The Healthy Post Natal Body Podcast
The Healthy Post Natal Body Podcast
Should an athlete's postpartum program be sport specific?
Should postpartum recovery be sport-specific?
I had a wonderful email from someone who said the following;
Hi Pete,
Long time no see, I hope you’re well.
As you probably know I gave birth again a few months ago and am working with a team on my recovery.
We’ve only really just started so I’m very early on. My physio is (name removed) ,obviously I’ve known him for years, but my women’s health physio is someone Iv’e never dealt with before (and neither has anyone else I know in (name of sport removed)) and she said something that stuck with me and made me think…ermm…I’ll ask Pete about that.
She said that my post-partum recovery program should be specific to (sport removed). And yes going back to playing is absolutely key but, how is the program sport specific? when I asked her to clarify she said that another sport’s program is completely different postpartum than ours is and she was a bit short after that so I left it.
Any thoughts?
So that is what I'm discussing today.
I go through my reasoning and explain the way I work, with both athletes and non-athletes.
Is it different if you're a tennis or football player? What about for judokas and shotputters?
BTW this episode is not just for professional athletes, it VERY much also goes for "normal" people who just want to go back to doing what they love to do.
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Playing us out this week; "Karma" by Cira Grandi
Hey, welcome to the Healthy Postnatal Body Podcast with your postnatal extrapital app. That, as always, would be me. Today I am answering a question from someone I used to work with who asked a wonderful question Should postpartum recovery be sport-specific? Now, this is not just for the athletes. So if you're thinking, oh, I'm not an athlete, I don't need to listen to this one. There'll be a lot of. I hope there will be some at least some useful information in this for you. But that's the question I'm answering for the next little while. So, without further ado, here we go.
Peter:Hey, welcome to the He Postal Body Podcast with little old me. Like I said, this is a podcast for the 15th of September and I am answering. I'm here surrounded by seven dogs, by the way. So, again, if you hear a lot of pitter-patter that I didn't edit out, or snoring in the background that I couldn't edit out, that is what that is. I am answering and today I'm talking. I hope you're well. By the way, I'm all over the shop again, apologies, I hope you're well. I hope you're keeping well. I hope you're crushing it, peter at HealthyPostnatalBodycom.
Peter:By the way, if you have any questions yourself, I had an email from somebody that I worked with a few years ago a professional athlete I'm not going to say who it is, you know I don't do names and all that sort of thing right and she had a wonderful, wonderful, wonderful question that I thought would be worth discussing here on the podcast. Obviously, I have permission. I always ask permission, right. When I read out emails I always say, okay, can I use your example? I tend to ask that to absolutely everybody, but especially if you are, you know, if you're a little bit more in the public eye than others. Hi, pete, long time, no see. I hope you're well.
Peter:As you probably know, know, I gave birth again a few months ago and I'm working with a team on my recovery. We've only really just started, so I'm very early on. My physio is um. Okay, I'm not going to name the names. Obviously I've known him for years, but my women's health physio is someone I've never dealt with before, and neither has anyone else. I know um from the sport.
Peter:I took the sport out and she said something that stuck with me and made me think. I'll ask Pete about that. She said that my postpartum recovery program should be specific to the sport I'm playing here. So you know, it's the sport she's playing here, and, yes, going back to playing is absolutely key, but how is the program sport specific? I'm playing here, so you know, insert the sport she's playing here, and, yes, going back to playing Is absolutely key, but how is the program Sport specific? When I asked her to clarify, she said that A Another sports program Is completely different Postpartum than ours is, and she was a bit short After that, so I left it.
Peter:Any thoughts? This is a wonderful question. I absolutely love this because I hear this quite a lot from, uh, certain corners and my thoughts are slightly different, because I am not part of any professional athlete's full-time team. Right, if you're a professional athlete and you want me to be part of your full-time team, then I'd happily consider it for the right amount of money. But I'm not. I tend to work with people for a relatively limited period of time, get them ready to go back to their team, and then I am pretty much not done with them. But, but you know what I mean? I hand them, I hand them over, right? All this stuff also goes for any non-athlete, by the way, that that I'm going to be, that I'm going to be bringing up, I'm um, yes, so where to begin with that sorry. So yeah, um, the magic of editing, there is almost choke on whatever I was choking on. So should a recovery program be sport-specific or not? And this is like I said, I absolutely love this question. I know some physios might disagree with me on this. So, peterhealthyplusnatalbodycom, if, if you do, I'm always happy to hear the other side, because for me this also goes for any non-athlete, by the way. Um, this is one of those well, yes and no type situations for me.
Peter:Obviously, little caveat here. Program is ideally always catered to the person we are working with, right um? Now, the healthy postnatal body program, for instance, is just a generic program for everybody, because most people don't have access to a physio, women's health specialist or even a postpartum personal trainer, right um? And that's why I set up healthy postnatal Body. So that is a generic, this works for 90% of people type of program. I would argue for more than 90% of people. But when you're working individually with a person, then you always cater to the individual. If you're working with a specific post-marathon specialist, you know that should be a no-brainer.
Peter:So it's a no for me, as in should the program be sport specific is a no for me, because in the beginning of every program, the beginning of every program is kind of just based around making sure everything works properly. Again, that has nothing to do with whatever sport you're in. This is just is the body functioning well enough? Is the pelvic floor functioning properly? What about the glutes and the core, et cetera? So what I call the first four to six weeks, what I call the activation stage, which I know drives a lot of people nuts, but I don't really care. Everybody knows what I call the activation stage, which I know drives a lot of people nuts, but I don't really care. Everybody knows what I'm talking about. You know, is everything working at the right time and is everything working well enough? So when we need the glutes, are they jumping in straight away in the way that we like them to work and all that type of stuff?
Peter:Now, I know this lady right and you know she will get a laugh from me calling her a lady. But unlike most professional athletes, she was very active during pregnancy and was even still competing competitive for a while I'm not familiar with. I wasn't like I said, I wasn't working with her at the time, because I haven't worked with her for a few years because she doesn't live in the UK anymore. So I don't know how she gave birth like C-section or vaginal birth but that doesn't really matter here. What we're starting with is always the activation stage and that's the same for everyone and definitely not sport specific. I don't see the difference in that first four to six weeks why you would make that sport specific when it comes to difference between football players, tennis player or judoka or anything like that, right. So the first four to six weeks, definitely not.
Peter:Now I'm not familiar with the complete setup of her physio team. I know the head physio because I've worked with him before, but I'm not sure what the setup of the physio team is. Quite often in women's sport there is a bit of a crossover. It's a really weird setup. Women's sport is in a lot of cases massively underfunded compared to men's sport and therefore you could either have a physio on the team who also has a postpartum recovery kind of qualification or certification on it, a strength and conditioning coach that has some sort of postpartum experience, or you could do what has happened with me before they bring you in temporarily and it's basically it's.
Peter:I don't know. It costs about a grand or something like that. It's not that expensive and you work with someone for a set amount of time and then you hand them back to their team and and you brief the team on on on how to proceed from there. But usually when, by the time I hand people over, it's always go, do whatever you want, and that's why I always say that this is. There is no difference for me between an athlete and a non-athlete, because my handover is always the same. You, by the time I hand you back, you can do whatever the hell you want, right, as long as you're aware of some of the basics.
Peter:Anyways, like I said, so I don't know what her team is like and I'm not sure what the actual setup of this is, but I would argue personally that the second stage should also not be sport specific, and this is the bit where some physios may well disagree with me on. So we had the first four to six weeks and that was like the activation stage. That is everything working properly when it should. That doesn't mean everything is strong enough yet. So when we're talking about things like diastasis, recti and all that type of stuff, the core is working, but the core is not yet strong enough to do what you needed to do on any sort of human slash, life level um, let alone competitive athletic level, the the difference between amateur sports. It sounds really stupid but a lot of, especially men, seem to not understand this.
Peter:The difference of the pressures on the human body of someone who's an elite level athlete and someone who's just a normal Joe, as in me, is, I mean, that is the difference between Earth and Mars. It is huge. I've worked with, uh, several female athletes professional athletes, elite level professional athletes, and what their bodies are capable of withstanding and dealing with. I would die genuinely. And it goes for women's football and tennis and judo and martial art, taekwondo, all that type of stuff. I mean it is so insane how much, how elite the body of a female athlete is. But even shot put, all that type of stuff just in case you're thinking it's only for the women's air quotes athletic sports. You know the, the sports that where you're slim, and all that the shot puts or discus for her. I mean it is insane how much those bodies can take.
Peter:So by the time we've done the activation stage, you're nowhere near ready to translate that into sport, so you're nowhere near ready to go back to your team yet, I would argue. So, apologies, but I'm I can't keep. Uh, apologies for clearing my throat, but I can't keep stop starting because this, this clearing of the throat, isn't going to. This tickle in my throat isn't going to go anywhere. I've had it for weeks now. I should get that checked out, pete, yeah, but I won't. You know what I'm like? A middle-aged white guy. We don't go to the doctor until we die, right?
Peter:Okay, so that second stage, I would argue, doesn't need to be sport-specific, because I don't know any. It's basically the strengthening up of weaker areas is a good idea for anyone, right, we need to make sure the core, the glutes, the upper back, arms, in some cases, just whatever any weaknesses have kind of been ironed out as well. I don't personally know any athlete that would benefit from having a weakness in certain areas, especially if they're straightforward to fix. That doesn't mean that, by the way, when I say that, I don't mean that I don't see the benefit of having certain type of athletes be much stronger in certain departments over other ones. Right, and you know, if you look at I don't know tennis players if you're right-handed, I completely see the benefit of your right side being massively stronger than your left. Right that is. I completely get that.
Peter:That's not what I'm talking about. I'm talking about fixing weaknesses. If you have no strength in your left, then you need to work that out. You can't just only go well, I only hit the ball with my right right. We need to, we need to put a bit more effort into that and and sorting. That is where I come out from when it comes to things like diastasis recti and all that type of stuff as well Diastasis recti, glute stuff, glute, weaknesses, that type of stuff and then we're already at almost once we've done that right.
Peter:So when we've done that stage, which is usually another four to six weeks right, when we've done that stage, which is usually another four to six weeks which is why I think you know, especially with people um, like you know, like this lady, who are professional athletes, three months recovery with me is usually enough because the muscle activation tends to be pretty good, um, it doesn't take that. They usually tend to go back to some sort of um training and rehab training recovery program fairly soon after giving birth, because by that I mean six or eight weeks right, usually maybe 10 or 12 in some cases, of course, if you have like an element of like postpartum depression or anxiety with, it can be a bit longer. But unless there is any sort of like birth trauma, they tend to go back sooner rather than later and that means the recovery process takes a little bit, you know, doesn't take as much time, doesn't take as much time. So at that early stage I already hand them after the activation stage, and another six weeks or so I already hand them back to their team.
Peter:Because I'm not a strength and conditioning coach, right, I don't do strength and conditioning with my postpartum clients, so let alone the sports-specific one. Now I have a pretty good idea as to what's required for I don't know, tennis, football player, judoka, discus thrower, I'm okay, saying okay, I think this is probably what you need, but that's not what I do and you know. So I don't. And someone goes back to the football club. That is when things start getting, say, sports-specific, not really before, then Now, same with tennis, if you go back to your team, that's where you do the sports-specific training. I have very little to do with that and I like to watch it. And I think those strength and conditioning coaches that do sports-specific stuff, especially the martial arts stuff, the MMA people it's really interesting to see. American football is the same.
Peter:Female women's rugby it's interesting for me to see, but I have no desire to bring that on. I think that's just a very specific skill set, so I have very little to do with that. I think that's a very specific skill set, so I have very little to do with that. When I hand them back, I give basically a pack or have a meeting with the head physio, if there is one, like in this particular case, there's a head physio. So then I would hand the client back and say, listen, this is the stuff you need to be aware of. But off you go, build it up slowly and, you know, go do your strength and conditioning stuff so that they can go back to competing.
Peter:Because, again, for women's sport, because it's so underfunded I know even in the Women's Premier League in the UK you know it's embarrassing and in the UK I mean in England the funding was so poor that a lot of the Premier League teams didn't have maternity leave and they didn't have daycare of any sort of meaningful at any sort of meaningful level and they didn't have a recovery uh program and I know people that have had to. That had to look, uh, that had to look for their own women's health professional, uh, their women's health physio. And I think that's changing now when there's more money flowing in the in the women's team. But just by way of comparison, I saw something the other day in the news that you know, one of the female football players was going to go for a world record fee. Walsh, I think she plays for Barcelona and Arsenal made an offer or something like that, and the world record fee was £900,000. And you know you compare that to male players that go for £40 million as standard, right, that is not even a ridiculous amount of money anymore. Then you can see what the discrepancy is. When clubs are protecting their investment and all that sort of stuff, I think probably if you look at clubs like Wrexham, who are driven from a much more socially aware if that's the right phrase and I think Reynolds and McElhenney are are much more aware of the social impact that their club has than, say, people at the Premier League level are the Women's Premier League level, are that? Then you have a really strong team of female physio specialists around you and all that sort of stuff.
Peter:Now, so for normal people. Pardon my my. That is the end of my little tangent. For normal people, this is a stage where I tell clients they're ready to do whatever you want to do. Right, you don't need me there anymore. So that means you can attend a spin class, a hit class, kettlebell class, do normal, go back to your normal pt whatever. For an athlete that just remembers remember means remember what I told you, but you know you can just go back to your normal PT whatever. For an athlete it just means remember what I told you, but you can just go back to your club or your team and do your thing. Give me a shout if you have any issues or questions.
Peter:Like I said, this comes with a handover document for the team, if they want one. Amazingly enough, they usually don't want a handover document. The teams are especially up in Scotland. They're not very yeah, they're just not at that high, higher professional level and have a lot of other things on Now, unless your postpartum specialist is involved with that stage of your training. Like I said, for instance, in a football club they may well be, because women's football doesn't have a lot of money in place and sometimes the work is done by someone who's already part of the general physio team. They just have a qualification.
Peter:Unless you're part of that group, I don't see the benefit of doing anything sports-specific as part of your program. I can see how your specialist will want to do a sport-specific test to make sure you're good to go back training again. But that's about it. You know that's what I would do, right, can you perform the basic test? So, with a judoka, for instance? So can you perform a hip throw and everything works and everything feels okay. Not a high level, I mean. I'm talking about the movement. I'm not talking about throwing me a 90-kilogram guy up in the air and onto the mat and breaking my neck and all that type of stuff. I'm just talking about can you perform the movement and everything feels okay and everything looks okay. As soon as you can do the movement and everything feels okay and looks okay, then you can start building it up and that is then sport specific strength and conditioning stuff. Like I said, I don't do. I don't really do anything with that. That part of it it is I am not interested in.
Peter:I don't see why your recovery program would need to be tennis or football or taekwondo specific. I just it is not part of what we're trying to do. The pelvic floor of a tennis player doesn't need to be any different from that of a football player, right? And the core always needs to function well, whether you play tennis, football or women's rugby, right? So that is. That is where I come in. I very much think that there is a lane for me to stay in, and I don't see why how straying out of that lane is beneficial, to the extent that I tell people that you know, a program needs to be sport specific rather than it needs to be person specific. That's what it needs to be. That is what it is.
Peter:Your physio, your women's health physio, should be saying hey, insert name here, right, my lady, so to speak, this is what's going on, this is what we're going to do, this is how we're going to sort whatever the issues are, and then three, four months at a push from now, you will go back to your strength and conditioning coach. I don't see how that is different from that, from any other approach that any good physio I think would take. I think most physios are awesome at this type of stuff. If you're a physio for a rugby team, then you don't treat everybody exactly the same. You treat them as individuals. Usually a catalogue of injuries and problem areas, usually a catalog of injuries and problem areas, right? That is how most people see this, see their client. When they're professional athletes, it's always oh, sam has this and Katie has that, and Katie is the ACL and Sam has pelvic floor problems, that type of stuff, and then there's always someone with a shoulder problem. That is the sort of thing. So that's what's happening. It's person-specific and not sport-specific.
Peter:Anyways, I hope that answers the question and I hope it makes sense for everybody who's listening to this, who's not an athlete. As in, the job of any sort of rehab, in my humble opinion, is to get you back to doing the things you love to do. Right, that is what it is. And then you can do the things you love to do. And if that includes whether you need to then go strengthen bits up and all that sort of thing, yeah. So then you don't work with your normal PT if you go back to the gym or you go back to your kettlebell class. That is not something your physio needs to be involved in, but they do need to sign off on it. Does that make sense?
Peter:And there is, of course for me, and I would say this I've said this before you have to make sure any physios listening to this. You have to make sure people physios listening to this. You have to make sure people understand what their next step is, um, and don't just tell them yeah, you're done off, you go right. Because then people come to me and say I had physio and now I have a weak shoulder and I can't do anything with my shoulder. Um, and that's not the point. You need to tell them what the next step is like. I said that's what the handover document is for. When I hand people over, when I do sessions with normal people, when I say people and I only work one-on-one in real life right, so I'm not selling you anything here when I do sessions with people, so they buy my postpartum package and it's like £700 for 24 sessions cheap as chips and it's like 700 pounds for 24 sessions Cheap as chips Then the last session, or the last two sessions, are all about preparing them for the next step. This is what you can do going forward, right, so that I don't say we don't have that gap of everything is kind of working fine, now you can do whatever you want, and then they just potter about aimlessly for the next year not really doing anything, and that is not beneficial. Right, we plan what the next step is and how, what they can do themselves. They're just not doing it with me usually. All right, I'm, I'm.
Peter:I like the conveyor belt of of clients approach. Um, admittedly, I have had some clients that have been with me for a long time, but I like to convey a belt. I like to see someone for three months. They're fixed, they go do their own thing because it gives me room to work with somebody else. Anyways, that is me done.
Peter:Waffling for yet another half hour. Um, because you know that's what I do. Um, obviously, the email that I sent back to this particular, uh, lady I'll keep calling her lady now because it's hilarious, if you know what you think it's funny um, um, the. The email I sent back to her was significantly shorter. So if you email me in, you're not going to get a half hour written response. A written response at Waffles Peter, at HealthyPostnatalBuddycom. If you have any questions of your own, just send them over. I respond to every single email I get. Here's a new bit of music. I'll be back next week with that promised episode on chronic fatigue and how to manage it with Miguel Batista, and you know you take care of yourself and I'll be back then. Bye now, thank you. We'll see you next time. Thank you, was it all just a game?
Peter:It's really such a shame that you would use me like that, blame me for the way you came in, get on with it and say Can't even get the sound of your name, I'm sick of all the drama. Baby, go and get your car. Mm-mm-mm-mm-mm, mm-mm-mm-mm-mm, mm-mm-mm-mm-mm, move it. Or just a game? It's really such a shame. Was it all just a game? It's really such a shame that you would use me like that and blame me for the way it came out. Yeah, I'm wrong with this. I can't even hear the sounds of your name. I'm sick of all the drama. Baby, go and get your karma.