27-28 Weeks - From highs to lows - adaptations and injury
Updated: Oct 25, 2020
And just like that running is a breeze again! 10 miles Friday, 9 miles Sunday. With 2 miles Saturday chasing Donnacha who is learning to ride his bike followed by a mountain bike ride pulling Cormac in a trailer. Almost like a normal training week!
Both runs just feel better and better the more miles I cover. Especially on Sunday where I plan for 4-5 and just keep extending. Partly to get some more time to myself before I head back to the house we’re renting with 2 other families for the weekend. In fact that’s often what a long run is really about for me – time to clear my head away from others.
We are staying at a water park in the Cotswolds and I’m supposed to be using the run to reccy paths to take the mountain bikes on after but I find a beautiful soft loop around a lake and keep doing laps! Towards the end of both long runs I feel myself getting faster– soft trail is so much more comfortable than concrete and by focusing on my technique and running tall I feel invincible. At home I’m back on the treadmill and perhaps feel too invincible! I set the speed too high for my first interval, bust my 160 HR limit and dial it back for the rest. My hip starts to tweak again – better get back on that stretching. But my speed on these intervals doesn’t seem to be falling week to week and I’m doing longer and longer efforts – 6 minutes x 3 at the top of the pyramid at 8.5 kph this time.
It’s in the gym that the big adaptations have to start. My beloved boxing class is a mix of boxing intervals and circuit training which means my brain has to be in gear! The boxing instructor is not prenatally trained. Most PTs aren’t – well not much beyond “don’t lie on your back”. And I also don’t want to take over the whole class with one thing for me and one thing for others. So I need to know what I can and can’t do and have my substitutions in my back pocket : )
It can be frustrating to do exercise classes in pregnancy – most antenatal ones don’t work up a proper sweat which is half of why we want to do them. So working out what works for you is so important. And of course that changes week by week!
I’ve had my knees extended out behind me for pressups ever since I had a first session with my physio Emma who pointed out my doming when I was doing full body ones. This is the same for low planks but I wasn’t doming on moving ones eg commando planks and mountain climbers so I’ve been keeping at them.
Today I have to draw a line under them – I just can’t have my head too low or I feel sick from the acid reflux! So through the class I just take every exercise and change it for me to work the same muscle groups – Russian twist crunches become side planks with leg lifts. Mountain climbers become standing knee lifts with a twist. And instead of the plank series I do supermans using a dumbbell.
I’ve just seen him do a poor set of walking lunges with a pair of 16 kg kettlebells so I retaliate by picking up a pair of 20s and working the lunges into my set. I’m mightily impressed with my ego-check cause I don’t pick up 24s which are my pre pregnancy training weight but he gets the point. And stops throwing down the dumbbells. Which weren’t that heavy anyway.
After years of weight training I’m lucky to feel comfortable walking into any gym but that’s not the same for most women. And aggressive behaviour from other gym goers makes it even more difficult. So I like to make a point of calling them out. Or just putting them back in their box ; )
I’m back to the midwife again and after my last bad experience with one who told me not to stand much or lift anything (see 2 blogs back) I’m relieved it’s someone new. I’m in run gear as I’m off on an easy 5 miler afterwards so was a bit concerned the other one would throw some awkward questions my way. Instead we have a good chat and her only comment is to make sure I don’t absolutely overdo it. She’s delighted to see me still active – and mentions a piece of research on baby fitness.
Apparently boy babies have a lower heart rate in the womb than girl babies, so she would have guessed I was having a boy if I hadn’t told her it was a girl. According to a recent study:
“Exercise during pregnancy benefits not just the mother's heart, but her baby's heart as well. The results show regular exercise during pregnancy lowers the heart rate of the fetus, and this effect persists for a month after the baby is born.”
So if anyone questions why you’re not sitting on the couch eating cake, you know where to send them ; )
Speaking of research this week I’m giving the keynote speech at the WISEAN (Women in Sports and Exercise Academic Network) conference this week. It’s an incredible honour as I’m not a scientist but I am truly passionate about research in women’s sport. Only 4% of sports research studies include only women – compared to over 20% for men. Yet we go through such significant bodily changes unique to us – from menstrual cycles, to pregnancy and menopause. We desperately need more research into women’s sport – and female physiology in general. But also we need to make sure the research being done is getting through to and benefitting the everyday athlete, and not confined to elite womens’ sport. That was the serious bit of my speech (the rest was a lot of ultrarunning stories) and here’s the link if you want to listen!
The more I research and study womens physiology, the more I am frustrated at how much we don’t know. And equally by how much bad advice we’re given based on studies only carried out on men! Addressing this inequality is real passion of mine and one of the reasons I’m now a trustee of Women in Sport (www.womeninsport.org).
But back to running…. My long run this week is just brilliant again. I feel like I’ve nailed how to minimise my pelvic floor issues with top tips being:
1. Hydrate well night before (with electrolytes if its hot)
2. Little sips in morning and drink to thirst in run
3. Run as early as possible
4. Wear my sized-up EVB support shorts (which feel like they give me more support than the ReCore belt)
This morning’s 10 miler involved only 1 pee stop which on a per mile basis must be a record for this pregnancy. I no longer feel the need for more than a banana pre run – which I wouldn’t have if I weren’t pregnant and a small flapjack mid run – which also felt slightly forced. I probably wouldn’t have bothered to eat if I weren’t pregnant and focused on fuelling. My body has definitely changed in its needs during the pregnancy – I needed a large bowl of porridge just to get out of bed a couple of months ago!
My legs are acting strange again though - they just don’t move for the first 3 miles of a run and don’t want to run anything over 11mm pace… yet for the second time I manage a sub 9 min mile at the end of the run which feels easier than the first mile! (I’m trying not to remember how I used to run that section at sub 7mm pace). My coach asks if I want to back off the longer runs now but if I make them all short I won’t ever get to the good bit!
I’ve given up wearing the ReCore belt I bought for running. It’s incredibly soft which is great for running but I feel really supported by my shorts for now and not sure what the belt is adding for running. I’m going to keep it in my arsenal for wearing under clothes soon though – and at some point just sizing up in EVBs isn’t going to work! (update - it's still working at 34 weeks)
The timing on runs is proving critical for my pelvic floor, which gets tired by the afternoon. My 5 year old is learning to ride his bike on trail so we take him to the downs to practise. He zooms off into the distance and a minute later all I can see is him sat down beside the bike. I’m worried he’s fallen off so break into a run – but a full bladder + no support shorts + a tired pelvic floor from earlier run means I have to stop and powerwalk. He was just taking a rest thankfully! But I’m going to remember to wear my BP3 pants if I’m out with the boys after a long run again! (These are amazing pants I reviewed for Womens Running magazine and have since become a convert to!)
ITS ALL GONE WRONG!!!!!!
Well in reality it hasn’t. I’m still carrying a healthy baby and I’m living a normal life fairly pain free. At 28 weeks pregnant that’s doing really rather well so I’ll try and keep this in context.
So my Tuesday boxing class is going brilliantly – I’ve switched my 10oz gloves up for my 16oz set to give more cushioning and reduce the impact from punches. They’re an old pink leather pair I used when I spent 2 months training Muay Thai in Thailand over 10 years ago – they’re heavier than fighting gloves to strengthen my arms! Since I stopped kickboxing and switched to running I’ve barely used them but they feel like old friends. I think back to my time in Thailand when I always skipped the Saturday morning 2 mile run to beach training every week – getting a lift in the truck as I couldn’t possibly run that far! Now that would be far easier than the 12 x 3 minute rounds 1:1 I used to do in training!
In boxing class here we alternate between bag work and floor work, which switches up each week (hence me having to think of alternatives on my feet where I need to!) This week we have weighted lunges, squats and a clean and press. When I switch for the last time I can’t find a heavy dumbbell for clean and press so I make do with a 7.5kg – a bit light for me for a minute of reps. I decide to add a bit of a twist at the bottom of the movement and see how quickly I can do them as it’s lighter than before.
This was not a good decision.
I twist to pick the dumbbell up at the start of the minute and explode upwards a bit too quickly. I feel a crunch crunch crunch at the top of my right hamstring and immediately know something is wrong. It feels like the individual muscles making up my hamstring have tangled themselves up.
Thankfully it’s the last movement in the class but I can’t stretch properly in the cooldown and hope its just a small strain. I treat myself to a yummy protein shake at the gym to cheer myself up and go straight home to start icing. I have medical insurance through hubby’s work so call up whilst icing (always multitasking) and book a triage appointment with their physio for tomorrow.
From mass amounts of Googling I think it’s a proximal hamstring injury – right at the very top into my glute. I’ve had an issue on my other leg before – the injury feels essentially like a pain in the butt. But this feels a little more serious. So I polish off a large tub of icecream sat on the sofa. Whilst icing. More multitasking.
The triage physio the next day is worried too. She’s worried I might have torn it away from the bone (ouch) and wants me to have an ultrasound or MRI to diagnose it properly. Unfortunately she can’t refer me so I have to see a consultant first. Which frustratingly takes a few days (and many hours on the phone to arrange) and I’m sent to a knee specialist as that’s the closest they have to leg. There are seemingly no sports specialists available. This turns out to be a big mistake.
I wish I’d videoed the appointment somehow if just to believe it actually happened. The consultant doesn’t seem to know why I’ve come. Yes I’ve got an injury but I’m 28 weeks pregnant so does it really matter? He does a few basic tests to check the muscle hasn’t come away from the bone (luckily it hasn’t) but is keen to let me know he can’t do a full range of tests as I can’t lie on my front. He tells me I can’t have an MRI as I’m pregnant (this I realise later is not the case after the first trimester) and as it will heal on its own within a few months there’s no need for one anyway. I’m pregnant after all of course – why am I even worried about this – I have a baby to look after. I should just be – yes – sat on the sofa getting fat. He diagnoses a proximal hamstring injury from asking a few questions and says he’ll refer me to a female physio he works with.
I try to ask what I can do exercise wise in the meantime. I try to ask if there’s a way to speed up my recovery – are there exercises I should do, should I be icing or putting heat on? But he’s already standing up ushering me out. I’m invisible to him. I’m not an athlete. I waddle back home trying not to cry.
The funny thing is that the injury itself hasn’t upset me. I’m already prepared for giving birth – I’ve put the work in so far and I won’t be losing too much fitness and strength over the next few months. It’s not like I have a big race coming up! If it was weakened anyway then this could have happened at any time and now I can put a big strength plan in place which will help to protect me in the future.
The lack of running for the next few weeks will also give me time to work on other things in the gym like my arm and back strength which I need for carrying around the little one. I get back in the gym 2 days later for a good set. And in true ultra mentality getting through this just makes me stronger for what’s to come.
On the negative side of course I might not run again in pregnancy, and there will be a few weeks where I can’t get the cardio boost I want while I take time to rest. There might be a few more tubs of ice cream eaten than usual. My school and nursery routes are crazily hilly which is the worst thing for it so I need to make sure I am taking that rest where I can.
I’m acutely aware of my mental health in all of this and will be monitoring it closely and being creative in finding some different feel-good boosts. As I can barely tie my shoelaces with the hamstring now I think that starts with a pedicure!!
What really hurts me is the dismissal – mostly from the consultant but also from those around me. Almost every one has commented that its almost ok for me to be injured now, as if being pregnant makes me no longer an athlete. That the consultant decided I didn’t need to get to the root cause of my injury, that 3-4 months rest was fine for me when he readily said he’d have suggested one if I weren’t carrying a baby.
Perhaps I’m being too precious about this, and personally I know I’ll be highly active in my recovery and do the best I can. I’m sure it won’t mean 3-4 months of doing nothing as the consultant suggested! My real anger is for other women who don’t have the same support network around them, and the same confidence to challenge (or just ignore) the advice of medical professionals who don’t have our best interests at heart. We need to get the message out that as pregnant women we should still be considered athletes – even more so than ever as we have the greatest challenge to train for. The more we speak out when we aren’t being treated fairly, the less likely it will happen to the next mother so lets keep doing it!
So unsurprisingly I’m not going to be sitting passively on the sofa. I need to work out how to recover as quickly as possible, and make a plan to stay physically and mentally healthy in the meantime. It’s the best thing for me and the best thing for my baby. Time for plan B.