In October 2019, when I was four months postpartum with my first kid, I was hospitalized for a week with a cutesy case of rhabdomyolysis.
As a fitness professional, I know the recipe for rhabdo. But as a postpartum woman attempting to redefine her “normal” while rebuilding her new, soft body and navigating a hormone tornado ripping through every fiber of her baby-having being… I wasn’t working with the right recipe, and when all was said and done (read: 150 push-ups later) I had made myself a piping hot bowl of self-pity and regret.
One night during my sterile staycation, my 2:00 AM alarm bell rang – reminding me it was time to pump. With painfully sore arms stuck in the T-Rex position and laughable wrist mobility, I attempted to assemble and affix my pump. And as I watched my rapidly dwindling supply slowly drip out of the flanges and into the bottles – it dawned on me:
“If a coach, with knowledge and experience and support and know-how, lands herself in the hospital while attempting to return to fitness… imagine what a woman without any of those things might wind up doing?”
And so Rebuild, my prenatal and postpartum training program, was born.
Let me be the first (and loudest and most annoying) to say that pelvic floor physical therapy and prenatal/postpartum training should come standard with every care plan for every pregnant woman. In my utopia, you see your birth practitioner (be it an OB or a midwife), and they immediately refer you to your pelvic floor physical therapist, who then refers you directly to your prenatal and postpartum trainer. With our powers combined, we would ensure every birthing human is their strongest, healthiest, and most empowered when entering parenthood and beyond!
But that is a soapbox vagina monologue for another time.
Today, I’d like to address something I’ve coined as “The Four P’s” of prenatal/postpartum pain or symptoms while training. These alliterative little indicators serve as a way for prenatal and postpartum women to develop a deeper sense of body awareness as they re-establish the mind-muscle connection that can get cloudy (or disappear completely) throughout pregnancy and postpartum. They can also serve as a symptoms checklist for when you need to be working with a pelvic floor physical therapist and/or working with a trainer specialized in prenatal/postpartum fitness (if, you know, you did not follow my utopian orders).
1. P is for Pinching: this symptom will often show up in a movement that has a decent amount of compression or loading on a joint. Does a knee pinch when you squat? Does your hip pinch when you hinge? What about your shoulders – do they pinch when you press or pull? If so, a likely culprit is the relaxin hormone running rampant throughout your body. Knowing when and how to modify a movement in order to work with the relaxin – and not against it – is key.
2. P is for Pulling: this symptom can commonly isolate itself in the lower back, hip flexor, or as the round ligament pain in your lower abdomen and groin. Much like the pinching symptom – if a movement causes a shooting, pulling pain in any of those areas, stop, test, and reassess. When pregnant, your body is rapidly growing and changing, and while bodyweight lunges may feel great at week 16 when you’re just barely showing, come week 18 after you’ve rightfully popped, it may be a different story entirely. A specialized coach can help you identify this symptom and find alternatives until your body recalibrates.
3. P is for Pressure: ever feel a heaviness in your downstairs at the bottom of a squat? Like your insides may quickly become your outsides if you do one more rep? This heavy pressing south sensation is caused by intra-abdominal pressure, a breathing/bracing strategy that we both advertently and inadvertently employ when moving and lifting with load. And when we don’t manage and disperse that pressure productively, especially when pregnant, that pressure will go to the most vulnerable places – out toward the thinning connective tissue of your linea alba (see: coning or doming of the midline) or down to your already overworked pelvic floor. Thereby causing that heavy sensation. I would (love to) argue that this is the biggest, most important P of them all – because a mismanagement of this symptom during pregnancy can lead to a whole host of issues postpartum.
4. P is for Peeing: listen, peeing during exercise is not a rite of passage. It’s not a silly little sign that OpE YoU’Re a MoM and it shouldn’t be something you accept as your new normal just because you evicted an alien from your body. This is common, yeah, but this is not normal. This is a sign of pelvic floor dysfunction, and my dudes, you can jump rope without peeing. You can laugh hysterically without leaking. And you can sneeze in public without having to borrow a diaper from your toddler. This symptom is another one that can be addressed with proper breathing and bracing strategies, and can be mitigated by understanding your fatigue threshold in common movements that may induce leaking (think: running, jumping, or lifting heavy loads). Your prenatal/postpartum coach can help you progressively overload your pelvic floor so you can build a bigger tolerance for high and repetitive impact, but if you are experiencing this more than a year or two postpartum, please go see a pelvic floor physical therapist and work with them so you can live that dry life.
Rebuild, the prenatal and postpartum training program at CrossFit Renew, was born because I was an idiot. But despite the hefty hospital bill and the unmistakably metallic taste of saline still lingering in my memory, I am grateful for that bonehead decision – for I am able use my experience and expertise to empower and equip women to train safely and intentionally throughout their prenatal and postpartum journeys.
This program has helped guide over a hundred women rebuild their confidence in and out of the gym, and I want that for every new mom. So! If you or someone you know has experienced any of those P’s throughout pregnancy and beyond – please reach out. I’d love to chat with you about how we can keep you moving in a safe, intentional way.
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