16-17 weeks - How to protect your pelvic floor and pelvis in pregnancy
It suddenly hits me. I’m walking the kids home from school down a steep hill and I stop in agony. A wave of severe pain goes through my pelvis and I have to stop and take a few deep breaths. Another few metres and it happens again. Luckily I’m just a minute from home and get the boys inside, send them to the playroom and go into childs pose on my rug.
My pelvis has been a bit achy so far – but NOTHING like this. Fortunately this seems to be a one-off – it doesn’t happen again this week. But it’s enough of a warning sign that I need to start looking after my pelvis and taking off the pressure where I can. I dig out my pregnancy pillow from my big pregnancy box I packed away after having Cormac.
I have a dreamgenii one (others available- diagram from john lewis website) – you lie on your side with the “tail” between your legs which keeps your pelvis in a more neutral position – as well as the other side supporting your back (or in my case stopping me sleeping on my back which is a no no from now). In my last pregnancies from about 20 weeks I wouldn’t go anywhere without it – I even took it to New York on a girls trip! The cost is about £45 which is fairly expensive for a posh pillow but it also comes in handy for nursing and on a per-comfy-night basis for me its been very good value.
I also had another catch up call with Emma, my physio on the pelvic pain. She thinks I’ve been holding some of my hip opening stretches for a little too long which might be aggravating the pelvis rather than helping it. After my treadmill runs or weights sessions I generally sit in pigeon pose whilst I enter the details into my training plan (and Strava of course)… and then I check emails etc so it’s a lot longer than I should be putting it under strain. Stretching is now back to that yoga “flow” I was supposed to be doing but have been skipping in lieu of plonking in pigeon for a few minutes and thinking that would work…
I decide to start on wearing my Gabrialla maternity belt (top) to relieve the pressure on my pelvis even more – especially during weight sessions. The first few times I try it it somehow doesn’t feel supportive enough which is a bit strange. Luckily for me my hubby’s physio happens to be at our house to treat him (he managed to break a bone in his leg a few weeks back) and spots me wearing it wrong and fixes it! In later pregnancy I wear it as a bump support – relieving the downward pressure and supporting my back – which is how I’ve been trying to wear it, with little relief. For now though I need to wear it lower – around my hips – to protect my sacrum. Immediately it feels much better and whilst it rides up a little during weight training I just adjust it back down. He also mentions I should adjust the side straps both together to avoid any twisting motion which I never would have thought of.
With my belt on I’m feeling really good during my strength set – even managing to up the reps on my 32kg kettlebell swings to 20 : )
After last week’s “floodgates” at the end of my long run, Emma and I also devise a plan to protect my pelvic floor:
1. Do my pelvic floor exercises
Nuff said really. I’m doing them, but not as religiously as I should be. 3 x day – 10 long count of 8 holds then 10 fast ones. I keep forgetting I’m not allowed chocolate until I finish them which I thought would work better than it has so I’m back to the alarm on my phone.
2. Change all my running shoes to cushioned ones
More cushioning = less impact on my pelvis and pelvic floor which is exactly what I need to keep running as long as possible
I run 90% on trail at the moment, but the hot early summer has meant that road shoes are far more appropriate. The issue is, my only road shoes are the Hoka Carbon X which is a racing shoe (ie not so cushioned) I’ve used only for track and intervals! And the pair of Cliftons I used for my 24 hour track race last year but these are a size too big (to allow for the swelling). But most cushioned shoes on the market are support shoes, or have a big “drop” (the difference in height between the heel and toe) – whilst I like to run in a neutral shoe with a low (0-5mm) drop which feels more natural.
The team at Hoka One One made a beautiful video of me and my boys to promote mothers running last year (see my homepage to watch it) and I’m a huge fan of the brand – having trained and raced all my ultras in their shoes for as long as I can remember!
So I reached out to them with my dilemma and they sent me a lovely pregnancy care parcel of neutral, low drop cushioned shoes (thank you Hoka). I’m using the new Elevon (black, bottom right) for long runs, and the Rincon (pink) for my incline treadmill intervals as it’s a speedier shoe. The crazy looking Clifton Edge got me to my scan this week with its massive heel to avoid the impact of running down a hill on tarmac! And I’m walking around in my Cavus (top left) instead of my vivobarefoots as walking impacts my PF too! (especially as I live on a big hill)
3. Hydration strategy.
I’m running straight after school/nursery drop-off in the morning, but I’ve usually had a cup of full-caffeine tea before which is actually a diuretic! I’ve now changed to a cup of green juice (I’m trying a new green powder in an effort to get more good stuff in) and make sure I’m fully hydrated the night before a run. It can be so easy just not to drink enough so I don’t need to wee all the time but its not good for me or baby!!!
4. Softening the run surface
Emma would really like me to have all my runs on a treadmill, at such a huge incline that I’m barely in the air (and therefore there is very little impact as my feet strike). This is probably the end-game for my running this pregnancy but I’ve convinced her there are a few more steps before we get there! She also understands the importance of mental health and the benefits of running outdoors in the forests for me so I’ve just switched 2 runs a week to treadmill on an incline for now.
This is actually inline with my training goals as I want to take on the Centurion Running “One-UP” challenge in 4 weeks time – the goal to climb the height of Everest (or other mountains). I haven’t mentioned taking on Everest to her (or my coach) yet of course…no point having a fight before I have to! But I do want to see how sustained hiking and running at an incline feels and if my body might be up to it.
We also agree to take my long run down to 90 mins from 2 hours – and take out the hills. I’ve a favourite route that heads to this huge area of open woodland I love to get lost in. The problem is that getting there involves 2 short steep tarmac downhills which I think are causing me the leaking problems.
I’m very lucky I live almost on top of a ridge that goes for 12 miles on trail along the North Downs Way so its out and backs along here for me for the next few months! (The views are pretty amazing so I can't complain)
5. Supporting the bump
I also started wearing my new running support belt to try and relieve the bladder pressure of my growing bump while I run. I’ve bought a Maternity FitSplint which is a much softer version of my Gabrialla, and more comfortable to run in (see top pic/ bottom belt in pic). It isn’t quite as supportive, but I can feel the difference even with my little bump (although a belt does make behind-a-tree pee stops more of a faff!).
With these changes I’m already feeling the difference. The added cushioning is definitely helping and I think I’ll at least be doing my recovery runs in softer shoes once baby is out as they feel easier on my legs too!
What is still holding me back is the damn tiredness!!! I cancel my first workout in weeks – life is so busy the only way I could schedule it involved getting up at 6am. There’s no point trying to do a “quality” session after lunchtime at the moment – I’m just too tired by then so the morning is my only slot.
But I hit the off button on my alarm and wake up 90 mins later… still tired. I miss a strength workout too – my body is telling me I need more complete rest days and I have to listen. I have to remember exercise is here to help me – if fitting it in is causing me more stress or more tiredness then I’m just going to let it go where needed. My hubby takes over a few of the school pickups this week so I can have a nap and recover for the evening. He’s still a bit perplexed by how his usually energetic wife is like a zombie but at least he’s taking it seriously and stepping in to help!
I have a call with my midwife this week and my blood results show my iron levels are unusually good for me so the tiredness at least isn’t anaemia. I do think I’m missing something on the fuelling side though. I’ve been hungry and inhaling bags of crisps and bars of chocolate in the evenings (the chocolate is normal, the crisps not so much). It means I really need to add in (better quality) calories during the day – especially before and after workouts. As someone who has spent most of their teenage and adult life on some form of diet it feels strange to be eating more before I’m hungry but if it means I’ll be eating better then its better for both of us.
And for the baby update – baby is doing just great 😊. Growth right on dates and all looks as it should for now. I’m having a few scans privately to fill in the gaps between the 2 the NHS provide. During our last 2 pregnancies I had a lot of extra scans as we were concerned about a genetic bone condition, but this has already been ruled out this pregnancy so we don’t have them booked this time. But especially in these early stages I still feel I want to see the baby and check all is well! Due to Covid John still can’t come with me which I worry will make it more difficult for him to bond – but at least I can send him a video of the baby bouncing around like crazy!
I’m definitely feeling kicks now – they’re too gentle for John and the boys to feel but as soon as they can I think this will start feeling a lot more real for the whole family! (and maybe I’ll be given time for even more naps…)
Next week will be a busy one - I'm a kit tester for the Womens Running Awards and a whole load of exciting gear is arriving daily at my house. I need to start working out how to sneak in enough runs to test it all properly!