While searching the internet for pregnancy fitness advice and reading about other runner’s experiences with pregnancy, I came across a common topic; pelvic health. Specifically, postpartum incontinence (aka peeing yourself) and diastasis recti (separated abs). These seem to be issues that many women deal with after baby and it sounds like most people just try to manage it on their own and accept it as a normal part of being a mom. Uh no. That’s not cool to me. I have some fitness goals I’m trying to accomplish in the future and I don’t want these issues to derail my plans. I’m also totally unsure that what I have been doing during this pregnancy has been safe and beneficial vs. potentially dangerous to my lose ligaments and abdomen. Through my research, I found that there are lots of educational resources out there but Women’s Health is not a topic discussed as thoroughly in the US as other countries. I found an Instagram page (@everydaybattles_scw) that is dedicated to getting the word out and listed a link to find a local pelvic health clinic in my area. http://www.womenshealthapta.org/pt-locator/ This is what lead me to set up an initial evaluation at Carolina Pelvic Health Center in Raleigh, NC.
The professional I met with has a doctorate in physical therapy and specializes in pelvic health. I believe a lot of her patients come from referrals from general practitioners and she probably only rarely gets someone like me in there who wants to be proactive before having any issues.
The first thing we did was go over my current pregnancy fitness routine. I told her that my goal was to train for the Boston Marathon which is 6 months after my due date. She immediately connected with me on this because she said she is planning to go to Boston, too, and this will be her 5th time. I was so relieved to know she could understand my goals and felt like this made a big difference in how she will help me as a patient.
She then had me perform various exercises to evaluate my form and recorded it all on my iphone which was so incredibly useful. She pointed out things with my posture that could be corrected and gave me advice on new exercises I should start incorporating into my routine.
After these exercises, she did a strength test on me to see how well I could resist pressure on my muscles or joints. This test revealed how weak my hips are (which was no surprise to me). My hips have been sore throughout this pregnancy and especially recently. She taught me an exercise to safely strengthen my hips while avoiding any strain elsewhere. She also taught me how to get out of bed safely and a technique to relax my pelvic muscles. Here are the notes she wrote down for me:
- Walking: Take slightly faster steps – Focus on “heel to toe”, pushing off the toe. Do this for a few minutes intermittently while walking longer distances or to/from somewhere nearby.
- Getting out of bed: Roll over, pressing through heel to engage glutes – makes it easier 🙂
- Squat: See video. Weight in heels, keep tailbone lifted – don’t squat quite as deeply, able to use glutes a little bit more efficiently. Keep bar in front vs behind neck/head.
- Lunges: Form looks great. Keep bar in front vs. behind neck/head.
- Wall pushups – Wider hands and more upright on the wall (see video). Focus on keeping neck/ribs/pelvis in alignment.
- Continue upper body work as previously.
- Shoulder rotation: Stand holding therapy band in both hands, thumbs up. Shoulders in neutral. Rotate one arm out to side against band. Repeat 8-10x, 1-3 sets each side as warmup.
- Arm lift/ arm extension: Stand holding band, arms in front. Exhale, bring band back with R arm. Return to start, Repeat with L. 8-10 reps, 1-3 sets.
- Hip lift: Stand tall (think: engage outer hip muscles). Maintain lift in standing leg, then bring knee up on other side. Hold on for balance as needed. 10x, 1-2 sets each side as warmup.
- Tailor pose (butterfly): Reclined on pillows OR seated modification for comfort. 5-10 minutes/day.
I thought all of her advice was so helpful and seemed to make a lot of sense. We scheduled a follow up visit in a month to see how these exercises are working out for me and to check how I’m feeling before the baby is here. I will also go back after my 6 week postpartum check-up with my regular doctor so she can give me a thorough fitness exam and clear me for training. I might also go see her periodically leading up to the Boston Marathon to make sure everything is recovering properly. I feel relieved to know I have someone to call if I have any sort of pain along the way.
I’m trying to be as smart about my fitness as possible and set myself up for success, if I can. I know once the baby is here, she will be my top priority and I will have many challenges to face when trying to get my workouts in. I don’t want pelvic and abdominal issues to add to the list and slow me down. I can’t wait until this baby is here but I also can’t wait to start working out hard, again!