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Bailey's Post-Partum Revival

Hello, I am Bailey Hammack, a wife, mother of two, and a physical therapist. Currently 6 months postpartum after my second baby girl born November 2, 2019. Let me just say that this journery has been significantly different than after my first because of a new perspective that I would like to share with all of you. After my first I so desperately sought to obtain my “pre-baby” body, and felt urged to push myself back to my previous workout routine in order to be “healthy, active, my old self.” As a former collegiate athlete and new physical therapist, at the time, I pushed myself back into vigorous exercise, that although possible, was not sustainable for my new lifestyle as a working mom. Today, at 6 months post partum, I am a more

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seasoned mother and physical therapist striving for a revival which includes improving my physical, social, and emotional well being. This all starts with setting a good foundation with a good plan, and giving yourself a little grace along the way (because the thing is YOU WILL fall a little short, and that is OKAY). So, let me dive into this new perspective and cover my personal journey, because it is my mission as a working mom and physical therapist to help women (like myself) reach their lifestyle goals.

What is a revival? An improvement in the condition or strength of something. OR, restoration to life, consciousness, vigor, strength, etc.

 

Let’s just clear the air, this inclination or phrasing that a woman must “get her body back” after delivering her baby, in my eyes, can do more harm than good. For starters your body did not go anywhere, in fact it was solely responsible for growing a human being, keeping them alive, and delivering them into this world. More like a miracle if you ask me, and we should embrace this new journey and work towards reviving this miraculous wonder that is OUR body. If we are desperately seeking to obtain our “pre-baby” body it can leave us feeling disappointed, hurt, or sometimes even injured. So, I urge you to instead turn your mindset to a goal for REVIVAL. And, as I stated before, it is important to give yourself some grace along the way, because many factors (sleep deprivation, hormone changes, balance of work/family routine, breastfeeding, doctor appointments, guilt, etc.) will impact your ability to regularly exercise. Oftentimes, it is more important to give yourself a chance to rest in order to SUSTAIN physical activity. Oh, and do not feel guilty in bettering yourself because it is important to invest in yourself. Setting this time aside to revive yourself is one of the best ways to serve your family and new baby, so don’t feel guilty!

 

The revival process will vary between women, and between every pregnancy/delivery. So, before I proceed to cover my journey I would like others to know their own journey may look vastly different, and that is okay! The beauty of motherhood lies in the eye of the beholder, and it is important that in the process we should avoid comparing ourselves to other people or even our previous pregnancy.

No mom-shaming here!

What exercise routine should I return to?

Returning to dedicated physical activity or exercise after baby can seem burdensome, scary, or just impossible due to lack of time or education on where to start or what type of exercise is right for you? Recovery across the spectrum from vaginal births to caesareans can look a lot different. A physical therapist can help guide you back to an active lifestyle tailored to help manage/treat YOUR current symptoms whether that be pelvic/back/hip/leg pain, urinary incontinence (by the way, it is NOT NORMAL to leak urine after having a baby), diastatsis recti, pelvic floor dysfunction, etc., and safely return to exercise. It is important for you to know it is never too late to begin exercise because the cut and dry 6 weeks clearance from your physician may not work for all mothers. In fact, it is crazy to think that throughout pregnancy you were given the opportunity to see your provider SEVERAL times to track you and baby’s health, but after delivery you are provided ONE postnatal visit that often times ends with clearance to begin a regular workout routine with no true physical examination! So, be your own adovocate and ask to see a physical therapist!

What is my journery towards my revival?

So, let me first start with the fact that I am continually striving to improve myself and I am still working towards my goals. But  this time I am making it a point to set a GOOD FOUNDATION. My first baby was delivered vaginally and the second via caesarean (cue the need for scar management). Currently, I am working on treating a diastasis recti, pelvic floor dysfunction/stress urinary incontinence, and SI pain. What are these you ask?

Diastatsis Recti: Diastasis recti is very common during and following pregnancy, and refers to the separation of the muscles running vertically on either side of the navel from the breastbone to the pubic bone. This is because the uterus stretches the muscles in the abdomen to accommodate your growing baby. One study found up to 60 percent of women may experience diastasis recti during pregnancy or postpartum. This is something a physical therapist can treat!

Pelvic floor dysfunction: The pelvic floor (group of muscles and ligaments) acts like a sling to support the organs in your pelvis — including the bladder, rectum, and uterus. Can you imagine as you grew a human (that only got BIGGER, may I add) that this increased the pressure/stress to these muscles. In some cases, as is true for myself, when intrabdominal pressure increases (i.e. with sneezing, laughing, coughing, lifting, jumping, running) one is not able to manage the increase in pressure, leading to stress urinary incontinence: otherwise known as involunatry leakage of urine. Yeah I am not ashamed to say, peeing your pants! This is NOT NORMAL and is something a physical therapist can treat!

 

What is the core? Concert of musculature that must work in unison. This includes your diaphragm, transverse abdominus, obliques, rectus abdominus, glutes, etc. Therefore, it is important to address all in order to maintain proper abdominal pressure and avoid risk for injury (i.e. lumbar or SI joint pain).

Sacroiliac (SI) Pain: Sacroiliac joint pain can result from muscle imbalances around the joint and/or ligamentous laxity between the backside of the hip, the illium and the bottom of the spine, the sacrum. Laxity is common with pregnancy, and is caused by hormone changes such as increase in hormone relaxin released from the beginning of pregnancy. The big job of relaxin is to increase the laxity (looseness) in the ligaments around the pelvis, which helps to enable the pelvis to expand during birth. The SI joint stabilizes and supports the spine and hips taking the impact of all movement on your feet. No worries, this is something a physical therapist can treat!

Scar management: With a C-section you should begin scar treatment around 6-8 weeks, which will help improve core activation and set you up for success.

 

How am I treating myself?

Dedicating time, at this stage of my life looks more like 15-20 min on my lunch break.

Training for me placed emphasis on building a solid and pain free foundation, starting with the basics of a lumbar stabilization program that includes awareness, stability, and strengthening of all core (as stated above) musculature. Progressing from symmetrical to asymmetrical positions, static to dynamic activities, body weight to resisted exercise and low/moderate to high intensity interval training. Currently I am working on progression toward higher impact activities such as running/jumping, but too often women may progress to these prematurely. In order to progress one should be pain free, no longer experiencing incontinence, and have proper core/LE strength both in double and single Leg positions.

 

I have seen a drastic improvement with resolution of my SI pain, improved core activation/endurance and stability in more advanced positions, significant reduction in occurrence of stress incontinence, and ability to progress to weight lifting again. I am now progressing towards training for a run with my co-workers! So cheers to dry pants!

 

This was a little insight into my routine, but remember exercise will look different for all women postpartum and goals should be specific to you. This is more like a marathon and not a sprint, so take your time and be an advocate for yourself if you need navigation along the way. A physical therapist can help establish a plan of care that is specific to you and your needs, and I would be honored to play that role!

 

Sincerely,

Bailey Hammack, PT, DPT, Wife, Mother of 2

Lauren's Ski Blog 2.25.20

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Hey! Welcome to our first blog! Anybody out there planning a ski trip this Spring? The snow was great in New Mexico this year! (Angel Fire pictured above.)

I recently took a Kamikaze trip for some time on the mountains. We drove 28 hours to ski 14, but it was so worth it. I insisted that we get out since I had developed a case of cabin fever beginning in 2017 when we remodeled our house after Harvey followed by the business start up for MAX in 2018. Brent and I put two teenagers in the truck with our ski gear and headed out President's Day weekend to see my Dad and Step Mom and hit the slopes.

I wanted to give myself the best chance at enjoying my trip and preventing injury since I hadn't been skiing in 3-4 years, so a few weeks ahead of the last minute trip, I started working out at lunch in the clinic on a PRE-SKI PRE-HAB program I developed for myself. I thought I'd share it with y'all in case anyone is headed out. There is still a little time left before Spring Break. Caveat statement: remember that all wellness training should be pain free or else you know who you need to pay a visit... :), your friends at MAX Rehab & Sport.

First, I worked on strength in 3 categories, legs, core and arms. Legs (quads, hamstrings, hips and calves) for obvious reasons but including plyometrics (jumping) for shock absorption in case Brent got me on the black moguls again which he did. Core work included planking side and forward, sit ups, bridges and hamstring curls on a physio-ball. Good turns involve a good deal of trunk action and hauling skis up inclines takes a solid core too so don't forget about the middle section. For arms, I focused on push ups and walk outs on physio-ball. I should have worked on my lats too due to some unfortunate poling on flat pieces of the ski runs that I had kinda forgotten about since my last trip. My lats were the only thing sore when I got back as a result.

Next was balance work. I wanted to perk up my balance reactions so that I had all systems go for uneven terrain. I focused on work on a wobble board, including squats on wobble board and single leg Romanian dead lifts with kettle bells with good form. 

Although I always run a few times a week, I next stepped up my cardio training. Running is my favorite, so I stuck to it but added frequency, duration and speed in small increments. This helped prepare for high altitude exercise by improving the oxygen delivery system since mountain air is noticeably thinner up there. Mountains also bring incline terrains that we flat-landers aren't used to, so the cardio helped me be able to hold a convo while hiking about toting skis. Gold Star Note: when you get back, if you keep pushing your speed and distance the next week, you may notice a little acclimation bounce your in oxygen system to help you get to the next level.

Last, I decided that the extra effort would be an efficient time to drop a few extra pounds by dovetailing all of the benefits of increased strength training and aerobic exercise with calorie counting. I used my Metabolic Evaluation calorie number (test offered here at the clinic) for weight loss as my guide for calorie intake. With the increase in muscle mass from strength which burns more calories and the increase in calorie expenditure from the cardio push, before I knew it, I had dropped 4-5 pounds. Last, last note.:I made sure to increase water intake before and during the trip to help reduce dehydration and altitude sickness.

That's it! Thankful to be back in one piece! Hope you enjoyed our first blog. Until next time...