Pilates And Exercise Physiology For Postpartum
Expert Interview with Stacey Pine
In this episode, we are joined by Stacey Pine, an Exercise Physiologist who provides mobile exercise physiology and pilates services. Stacey has over ten years of experience specialising in exercise rehabilitation for musculoskeletal conditions, pre and post orthopedic surgery, chronic pain and women's health issues.
In 2014 Stacey started Progressive Motion, a mobile pilates and exercise physiology business. This allows Stacey to see mothers in their own environment and help them keep active in pregnancy and return to exercise safely in the postnatal period.
Stacey discusses the frustrating elements of our culture. She advises mothers to reconnect with their bodies, regain their strength, and gently build up to more intense exercise. Tune in to learn more on this and other exciting topics!
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About Stacey
Originally from Canada, Stacey completed a BSc in Human Movement at the University of Alberta and travelled to Perth, WA for her practical placement in 2007. She became an Accredited Exercise Physiologist (AEP) in early 2008, working mainly in musculoskeletal rehabilitation and gaining experience with some of Perth’s best Orthopaedic surgeons and AEPs doing pre and post surgery exercise programs.
We explore the following questions:
Can you give some concrete actions that people can take in their own lives to get some of that reconnection with their body and some of that strength and health back again?
How can moms get back into more intense exercise after giving birth, especially if they've had traumatic births or pelvic floor issues?
What should mums do if they are told they can never do certain exercises again, like running or weightlifting?
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Transcript
Julia Jones:
Hello and welcome. Today on the podcast, I am talking to a friend of mine who also has helped me out on my own postpartum journey, and her name is Stacy Pine and she's an exercise physiologist. And what she has done for my body in the last couple of years has been completely amazing. And just to give you a little bit of background on my story, my third baby was very big. I was quite sick during the pregnancy and I had a few complications, so I couldn't really exercise. Plus I had two other kids already and my body got into a bit of a state. And after my baby was born, I was hoping that not being pregnant anymore would sort of just mean it would resolve, which I'm sure Stacey's laughing about this because probably physios and exercise physiologists, and anyone who works in that kind of fitness area hears this all the time.
Julia Jones:
It is not going to fix itself and it's not just going to go away. So if you're listening to this when you're pregnant, go and see a physio now and don't do what I did. But what really blew my mind about working with Stacy was the simplicity of the work that we did together. Stacy's very hands off and she was always just only touching my body enough to remind my muscles of what to do and just to give me a few pointers, but it was more like doing a yoga class or something because it was always about me in my body, getting to know what works and what doesn't. And that was really powerful and really subtle and a lot more gentle than I expected and a lot more profound. So I'm a really big fan of Stacey's work, as you can tell. And so I've brought her on the show to talk to you about how your body works and how to keep yourself strong and healthy during that transition to motherhood. So Stacy, do you want to introduce yourself?
Stacey Pine:
Sure. Hello. So I'm Stacy, as you said, an exercise physiologist. And for those of you that don't know what an exercise physiologist is, we are in the rehab profession. We're allied health professionals, so slightly like a physio. The main differences is that we are hands off like Julia said, which can be quite cool, not so good if you want to massage, but we send you to massage people too. That's all right. But we're hands off, which really allows us to empower you by giving you the treatment that you can treat yourself. So it's pretty fantastic really. You get to watch people really thrive in their own bodies and find their bodies again, which can be a tricky thing when you're a new mom.
Julia Jones:
Yeah, absolutely. I think that is a big journey for a lot of people is you feel like your body isn't even your own body anymore. Everything changes so much that often, that kind of thing of having some exercise, it's really kind of grounding, isn't it? So tell me, what do you find really frustrating about our culture of postpartum care?
Stacey Pine:
Sure. Well, I have to say that the whole attitude of getting your body back really, really grates me. It has to be one of the worst, I think, and detrimental attitudes to most women. So getting your body back theory as well as the lack of knowledge from many health professionals as to what exercise is good and not so good, and the way to gradually progress people back into exercise, especially as you would know, having a big time of not exercising during pregnancy in the postnatal period. So what happens with most people is they're told not to do anything for the first six weeks until they get clearance from their doctor. And that clearance is important. I have to say that if your body feels up to it, that first six weeks is a great time to start to gradually progress into things like walking, really gentle, stretching things that and that you're comfortable with.
Stacey Pine:
I think being sedentary isn't always the answer, but definitely listening to your body and moving at your own pace in those first six weeks, if you feel like going for a walk, then it might be time to go for a walk. So then what happens is people hit six weeks, generally they've done nothing, and then they go straight into the doctor says, yep, you're clear for exercise. And they go, great, let's go to bootcamp and get my body back. A couple of reasons I think this is quite harmful is there is absolutely nothing wrong with your brand new motherly body. It's doing some fantastic things. It's gone through a huge transition, and I just think we need to take the time to honour that and honour that transition and progress into a new body rather than getting some imaginative, figurative body back that we used to have. It's just really impossible for a lot of people to return to the exact way they were. And I think we should encourage people to find a new and improved motherly body. That doesn't mean that you can't get a six pack again or anything like that. It just takes the pressure off.
Julia Jones:
Yeah, I love that. I love that. And there's certainly something that I see a lot too, is this idea of fitting back into your skinny jeans. I actually even had a friend who when she had her first baby, she packed her skinny jeans in her hospital bag thinking that she would have the baby and be able to put her jeans straight back on. So that just gives you some idea of how unrealistic our expectations are of our bodies. And yeah, like you say, it's pure fantasy, isn't it?
Stacey Pine:
Yeah. Yeah. And there there's so much emphasis in weight loss, and if you look at the general population, women are on average two kilos heavier than at a year postpartum than they were pre-pregnancy. But two kilos isn't in a general health perspective going to really harm people. But something that is really harmful is that we're going to hit menopause and 50% of us are either going to be incontinent or having our organs fall out. And that for me is very worrisome. We still don't know what extent of that is because of the pre and postnatal period, but it's definitely something to look at, and I just think honouring that time and taking a bit of time to get the right muscles back at the right time can make such a difference in the rest of your life.
Julia Jones:
Yeah, I love it. So we should be really focusing on health and on function rather than on just how it looks from the outside.
Stacey Pine:
Yeah, absolutely.
Julia Jones:
I think you've mentioned this a little bit, but what kind of advice do people often get that you would really disagree with? Do some people do moms come with you to you saying, oh, so-and-so told me to do this, and you just go, oh my gosh, that's a terrible idea.
Stacey Pine:
Yeah, they might have one favourite exercise that's going to fix their separated abdominals or they've been weightlifting with the pelvic floor. There's all sorts of little tips and advice. And I guess the main thing I can say to that is for fixing things like pelvic floor problems or separated abdominals, you have to realise that it's a whole body and a systems issue. So there's not going to be one magical cure. All exercise breathing is going to matter. The way that you're standing all day is going to matter. Possibly the things that you're doing all day are going to matter more than the actual one or two exercises that you're doing to fix it. So really taking the whole person and the whole mother into account is the best way to deal with the postpartum issues, as you will know.
Julia Jones:
Yeah, I love that because a lot of the time when we were working together, Stacy, if I had a bad week and I would say, oh, my back's extra sore today, it's been building up, and you would always ask me lifestyle questions like how much sleep have I been getting and have I been pushing the pram or carrying the baby more than usual? And it really made me stop and think about my whole life, not just the five or 10 minutes a day that I spend doing specific isolated exercises, but rather thinking the kind of support I would need generally in my whole life and seeing it as a whole body, really holistic kind of thing.
Stacey Pine:
Absolutely. And moms can find it really hard to put an hour a day aside for exercise. And part of what I encourage to moms is getting them, it's okay to do a 10 minute bout of exercise. 10 minutes is actually a lot if you're doing focused exercise that whole time. And it's okay to exercise throughout your day. As moms, we're not really stuck at a desk for eight hours in a row, so it's not as important to just go out and exercise for one hour in a row. We can get little bits and pieces, we can have a lovely walk, we can do 10 minutes of strength work, we can get in a little session of yoga after the kids are asleep. So yeah, there's a lot of things to factor in there.
Julia Jones:
Yeah, I love that. I love that. So you've just told me that you can't really give generalised advice obviously, and I really strongly advise all postpartum women really, I think even if you don't think that you've got any problems, I still think it's worth checking in with a women's health physio or someone like Stacy really to just settle into your new body so you don't end up with longer term problems. But given it's just a podcast and we can't work one-on-one with everyone right now, have you got some kind of concrete action that people can take in their own lives to get some of that reconnection with their body and some of that strength and health back again?
Stacey Pine:
Sure. Now this is going to sound for people wanting to get out there and exercise. This is going to sound possibly a little bit not what they were expecting, but one of the first things we do in any sort of pelvic floor rehab or abdominal rehab is remind people how to breathe. So focused, directed, breathing for a couple minutes every day can make such a difference. So often what happens with mums is that we get really locked down rib cages, so your rib cage is expanded through pregnancy, and then we go around pushing prams and holding babies. And so our rib cage forgets how to move. So your rib cage is opposed to expand three dimensionally as you breathe. And often for us it doesn't happen. So what that creates is some dysfunctional breathing patterns, more pressure on pelvic floor and more pressure on the front of the abdomen. So if you can get down on the floor or sit somewhere comfortably and actually imagine your rib cage like a giant balloon and get it expanding three dimensionally and practise that for a couple minutes, that can make huge differences to your entire body. And then you can take that breathing and incorporate it into whatever type of exercise that you do.
Julia Jones:
Yeah, I love it. I love it. So I think that's all my questions. Do you have anything to add, Stacy?
Stacey Pine:
Absolutely. Well, just a couple, I guess extra points, and people are probably wondering how to get back into more intense exercise because a lot of people I see are, they come out from possibly traumatic bursts or pelvic floor issues, and they want to get back to something like running or higher intensity bootcamp. My big advice to you is never stick with a health professional that says you can never ever do something right. There's always a will and a way. And if you get the right team behind you, I've seen people with quite bad prolapses between me and a woman's health physio get back to running again. If you have something that you love to do, the best exercise is stuff that you love to do because you're going to do it and you're going to enjoy it, and it's going to help your health immensely.
Stacey Pine:
So find something that you love. And if you cannot do that without pain and symptoms, then find someone to back you up. So get to your women's health physio, find an exercise physiologist. Our job is to be the bridge that gets you from your pelvic floor specific exercise to the exercise that you want to be doing. So yeah, I think a lot of people are told, sorry, you'll never be able to run again. And that's just not true. You can run, you can lift weights, you can be strong. You just need to do it the right way to keep your body healthy and happy. So what I have done in my business is I've made an online course for months. You can do it at any stage, postnatal, it takes four weeks, and each week we have a different focus. So week one is just breathing, and week two is just looking at the pelvis, and half of it is doing an exercise every day.
Stacey Pine:
And the other half is an awareness exercise. So you spend the day going, okay, am I holding my breath or am I sucking my stomach in? Or how am I actually sitting on my pelvis? So it's not actually just exercise you using lifestyle factors to improve your health as well. So it's called restore your core and pelvic floor, and it's just taking all the whole of you, the whole holistic parts of you and putting it together and trying to show you how much is involved in rehabbing abdominals and pelvic floor, because unfortunately there's not a simple answer, but if you're happy to learn more, that it's actually quite empowering.
Julia Jones:
Yeah, that's absolutely been my experience, Stacy. It's been quite a long journey for me to feel strong and comfortable in my body again after this third pregnancy. But absolutely, it's been worth it, and I feel like I understand my body better now than I actually did before. So thank you, Stacy. And we'll pop the link up in the show notes so people can find out more about your work specifically. And in the meantime, if you're listening, go and do some three dimensional ribcage breathing.
Stacey Pine:
Awesome. Thanks for having me, Julia.
Julia Jones:
Thank you so much for listening. It's been really great to have Stacy on the podcast. And if you want to know more about her work, you can visit her website progressivemotion.com au.
