CategoriesFemale Training Program Design Strength Training

You Need to Lift Shit to Fix Shit: Some Postpartum Considerations

I know, I know…

I’m a dude.

What could I possibly have to say when it comes to the delicate intricacies of postpartum anything?

Well, as it happens, I’ve worked with many women during and after their pregnancies throughout the years, and have had pretty good success with mansplaining the inner workings of a uterus helping them understand that, whether they’ve given birth seven months ago or seven years ago, strength training can help with myriad of postpartum issues.1

*cue the trumpets*

Copyright: nightunter

You Need to Lift Shit to Fix Shit

Just so we’re on the same page…

…when I say “lift shit” this DOES NOT insinuate anything close to maximal effort.

For starters: I’m not an asshole.

Secondly: All strength training is not powerlifting. It’s still feasible to have someone lift appreciable loads – even postpartum – and not assume I’m attempting to turn them into Stefi Cohen.

But more to the point: I’m not an asshole.

I understand, to the best of my Y chromosome having abilities, the intricacies and delicateness that coincide with the months postpartum.

It’s not a time to rush back into things and to race oneself back to pre-pregnancy gym numbers.

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

It’s Not Just About Kegels

Kegel exercises are amazing, but as Dr. Sarah Duvall notes in her spectacular Pregnancy & Postpartum Corrective Exercise Specialist 2.0 course they’re often OVER used.

Or, more often that not…the ONLY thing used.

For many women their postpartum approach = kegels (and that’s it).

Alternatively, a more germane (and, not coincidentally, successful) approach to postpartum training is:

  • Kegels
  • Teaching a GOOD breath – focusing on the canister position.
  • Cementing all of the above with “strength.”

Kegels are a fantastic (and proven) tool to use to help with pelvic floor dysfunction. Teaching them the right way (and when appropriate) helps to connect and educate the pelvic floor. As it stands, women who did dedicated pelvic floor training = 17% less likely to report incontinence.

However, when OVER used kegels can lead to an overactive pelvic floor. Compound that with the all too common scenario of very little attention being made toward the efficacy of positional breathing drills – I.e., emphasizing the canister position (pelvis stacked underneath the ribcage; or reduced rib flare)  – and you have a recipe for disaster.

Photo Credit: Inspired Physiotherapy

Left Image = Canister Position (diaphragm stacked on top of pelvic floor)

Right Image = not that.

Positional breathing begins with teaching a GOOD inhale. This entails 3D (360 degree) expansion of the ribcage. With a good inhale the diaphragm contracts down and it able to “let go” and relax. Moreover, as Sarah notes in her course, every (good) inhale can push down on the pelvic floor which is okay.

Bearing down is one thing. This is not ideal.

However, with a proper inhale, the idea is to push the “ground floor of the house to the basement.” In other words: the inhale EXPANDS pelvic floor. Then, a full, accentuated exhale brings everything back to the ground floor.

For the visual learners out there this may help (graph taken from Sarah’s course):

Again to reiterate:

“Inhale = pushes down onto pelvic floor (get it to the basement)….exhale = RELAXES.”

Taking the time to really build context and to hammer home the importance of the canister position will be a home run for many (if not most) postpartum women.

A simple example would be something like a deadbug, performed with a full 360 degree inhale followed by a drawn out, full exhale (without aggressive bearing down of the abdominals):

 

Tony, Did You Forget About Lifting Things?

Puh.

Not at all.

Strength training is the part where we “cement” all of the above into place. It’s crucial to build pelvic floor awareness (kegels) as well as function (positional breathing drills). If someone is unable to do this right, I am NOT going to load them.

However, assuming the work has been done I see no reason not to.

First we start with TIMING of the breath with the bodyweight squat. Inhale on the way down (pelvic floor expands and relaxes).

Exhale on the way down (pelvic floor comes back up and contracts).

 

Once that is mastered, then we can begin to THIS IS SPARTA. BACK SQUAT MAX EFFORT, BABY.

Just kidding.

I just use common sense and progress accordingly with something like Goblet Squats and always remain cognizant that I DO NOT want any aggressive bearing down of the abdominals and to keep IAP in check. The pelvic floor is just like any other muscle and needs progressive overload too.

Being postpartum is not a disease and I find it increasingly frustrating that many women are programmed into thinking that the only approach is with kegels and kegels only.

It’s a far more multi-faceted approach that requires attention to detail and dare I say…

…lifting shit.

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 recent memory, 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 opened up access to the entire PCES 2.0 course:

  • 34 hours of content loaded with a tsunami of lectures, videos, and case studies.
  • CEUs available
  • Save $250 off the regular price through May 21st. Access to the course shuts down on 5/25.
  • 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 5/21 to SAVE $250 and access to the course ends on 5/25.

👉  CLICK HERE 👈

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.

 

View this post on Instagram

 

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.2

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.3

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 👈

CategoriesCorrective Exercise Female Training

4 Things to Consider When Working With Postpartum Women

I’ve always prided myself in my ability to recognize (and then attempt to address) my knowledge gaps.4

  • Understanding functional anatomy? ✅
  • Peeling back the onion on the importance of breathing mechanics? ✅
  • Having a better understanding of how to appropriately program plyometrics? ✅
  • Long division? ❌

One of the best things I did for my career, however, was to better educate myself on the topic of training clients’ through pregnancy in addition to having a better understanding of the intricacies working with postpartum women.

Anyone who works with women – which is pretty much every coach, ever – should consider investing in this area. I can only speak for myself, but studying this topic in more depth has given me much more confidence as a coach.

I’m also speaking for myself when I say one of THE best courses I have ever taken – not just on the topic, but ever – is Dr. Sarah Duvall’s Pregnancy & Postpartum Corrective Exercise Specialist course.

She’s just revamped the entire course and starting today (through tomorrow, 2/24) you can purchase Pregnancy & Postpartum Corrective Exercise Specialist 2.0 for $150 OFF the regular price.

  • 34 hours of content (legit, everything is covered: The only thing not covered is showing a live birth).
  • CEUs available (the total # will depend on your certifying body).
  • Payment plans are available too.

I cannot express enough how valuable this course has been in helping me not only become a better coach, but also gaining the confidence/trust of my female clients. I have little reservations in saying that investing in this course will pay for itself tenfold.

Below is a repost of an article I wrote last year sharing some of the things I’ve learned taking the course. But for those who prefer to skip the foreplay, you can go HERE to purchase. REMEMBER: The discounted price only lasts through Wednesday (2/24).

Outside of that, you should totally read my article (pretty sure it’s Pulitzer worthy).

Copyright: sangriana / 123RF Stock Photo

4 Things to Consider When Working With Postpartum Women

1. Once a Woman is Postpartum, She’s ALWAYS Postpartum

This is a powerful quote and something Sarah stresses over and over again in her course. Whether you’re working with a woman who is very recently postpartum or she gave birth three years ago, you still need to do your due diligence as a coach.

Just because some time has passed doesn’t mean she’s out of the weeds yet. Some women exhibit significant Diastasis Recti years after giving birth and shrug it off as “meh, that’s just the way things are.”

Likewise, some women view incidents such as incontinence (urine leaks) as equally “normal” and shrug worthy years after the fact.

NEWSFLASH: they’re not.

In light of that, it’s important to ask questions and to peel back the onion on a woman’s (reproductive) health history to glean as much information as possible.

Now, I get it: I’m a dude.

There’s a high degree of professionalism at play here.

“So, where you from?”

“Born and raised in Boston.”

“Awesome, do you have any major injuries I need to be aware of?”

“Nope, none I can think of.”

“How many kids do you have? Did you have a natural birth or c-section? Oh, and do you pee when you squat?”

To help stave off any awkwardness, I’ll send all prospective clients a questionnaire to fill out a head of time with pertinent questions related to this part of their health history.

If they’ve never given birth then they can skip and move on to the “Favorite Movie of All-Time” section (which is TOTALLY a thing by the way.  I find it’s a great conversation stimulator and helps break the ice). And if they do have kids I ask them to fill out that section which has a handful of follow-up questions.

They can then go into as much detail as they feel comfortable with with 1019% less awkwardness.

2. Breathing –> Core –> Posture –> Everything Else –> More Kitty Cuddles

That’s the order of things you’ll almost always want to prioritize when working with postpartum women. I’ve had a crush on the importance of positional breathing drills ever since my days at Cressey Sports Performance.

We found there was a lot of efficacy towards their use with getting athletes into a better position prior to training; specifically nudging toward a canister position (Zone of Apposition, I.e., the act of bringing things together or in proximity) as opposed to a scissor position.

Canister Position = diaphragm and pelvic floor stacked on top of each other.

Scissor Position = the opposite of that.

The latter tends to be a much more UN-stable position and can (not always) result in a fusillade of things we’d rather not see happen:

  • Poor breathing mechanics.
  • Lower back pain.
  • Shoulder pain.
  • Many of the things I’ve already noted above: DA, pelvic floor issues, etc.
  • Global warming
  • Another Transformer movie.

Honing in on breath can help “glue” or connect things more efficiently. Making sure someone is getting 3D expansion of their rib cage (and not just breathing UP into their chest) can be a game changer and helps to set the stage for everything else that follows.

If you don’t own breath, you’re not going to own “position” during exercise.

Something as simple as the Deadbug exercise – done correctly, with emphasis on the breath – is a great example.

 

It’s important to note that everyone is different and every birth is different. I can’t stress enough the importance of encouraging a woman to wait until she’s ready before implementing any mode of exercise. However, it’s important to note that it only takes 14 days of bedrest to notice atrophy of the Multifidi and surrounding spine musculature.

Encouraging small walks in conjunction with very basic breathing drills can help offset this.

 

Reiterate – from the rooftops – that a woman’s core is GOING TO BE WEAK FOR A LONG-TIME and that it is okay, normal, and 100% human for this to happen.

It still behooves them to set in motion – when they’re ready – these mini interventions that will pay HUGE dividends down the road.

3. It Takes Time

Women who train during their pregnancy are often the most vulnerable. They want to revert back to their “normal” training schedule often times before they’re close to being ready.

The pelvic floor (and other places of trauma) need time to catch up.

A good rule to keep handy:

“9 months to grow, 9 months to recover.”

This is not to imply that a woman can’t start lifting weights or exercising more vigorously prior to nine months, however it’s just to toss in a bit of expectation management.

The kipping pull-ups and heavy squats can wait.

FIRST FOUR MONTHS = rebuilding solid base (get the pelvic floor and core working with a ton of breathing drills).

But even this approach can be tempered to that of the client and her capabilities.

As an example I have a current client who gave birth less than a month ago who has just started to come back to the gym to train. She had been working with me for two years prior and knows her way around the weight room.

Here’s an example of her first week of training back:

A1. Deadbug 3×5/side
A2. Goblet Split Squat: 3×6/leg

B1. Standing Band Row: 3×10
B2. Breathing Side Plank: 3×3/side

C1. Pallof Press: 2×10/side
C2. Suitcase Carry: 2×25 yds/side

D1. Box Jumps – AMAP x 2x30seconds
D2. Just kidding. The fuck outta here.

Again, everyone is different.

The umbrella theme to remember, though, is to TAKE THINGS SLOW!

4. What To Avoid in the Early Stages

On that front, here are some thing you’ll likely want to skip altogether in the early stages of working with postpartum women:

Plyos – burpees, jumping jacks, stairs, stop it.

Running – just an accentuated plyometric.

Front Abdominal Exercises – planks, sit-ups, push-ups, leg lifts (or anything that makes the abs bulge in front or uses the core to support a lot of the body weight).

Ninja Fights – Probably best to avoid ninjas at all costs, actually.

And That’s That

There’s obviously a lot more to consider, but that’s a pretty good start. For much, MUCH more on this topic check out the Certified Pregnancy & Postpartum Corrective Exercise Specialist 2.0 course HERE.

Your face is going to melt so hard you’ll learn so much.

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.5

—> 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.

 

CategoriesFemale Training

Fitness During Pregnancy: What’s a Girl To Do?

It’s not lost on me I have a Y chromosome and that discussing pregnancy and how to train during and after it can be a bit, well, peculiar. I mean, it’s something my body will never experience, so how can I discuss the topic without coming across as some mansplaining a-hole?

Simple.

50% of the human population is female. Surprise!, roughly 50% of my clientele are female. And, as it happens, I have worked with several women through their pregnancies (and after) and have always felt it important to understand and respect the nuances that manifest during this delicate time in a woman’s life – both pre and postpartum. 

While I very much operate under the umbrella that every pregnancy is different regardless of one’s previous fitness level and experience and that how someone feels during any exercise or workout should dictate the path taken – progressions, regressions, loading, volume, etc – I also feel there’s a strong stigma that women shouldn’t train during and after pregnancy. 

Come on. 

The body is preparing for something a helluva lot more traumatizing than a set of squats or deadlifts. It’ll be okay.

What’s more, as my colleague and women’s health expert, Dr. Sarah Duvall, often says with regards to postpartum considerations: “women need to lift shit to fix shit.”

And it’s on that note I’m gonna take my little Y chromosome and STFU. I’m elated to introduce to you another woman whom I feel is generating a ton of useful information on the topic of training during and post pregnancy: Terrell Baldock.

She wrote today’s guest post and it’s awesome.

Enjoy.

Copyright: wavebreakmediamicro / 123RF Stock Photo

 

Fitness During Pregnancy: What’s a Girl To Do?

With all the random misinformation out there it’s tough to know how you should workout – or heck, whether you should even workout at all – during and after pregnancy.

Here’s the good news:  The short answer is yes.

You should continue to exercise during and after pregnancy.

You can keep being the best version of yourself. And isn’t that what it’s all about?

But exercise during and after pregnancy needs to be done the right way.

Lindsey’s Story

My client Lindsey was a competitive volleyball player who wanted to get right back into hard training and competition after her daughter was born.

Then, reality set in.

Lindsey noticed when she was working at a high level of intensity, she’d pee a little.

Still, she pushed through.

That continued until she became pregnant with her second baby.

When she went through the same experience, Lindsey knew she needed to see her doctor.

Bad News: She had a grade-two bladder prolapse. She was told: “Lindsey, you can’t play volleyball anymore.”

Lindsey was crushed.

This is when Lindsey and I started working together. My role as a coach is to show women like Lindsey exactly how her prenatal fitness and postnatal fitness programming could affect her body both during and after pregnancy.

Unfortunately, women are cleared for exercise at the six-week checkup with little to no information regarding rehab, their core, or pelvic floor.

As you can imagine, women like Lindsey feel betrayed by their body. It’s as if they have an entirely new body to “figure out” as they begin their new lives as mothers.

I want to help you avoid common problems such as pelvic organ prolapse, incontinence, and even other issues such as diastasis recti that haven’t healed postpartum.

Training Before Pregnancy

With up to 50% of the female population experiencing pelvic floor dysfunctions like incontinence and pelvic organ prolapse, the combination of pregnancy and childbirth along with high level exercise are leaving women vulnerable.

Even more shocking?

Most women who train hard during pregnancy never have symptoms until they’ve had their baby.

Training During Pregnancy

Generally speaking, you can continue to train the way you did before you were pregnant in your first trimester.

But adaptations need to be made in the second and third.

A common misconception that you’ve probably heard is that you can continue to do what you’ve always done during your pregnancy because your body is well conditioned.

Big mistake.

First trimester

Pregnancy brings on structural change that impacts your fitness performance and how you move naturally, which begins in the second trimester.

In the first trimester, the core and pelvic floor isn’t a big concern but this is a time where rapid change is happening physiologically. Energy is low and nausea may be a factor.

Women also tend to experience breast tenderness which may make exercise feel impossible.

If the symptoms are intense, exercise may be sporadic at best.

Second Trimester

In the second trimester, symptoms usually subside or disappear completely, and because of this, women are ready to return to their regular program. This is also where the body starts to visibly change and the Transverses Abdominis becomes inhibited (Hodges et al 2003).

Alignment changes begin to put more pressure on the core on pelvic floor. This is generally when the pelvis anteriorly tilts, the ribs shift and move behind the pelvis.

If this isn’t taken care of and training is continued, the glutes become inactive and the low back, adductors, abductors, and hip flexors take over.

Many women will begin to experience pelvic discomfort and/or pain like pelvic girdle pain, SI pain, and lower back pain which occurs in 45% of pregnant women and 25% of postpartum women (Wu et al 2004).

Third Trimester

In the third trimester, 100% of pregnant women will experience diastasis recti which is classified as the “unnatural separation of the abdominal wall” (Mota et al 2014).

DR is a completely natural part of the pregnancy process, but it can be exacerbated by the nature of the training as well as alignment in addition to the growing baby.

The pelvic floor is vulnerable, especially in the third trimester because of the physical and physiological changes. The pelvic floor isn’t designed to carry the load of a 200 pound back squat and meet the demands of pregnancy. This is where women experience issues postpartum.

Combine that with stretched and a weakened core and the impact of vaginal delivery (Sleep et al 1984), this can lead to pelvic floor complications like incontinence or pelvic organ prolapse if a woman returns to her fitness program before taking the steps to recover, rehab, and recondition first.

Training Post Pregnancy

The body doesn’t completely heal in six weeks postpartum.

It has taken nine months to adapt to the changes that occur during pregnancy. It takes at least that much time for the body to completely heal.

And that’s with rehab.

In fact, if Diastasis Recti hasn’t completely healed within the first 8-weeks postpartum, research shows that it won’t heal on itss own (Coldron et al 2008).

Whether you’re a lifter, runner, or enjoy taking classes at your local gym, you can still partake in your favourite activity. But you will need to cut back during your pregnancy.

Retraining following birth to optimize your performance long term.

New moms are often eager to return to high impact fitness, boot camps, or athletics before their bodies are ready.

Most skip the rehab and retraining process.

This leaves some of these women with less than desirable results like peeing their pants, pelvic organ prolapse (where the pelvic organs descend through the vagina), back/hip discomforts or pain, and lagging performance when working at a high intensity.

As your pregnancy progresses, you’ll find that you’ll need to make modifications to your lifts. In this video, I will show you how to modify your deadlifts using a barbell and kettlebells.

 

And there’s a lot more information in my Barbell Training For Pregnancy: Your 3 Step Guide For Maximizing Performance During and After Pregnancy.

It features simple and actionable steps to maximize your core and pelvic floor function, improve performance, and most importantly, avoid the complications that can arise from postnatal exercising.

Click HERE to access your free guide today.

About the Author

Terrell Baldock is a Prenatal and Postnatal Exercise Specialist in London, Ontario, Canada. She specializes in working with women with core and pelvic floor dysfunctions, and prepares them for the demands of pregnancy, birth and postpartum recovery. Check out her award-winning website Mom’s Fitness Boutique.

CategoriesCorrective Exercise Female Training

5 Things to Consider With Postpartum Training

My wife gave birth to our son on January 31st, which was a Tuesday. She was back in the gym that Friday. Although, admittedly, all she did was a few easy bodyweight exercises and listened to my advice on hammering drills like deadbugs, birddogs, and anything else that would help to build back her core strength and integrity.

Postpartum training is a very tricky topic, and a serious one. Many women make the mistake of jumping back into (aggressive) exercise before their body is ready and sometimes suffer the consequences.

In today’s guest post, Dr. Sarah Ellis Duvall, helps shed some light on a delicate topic.

Copyright: maximkostenko / 123RF Stock Photo

 

Recently, I saw an awesome Instagram post by Tony of his wife, Lisa. She was maxing out on bench press when she was only a few weeks postpartum. Go Lisa!

She is kicking butt and taking names and I was totally impressed.

Note From TG: THIS is the post Sarah is referring to. It was an awesome lift. What was not so awesome was how another trainer came in to highjack the thread and grandstand about how “dangerous” it was that Lisa was lifting so heavy so soon after giving birth, despite, you know, Lisa having been training all through her pregnancy, taking her time after giving birth to get back up to that point, AND being cleared by her doctor.

Since she has an awesome coach, her programming is perfect, but what if you are postpartum, headed back to the gym and not being trained by Tony?

Well, your life is probably a little less fun and devoid of Star Wars humor but here are 5 things to keep in mind before maxing out on your lifts postpartum.

#1. Do You Have Full Core Strength Back?

Start by checking for a diastasis. This is a thinning of the fascia (think shiny layer when you pull the skin off a chicken) that connects the front of your abs. It should feel like a trampoline when you lift your head and poke it. If your finger sinks in, that’s telling us your core is not connecting yet.

Lie on your back, knees bent

Place your fingers in the middle of your stomach

Lift your head just a little and push

Do they sink or do they spring?

Check halfway between your ribcage and your belly button, right above your belly button and halfway between your pubic bone and your belly button.

Anything that sinks in or is more than two-fingers wide is considered a diastasis. I consider the sinking part more important than the width.

 

Think about this as how well your core is transferring a load or pressure. It will not transfer well if there is a gap or hole in the system.

#2. Check for Doming.

When you do a crunch, sit up or plank your abs should flatten, they shouldn’t dome out in the front.

Doming tells us that your abs aren’t firing together correctly.

Along with not supporting the spine and pelvis enough, doming can also lead to hernias. Prevention is definitely the best medicine when it comes to hernias!

 

#3. Is Your Deep Breathing System in Place?

Does your inhale reach your pelvic floor or is it all upper shoulders or belly?

This is also part of building correct core strength.

Your diaphragm is the top of your core. Think about it as the top of a pressure cooker. We use pressure to help support our spine. If your diaphragm and core muscles are not firing correctly, it can either create too much or too little pressure. The pelvic floor really hates both those scenarios because that can lead to leaks and prolapse (months and months down the road).

I love the umbrella analogy. If you breathe up into your neck and shoulders, you will never open the umbrella. If you only belly breathe, that’s like opening a broken umbrella where only one side works. Aim for your back, sides and front around your ribcage to expand with every breath.

#4. Make Sure Your Pelvic Floor is Timed With Your Diaphragm

A long pushing phase or holding too much tension in the pelvic floor can disrupt the natural movement of the pelvic floor. Make sure you can feel your inhale pushing down on your pelvic floor – pelvic floor responds by relaxing down, then naturally recoils up on your exhale.

 

#5. Be Aware of What Happens Under Exertion

The more demand, the harder the exhale, the more your pelvic floor should contract. Sometimes this gets mixed up and instead of your pelvic floor contracting it bears down in response to pressure.

Bearing down is a great way to cause leaking and pelvic organ prolapse.

I’ve seen many women in person and received many, many more emails from women that have gotten pelvic organ prolapse 3, 8, and even 10 months after having a baby.

They thought things were going well.

They thought they were in the “clear.”

Then they tried some new crazy bootcamp class with lots of jumping or they maxed out on a lift or they simply lifted something heavy over their heads. Getting prolapse at anytime can be very heart wrenching and frustrating, but getting it months after you thought you were fine is the worst.

I’m not saying, don’t exercise hard.

I’m simply saying be aware of what’s going on and make sure you have the groundwork laid before pushing your body. If you don’t know what your pelvic floor does under pressure, that’s the same thing as not knowing your knee caves in during a squat. If any professional saw you, they would immediately fix the knee caving in issue and tell you how they just saved your knee from years of pain.

Pelvic floor prolapse is a real issue with real consequences, and it’s crucial to take the requisite steps a head of time to (hopefully) prevent it from happening.

About the Author

A wife, mom and adventure sports athlete, Dr. Sarah is a women’s health specialist that believes in teaching. Helping women understand how the body works is the basis for her results-driven online program. She focuses on issues from the pelvic floor and diastasis to building strength injury free. When she is not hanging off the side of a mountain, Sarah enjoys writing and presenting at Core Exercise Solutions and figuring out how her patients can continue to pursue their dreams and lead a strong, adventurous life. 

Find out more about her Pelvic Floor and Diastasis Programs here: http://www.CoreExerciseSolutions.com