)

I’m not going to beat around the bush, if you’re a fitness professional you should considering taking this course.

It will undoubtedly make you a better coach and better prepare you for the delicate nature of working with women postpartum (which, as Sarah noted, never really ends).

I’ve trained several women through their pregnancies and have obviously trained hundreds after the fact.  I thought I knew what I was doing, and I’ve done okay.

I guess.

This course has helped me immensely and has really shed a spotlight on some coaching/information gaps on my end. I can’t recommend it enough.

Sarah only offers it a handful of times per year and she’s been kind enough to extend it for another week so my readers can take advantage. What’s more, if you use the coupon code TONYG at checkout you’ll get an additional $50 off your order.1

—> Click Here to Save <—

About the Author 

A wife, mom and adventure sports athlete, Sarah is a women’s fitness specialist that takes functional training to a whole new level. In her unique approach to treating patients, she believes in teaching. Fully understanding every aspect of the body is a necessity to complete healing. She integrates functional movement with cutting-edge exercises to bring you results-driven programs for postpartum recovery, with an emphasis on the pelvic floor and abdominals. When she is not hanging off the side of a mountain, Sarah enjoys writing and presenting at http://www.CoreExerciseSolutions.com and figuring out how her patients can continue to pursue their dreams and lead a strong, adventurous life. 

References

Viktrup L, Rortveit G. Risk of stress urinary incontinence twelve years after the first pregnancy and delivery. Obstet Gynecol. 2006 Aug;108(2):248-54.