25-26 weeks Why I see a Womens Physio... and still training hard
Updated: Oct 13, 2020
For my training plan (ok what I actually did...) for these weeks scroll down!
Off again on another mini-holiday – this time to the beautiful Brecon Beacons in Wales. But it coincides with another of my mini pain periods. Damn pregnancy moving my body around!! I'll start with the downsides of the last 2 weeks but overall its still going well.
On the 3 hour car journey to Wales I start to have back pain in the mid-upper part of my back. And it starts again every time I’m in the car for more than half an hour while we’re there. In the earlier parts of pregnancy I was suffering more with lower back pain so this feels quite strange. I'm very grateful for our car having heated front seats which act as a good form of pain relief. And for remembering to bring my lacrosse ball (a hard ball like a trigger point ball) which I lie on frequently to release the pressure points in my back. I do fall asleep on it one evening having a nap while hubby takes the kids for their tea and develop a bit of a bruised patch though!
The awful pelvic pain hits again too. Just once, whilst I’m standing in our hotel room and can’t move or speak for a few minutes until it passes. John just has to look at me to know what’s happening and to keep the boys from charging into me until the wave is over. In some ways it’s like a contraction – short, intense pain so I guess it’s helping me mentally get ready for the big event!
I’m also struggling to catch breath at night when going to bed. Every time I have a little panic then remember it’s ok, it’s natural, I’ve been through it before. What seems to work best is sleeping propped up (3 pillows) and doing 20 sets of the breathing Wim Hof (aka the Ice Man) taught me to control pain. I breathe in deeply through my mouth for a 3 count, expanding the bottom of my lungs. Then breathe out quickly and strongly through my mouth as if to say “Huff”. I learned the technique from him whilst recording a Slate Podcast just before I ran the Spine Fusion race (268 miles non stop on the Pennine Way).
The podcast is entitled “How to withstand pain” - here's the link:
and I was the guinea pig using his advice on the race. I was sceptical when I spoke to him but it did help me and I use it pretty frequently now – whenever I am anxious, in pain or breathless and it really does work. 40 sets are best but I usually do 20. Hoping it works for labour too!
In Wales I manage to squeeze in a couple of longer runs. It’s incredibly beautiful – we’re staying in the middle of an Arboretum with no other buildings in sight - and I love exploring new trails. With all the rain they are really soft underfoot and I decide to stretch the runs just a bit more each time. Unfortunately we have a breakfast booking each day which is the real limiter as I like to run before! I’m finding I just need a little snack mid run and don’t need to eat before – nothing like the full fuelling I needed to do a few weeks ago. Strict rules, whether on nutrition or anything else, just don’t work for me through pregnancy. My body is constantly in flux with changing needs so I’m just trying to tune in to what it says every day – and making sure I listen to it.
As well as running I manage to get a few good family hikes in, firstly around an area of waterfalls then we set ourselves the challenge to walk as a family up Pen y Fan, the highest peak in the area, at 886m (the path starts around 400m asl). We have the rucksack to carry Cormac (well for John to carry Cormac) but he keeps plodding on (fuelled by Haribo) and makes it up himself! 2 years 3 months might be a record – he manages to pass quite a few adults along the way too. The wind picks up so John carries him down whilst my 5 year old and I hurry down, discussing downhill running technique. Donnacha learns how to choose where to place his feet for the best grip and how to look ahead to pick the best line. He loves testing different things and trying to go faster – getting nicely set up to be a good trail runner!
Seeing many of the people we passed (at the pace of my 2 year old) still struggling to make it up makes me realise that one size doesn’t fit all in terms of activity advice – in pregnancy or otherwise. We have to look at our individual scales of exertion and difficulty and listen to our own bodies. Guidelines are always designed for the "average" person. Which I'm guessing if you are reading my blog you are not (in the best possible way).
Once we’re back home I’m straight back into training catching up on my interval sessions I’ve missed. I push a bit hard in spin class – it’s sometimes hard to see my HR on my watch as its in the dark and I was out of the saddle on a longer climb, cycling to the beat and just set it too high (about 210W). Was just keeping the beat but I start feeling noticeably out of breath and checked my watch which read 166. Too high. Which my body had already told me so I’m not sure I needed to look! It would be good to work out how to keep the light on my watch face through the class so I could pull back before then but I need to listen more closely.
As usual I try and catch things up too quickly after 5 days in Wales – a 6 mile run (+ Pen y Fan that day), a 4.5 mile run, a treadmill incline session, boxing & strength and then spin! Normally (ie not being pregnant) I think I’d be fine but my legs are crying out for a rest day. Recovery is just taking that much more time after every session now.
I naively reckon one rest day is enough and my legs are still very annoyed at me at the start of Saturday’s long run. They still feel so tired – even the initial hike up the hill is a challenge – and the first mile is just awful. I wonder whether I should just ditch the run, whether I can just do 2 miles, even less. I’m running slower than 11mm pace and it feels hard!
So I decide to focus on my posture like Shane Benzie, a running coach had taught me and just run tall, ignoring the pace. And without realising my pace starts picking up – (ok picking up means I run a couple of sub 10 minute miles) but it feels so much more comfortable. The trail is lovely and soft after all the rain and instead of shortening it I keep extending the run. In my plan Eddie has given me 6-7 miles but I end up with 10. I think about going even longer but don’t want to risk it (I also have friends coming over and a cheesecake to make). It was perfect running weather – cool and calm. My pelvic floor held perfectly too - just a couple of pee stops (which on a per mile basis is as good as its been for months!). I might not get another 10 miler this pregnancy. I probably won’t. But I feel so grateful for this one.
It’s a reminder that pregnancy isn’t a one way direction. It reminds me of one of the first big ultramarathons I did called Comrades in South Africa. The course switches direction each year from “UP” to “DOWN”. I ran a “down” year but there seemed to be an awful lot of ups at the start!! Then at one point it started to just go downhill. Pregnancy is the same. It’s mostly downhill of course (or uphill depending on how you want to look at it). But periods of pain or weakness – of not being able to do something – don’t always mean that you won’t be able to until after baby arrives. Trying again a few weeks later might feel completely different.
I feel I’m still making progress on my treadmill intervals. Eddie my coach is giving me no let up (which is amazing) and my intervals have expanded from 3 mins to 5 mins with the with same HR target (160) and same 90s recovery. It takes 90 seconds for my HR to get that high after my hiking breaks so it’s really now over double the time in the higher zone!
I do cheat slightly - the session does say 12% incline instead of 10% however, but my calves veto that one quickly. I’ve never been disciplined at stretching my calves, and I swear they’re shortened from years of pre-baby 4 inch Louboutin wearing. My hip is also tightening up a little on the treadmill incline sessions again (as it did during the Everest challenge) because I’m not bothering to stretch it either.
So I’ve bought a calf stretcher (this stylish blue and white contraption) and all I have to do is stand on it. Except I can only stand at 18%. And even my very inflexible hubby can stand at 20%. The Louboutins have been away for years but still having their effect. To make matters worse the info sheet says a “normal person” can stand at 30%. I took a picture of me trying to do that. I'll share a before and after when I finally manage it! So I have work to do…. But on the upside its something practical I can work on during pregnancy – especially as I have relaxin in my body to loosen things a little. I never have time to do all the things I know can benefit my running but now my mileage is down this is something I have no excuse not to make time for – and I’ll return to running even stronger for it. So the calf stretcher is happily now located in our kitchen, where both my boys laugh at me and demonstrate how I’m supposed to look…
Demystifying the womens / pelvic health physio...
I’m off to see my lovely womens physio, Emma Brockwell (@physiomumuk on insta) to get a proper checkup down below as my concerns about swelling were dismissed by my midwife (see last post). I feel better but want to be pro-active with my care. Emma is frustrated with this too – my symptoms could have been a number of things that would have needed support or an intervention so the midwife should have checked me rather than finishing my appointment early for an extended tea break.
I knew I could see Emma so was able to walk away from the midwife, but we all really need the confidence to say “no check me properly”. Or better, to have our concerns properly listened to in the first place. Being told to not lift anything, or not stand for too long without any diagnosis is just not good enough.
Anyhows so I go through my symptoms with Emma. 2 weeks ago I was feeling very heavy and swollen down there, with a few cramps. Turns out that was at 24 weeks when there is often a big relaxin increase in the body which might have been behind it. Now I’m absolutely fine and can continue my training for now just listening to my body.
Going to a womens physio is something many women put off or don’t consider. But its really not that scary and can give you the confidence to continue exercising during pregnancy – as well as the knowledge you need to recover afterwards. So here’s what happens:
Firstly Emma did an internal check for prolapse (when 1 or more of the organs in the pelvis slip down and push into the vagina) then tests my pelvic floor. She essentially gloves up and sticks a finger inside me while I either cough or squeeze my pelvic floor. It doesn’t hurt at all and frankly having had internal ultrasounds during early pregnancy its not even that weird either. Though after birthing 2 kids I’m not sure if anything is too intimate anymore!
I’m really happy I can do a good 10 second hold (squeezing my pelvic floor). Previously I could only do 8 seconds which gives me lots of confidence that the exercises are working and convinces me to do more of them. It's really hard to keep something up unless you can see the progress. I do a few fake coughs for Emma to check everything is in the right place. Being a third pregnancy means prolapse risk is high and I want the confidence to continue with my running. In the last few weeks I’ve had fewer leaks (and urgent pee stops) whilst running which has given me some confidence in how my body is managing pregnancy.
Emma and I start to talk about labour preparation and when I need to start stretching – limbs as well as to prevent tearing. It’s not for a while (well into third trimester) but everything can come so quickly that I want to have it all on my radar and I’ll definitely write about it when the time comes! We also start talking about what happens post labour. I’ll be messaging her straight away with an update of course – whilst I would love another straight forward labour (minus a tear) of course I could end up with a c-section or more damage. I still have some ab separation (Diastasis Recti) from my last pregnancy so I might be using a girdle straight away, and if my pelvic floor needs urgent support there are pessaries I can use in the short term while it heals. I’m arming myself with all the information I need before I see her for my 6 week check!
The main thing for me is not to do any damage now – I can’t and don’t need to make fitness gains, perhaps I can some strength ones. But doing too much or the wrong things can definitely overwork and overstress my body, especially in my pelvic region which would hold back any recovery from labour.
My strength sets are clearly working – getting to this point in pregnancy feeling fit and strong is a big win. In boxing class this week my bag has a spotlight on it and my legs are looking pretty toned in the mirror! (in contrast to my growing bump). If I can’t train at all from now, I really won’t be losing much going into post labour recovery.
In spin class I’m really getting to listen to my body and feel where my heart rate limits are. Instead of maxing out on the intervals and recovering easy I can’t hit them so hard now – so I’m only dropping 20-30% wattage to recover rather than down to almost zero and spinning easy. It’s a different way of riding – in running terms I guess more like a Kenyan hills session rather than hill sprints but it works for my body and the stresses I can put on it now. Almost everything can be adapted for pregnancy it seems : )