Episode #07: Returning to Running Postpartum with Kathleen White
Subscribe: Apple Podcasts Spotify Google Podcasts
In this episode, Dayna and Rhonda welcome pelvic floor physiotherapist Kathleen White to discuss all things returning to running postpartum.
Kathleen White is an orthopaedic and women’s health physiotherapist who supports women on the run. She has a passion for helping women return to fitness after injury and pregnancy especially returning to running without pain, leaking or injury. As a mom of two active boys, she understands the demands of motherhood and being a working professional as well as the realities of trying to maintain an active lifestyle with kids.
In this episode we talk about what inspired Kathleen to become a pelvic floor physiotherapist with a focus on running, the timeline with getting back to running postpartum, “runner’s brain”, different strategies to help manage symptoms with running postpartum (such as leaking), and so much more!
Find Kathleen here:
Instagram
Website
-
Episode #07: Returning to Running Postpartum with Kathleen White
We're excited to have you join us for this episode of Pelvic Health and Fitness. I'm Dayna Morellato, Mom, Orthopedic and Pelvic Health Physiotherapist. And I'm Rhonda Chamberlain, Mom, Orthopedic Physiotherapist and Pre Postnatal Fitness Coach. On this show, we have open and honest conversations about all phases of motherhood, including fertility, pregnancy, birth, postpartum, menopause, and everything in between.
We also provide helpful education and information on fitness. The pelvic floor, and many aspects of women's health, including physical, mental, and emotional wellness. Please remember as you listen to this podcast that this is not meant to treat or diagnose any medical conditions. Please contact your medical provider if you have specific questions or concerns.
Thanks so much for joining us. Grab a cup of coffee. Or wine. And enjoy!
Hey, everyone. Welcome to episode seven of Pelvic Health and Fitness. Today, we are joined by Kathleen White, and Kathleen is an orthopedic and women's health physiotherapist who supports women on the run. She has a passion for helping women return to fitness after injury and pregnancy, especially returning to running without pain, leaking, or injury.
As a mom of two active boys, she understands the demands of motherhood. and being a working professional as well as the realities of trying to maintain an active lifestyle with kids. Kathleen can be found in clinic at depth training in Waterloo, treating every everything from sports related injuries to pregnancy and postpartum related concerns.
She also supports women on the run through her online run coaching business, as well as her run program. Return to running without peeing your pants, which I love that name. So awesome. And Kathleen and I met through an awesome mastermind group through Emma Jack, Press Play Physio. And I just loved her passion for helping women get back to running postpartum.
And she just has so much knowledge. So we're so excited to have you here, Kathleen. Thank you. And so how about let's just start out to kind of get to know you a little bit. So how, first of all, did you decide to become a physiotherapist and when did you start to sort of shift focus towards running? Yeah, so I've been a physio for 12 years now, which makes me sound old, but I'm still learning.
Um I was an active kid. I figure skated and played soccer, uh, had a few injuries along the way. Uh, so probably I saw a physio I think for the first time when I was 13 after a volleyball injury that broke my ankle and then just kind of fell in love with the human body and it was. It was really fun to go to physio and I liked it and, um, ended up doing kinesiology at university and just loved it even more.
So, uh, I was pretty young when I figured out I wanted to be a physio, which is great. Um, and then I, like I said, I was always really active, but I tore my ACL and had it repaired just as I was finishing my undergrad. Um, and so. I was always a little bit worried about returning to soccer, even though I didn't need to be.
So I started working on running and found that I actually really liked it. And it was really easy to fit into my schedule. And then as I became a busy working professional, it was harder to play organized sports, but it was super easy to squeeze in a run. And then that theme kind of continued after I had my kids.
And it's just very accessible, uh, and a great way for me to think and clear my mind. And I love it. Yeah, that's awesome. And so did you want to be a women's health physio right from the get go to or when did that shift happen? No, if you if you told me like 10 years ago, I would work women's health, I would probably laugh at you.
I actually wanted to work in stroke rehab. That's what I wanted to do. I really like neuro. It was really interesting. Um, so I kind of joke that I just do like neural learning with the brain in a bit of a different way. Uh, the brain's just so cool. Like it can do so many things and it's awesome. So, um, I had a breech baby for number one, uh, and I remember going in when I was pregnant and the nurse sat me down and was like, okay, now that you're pregnant, you can't run, you can't play any contact sports, you can't lift weights, you can walk and do yoga.
And I was like, hells no. So I printed off a bunch of research and basically threw it at my doctor and was like, you need to change the conversation you're having with women. This is not okay. Uh, yeah, yeah, it was a pretty bossy pregnant lady. Uh, and then with, so he ended up being a C section, which is not what I wanted, but it's what we needed.
Um, and then with number two, he was a very big baby. He just, I made a good home for him. He didn't want to come out. So I ended up with a prolapse afterwards and I started to learn how poor our healthcare community assisted women with concerns. So I started trying to figure out how to treat myself. Even my OB like brushed everything off and I was like, I'm pretty sure I have a prolapse.
It's fine. You're young. You're healthy. You're good. Don't worry about it. Yeah. Um, so I started all my training and then when I came back from my mat leave, I started dabbling into women's health and realized there's a much bigger need than I had realized. And I went down that rabbit hole. Love it. And I haven't turned back.
Yes. Very, very similar path to myself into it, just how do we fix this? You know, how do I, how do we learn more for myself a little bit selfishly, but then also just realizing such a need to get this information to other women. Yeah, I find it so helpful when my patients can like hear me tell my story because they understand that when they're telling their story, I am listening and actively trying to help them from a place of complete understanding.
Right. Um, and I think that's one of the big things that's really missing in healthcare for women. Um, they're like, I have learned recently that the intuition center of the brain in women is double the size. Of that compared for a male counterpart. And so when they say they think something's wrong, we need to listen to them, but often healthcare just brushes them off because they don't take them seriously.
So we need to start listening to those concerns that women have and helping them in the best possible way that we can, which means first off, listening to them and second off, creating a plan that works for them. Yes, totally. So often it's just brushed off as under the umbrella of, well, you had a baby.
Yes, of course your body feels different or of course you feel X, Y, or Z and it'll get better. Yeah. Right. 100%. So, with all of your research, what is the general timeline that you give to clients when they want to return to running postpartum, and does that change if it's somebody who's starting to run for the first time postpartum?
For sure. Uh, the hard thing with this question is the answer is always it depends. Yes. Which everyone hates. Um, but, uh, I think it's really important that we look at each individual woman because their pregnancy, whether it's the first, second or third or more, uh, and their deliveries are all very different.
So they're going to heal with different timelines. So I have had patients that have gotten back to running at two months and they're great. Um, and then I have other women that's taken, you know, three plus years to get back to running because it took them a bit to kind of figure out what they needed and find the right person that drives for them.
Um, so I think it's really hard to answer that question, but normal tissue healing is going to be, um, about three months. So we generally like women to wait at least until they hit the three month mark to allow for optimal healing and then, um, to work with a professional like either one of you that can put them through, um, some testing to make sure that their body can tolerate the load of running.
Every time you strike the ground when you're running, it can be anywhere from two to six times your body weight. And you're going to strike the ground about a thousand times for every kilometer that you run. So that's a lot of weight that your body and your pelvic floor has to absorb. So it's really important that we prepare you to do that so that we don't have any concerns down the line because the research is not there.
Um, In what will happen if someone runs earlier versus later. We're still working on that. Um, so I think if we can build up their tolerance and get them strong to run, they'll do way better and be more successful with less symptoms. Yeah, makes sense. So Dayna and I often talk about athlete brain. So that's something Brianna Battles talks about all the time.
And I, I'm not a runner myself. I know Dayna, I think runs a little more than I do. So maybe you understand the runner's brain a little more. Although I used to run a little bit and I, I get the feeling, I get the feeling of when you're out on a run. And it feels really good. I get it. Yeah. I'm not an avid runner though, but I think, I don't know if you would agree, Kathleen, that runner's brain is like a whole different world.
Um, where again, you just love running so much. You get that runner's high. And it's hard to give up when you're injured, when you're postpartum, when you're pregnant, if you need to. So how do you talk to and kind of work through that with clients that have runner's brain and maybe are resistant to that advice of taking it slow postpartum?
Yeah, for sure. I mean, I love that. I just love calling it, um, the athlete brain because it makes so much sense, right? Um, I think the big thing is my job is to not tell women what to do. My job is to help educate them in the best way I can so that they can make an informed decision for themselves. And there are lots of people, including myself that use running as a way to manage mental health.
And so we have that discussion of, um, if this is going to help you mentally to be able to do what you need to do, even though it might. Make your, your symptoms a bit worse. That's your decision to make, but your mental health is equally as important as. As your physical health. Now, of course, there's always the conversation of, um, you know, there's only so much that I can do from a physio perspective, and I truly think that women need a team approach.
And so counseling, social work, um, psychologists, uh, someone to help with diet. Those are all like really great people we can bring in onto the team to help. But I think it's really important that we not tell them that they can't run because as soon as you tell them they can't run, they're going to run anyway.
So, so we have to find if they're going to keep running, let's see if we can work with them to reduce their symptoms or modify their training schedule so that we reduce that load. Or maybe we throw in a little bit more cross training so that we can keep them doing things that look like something they like to do, but just decreases that risk to the point that they're comfortable with it.
Makes sense. I love that you say the mental health is a huge, we have to consider that, especially if running is a part of someone's identity. I think we can all agree that having a baby can kind of flip your identity on its head. And so to say to somebody that they can't have that big piece of themselves can be pretty upsetting if not damaging, right?
Like that's cool. Yeah. I had a client recently and she was just so nervous. because of her, her symptoms that she would never be able to run again. That at one point, I just said, go and try it. Like you're not at that 12 week mark, but go and try, keep it short, you know, maybe keep it slower, but let's just see what happens.
If it's that important, let's just see what happens. And it was like a light bulb change in our sessions together. I think that's the thing, like, I think, um, physios, we're all well meaning, but I think there has, there was a pendulum swing, right, where, um, so I think some physios are, you know, they're trying to put their client's health first, but also understand that it can make your symptoms worse, so then there is a little fear mongering language that comes in, right?
Where again, like you said earlier, that if someone runs for their mental health, then you start to almost like lose trust in that physiotherapist as well, right? Because it's, I'm coming to you for help and you're telling me now I can't do the thing that I love to do, right? So I think I know myself, I'm extra mindful the more I learn about my language, right?
And how I approach these things with my clients to, like you said, educate them and let them know, you know, potentially this could make your symptoms worse, but. Go try, right? There's nothing stopping you. They are just symptoms. Symptoms are just our body's way of talking to us. It doesn't necessarily mean you're doing further damage, right?
Oh, for sure. Language is huge. And I think when you start to talk about the difference between like symptoms versus damage, it helps them get a better grasp on things, right? Like when it comes to the pelvic floor, we honestly, we just don't know. Right? Like if someone starts running at 12 weeks, even though they don't have any symptoms, is it going to create issues farther down the line?
Sure. We can fear monger and tell them that yeah, it might eat is possible, but we don't actually know. So if we can work on getting them strong, so there's, they're supporting their body. And can we work on their strategy and modifying their plan so that we build up to what they want to do? They can be really successful in those particular activities, even though others may say it's.
Risky for it, but we don't actually have the research to support that. So true. I love it. So you mentioned cross training and that there's so much more we can kind of do when we're training for running. So what are your favorite cross training type exercises or activities? So I have two things I always include in every plan.
Uh, one is mobility work. Cause women need to rotate, need to let go of the abs and we need to rotate. So, um, you can call it yoga. You can call it mobility. You can call it active stretching, whatever you want to call it, but we need to find ways to move out of the frontal plane. So the frontal plane is that running like front, like front to back motion.
So we need to move side to side and we need to rotate. Um, but then we also need to get strong. So for me, cross training is how can we make strength training really accessible to you knowing that we're going to build more capacity in your tissues. So you're going to get stronger and you're going to get more powerful.
And so that's how I sell it. Like, do you want to be a more efficient runner? Cool. Let's strength train. You'll be faster. And then usually runners like, cool, they want to be faster. And I'm like, yeah, you got to get stronger to do that. And then that's how they'll, that's how you get that athlete brain.
Right. Do better? Let's do this. You do it better. And then they're all in. Um, if someone is on, uh, on like a modified schedule, cause they're injured, we might throw in some swimming or some cycling or something that like makes them super happy. Uh, but if you tell a runner to go swim and they're not a triathlete, they're probably going to walk out the door.
So we have to look at what they want to do, right? Like what. Um, I, I lovingly say what makes your heart happy and if we take running out of the picture, what else makes your heart happy? Because maybe we need to add a little bit more of that in, um, so that we can get you where you need to go, but we still need to make sure that you're feeling nourished and your cup is full.
I love that. Um, so I know a lot of women are eager to get back to running and sometimes that looks like running with a stroller and I know that's often sold to women too, right? What is your approach to running with a stroller? Any tips? Um, can you start that right away postpartum? What does that look like?
Yeah. So again, it'll depend. Uh, some women like, or even just people in general, like to just be by themselves to go run or, um, some people have like running groups or parties, like partners that they want to go out with. Um, so having a stroller, it can sometimes kind of get in the way of that because that's that socializing piece to the running world, which we haven't really seen for the past year and a half.
Um, that does exist in the normal world. Um, and for some women, the stroller can be a really great way to change their strategy. And so if they're leaking, um, you can give them a stroller where they can kind of lean into it and that can help get them in a position where they're able to load the front part of the pelvic floor where there's more muscular support.
And so they may feel their symptoms are better. For other women running with a stroller may reduce the rotation. So if they're really good at using their abs and maybe a little bit too good, uh, by giving them a stroller and you taking away that rotation, they might end up getting more symptoms because the abs are just adding more pressure downwards.
So their pelvic floor has to work too hard. So it's again, one of those. How do you feel when you're pushing a stroller? Does it feel good for you? Great. If it doesn't, then maybe we try run walks, or you go with your partner, um, so that they can push the stroller, while you just run, um, or maybe you just want the alone time and you go on your own.
Uh, but the big consideration is actually the baby. And so, um, we want to make sure that you're actually, you have a running stroller, something that will help absorb some of the shock because, uh, until they're about six months old, they don't really don't have the best head control. So if they're sloshed around in the stroller and you're just looking at it, you're.
You may not know it's not the best for them. Um, so we, we generally recommend waiting until about six months to run with a stroller. And then if you are going to having a head support or two rolled towels that get tucked on either side of your child's head. So it just helps to support their head in a good position, but making sure you have a good running stroller is, is key.
Um, it'll move much smoother and it'll be a better ride for your baby. That's helpful. We have to consider the little beans that are with us in the stroller. And then, you know, just remember if it's too hot out, if it's too hot for you, it's way too hot for your baby. So maybe, maybe not the best time. For sure.
Um, so you mentioned the abs there. So I'm just curious, do you have any specific recommendations with When it comes to the abdominals with running, do you have any specific instructions that you give people? For example, I have a lot of clients that come to me and they're just gripping their tummies. It doesn't matter what they do.
They're stuck in their tummies. And I work a lot on letting that go. Is that the same when it comes to running? Okay. Yes. We're clapping. Yeah. So, so pelvic floor physios can be great for this. I'll do a lot of manual. release to try and get the ribcage moving. But actually the best thing we can do for our ribcage is breathe.
So I spend a lot of the time, a lot of my time working on, um, like a ribcage breath. So having them try a 360 degree breath, where if you think of your ribcage, like an umbrella, as you breathe in, the umbrella is going to open up all the way around, um, because, um, that's going to help make more space for the, for your lungs.
You can get a better breath in. Um, and then I have them practice rotating. Um, so if you can even try it while you're just sitting there, if you grip your abs and try and rotate, you can't really rotate if you're gripping with your abs. So I have them do some rotational drills before they run, or they may, if they're doing a run walk cycle, I may have them, um, do what I call a Phoebe run where they like exaggerate the arm swing and, um, someday that reference is not going to work, but for now it's working.
So. Yeah. We're here for it. Lovely. Um, so just exaggerating that arm swing and getting that trunk to rotate so that they can learn what it feels like to let go of those abs because no one will ever let go of their abs by someone saying, Hey, just let go. We do it for a reason, right? So it has to be something unrelated.
So I find those two cues kind of work the best for my patients. I'm going to use that. Yeah. Yeah. I love it. Awesome. Um, so in terms of, I feel like this is even something, um, as I'm helping my clients get back into running, they always want to know like, how far can I run or how, you know, can I go out for a 5k and what does that look like?
Right. So I'd love to hear your sort of advice that you give to your clients in terms of like distance when they're first starting out postpartum, what advice do you give them how to ease back in? Yeah. So I think first is I want to make sure that they've got. Some cardio volume there. So I want to make sure that they're either like walking or hiking for at least 30 to 45 minutes before we get them out running, um, because they need to be able to make sure that they can get back from wherever they were.
Um, so it's a good kind of test. Um, and then the other thing as I start, um, depends, so it depends to be totally honest. It depends whether they were running before pregnancy or after. So it's going to look different for someone who is running, you know, to 30. You know, 35 weeks versus someone who ran 20 weeks versus someone who's.
never run before. So for someone who's never run before, we're going to start them on a run walk cycle. So it'll be, um, you know, one minute run, three minute walk and kind of aiming for that 20 minute timeframe. And then we can slowly build from there. Whereas someone who is running continuously through their pregnancy, they may be okay to get back.
To a 5k if they've only been off for a couple of weeks But if they've been off for for more than a few weeks, um, it's safer to start in that lower volume So they may not start at a one minute run a three minute walk. They may start at a one one or a two to one um, but we want to slowly build that volume because one of the Big predictors of running related injuries is too much load too fast.
So by being more conservative, we can help our patients reduce their risk of running injury. The other thing that we can do if they're really concerned, um, is that's a gait training. So having someone who's trained to watch you run and analyze your running gait can reduce your risk of injuring within three sessions by over 60%.
Oh, wow. So it's like a huge, it's a huge number. Um, and it's so interesting if you start to ask your patients. Who have seen other physios before for running related injuries, ask them if they, if anyone's watched them run. And I will say I'm like totally a victim of like, I did this for sure. Um, but when we watch them run, we get to see how they perform the skill.
So just like with someone who wants to get back to squatting heavy, I wouldn't just give them a way. Without watching them squat first and talk about what mechanics are going to work best for them. But for some reason, we just get all these women back to running without actually watching them run to make sure we get them doing things the best way for their body.
Yeah. That's a good point. It's still hard. Yeah. Do you There's like a few tricks you can watch for, but Do you just get them to run? Do you get them on a treadmill or do you just get them to run? How do you, what do you do to assess them? Yeah. So it depends on the patient's comfort level. Um, so right now with COVID, sometimes I'm having patients run out in the parking lot because then they can take their mask off and just run.
Yeah. Um, so I'll take a video of it and we can watch it in slow mo. The easiest is treadmill. Um, but, uh, not everyone is comfortable running on a treadmill. So we have to. Help set them up for success that way. But yeah, just watching, watching them run, take some videos. We talk through it. Um, uh, and then based on what we're finding, we'll give them one or two cues to work with.
Um, uh, and then they might, I might kind of put it into their warmup. So I'm a big fan of, um, using their fitness to be their rehab. So whatever the drills are that we want them to work on to help their running, that becomes their warmup for their run. So it gets their body rolling in a way that works for them.
And then. Off they go. Love it. All right. So we have obviously many conversations about pelvic floor and symptoms that can crop up and symptoms that can come up with running are similar to any pelvic floor symptoms, right? The common ones would be being leaking. Um, probably the number one, but also likely heaviness.
Prolapse symptoms. Yeah. Yeah. I get more, probably more leaking concerns. Um, I think there is still a lot of stigma around prolapse. And so once people have gotten the prolapse diagnosis, they've been told to never run. So they don't, it's not even on their radar anymore. So when they come to see me and I'm like, well, you want to run, like, let's talk about it.
I have a grade two prolapse. And I manage my symptoms. So let's find a way that works for you. Um, so I find that people are coming in because they're leaking when they run, um, more than anything else. But really the big thing that presents to me is hip pain. Um, so like you guys know, hip pain often is related to the pelvic floor.
So then we start, so they don't often come to me for pelvic floor reasons. They come to me for other reasons. And then we start that conversation, especially in my women that are like. in their late 30s, kind of 40s realm where like they kind of know what pelvic floor physio is, but like no one really did it because it wasn't me.
So like they'll, they'll be like, Oh yeah, can I tell you about how I pee my pants when I jump? Like, they're just like waiting for someone to start a conversation with them. Um, so then we can kind of take this more kind of whole body approach for them. But yeah, usually it's hip pain. That they see me for.
Yes. So interesting. I see a lot of that too. And then you just see their like brains explode when you do, if you are practicing internally and they're okay with that. And you find that point internally and they're just like, Whoa, that's my pain. Nobody's been able to find it. Yeah. It's fascinating. Okay. So let's start with leaking our, what are our thoughts?
Is a little leaking? Okay. Is we want no leaking. So I always say it's common, but it's not normal. Yeah. And we deserve better as women. We deserve better care. So yes, you can put a panty liner on. Yes. You can wear black tights, but is that okay? Not my world. Yeah. Yeah. I agree. You don't have to deal with this just because you had a baby.
Right? 100%. Absolutely. And again, we've been sort of just told, you know, you're a mom, suck it up. You're going to pee your pants. And I think it is mind blowing to women when they hear that message that, Oh, I don't have to just live with this. So I think if we can let them know that that's a whole game changer, right?
Running, jumping on trampolines and jumping jacks are like the three things women live in fear of postpartum. Yeah. Right. And it's often like, let's just change how you're doing things. Yeah. Like they're just like really good at doing things one way, which is great. Um, but I think reinforcing that conversation that they're not broken.
They just are really good at one strategy. So let's try something a little bit different and see what happens. My favorite like is honestly, if there's anyone listening and they are like, yeah, that's totally me. I want you to sing out loud while you run, um, because you can't hold your breath. When you're singing.
Oh, so, so it's funny. So I'm like, just put headphones on and I just want you to like belt it out as you go. Um, and it's one really easy way that they don't have to think about it. And it helps 'em, it helps you get buy-in. Right? Because if you can do something right away that's gonna change their symptoms, then they start to, you can see the wheels turning.
They're like, okay, cool. Like I can change this, I can work on this. And then they start to build confidence that their body can do it. Yes. Yeah. Singing is like a favorite of mine. I love that. So the holding, the holding the breath. What are, what are some other common sort of those quick fixes that you can give them that help with leaking?
Yeah. So breathing rotation. And then my other big thing is leaning. Um, so you'll see that like pregnancy lean back that they've learned and it'll stick with them. So I have them think about being a ski jumper. So they're going to lean forward or like they're running into the wind. And those are my three like quickies that'll work.
Um, sometimes it works a little bit, which is great. Uh, sometimes it's not enough, but sometimes that's all they need, right? If you can just get them to breathe, rotate and lean, then they're, they're good. Bri Brianna Battles says for the lean, tits over toes. And I was like, oh, I love that. Tits over toes. It should kind of almost feel like you're falling is maybe a strong word, but almost like you're kind of.
Falling into your next step, right? So it's funny because that's the definition of running. Yeah. Running is like basically a controlled fall forward. Oh, okay. But everyone's like worried about falling, so they're like tipping back. Which is where the stroller can be helpful, right? Because they feel supported when they're leaning into the stroller.
Yes. Do the, do the suggestions or tips change if it's a prolapse situation for someone who's getting any sort of heaviness or that feeling of a tampon sitting there? Yeah. So for, for prolapse, um, it's going to depend on how symptomatic they are when their symptoms come on. Um, it's, that's actually going to vary for everyone, but for prolapse specifically, because I find a lot, and you might notice this too, Dayna, a lot of my patients, um, it's going to change depending where they are on their cycle.
So I actually start to have them track their monthly cycle. So. For me, the day or two leading up to my cycle on the first day of my period are the days where I feel the most symptoms. So I just don't run on those days. So if I'm scheduled to run, those run days get either kiboshed or they get bumped to a day because like, I, I just don't feel awesome.
And I've come to the point where like, I want to run and I'm comfortable running. I just, it's not worth it for me to have this, the feeling of that heaviness. when I run on those days. So I think again, it comes back to like, how can I empower my patients? And so when they start to kind of track their symptoms and when they're noticing it more, then they can start to plan their workouts around when they have symptoms and it gives them that little bit more control over it.
Yes. 100%. We're hormonal creatures. I always say we have to pay attention to that cycle. Yeah. And when you start to like talk to them about like, you know, maybe the first, the first week or two, that's when you're like you're high energy. So like, go like do your long runs then. And then that week leading up to your period, you're low energy, low hormones, like.
Focus on your rest and mobility. And then instead of training on this like weekly schedule that is designed by men and their hormones, we start to train on a four week schedule. And actually, if you look at the high level athletes, especially in like the triathlon world, they often train on four to six week schedules where they do three to four weeks of heavy, intense training, and then they have a rest week.
And so you can really put that plan nicely. into women and their cycle by like planning when that rest week is. So you just decrease your volume on the week or that time when you may have more symptoms. Yeah. Yeah, for sure. We have to pay again, whole person, right? Yeah. Yeah, absolutely. I'm curious what your opinion or thoughts are on pessaries.
Yeah. So I don't work a ton with them, but I think they can be a great strategy for someone who has a lot of symptoms. or has symptoms that bother them enough that they'd like something to feel more supported while they're working on their strategy. Um, there's a, a really great physio in, um, Guelph who I know does pessary fitting.
So I send my clients to her if they need that. So for those that don't know, a pessary is, um, like a silicone, either like ring or cube, and you can insert it vaguely and it. Um, just creates almost like a little bit of a splint to hold your organs, um, up in place. So it can work really well with symptom management.
Kind of like a sports bra for the vagina. Yeah. Basically. I love that term. I often wonder if they're a bit underutilized or just in that return to running or school. Um, I don't know if it's a sport phase and whether we, I mean, more research to be done, certainly, and what happens if we give them as kind of a proactive approach or, you know, as people are, are trying to get back to their activity of choice.
Yeah, that's a great point. I think too, there, there is a little bit of gray area between like the physio and the OBGYN world. And so our scopes are starting to overlap a little bit. Um, And so I, I think there's a little bit of like some interesting dynamics that are happening there. So if we can kind of sort that out and just realize we all want the same thing to help women, I think we'd be way better off.
But, um, anytime there's a bit of a turf war and I, like, I'm just like, like throwing that out there. I don't know for sure what's happening, but it is interesting that there are two different professionals that are doing it. I think anytime that happens that we may not see the service used as well. Cause it's like, who do you, who do you go to work to, right?
Right. It's interesting though to have that tool available. And I did, I have a, I had a client in the last year who was just told young. She was, I think, 35, um, was told she'd never run again because she had a prolapse. Wow. It breaks my heart. It broke my heart. Yeah. And so we just, I mean, she was running by the time we were done, but she, yeah, you have to kind of do a little bit of undoing the language that was used.
Right. Yeah. I get that a lot with clients with lifting. Like they've had someone along the way tell them they're not allowed to lift over 20 pounds ever again. I'm like, but what about your 30 year old child? How do you manage that? Dog food bag that weighs a million pounds. Yeah. Yeah. Yeah. So it's like, why not then prepare our bodies for those activities?
So it isn't as taxing on us when we pick up our 30 year old 30 pound child, right? Yeah, hopefully not 30 year old. 30 year old child. , . I hope I'm not picking up. I hope I can. Yes. First, I hope I can pick up my child when they're three , but I hope I don't have to strong enough, but don't have to. Yes. Yeah.
That's what we can all hope for. Okay. What is some advice for c cesarean section mamas? Do you give differing advice for them postpartum, or what does that look like? Yeah. I'm sure, Dayna, you say this too, uh, a c-section is major abdominal surgery. Yeah. Like it's treated like, it's just like a nothing thing.
Mm-hmm. , like a run of the mill, like you're cool. They cut through seven layers of tissue and then often there's like double stitches and a layer of staples, like it's major abdominal surgery. Yeah. And so if we had someone who had major abdominal surgery that wasn't a C-section, they would honestly be on a very specific rehab protocol that took at least three months.
To allow that tissue to heal and then we would progressively load it throughout that time to build up to it But for some reason for c section moms, you're like, they're cool six weeks Awesome, that outer layer is healed. Go for it So I think the conversation needs to change. I will say full disclosure. I was a c section mom running at six weeks So, you know, I have some like residual undoing that had to happen.
Jacqueline talked about that in her episode too, right Dayna? That's that's sort of like where her passion now comes from is that she had zero advice. Just get back to whatever you want to do. No big deal. Yep. Um, I think the big thing for C sections though is women, I just actually read a paper on this.
I'm a giant dork for those that don't know. Um, uh, that the big things we need to do for moms with C sections is they need to look at their scar. They need to touch their scar and they need to work the scar. And I have a lot of patients that have a really big fear of like touching the scar. So I love the Courageous ball from Tune Up Fitness.
It's like a deflated kids ball, but there's lots of really nice, um, tissue work we can do for it. Um, but the other thing to remember is that when you're looking to return back to sport, because when you're running, like your opposite arm and leg are coming forward. So we have this like kind of anti opposite movement.
Um, We need those lower abs to kick on. And, and often when you see, when I see women who are really gripping through their upper abs, um, a lot of them are like C section moms. They just have never learned how to turn those lower abs on. And part of that is, can we get in, can we work that scar and then can we load it?
Because there's this like fear of loading an abdomen that had a c section because they're like, Oh my God, it might pop open. Right. So let's not load it, but then let's go back to running where we have to absorb six times their body weight, 5, 000 times. Because the calendar flipped over to six weeks. So you're right.
Exactly. Yeah. So I think Um, there's definitely like conversations that have to happen there about like what's a realistic timeline and how do we modify that based on the individual in front of us. Right. Fantastic. So along the same lines of just abdominal loading, what advice would you give to someone who wants to run but has a diastasis?
Yeah. Yeah. Cool. Uh, so again, it's not about the gap. I feel like I spend so much time. Yeah. It's not, it's just like how do you use those muscles and, um, we have to rotate you like you have to rotate and you have to flex. Um, cause I still get a lot of women that are like, no, no, no, I can't, can't flex cause I got, I have diastasis.
So, um, I'm a big fan of like teaching them how to pre activate their core and making it automatic. And then we have to flex and rotate. Um, and again, it doesn't have to be perfect. We're, we're kind of looking on the spectrum of like, where are they? What's perfect? And can we make you like one or two steps towards what better looks like for you?
Um, but allowing you to do your activity in a way that feels really good, but we're getting a little bit better activation so we don't run into issues. Um, I don't we don't, again, we don't know. Right. We don't know whether it's going to cause issues down the line. Yeah. A lot of fear around the gap right here.
Yeah. A lot of fear. I always say that I see that sentence to every to clients all day as I'm sure both of you do as well. We have to load it. Yeah. Load it. Yeah. It's so true. It's just like any other area of the body. How do we get anything else stronger? We have to load it. Right. But it's this fear around making the gap wider, which like we said, it's not about the gap.
Just get those muscles functioning. Yeah. Well, and I think once you can show them like what it looks like to actually activate those muscles, they're like, Oh, okay, cool. Like I can totally do it. And then I actually get them to like feel along. So they feel the tension, even though the leg. Yeah. Yeah. They look slightly bigger, but they're able to generate good tension.
Yeah. Um, and yeah, I think I have a lot of women that are just concerned about the actual look of it. Yeah. And so I'm like, well, you know, with any other injury, if. If we were thinking about surgery, we try and do the best possible prehab that we can, and that's totally your choice. If you decide you want to go in for surgery so it changes the look of it, great.
If you want to have surgery so you get better tension, awesome. Like, I'm here to support you in any way that you can. Yeah. Um, but it doesn't, it doesn't really matter a whole lot what it looks like. It matters how you're able to generate tension through that area. How it functions. Yeah. Yeah. Amazing. So good.
Can you tell us, sorry. So Go ahead. Can you tell us a little bit more about your run program, Return to Running Without Peeing Your Pants? Yeah. So this is a passion project of mine and a long time coming as well as Round the Nose. And I love it. I can tell, I can tell just the excitement and your passion when you talk about it, which is so cool.
Thank you. Um, yeah, so it is a 12 week program. That works on, uh, basically a couch to 5k with strength and mobility included in it. And so the workouts, there's like two strength workouts a week and two to three runs a week. I tweak it based on what you want to do, um, and then you get support through it.
So the other really nice thing is it comes with, um, This big PDF document that kind of talks about what's your pelvic floor, what are all these muscles, what do they do, how does that relate to running, um, and how can we be more efficient in our running. So it, um, gives a lot of good information that I tend to talk about all of the time in clinic, but it makes it accessible to people who can't always come to see me in clinic.
Um, and one of the things I'm super proud of with this particular program is that it's a pay what you can program. Um, so that. Uh, there's like two different price points, but if someone just like really wanting to get back to it and that didn't work for them, then I will make it work. My goal is just to get the information out there so that if you want to run, I will help you do that.
Amazing. I love that. So simple. And what has the feedback been so far on the program? Really good. I do have a couple of busy moms right now. So I had to like condense stuff for them, but that's the, the joy of it. So we kind of shortened things up, snubbed it up, um, which is great, but they're, they're liking it.
It's good. Everyone is for the most part running week free, which is great. Um, yeah. So, so when people like tell you, it feels so empowering for them to run again, it just like, it makes my heart so happy. Oh, I love that. So cool. So great. Awesome. Anything else that you wanted to touch on Kathleen? I think we went over all the questions we had.
Anything else you want to leave us with? No, I think you guys are great. And I love that you're doing this. I love watching, uh, like females working hard, supporting one another. Um, and it just like, it's so great. It's like we can rule the world and do great things without competing and just supporting one another.
So I just love it. That's the thing. And that's what we always said about this podcast. I mean, obviously we want this information out for everyone, but truly Dayna and I just love this stuff too. Right. So we could just chat about all these topics all day. And so, yeah, we are so excited to get your feedback about running and just, yeah, just learn more and spread it to the world.
I love it. I can talk about running and public health all day long. Ah, so good. So tell our listeners a little bit more about where they can find you. Yeah. So I work in clinic, uh, uh, depth training and physiotherapy in Waterloo. Um, and so you can check us out. The website is www dot. Depth training. ca. Um, and then you can find me on Instagram and Facebook.
Uh, it's at Kathleen white physio. Uh, there's lots of good, um, tips and tricks on there. There's also a free guide to help you return to running. And it talks about some of the things we talked about today. Basically the lean, uh, rotate and breathe. Um, so it's a good starting point for anyone who has symptoms and accessibility to pelvic floor physio is, is not the easiest.
Awesome. Well, thank you so much for coming on and chatting with us tonight. Thank you for having me. It's been so much fun. Thanks, Kathleen. That was great.
