For Melissa Bishop and Malindi Elmore running is their passion, and they’re fast. In fact, running is their job.
Melissa is a two-time Canadian Olympian in the 800-meter event, and a world silver medalist at the 2015 World Athletics Championships. Malindi is a 2004 Canadian Olympian and a professional long-distance runner and triathlete.
Both are also mothers.
They needed guidance on re-strengthening their postpartum body to return to their passion and job with care.
As a pelvic health physical therapist (PT), I treat a lot of postpartum women who are physically active. My caseload is full of patients with bladder incontinence, urinary frequency, painful intercourse, pelvic organ prolapse, chronic injuries, unresolved diastasis recti, and pelvic pain.
All these symptoms directly relate to the pelvic floor: a neglected group of muscles important in a healthy return to sports and physical activity after giving birth.
When Melissa and Malindi first reached out to me, they were eager to return to training and competition. But they’ve heard cautionary tales from fellow runner moms who skipped over foundational steps in their return and costed them.
I dedicate my practice to helping women rehabilitate their core and pelvic floor so postpartum parents can safely return to an active lifestyle, whether that?s international competition or going for that much-needed trail run.
The “Do Nothing” or “All In” Mentality
Typically, the postpartum recommendation is to avoid any physical activity for the first 6 weeks of giving birth. Then your OBGYN or midwife clears you for exercise with no real guidance on how.
That whole time, you?ve been lifting your baby, carrying your older child, and doing your daily chores while feeling a bit off in your body.
For athletes and active moms, that arbitrary 6-week embargo on exercise and lack of guidance once given the ?okay? can push women into one of two camps:
- Those who come flying out of the starting gates, pedal to the metal
- Those who are scared to move
“Pedal to the metal”
These women tend to feel great postpartum, so they start exercising within the 6 weeks of giving birth, or they jump right back to their intense pre-pregnancy routine once given the green light.
Doing either incorrectly or without guidance can lead to common postpartum symptoms like leaking and pelvic organ prolapse, signs that their pelvic floor can?t keep up.
“I’m scared to move”
Women in this camp may have lingering postpartum symptoms. Or, they may have heard of horror stories about women with advanced stage prolapse or needing surgery for pelvic floor dysfunctions. This fear prevents them from engaging in physical activities they love.
But it doesn’t have to be that way!
Among my athletic postpartum patients, exercise isn?t just a part of their mental and physical well-being, it’s part of their identity and possibly even their job.
I often hear about athletic postpartum women who train in secret not long after giving birth. They hide their return to exercise in fear of judgment and shame for not following doctor’s orders, not respecting the healing process, or not ‘prioritizing’ their baby.
To Rest or Not to Rest?
There’s a myth that women should do absolutely nothing during their first postpartum weeks. But training in secret puts them at risk for injury, which ultimately delays their return to sports.
But new moms are given zero guidance on how to safely return to exercise after they give birth. Most women receive no education around the physical changes of their body during and after pregnancy, and how to gently guide themselves back to movement.
I know I didn’t get this education, even in my standard curriculum for physical therapy school. I only learned about it in my advanced training for pelvic health.
I’ve seen more women taking matters into their own hands, eagerly looking for information that safely guides them through postpartum recovery and back to the activities they love.
This Gap in Knowledge Turned into a Calling
After having my two kids, I knew enough was enough. Women needed better information on postpartum rehabilitation, and so did I. I switched my practice and took on more schooling to specialize in pelvic and postpartum health.
While I got great satisfaction helping women in the clinic, I wanted to extend that support to their homes and day-to-day lives.
The program educates and guides postpartum women through pregnancy, birth preparation and postpartum recovery. The goal is to support women as their body changes, prepare it for birth and gently but proactively support moms with a successful return to physical activity.
Building Your Postpartum Foundation Like Olympians
Melissa and Malindi were anxious about how to return to training after giving birth. Running was their passion and livelihood.
They didn’t want to push the limits of their postpartum body, but doing nothing for 6 weeks wasn’t a choice. They reached out to me for help while pregnant.
I helped them to understand the role of their pelvic floor in their upcoming delivery and how to engage with these muscles to decrease potential trauma during delivery.
Within days after giving birth, Melissa and Malindi were using the postural tips and gentle breathing exercises in the Mommy Berries program. It connected them with their pelvic floor, diaphragm and transverse abdominis.
These activities aren’t ‘exercise’ in the conventional sense but offer ways to connect with our core and work on optimal alignment during day-to-day movements with a new baby.
Most women with uncomplicated pregnancies and deliveries can gently re-engage with their pelvic floor and core muscles within days of having a baby. These important muscles go through drastic changes and even injury during pregnancy and delivery.
Why shouldn’t we rehabilitate them? If we tore a knee ligament, we wouldn’t think twice about resting and then slowly rehabilitating it, right?
Goal-setting is a great motivator for returning to your beloved sport or activity. It’s also a way to take in the big picture of how you’ll get there.
With Melissa and Malindi, I took stock of their long-term goal when they were pregnant. Melissa envisioned medalling in the 2020 Tokyo Olympics. Malindi aimed to run a sub 2:35 marathon at seven months postpartum.
Your goals don’t have to be this specific or ambitious. What’s important is to have a realistic target and a general timeline. For me, I wanted to do a sprint distance triathlon within a year postpartum after having my second child, which I did.
From that goal, we work backwards accounting for the time needed to build your foundation of core and pelvic strength. Depending on your pregnancy and delivery, this may take a little more time than expected.
Be kind to yourself and listen to your body?s signs and symptoms. Rushing through the basics will only delay your progress. Mommy Berries? From the Inside Out program will guide you through that foundation and cue you to look out for potential issues.
From Rest, Recovery, and Beyond
After giving birth, our body goes through an initial phase of healing during the first 6-8 weeks. Rest is crucial for the tissues and muscles to heal.
To make the most of this phase, I recommended Melissa and Malindi to give their body adequate rest, but to also use this time to start with the basics: reconnect with their pelvic floor, diaphragm and transverse abdominis outlined throughout all six weeks of Mommy Berries? From the Inside Out program.
This active resting is important since our body relies on these muscles for every single movement we do in the day, like lifting and holding up our baby, grabbing the car seat, and moving laundry along.
The program recognizes both the need to recover while doing our day-to-day activities. It guides you through the small details that make a big impact on recovery, such as:
- Posture that encourages proper alignment, core engagement, and diastasis recovery
- Care for perineal tearing, episiotomy, or C-section incision
- Proper breathing mechanics to reduce the downward pressure on the pelvic floor
- Learning how to use the core while strengthening major muscle groups
- And so much more!
The weeks progress to gentle, yet effective, cardiovascular fitness interval training.
By starting the program within days of giving birth, Melissa and Malindi were able to feel confident with the information and skills they gained and could transfer this to their training.
Smart and Steady Wins the Race
I don’t want postpartum women to fall into one of the two most common postpartum camps: ‘pedal to the metal’ or ‘I’m scared to move.’
From the Inside Out is designed specifically for us moms who need an alternative between those extremes to safely return to our physical activities.
The program encourages you to watch for symptoms like leaking, vaginal or rectal heaviness, and back pain that all point to how your pelvic floor and core muscles need more support for the demands placed on them.
By the time Melissa and Malindi worked through the program, they transitioned to a more conventional training that gradually increased the impact and intensity of their workouts. They took with them the cornerstone the program: to listen to your body and build the foundations of your core and pelvic floor.
Melissa and Malindi applied this philosophy to their postpartum recovery. As of 2020, Malindi holds the Canadian record for the marathon. We’ll be cheering both Melissa and Malindi on in the 2021 Olympic games in Tokyo.
What’s Your Postpartum Goal?
Most of us aren’t Olympic-level athletes, but we can all work toward achieving our personal best in any aspect of our lives. Common postpartum symptoms shouldn’t leave us paralyzed with fear, nor should we push through them.
As a pelvic health PT and a fellow active mom, I wish for all postpartum women to feel empowered by their rehab journey and be excited to reach their goals while honouring their new body.
If you are that active mom not yet looking to hang up her running shoes (or cleats or weights), I highly recommend seeing a pelvic health PT for a full body assessment. While some injuries are irreversible, many are not, and we can help you navigate your healthy return to sports.
Whatever your postpartum goals or physical abilities, you’ve got this!
I’d love to hear from you! What advice were you given during postpartum to help you return to activity?
Ready to rehabilitate that postpartum body? Check out my program From the Inside Out.