Episode 4. Safe return to exercise for new Mum’s with Body beyond Baby’s Jen Dugard.
I’d like to introduce Jen Dugard. Jen is on a mission to redefine how Mum’s are educated and cared for after entering motherhood.
Her award winning business Body Beyond Baby ‘Group Exercise with childcare’ was founded in 2008 and looked after 1000’s of Mum’s. The recent sale of the group training aspect of this business has seen the evolution of the Body Beyond Baby brand as ‘the go-to place online for Mum’s to find quality and trusted mum-focused fitness services in Australia and New Zealand”
She authored the book “How to Love your Body as much as your Baby” in 2013 and in 2016 created the Safe Return to Exercise accreditation for Fitness Professionals, which I have done and would highly recommend for anyone who works in the fitness industry with women, which has now been delivered across Australia, New Zealand and in Taiwan.
In the interview we cover:
- What do Mum’s need to know about returning to exercise after having a baby
- When is it ok for new Mum’s to return to exercise?
- What are the main postnatal issues (contraindications) women come across
- Can you tell us a bit more about pelvic floor weakness and what we should do about it?
- Why do we get abdominal separation and what should we do about it?
- What are the most important types of exercises pregnant and postnatal Mum’s need to do?
- Is there any exercise pregnant or postnatal Mum’s should avoid?
- What kind of team of people would you recommend to support new Mum’s and why are they important?
Connect with Jen Dugard and Body beyond Baby here
Connect with the Fit Chick Health Coach
Safe return to exercise for new Mum’s with Body beyond Baby’s Jen Dugard
Jill Lister 00:00
Welcome to the Fit Chick health coach podcast. I’m your host, Jill Lister Martin. Join me as I help women up level their lives through food and fitness, interviewing experts deep diving into my own adventures and finding a balance between motherhood life and a sweet tooth for licorice and wine. Because let’s face it, life is messy and sometimes a little bit overwhelming. Fit check is about finding that balance and inspiring women by giving them the tools to take control of their own health and feel amazing. Let’s get started. I’d like to introduce Jen Dugard. Jen is on a mission to redefine how moms are educated and cared for after entering motherhood. Her award-winning business body beyond baby, group exercise with childcare was founded in 2008 and has looked after thousands of mums. The recent sale of the group training aspect of the business has seen the evolution of body beyond baby brand as the go to place online for moms to find quality and trusted mum focused fitness services in Australia and New Zealand. She authored the book how to love your body as much as your baby in 2013 and in 2016, created the safe return to exercise accreditation for fitness professionals, which I have actually done, I would highly recommend, works with women in the fitness industry and it’s now being delivered across Australia and New Zealand and in Taiwan. Hey, Jen, how are you?
Jen Dugard 01:17
I’m good Jill. How are you? Thank you for having me.
Jill Lister 01:20
No worries. What do you do for your own mental and physical fitness or health in general?
Jen Dugard 01:25
What do I do? Alright, so I guess it changes for me from time to time and one of the things I’ve really learned to do as I’ve gotten older is listen to what I need. Because at some point in my life, I was you know, I must exercise hard and fast for my mental health and if I didn’t do it, I’d layer on that layer of guilt on top of the fact that you’ve not done something. But now it’s about making sure that I take time out for myself and move in a way that feels right for me on that day. So, for example, on Monday, I did a yoga class, like a yoga online thing and then today, I went for a run and then also I bring meditation in when I feel like I need it and I journal as well. So, I will write.
Jill Lister 02:07
Nice. So, actually looking after yourself. What do mums need to know about returning to exercise after having a baby?
Jen Dugard 02:13
What do mums need to know? Lots of stuff. So, I really believe that there’s this big gray area at the moment we learn when we’re pregnant, about what’s gonna happen when we have a baby and then we have the baby and then we get our six-week checkup and then we just go back into exercises and in exercising in some way, shape or form and there’s this gap of helping mums to understand that her six-week checkup is not enough to return to the exercise that she was doing beforehand. So, that would be number one, know that just that tick of approval from your doctor or your carer is not enough for you just to go back to the CrossFit class or the body pump class or whatever it was before you’ve gone through a period of what I call rebuild from the inside out. So, rehabilitation, second one would be understanding your pelvic floor. So, for a lot of women, they don’t understand that their pelvic floor is an internal muscle.
A lot of personal trainers don’t even understand that a woman’s pelvic floor is an internal muscle, and your personal trainer and your Pilates teacher and your yoga teacher no matter how good they are, they can’t actually tell you what your pelvic floor is doing and what we know from research is that 50% of women, when they think that they’re drawing their pelvic floor up, they actually push it out. So, if you think that you’re practicing your pelvic floor exercises, lots of times a day, rather than making it stronger, if you’re bearing down or pushing out, you might be making your pelvic floor weaker. So, they will be two top tips. You want me to keep going or…? I think the other one is understanding your abdominal wall and I’ve just thought of another really important one that we always miss but a lot of women will have what we call a drama separation after having a baby. So, that’s where the rectus abdominis.
There’s some connective tissue in the middle called your linear Alba and that’s where any separation can occur. So, as a mom moving back into exercise, we want to know what the depth of your separation is and also, the width. So, a while ago, we were really obsessed with bringing that gap back together. But weren’t learned, something more about what we call abdominal control. So, you could have someone with quite a large abdominal separation, but it’s very shallow and they might have more abdominal control than someone that has a narrow but deep abdominal separation. So, understanding one, what it is, where it is and then starting to work with the way that your body is functioning is super important and the last one was understanding your birth story or your birth experience.
So, I think we flipped straight into exercise, which I did when you ask that but if you don’t understand what happened to you during childbirth, then there could be a lot of emotional trauma that hasn’t been processed or there’s reasons, maybe your pelvic floor is more traumatized. You’re not sure why that happened or whatever it may be. So, doing some kind of post birth debrief, either talking it through with your partner about what happened, or your carer is probably the first step in returning to exercise.
Jill Lister 05:16
What kind of team of people would you recommend supporting new mums? And why are they important?
Jen Dugard 05:21
I am a massive advocate of a team, Jill, as you know, so the team you want around you, I mean, if I could drill down into one person, so obviously you want your support person but the number one person that every woman needs on her team after she’s had a baby is a women’s health physiotherapist. So, a women’s health physio is not a normal physio. So, you can’t just go to your doctor, I mean, your physio that you would normally go to for a sprained wrist or a sprained ankle, you need to find someone that specialized in women’s health and they can assess your abdominal wall. So, we talked about abdominal separation before and they’ll also look at your pelvic floor. So, where we said that a personal trainer can’t see a pelvic floor on from the outside. Your women’s health physio can use tools so she can use something called real time ultrasound, which is what it looks like the scan of your baby. Or she can do an internal examination. So, your women’s health physiotherapist is pretty much the only person that can give you that full picture of where your body is right now and guide you into the best exercise.
Jill Lister 06:26
When is it okay for new moms to return to exercise? Because I know you talked about your six-week check. Do you see your women’s health physio first, and then is that the go ahead to go back to exercise?
Jen Dugard 06:37
I mean, the guidelines are six weeks postnatal, after a vaginal delivery and eight to 12 weeks postnatal, after a C-section. Now that’s to return to the rehabilitation exercise not to return to your CrossFit class or whatever it may be. I do believe that women can start doing some of that rebuilding. So, if you’re someone who’s learned about pelvic floor about TA, you’ve got some great postural exercises that you’ve learned from your personal trainer in your toolbox, you could start to do those as soon as you feel ready postnatally but when I’m talking about this rebuilding exercises, they’re basically done laying down your back, there’s not a whole lot of movement, you’re doing postural exercises, it might be chest stretching, back strengthening, very simple exercises, but nothing with impact or load and then at that six weeks, you can go back to seeing to the gym or seeing a trainer prior to your women’s health physio check. But if you can get that done beforehand, that would be the ideal scenario and then every woman’s different from that point, it’s like yes, you can go back to training at six weeks or eight to 12 weeks but when is your body ready to exercise in the way that you want to. So, what we can do and what is right for each person could be two very different things and that will be emotionally and physically.
Jill Lister 07:56
What are the main postnatal issues that women come across?
Jen Dugard 08:00
So, within safe return to exercise the course that I do and what I observed over 10 years of working with mums was what I call five key contraindications. So, the first one being pelvic floor, often pelvic floor weakness, but someone might have an overactive or hypertonic pelvic floor, which is still a weak muscle because it doesn’t move through its full range of motion, but it’s a tight muscle. Rather than a looser muscle for pelvic floor. You also have abdominal separation, which we touched on before we often see women with pelvic pain or could be pubic symphysis pain, which is felt on the pubic joint, could be Sciatic pain, which runs down the back of the leg, could be pelvic girdle pain, which is basically any other pain around the pelvis and we also see wrist pain, mums get sore wrists from all the movement, sometimes it’s carpal tunnel, which is a compression of the nerves through fluid retention and the number one thing that I say to women with wrist pain is no creases in your wrists. So, if you’re pushing the pram or when you’re ready to do weights, or whatever it is in the gym, just check out your wrists when you’re holding a baby. Make sure there’s no crease in that wrist and that’s going to protect it even if you don’t have wrist pain at the moment and then the other one is knee pain. A lot of women are doing a more physically demanding job than they’ve ever done before. They’re getting up and down off the ground a lot more than they’ve ever done before and these can definitely cop it. Nice big list.
Jill Lister 09:24
It is a big list. Can you tell us a little bit more about pelvic floor weakness and what we should do about it?
Jen Dugard 09:30
So, I guess the number one thing about pelvic floor weakness is, one it’s not normal. So, it’s common to have a weaker pelvic floor after having a baby but it’s not normal and some of the symptoms that a woman might be looking out for are things like any kind of leaking, any kind of incontinence I guess it’s a similar thing, but that can be urge incontinence meaning I got to go to the toilet right now. It can be stress incontinence that could be caused by jumping, laughing, running, any of that kind of thing. Also, things like a feeling of heaviness in the pelvis, which could also be sign of a potential prolapse, or prolapse being when any one of the organs in the pelvis starts to fall into the vaginal walls. Also, things like painful sex can be a symptom of pelvic floor weakness or pelvic floor dysfunction and also, interestingly, you may or may not know that your superficial pelvic floor must contract in order for you to have an orgasm. So, that that’s not often a conversation that’s brought up. But I believe in having brave conversations with people and if you had a client, let’s say, you were a mum who’d had a baby and then for two years after having the baby, you hadn’t had an orgasm, but you didn’t have any other symptoms of pelvic floor weakness, it might be worth a trip to a women’s health physio to have your pelvic floor checked and you may fix that as well.
So, there’s lots of things around pelvic floor that are not just exercise related, like we can look after someone’s mental health, physical health, that’s your emotional wellbeing that’s your relationship with your partner, depending on how you feel about pelvic floor and that kind of thing. What else about pelvic floor, so understanding that women sometimes push out rather than drawing up, and if that’s you, and you practice it a lot, and then let’s say you go into a gym, and you lift weights, and you think at the bottom of your squat, I got to lift my pelvic floor but instead of lifting, you push it out, and you decided to pick up a 40 kilo barbell, then all of a sudden, you’ve pushed out through 40 kilos of load. So, that’s something to be definitely aware of, making sure that your pelvic floor is contracting in the right direction, so upwards, rather than pushing out.
Jill Lister 11:40
So, what you’re saying is that leakage when you jump is not normal, and we should do something about that?
Jen Dugard 11:46
Absolutely. We shouldn’t be going to the supermarket and buying pantyliners, we shouldn’t be living with it. Because we just think that it’s a side effect of having a baby. Yes, it is. But it’s not something you should live with for the rest of your life and if you don’t deal with it, now, when you move further through your life as a woman and you’re approaching menopause, we have hormonal changes that will make anything like that worse. So, we need to get onto it now.
Jill Lister 12:11
That is really important. Why do we get abdominal separation? And what should we do about it?
Jen Dugard 12:16
Okay, right. So, we’ve got four layers, abdominal muscles, you’ve got your rectus abdominis, down the front, you should join here with me, with the one you’ve got right to the neck. So, we’ve got rectus abdominis, down the front, then we’ve got external obliques, then internal links, and then you’ve got transverse abdominus, that runs all the way around from the back to the front. So, there you have four layers from the outside to the inside. Now, when a woman’s baby grows, her abdominals have to stretch to accommodate the growing baby and sometimes her abdominal muscles get to a point where they can’t stretch anymore. So, that connective tissue down the middle that we talked about earlier, the linea Alba, that’s the weakest point. So, that’s where the separation might occur. Now there is research out there that says every woman that has a baby has abdominal separation, it just depends on whether it heals on its own afterwards, or whether we need to do some work in order to help it heal, I guess. So, I guess what we need to do, what do we do about it, one of the biggest things is knowing you have it. So again, checking the depth, checking the width, if you don’t know how to do it yourself, working with a trainer that does or working with a women’s health physio that can check that for you and then understanding the exercises that are those rebuild from the inside out exercises. So, for me, I would always start with a client with a pelvic floor contraction, I teach her the best I could myself and then I would get her to see women’s health physio to make sure that she’s doing well.
I then layer on top of that a transverse abdominis contraction, so we get pelvic floor and then we get that TA layer which is the innermost abdominal wall and interestingly when we’re working with TA it does put stress on with your elbow. But if it’s working well, it can help to fix abdominal separation. The other thing for people to keep in mind is when you’re doing those basic pelvic floor exercises is just checking with your obliques. So, your obliques are the muscles just underneath your ribcage and if you were to do a cough, or a move from side to side, you can feel those muscles and if every time you’re doing your pelvic floor into a contraction those muscles are switching on, it might be that they can hinder that correction process. The other thing with someone who has over fit obliques, it could if you’re doing big bracing and tensing. If you have a weak pelvic floor, it could put stress on your pelvic floor as well and for anyone that’s listening in pregnancy, relax your obliques to avoid abdominal separation.
Jill Lister 14:34
What are the most important types of exercises pregnant and postnatal moms need to do?
Jen Dugard 14:39
I would absolutely say it’s pelvic floor TA, if we can teach all of our pregnant moms pelvic floor in TA and then we can carry it over into the postnatal period and then we can layer on top of that, whether it’s leg slides or knee drops. So, those basic core exercises that you might see in something like Pilates but done knowing that we have a pelvic floor lift without obliques, so that’s important to me and then things like postural exercises, so keeping glutes nice and strong. So, it might be a hip bridge, it might be a cramp. A lot of mums spend a lot of time with folding forward. So, we want to stretch out those hip flexors and we want to strengthen the glutes. So, we want to stretch the tight muscles and strengthen the weak muscles and the same when we move up the body. So, stretching out the chest, and then strengthening the rhomboids which sit between your shoulder blades because as we know, a lot of pregnant and postnatal moms spend a lot of time in that hunched over position, we get a tight neck and all that kind of stuff. But if we can stretch out the chest and strengthen the back, so if you were doing nothing but pelvic floor TA, glute raises, which is a hip raise, hip stretch, chest stretch and a cobra back strengthening, you’d be doing yourself some good things and it doesn’t have to be hard, right? That would take you 10 minutes.
Jill Lister 15:55
Which is sometimes all you’ve got when a new mum, any exercises that pregnant or postnatal moms should avoid?
Jen Dugard 16:03
So, if you’re a pregnant Mom, I would be steering clear of anything that is deliberately tightening the abdominal wall. So, your traditional core exercises, and what we want to do is promote that relaxation of the abdominal muscles so that the baby can grow, there’s less stress on the linear Alba and hopefully we have less abdominal separation. So, right from the get-go, avoiding those tightening, exercising, avoiding any oblique strengthening exercises, things like the back bends, if you love yoga, you might take out your back bends for the time being. A good tip for people that they might not know is avoid lying on your back. Now conservative guidelines are after the first trimester, other people will push up to 18 – 20 weeks and actually, I am not a big fan of running in pregnancy and I think that this is a good time to bring it up what I know about women that want to run in their pregnancy, they’re generally the women that want to get back to running postnatally.
So, my advice to all of the pregnant women that I work with, or any pregnant women listening, is stop running at 18 to 20 weeks, because that’s when you start to get a little bit bigger. If you’ve had any signs of needing to go to the toilet when you’re running prior to that, any kind of leaking, anything in your pelvis, that doesn’t feel right, definitely stop. But after that 18-20 weeks, you really want to ask yourself, what is the benefit or the reward over the risk of running right now and there’s also not a lot of women, we think that we want to run for mental health, but it doesn’t actually feel good. Sometimes we can be more that layer of what we think we should be doing.
Therefore, if we don’t do it, we add a layer of guilt on top of what we’re not doing and then for our postnatal mums, again, wait until your pelvic that you’ve done that rebuild from the inside out before you go too fast, very much depends on your postnatally, you want to be working with someone that can look at your body, look at what you’ve been through, look at what you’ve done, and give you the right exercises at the right time, you might have a woman that is six weeks postnatal, and she’s had really good care through her pregnancy and early postnatal stage and she can return to a higher-level exercise a lot sooner than a woman that’s had no postnatal care at all and she might be six years postnatal, and still be leaking or have pelvic pain or whatever it may be. So, be guided by your body and don’t forget to lay the foundations.
Jill Lister 18:27
Is there anything else you think that pregnant and new moms should know about safely returning to exercise?
Jen Dugard 18:32
I think if we can take the pressure off the aesthetic side of things, then women will be returning to exercise or performing exercise in pregnancy more safely and effectively by default, because I think the reasons why women don’t listen to their body are because they’re either chasing an aesthetic goal, or they’re chasing a performance goal and if you have an aesthetic goal that’s based upon self-worth, then we’re going to ignore all of those signs. So, signs of like if you’re wetting yourself when you’re running, but you’re running because you want to reach an aesthetic goal, you’re going to ignore the wetting yourself because the aesthetic goal to fill that self-confidence or that self-worth is much. It’s much more of a driver then I’m just wetting myself and pelvic floor weakness and abdominal separation are not driven by pain.
So, it’s very easy to ignore them or not often driven by pain. So, I think Yeah, for me, the biggest thing is let’s get rid of the desire to get your pre baby body back and learn to love ourselves as we are right now in any state and then of course, any woman has the right to do whatever she wants with her body, but we want to make sure that she is doing it from a place of self-love rather than self-hate and I think that’s where the exercise gets very complicated, and women returned to doing things a lot sooner than they should. Because it’s wrapped up in a whole heap of emotional stuff that maybe we can help them to know that they’re amazing. Whatever their size, whatever their shape, and they’ve just grown a baby and a human.
Jill Lister 20:18
Where can we learn more about you and what you do?
Jen Dugard 20:21
So, if you are a mum that is listening, so I would be heading to the body beyond baby website. It’s full of great exercise opportunities. There’s a heap of articles on there. If you’re a trainer, then you can also head to the website, we’re just in the process of building a separate exercise website at the moment, but also my Instagram, I put a lot of information for trainers on my Instagram channel, which is just Jendugard.
Jill Lister 20:46
Awesome. Thank you so very much.
Jen Dugard 20:48
Thank you for having me.
Jill Lister 20:50
Hey, if you enjoyed listening to this podcast, you have to come and check out reboot, reset raw, reboot your systems, reset where you see yourself in 12 months’ time and roll out with the confidence in the new you. It’s my 90-day coaching program where we will take all this material and find the best way to make it work for your life plus a little bit of accountability and support along the way. Join me over at the FitChickhealthcoach.com/join. If you’d like to hear more, please let me know by sharing and leaving a review. I will talk to you soon.