Elite Pregnancy & Postpartum Running Rehab: What Every Runner Should Know — with JESSICA DORRINGTON

Jessica has been a physical therapist in Portland, OR, since 2002, helping elite athletes—including pros and Olympians—get back to peak performance. With a holistic approach combining pelvic health, core strength, gait mechanics, and orthopedic care, Jessica’s mission is to empower patients to return to what they love most.

When she’s not helping others, she’s hitting the trails, roads, and tracks herself! 🌟

In this conversation, we dive into:
🔹 Finding pelvic health
🔹 Becoming a better runner as you age
🔹 Key differences between pro and recreational runners
🔹 Changes in the industry since the 2000s
🔹 Lifestyle factors impacting pelvic floor health
🔹 “Pushing through” vs. listening to your body
🔹 Postpartum perspective shifts
🔹 Stress management alternatives
🔹 Core work during pregnancy
🔹 Using diagnostic ultrasound

CONNECT WITH CARRIE

IG: https://www.instagram.com/carriepagliano/

Website: https://carriepagliano.com

CONNECT WITH JESSICA

Instagram: https://www.instagram.com/jessica.w.dorrington/

The Active Mom Podcast — a real mom's guide to pregnancy, postpartum, perimenopause & beyond, for active moms and the professionals who help them get there.

Quick-hit conversations with moms, providers, and researchers... because you don't have a lot of free time (you're probably listening at 1.5x right now).

Follow so you don't miss an episode. Rate & review ⭐⭐⭐⭐⭐ — it's how the next mom searching for these answers actually finds them. Share it with the friend who needs it.

Questions or topic requests? DM me 💌

Transcript

SPEAKER_00 0:01

You're listening to the Active Mom podcast with Post Active Carit Foundation. I'm a mom physical therapist and your go-to guide for staying active with public substitute pregnancy, post-partum fair, metaphobics and beyond. Whether you're a fellow mom, physical therapist, or women's health professional, join me where I'll share expert insights, real life stories, and the latest research to help you approach running CrossFit yoga photograph or whatever activity log with confidence and evidence-informed guidance. Let's start the show. Okay, I can officially say that this is the longest it's ever taken me to nail down an interview. I have been talking with Jessica Dorrington for easily a year and a half. And finally, finally, we are gonna make this happen today. So I'm so excited to have physical therapist, mom, runner, extraordinaire, uh runner to the stars, or uh PT to the stars, Jessica Dorrington on the podcast. Um Jessica, welcome finally to the show.

SPEAKER_02 1:02

We finally get to make this happen, and I'm so excited for the rich conversation we're gonna have.

SPEAKER_00 1:08

So good. All right. So for people who have no idea who they are and they have no idea what what joy and fun is about to occur, tell us a little bit about who you are, where you're from, what you do.

SPEAKER_02 1:18

Great. Uh I'm a physical therapist that has been working for about two decades, um, both in the orthopedic hat and in physical therapy for the pelvic floor. So I took a background of orthopedic knowledge first, and I have a huge love for running as I'm a runner myself and combined all three of those spaces of sports med, pelvic health, and orthopedics. And um I'm a director of a clinic out in Portland. We have 15 PTs at our clinic. Um, half of those are pelvic floor therapists, so that tells you the need of PT out in um out in the world. And yeah, I'm a mom of two sons and avid marathoner.

SPEAKER_00 1:58

Yay, just a few things. Just a few things. And then how how did you because you do you ran in college, yes?

SPEAKER_02 2:07

Yeah, I ran high school and collegiately, cross country and track. Um and then running took a back seat while you know you're working on your profession and finally kicked it back up about four or five years ago and said, I'm gonna put my own health first and see what can happen if we actually put into play what we teach our patients to do. And I think working with all the pro and Olympic athletes, they inspired me each day. And so I got back out and started competing um on the marathon scene.

SPEAKER_00 2:36

Yeah, and you've been kind of killing it, by the way.

SPEAKER_02 2:38

Um she's being modest. I'm enjoying the ride. You know, I'm running faster than I was in high school and college, um, which I think just has to say like if you put in the work and you do the strength training and the plyometrics and all the things that we know we need to do, both for our menopause and post-menopause um kind of training, as well as what we're teaching our patients to do, you really can do a pretty amazing thing. So I'm gonna keep riding the wave until those PRs kind of lose themselves and then figure out what.

SPEAKER_00 3:10

So you were one of those PT students that said, I want to go to PT school because I love running and I want to work with runners. Um, when did the shift finally happen where the orthopedic mashup came with the pelvic health mashup? And then you're like, wait, these shouldn't be separate, they should be mashed. Be together. Yeah.

SPEAKER_02 3:31

Well, I fell into pelvic. If you would ask my PT classmates, they'd say Jess is the last person to ever do pelvic health. And there were a couple of people in our class who were like, This is what I know I want to do. And my first job out, my first year as a PT, they said, Will you take over the pelvic floor program? And I was like, I will only teach at that time Kegels, right? That's all I'm doing. And you started to realize how much better it made people's lives. You realized the impact it had both on their intimacy, on being able to go places, on being able to run and do activities without leakage. And you saw the bigger picture of it. So I always kept that as part of my hat. And then the need was just so strong that all of a sudden that became my caseload. And I'll never forget, I reached out to my mentor and I said, I don't know, my caseload's getting so big in pelvic. And he was my orthopedic mentor, and he goes, Jess, it's still orthopedics. Right. The pelvis is still orthopedics. You still have to do all your ligament testing, you still have to know all your muscle functions, you have to know your biomechanics. And at that point in time, I was like, aha, yes, I can do both these worlds, and then and then combine everything.

SPEAKER_00 4:45

So yeah, no, I I love I I fell into it in a very similar way, got hired to do pelvic health, and it was very separate from orthopedics. And then one day you're just like, well, why don't I put it all together? Which again sounds so ridiculous today, but was so novel back in the day. Um and and again, back then we weren't really, because you got you and I are similar vintage, we weren't really treating a lot of everyday runners because that wasn't necessarily as common as it is today. And that wasn't like that long ago. We're not that old. I mean, when did you start, did you start to see the shift more kind of working with athletes um more specifically with like semi-pro or pro athletes and then more the everyday runner? Or was it vice versa or about the same?

SPEAKER_02 5:36

Uh, I would say, you know, part of it was just whenever your someone would come in, you'd be like, what do you love to do? What do you want to get back to doing? And so for you know, your regular clientele, I felt like that was always our end goal is can you get someone back to running and how do you get there? And I just always have looked through that orthopedic lens. Even when I sit in a PT class, you know, or continuing education, I'm always thinking, like, how does this fit with the orthopedics and what we know to be true from a clinical reasoning standpoint? But from the pro-athlete standpoint, you know, most of them, I started seeing them prior to having babies for many of them, knew their bodies really, really well. And then you start to go through the process of, okay, you know, the Olympics are done or worlds are done, and it's time to think about kind of creating creating space and um expanding their family. So there was a lot of that where it was just naturally integrated, I think.

SPEAKER_00 6:30

Yeah, and you're also in such a great part of the country to work with runners, period. Yeah, yeah. Like not for nothing.

SPEAKER_02 6:39

Yeah, we're really fortunate out in Portland. You know, it's uh obviously the hub of Nike and Adidas and Under Armour. Um, they're all out here in Portland, Oregon. So it's definitely, definitely a great place and great venue for that.

SPEAKER_00 6:52

Just a few famous faces walking around.

unknown 6:55

Yeah.

SPEAKER_02 6:55

Although, although most people have moved to altitude, um higher up. So that's been definitely a shift in the last four or five years for for the pro and Olympic athletes for sure.

SPEAKER_00 7:05

Yeah, for sure. So if you had to like describe the journey of an everyday, you know, postpartum runner, you know, getting a back versus a high-level athlete, what are the key differences and what are the the key similarities that you have found?

SPEAKER_02 7:26

You know, it's funny. I I'm actually writing a book right now with Shannon Roberry. Um, it's called Strong as a Mother. You'll like the reference of that. But it's all about how to get back. And what that does is that starts during pregnancy, right? We know that if you exercise during pregnancy, you're twice as likely to get back to the activities you love to do postpartum. And when patients would come in postpartum, I'm like, oh, I wish I could have seen you beforehand, right? Because I could have taught you all these things along the way and we'd be setting you up for success postpartum. And but with working with so many pro athletes and working with regular recreational athletes, you realize it's very similar. It's so similar because we've seen athletes who will take a really high approach. I've seen athletes who, you know, ran 100 miles a week, even so while they were pregnant, came into our office, had some issues. You saw people who really step back, and everybody kind of settles in the middle. And settling in that middle is for most people, you know, reducing the frequency, reducing the intensity and duration, but staying in a place where we know we can get our heart rate up still and still do the strengthening and do the abdominal and core work that we need. So it's really probably more parallel than not.

SPEAKER_00 8:42

Yeah, no, I it it I think that's the funniest thing when you go kind of look at the evolution of research is we do have these separate paths that have to occur, but there's so many, you know, between the everyday, you know, person and and the high-level athlete. But there are those similarities. But you you mentioned before we hopped on, you know, one of the things about pro athletes is you have to watch your dosing and watch your words.

SPEAKER_02 9:08

Yeah, I said being, you know, being a PT for for high-level athletes is very humbling because you decide clinical reasoning, you're like, okay, I think X, Y, and Z are contributing, and I'm going to give you these three exercises, and they'll do them a hundred times. And if you know they come back and things aren't different, you know well that your dosing and your clinical reasoning maybe weren't the weren't the best. Um, and you have to take a different path. So definitely humbling in that way.

SPEAKER_00 9:35

We we get that here in DC, not because we have a lot of pro athletes, but we have a lot of very different driven people, and we have to be very clear. Love you patients, but you know what I'm talking about.

SPEAKER_02 9:48

I used to work in a different part of town and I would dose twice as much because a few of the patients wouldn't do the exercises. And now my clinic is very close to Nike and Intel, and the population tend to overdo the exercises. So when I first moved out here, all of a sudden patients were like, Oh, I already did my exercises twice before I came in today. Right. Oh goodness, I only told you to do those twice a week.

SPEAKER_00 10:12

Right. You're like, oh, forgot where I was. I'm not in Kansas anymore.

SPEAKER_02 10:17

Not in Kansas. But but I would say the one difference when you're looking at postpartum for athletes versus a recreational athlete is really the drive to getting back. And that I think is a different, um different piece. I think number one, because they're strengths coach and their coaches get involved, and sometimes you can't manage the dosing. And sometimes they sign up for races or they run more than you want them to, um, because either A, they have personal goals, or B, they have contracts, which contracts have changed now, but they used to have to run or to keep their contract so that they wouldn't get reductions. And you know, those those different stressors, um, when the system isn't ready for it, we do see that a lot of those athletes were having issues if they were coming back too quickly and some of that beyond their control.

SPEAKER_00 11:11

So yeah, no, I would think that would be a big challenge. Um, I have a bunch of friends who work um for some pro sports teams, and and I mean, navigating those interrelationships and the hierarchy and all that kind of stuff sounds quite challenging. Um, how has that changed, you know, as far as respect for for you? Because I I feel like PT has a role, but then yeah, you're kind of in this weird, almost like untouchable sort of space where they're like, oh, you know about those things that people don't want to talk about. Like how has that evolved?

SPEAKER_02 11:47

Yeah, you know, I think um early on, I mean, uh several of my athletes, the coaches, called me up and said, Hey, you know, what do we do? How much dosage should we have? They really respected that kind of um knowledge that we bring to the table and just kind of said, here, here you go. On the flip side, there are also um, I think we're times where coaches are like, you hit that 12 weeks postpartum where we kind of in our society have kind of tagged 12 weeks as, oh, maybe you can get back, and coaches start to take over more or athletes' programs start to progress. And I think that's where a little bit of it gets lost. If I had a magic wand, I'd be able to follow somebody, you know, all the way through a year or two years. Um that that takes that long, but insurance-wise, sometimes that's um not always feasible.

SPEAKER_00 12:40

Yeah. Do you find that that um athletes are coming to find you like you're like the third person to find out they're pregnant? Or I know I am sometimes. It's like the doctor knows, the spouse knows, and then you know.

SPEAKER_02 12:54

Yeah, as you say, or even sometimes just them and their spouse so that I'm the the next phone call, um, which is pretty fun to be able to navigate, but it it really has allowed us to see what happens when you do implement all the important factors that we know that we really want to be able to add into a program really early on. And, you know, oftentimes patients won't come in until either there's a pain, maybe you know, second or third trimester they're coming in, and then you want to give them all this knowledge about strength training and what they should be doing for cardiovascular fitness during this time frame. So it's been fun that way to be able to implement everything early on, as I'm sure you probably see too.

SPEAKER_00 13:34

It's it's I mean, again, we're we're a little high achieving here in DC. And so I have that will reach out while they're trying to get pregnant.

SPEAKER_03 13:41

Yeah.

SPEAKER_00 13:41

Um, because you know, we we want to check those boxes over here, which is great. I love it. Um but again, like it just allows you to have a lot more opportunities for conversations to answer questions rather than like somebody screeching in at like 38 weeks into it, tell me everything. Yeah. Um, but again, I feel like we're in such a, and we kind of talked about this briefly before we we hopped on, was like we're in such a different place now as far as the advice that we can give, the recommendations that we have. Whereas like when we came out of school, like you you were early 2000s, I was I was 99, like we didn't really have anything to say. You know, we're like stay active, but like we didn't really know what that meant. I mean, what has that evolution looked like for you as a professional? And then also, because your kids are how old?

SPEAKER_02 14:31

Yeah, uh 10 and 14.

SPEAKER_00 14:32

Oh, yeah, so we're similar. I have 11, 11, and 13. Um, yeah, so I mean, you experienced this very differently. Um, kind of what has that evolution looked like for you personally and professionally?

SPEAKER_02 14:44

Yeah, it's funny. I was teaching at the college last night to the PT students that are interested in pelvic and an ortho lens of pelvic health as well. And I told them, I said, it's funny in PT school, it was just, you know, you do a curl up with a towel around your waist and get rectus abdominis, and that's really all we knew what to do with pregnant women. And I said, then we went through this evolution of transverse abdominis was the big thing. And I actually got a rehabilitative ultrasound 14 years ago. Me too. And we're twinsies the best. I yeah, the best. I'm sure you saw it was like, oh, research is saying we should do this. Research is saying now we need to focus more on the obliques. Now we are thinking differently about the diastasis recti or the interrecti distance, and to see it on the ultrasound really helped to filter professionally to figure out what you wanted to include and where you wanted to go. So that was absolutely fantastic. But it's been fun to see more data come out. I know even with my second child, we had some um difficulties getting pregnant with our second. And so they said, you can't run, you cannot get your heart rate up. You need to, you know, just basically sit for nine months. And that was that was the advice given only 10 years ago. So yeah, it's amazing how much it has changed and how empowering it is be able to tell moms, like, no, you can still do this, you can still do that.

SPEAKER_00 16:18

No, I bring that up all the time. And again, I was like, 10 years isn't that much time. Yeah, you know, and there's so much that has changed. And and I do you have any FOMO at all? Like, do you wish that what moms have now is um you had a little bit more access to personally?

SPEAKER_02 16:38

Like you know, uh yes, I think number one, um, I think just knowing like not the fear behind it. There was a lot of fear instilled, but two, more than FOMO, I have this like, I wish I could go back in time and retreat all the patients that you've given advice to. And I told that to the students last night. I said, your first decade of your career is gonna go back and have the opportunity to talk to patients and tell them the new information that we gave them the best information we had at the time, but now that information is different. They can do planks and they can do sit-ups if they have an interrect distance, and they can do running if they have a prolapse. Like you get the opportunity to change that. But I wish I could go back and tell some of those patients different information now that I have it.

SPEAKER_00 17:28

Well, I'm I'm thinking about specifically, you know, these women who were fighting so hard to be relevant on the pro scene and just forcing themselves through. And on one hand, they're being told you're doing too much, but on the other hand, like if you don't do anything, you're gonna lose your contract. Like I I again, like it, it it's such a double-edged sword. It's like, yay, glad we got you back, but there was a little bit better way to do it, but you didn't really screw yourself completely, but might have like I feel like there's like there's just we need a do-over.

SPEAKER_02 18:04

For some of these moms. Yeah, we need a do-over, and on the pro side, I also think that we still need more information. You know, the the sleep and the nutrition and the breastfeeding, those aren't my forte, those aren't my strong skill set. And I think that's where we really set these moms up for not succeeding, is when they're showing, you know, relative energy deficiency in sport, they're starting to see some of those signs. Even if they get their cycle back and they're not checking the tick mark boxes, they still are going into relative energy deficiency, getting bone and stress injuries, yeah, because all those other things aren't well managed. And I think that's hopefully where our profession goes. I'm sure you see that all the time. Yeah.

SPEAKER_00 18:45

No, I'm so glad you brought it up. We had a conversation earlier this year um with Rachel Drake about that. Um, and then also uh Molly Huddle just posted on uh uh with the Huzza Hub um her story and and mentions you. Um I think that's one of the things like I feel like Red burst onto the scene just the the everyday algorithm, probably maybe a year and a half ago, two years ago. But I just again I feel like we're having these conversations about bone stress injuries and energy deficiency and lactating athletes. Number one, because they're out and about. And, you know, bless Sophie Power for her, you know, image. I'm sure that she didn't realize was going to go viral of her, you know, breastfeeding in the middle of, you know, an ultra. But like these things are happening now, but women are sharing their stories of these bone stress injuries. And I'm just like you. It's like, okay, how do we figure out what is too much and what that right dosing is? So how are you navigating, like, are you starting these conversations in pregnancy? Because obviously, like even before they get to that lactation point, yeah, they want to keep active, they want to keep running, but there's different demands on their body, you know, stress-wise, nutritionally, energy-wise. Like, how how do you start that conversation?

SPEAKER_02 20:02

Yeah, I mean, I think that conversation comes by giving them the algorithm so that they can personally do the check mark boxes, look at some of the things that their body are giving them those early cues. And the biggest thing is when they go out and run, whether this be pro or your recreational runner, if they go out for any type of activity and they come home and they have to take a two-hour nap after their activity, or they wake up and they are feeling either pain or more fatigue the next day, they know that they've then pushed the limit too much during that time frame. So I really use kind of them queuing into their body all the way from when they're pregnant all the way postpartum, obviously, um, to try and navigate that. But the the sleep, I think, is probably one of the biggest factors, sleep and stress. And I think those are hard things for people to necessarily navigate sometimes, especially when you have a newborn that isn't sleeping, your sleep is disrupted. And, you know, that's obviously when the body's healing itself.

SPEAKER_00 21:00

Yeah. Well, I feel like it's it's such a clash of mindsets, especially if you are a very, you know, even if you're not a pro athlete, if you're very type A athlete, then you've always been taught or always accepted the identity that you can just push through. And I've seen a lot of moms here, we we have a lot of older moms here in DC. I can say that because I was one, um, where you've been able to control everything in your life up until this point. And so you think I'm gonna be able to apply this same mindset to becoming a parent. And it doesn't work that way at all. And yeah, those are the moms that I worry about because they may not have the ability to listen to their bodies because everything up to that point has told them to no, I got this.

SPEAKER_02 21:49

Yeah, yeah, I can just do more, I can do more. But you know, on that scene, I think also motherhood changes people in some regards that you know they have. Have something else, they start to learn that they can fit only the amount of training that they can into the day. And it's neat to see, you know, even though their career was number one, motherhood kind of take that precedence afterwards. So that's a that's a a great thing that I think happens at post-party as well.

SPEAKER_00 22:18

I wish, I wish we could plug that into pregnant brains sooner. Um but that again, that's where I I I I have to give so many props to some of these athletes that, you know, their kids are toddlers now. I I'll bring up Rachel again, um, that she just won the JFK 50 and was very transparent. I guess she's in residency now. And then, you know, she's she's got her Cha Lu and navigating, you know, trying to do this training and all of this. And she's like, yeah, I don't run as much as the other people. I'm not looking at anybody else's Java because I don't have time for that mileage. But being a mom makes me be make these choices that I need to choose sleep or I need to choose this or that. I feel like that's a wisdom that it takes a while to get in postpartum. And it's a wisdom that maybe you can hear it in pregnancy, but it doesn't hold it doesn't resonate the same way until you have, until you're in the shit, quite honestly. I mean, I what what do you think about all that?

SPEAKER_02 23:21

Yeah, I mean, it takes time. I mean, I always say like motherhood is, you know, you don't get an instruction manual and um you get a baby and here you go. It's like you just try and be the best you can with the information you have, which is partially why Shannon and I, so Shannon Roberry and I are writing a book on pregnancy because we want people to have a guide and have those tools because once they come into the clinic, you're trying to go, okay, how do I help you navigate your SI dysfunction? How do I help you navigate your low back pain or your pelv floor disorders? And there's all this other information you want to give them. I'm like, I'd like to see you for 30 sessions, please. So just trying to give people a roadmap and you know, knowledge is power. So the more knowledge they can have about their pregnancy from the day they get pregnant all the way through that first postpartum trimester or the fourth trimester, um, so that they can figure out what movement is medicine and how to dose things appropriately.

SPEAKER_00 24:20

What are the the most common things that um you wish moms would seek out PT sooner for in pregnancy? What are the things where you're like, dang, I I wish I could have seen you like six weeks ago or three months ago, or I had one of those yesterday. So I I want to hear your answer first.

SPEAKER_02 24:39

You know, I think uh two a couple of things come to mind, like from an upper extremity standpoint when people are like, oh, I have carpal tunnel and it's on both sides. Like orthopedically, that's not carpal tunnel, that's rib position that tends to be, you know, looking at kind of what's happening up in the upper area. So people navigating that, I think not knowing what they can do for the cardio perspective, that's also huge. You know, women just feel like, oh, I wasn't sure what to do, I wasn't sure how much to do. And then obviously anything from a stress incontinence standpoint or pain standpoint that they have in the pelvis, I think those are really important to come in sooner.

SPEAKER_00 25:19

Yeah. I had the worst decre veins, which they refer to as mommy thumb, or or yeah, it used to be blackberry thumb, but nobody has blackberries anymore. Um, I had it the worst with my oldest, and it continued on into postpartum. And so I would be like changing my son and he would accidentally kick me right here.

SPEAKER_02 25:38

Yeah.

SPEAKER_00 25:39

Oh my God.

SPEAKER_02 25:40

Yeah.

SPEAKER_00 25:41

Worst. Um, and that's when it's great to have a best friend who's a PT that does house calls, who's had kids, and he's like, I'll be right over. I'm like, thank you, Jesus.

SPEAKER_02 25:51

I'm actually I'm actually married to a PT. So I sometimes have to wave the white flag and be like, um, can you can you just do this, this, and this? He won't, he won't actually evaluate, but he'll do any treatment that I'm asking.

SPEAKER_00 26:03

You're you're a better woman than I. I married the IT guy, which trust me, is has good news, bad news. Um, but my email got hacked while I was in labor with my oldest. So while I was initially in labor, he was unhacking my email. So good to have that.

SPEAKER_02 26:16

Well, I was gonna say, and the other one I think is that is one of the most common myths is round ligament pain. I think people, if they can just come in, I'm like, not everything can be blamed on the round ligament. Like, let's orthopedically look at your pelvis, look at what else could be causing it, or medically, if there's something that's really driving it, that's you know, that the doctor needs to know about. So I think round ligament pain is this overdiagnose, like everything. Oh, that pain is just from round ligament. It's like, well, no, actually, orthopedically look at it.

SPEAKER_00 26:46

And everybody's an expert on that. Like, I can't say all the Facebook groups are like, oh, that's round ligament. I'm like, bullshit, it's not like it's SPD. So that was the one I was gonna bring up. I had a client I was talking to yesterday, and she's been seeing an orthopedic PT, did not acknowledge or did not recognize she had symphysis pubis issues. It was very clear during split squats. I'm like, okay, you can't get any more clear than that. And you can address it. And she's only got a couple weeks left, and it's like, yeah, you know, she's like, well, I'm not really doing much anymore. Yeah. But again, people, you know, the way I kind of describe SPD versus round ligament, round ligament, the way I experienced it, I would be curious to you. Like, if you go to stand up, it'll kind of like catch you, and then you take a couple little steps and then it sort of eases out, and then you're fine. But it catches you kind of on the inside of the the pelvis bones. But SPD typically asymmetrical weight bearing, rolling in bed or things like that. Like, yeah, they're very different.

SPEAKER_02 27:45

It's not hard to tease it out. Very different. And orthopedically, you can stress test, you know, the pubic synthesis. They can't put their pants on without lifting one leg, trying to push in a chair or push in a drawer with their leg. It gives them pain. So it's very, very clear, usually orthopedically, that it's getting driven from the pubic synthesis.

SPEAKER_00 28:04

That one I I love to do via telehealth because I'm like, look, this really isn't hard to figure out. I'm like, I don't even need to touch you for this. I was like, this is what we're gonna do. Totally.

unknown 28:16

Yeah.

SPEAKER_00 28:16

All right. Let's talk, um, let's talk early postpartum because that's where I feel like there's been a really huge shift in our profession as far as early care. Like back when we first started, it was like you weren't putting laying your hands on anybody until you have a clearance order at six weeks. And um, now we're saying sooner is better. And we did have some, albeit like it could have used a little more mention in the ACOG white paper in 2018 about the fourth trimester. They they could have said a little more. We're just gonna be honest about that. Um, when did you start to make the shift to early care and what does early care look like for you when you're working with somebody?

SPEAKER_02 28:59

Yeah, you know, that's a good question of when. We started something called the Bump to Baby program. And I would say it's been over a decade that we did Bump to Baby program, um, maybe even 12 years ago. And what that entailed was giving them all the information during pregnancy, helping them do a birthing preference plan 36, 37, 38 weeks, and then seeing them postpartum. I always had them come in after they've gotten settled with breastfeeding and two to three weeks postpartum, they would come in. And because we had the rehab ultrasound, right? We were using that at two and three weeks, saying, okay, what's your core look like? Let's get you started on core, let's take a peek at your pelvic floor, let's look visually, you know, externally on the pelvic floor until you get cleared for intercourse. And then we would do internal at six or eight weeks, depending on when. So we've really followed that path or pattern. Um, but I think again, the rehab ultrasound really is probably what drove us for doing that earlier than what I think most of our profession was doing.

SPEAKER_00 30:03

So yeah, no, I I and that's the thing that I I do appreciate about the interwebs and and social media is that you and I did not know each other then. Yeah. But yet we were kind of thinking this, and that's what I love. I've I've talked to Sarah Tanza about this too. I was like, Yeah, we didn't know the other existed. We were coming up with the same ideas, and now I feel like I'm not stupid. I know things.

SPEAKER_02 30:25

Yeah, absolutely. You're like, I'm rocking the boat a little bit. I know my profession isn't doing this yet, but it makes clinical sense. Right. And, you know, then you get out there and you're like, oh yeah, this is great.

SPEAKER_00 30:36

Yeah, and that's when you know you're like, ah, I'm in the right room. You're like, oh, you thought of that too. Oh, this is so crazy.

SPEAKER_02 30:43

I love it. I love it. And I love Sarah as well. I know.

SPEAKER_00 30:47

She does again. I have this huge group of people. I'm like, we need we need to have a super secret running therapy group that we meet in an undisclosed location and just have a good time for a very long weekend. Um I love it. Yes, we will do that. Um, no, if you're listening, you're not invited. Um just for us. No, anyway, um, yeah, so I feel like early access has made a huge difference. Um but I also feel like and the the downside on social media is it has kind of opened the door for, okay, you know, am I running, I'm gonna run as soon as I possibly can, or I feel great because my kids sleeping and eating and I'm gonna go out and do this and so on. And in 2019, we did get the UK guidelines from uh Emma and Grenya and and Tom, which I I feel like was such a great start. Um, again, a lot of us were doing similar screening sorts of things that were like we need a framework to work around. Um, what is your process when you're trying to navigate with someone, whether they're pro or not? Like when when should we get this party started for a walk-run program? Because I feel like that's kind of this moving target. Yeah.

SPEAKER_02 32:01

Um, A, I I'm always gonna use the answer. It depends, right? Of course, yeah. No, no, no. Um, just depends on their mode of delivery, depends on their mental state, depends on all the different factors. But I think the number one thing is just getting them out on a really small walk and telling them, I want you to go around the block. I don't want any out and backs. I see so many times moms will go, oh, I'm just gonna take my toddler to the zoo for a two-mile walk, and they get out a mile and maybe I can't get back. And so we really start them pretty early on. We say, you know, rest that first week, then go out and get outside and just walk around the block and see how you feel. If that feels good, you can start going another loop around, but really making small dosages that way. Um so we really progress it pretty early on, but it's we're talking a one block walk when when they're first starting.

SPEAKER_00 32:53

Yeah, no, I I we had um we lived in uh the Rosalind part of Arlington, which just overlooks the the Potomac and Georgia. And we had a little kind of terrace that the first time I went out with my oldest, I'm like, oh my freaking God, I am not gonna get around this like ever. And thank God, you know, I eventually did, but I you gotta start somewhere. Yep.

SPEAKER_02 33:16

Yeah, I being the PT did not follow any of my own advice. And I I ran at two weeks postpartum with my first, you know, I have a 200-meter track by my house. I thought, I just want to see if I can do it.

SPEAKER_00 33:28

So clearly you were feeling well.

SPEAKER_02 33:30

Clearly, I was feeling well, and I was not any guidelines, right? There wasn't any things that you have to start at this time, you have to start at that time. And um, then with my second, we went on a pretty long hike, you know, 10 days afterwards, and it was fine, you know, went for two miles, and but would I advise that? Probably not.

SPEAKER_00 33:52

Well, and I that's the thing that you know, it if anything when you're talking to somebody and they're they're looking at this for themselves, yeah, they hate it when we're like, it depends. I'm like, but it freaking does, exactly. We can give you the broad expanse, and I think for both of our situations, like I was in no state, like it wasn't even on like me getting out of the house with my first was just like, yay, okay, you can do that. So running wasn't even part of the conversation. Yeah. Um, the people I actually worry about more are the the moms that everything went really, really well, or it went okay. And running is such a huge part of their identity and a part of their mental health management. And if things are not going as planned, or you've got stressors with kids, you know, colic not sleeping, da-da-da, all that other stuff, this becomes a stress management issue.

SPEAKER_02 34:48

Yeah.

SPEAKER_00 34:48

And that's what I worry about.

SPEAKER_02 34:50

That's a huge factor to factor in a what can they do for their stress management? And also if we do tend towards exercise compulsion, making sure that they're not starting too early. I think both of those things, sometimes maybe they should start a little earlier if it is part of their mental health and they've they've got a good grasp around it, versus on the flip side, if exercise compulsion is is um something that's in their history that then maybe they need to delay a little longer because they know they're gonna overdose it. So it's definitely a fine fine balance between those two. And then you have to look orthopedically, right? And biomechanically. I always say it's no different than if you had an ACL tear. I'm not gonna release you for running until you can pass all the orthopedic tests biomechanically to make sure you're strong. So really making sure that they have those as parameters and are focused on kind of getting back in that regard, um, no different than anybody who's had surgery.

SPEAKER_00 35:46

Yeah. And and even with that, and I think this is again where we have a lot to figure out still because we have moms running sooner, we have moms doing well, and they're we've got some clearance. Sometimes you can do all the quote right things and still end up with bone stress injuries. Um and I'm hearing more stories of that come up in the media, people sharing their stories as pro-athletes, and and and I I appreciate it because they're being honest and upfront and saying, hey, this is what happened to me. I did all the right things, I worked with all the right people, and this still happened, and we're still trying to figure out why. Yeah. Um, in the rear view, because I'm sure you've heard some of these stories, we we're not gonna name names or anything, but like what are the things that we need to dive further into, or you know, where are there opportunities for us to um be better acquainted with what's going on with that athlete?

SPEAKER_02 36:48

Yeah. I I think two things. Um, number one, I don't know, or I'll be interested to see if research tells us it's not biomechanical for the stress rate related injuries, because you can have an athlete who's super strong biomechanically past those, and it goes back to that nutrition, sleep. You know the bone is recycling constantly, and if they don't have enough calcium stores or they don't have enough sleep in their system or they have too much stress, I think that I think we might see um, at least that's my hunch, is we might see it be more of the other factors that we aren't looking at yet. Um, so I think that can be number one. Number two, it takes six to nine months for our abtone to return to normal. And when you think about the anterior tilt that happens for pregnancy, I would love to see more research on what that anterior tilt does, what it looks like at zero, three, six, nine months postpartum. Because if you stay in an anterior tilt, even by three, four, five degrees, you've now got more pressure on your lumbar facet joints, your sacrum is in a different position. So now you get different sacral torsions. And you think of somebody with femoral acetabular impingement, now I've got more pressure onto the anterior aspect of the hip. So I really think we might, you know, I think we'll see more research that comes out of it. But I think it's gonna be less about your leg strength and your and your hip strength. And are you biomechanically perfect on all those tests? And there might be more that follows those paths.

SPEAKER_00 38:20

Yeah, no, I was thinking of kind of two separate but related topics. Looking at that in the research is, you know, we're we're now saying, hey, maybe we shouldn't be backing off ab work and pregnancy so much and not be avoiding rectus in postpartum because don't worry about IRD distance, the interrectate distance. Um, should we be doing more abs across this whole time period, which would ideally help with that? That's one thing I was thinking of. And because I I think even with the best intentions, we don't. Um and then the other one was oh, it flew right out of my head. It was a good one, it'll come back to me.

SPEAKER_02 39:01

No, but like, no, but it but you're right on, right? Like rectus is so important. And when you think about that anterior tilt, rectus what rectus is what brings your pelvis back into a good position. So rectus training, both during pregnancy and postpartum, as we see now in the research this past year, yeah, really coming to the forefront again. And I I really it'll be interesting to see if someone does all that rectus training, gets their anterior tilt corrected, do we see less bone stress injuries? It could be something that comes up.

SPEAKER_00 39:33

Yeah, the other thing I was thinking was now that we have a little bit of data looking at what mechanics of running look like in pregnancy versus postpartum, kind of what those trends are, what are things that we can do to kind of target that a little bit differently? And and I I love these studies because we read them, we're like, yeah, that's totally what's happening. You like, you know what a pregnant woman runs like. And what I always tell like my my patients is I'm like, okay, so your brain is still operating like it's pregnant, you're still walking like you're pregnant and you're not. And we need to, we we need to get reacquainted with what's going on here because you literally still, I mean, everybody knows what I'm talking about when you you walk with your belly up because you're so proud, you know. And then afterwards you can't get that sucker shoved back in.

SPEAKER_02 40:23

Yeah, even literary training.

SPEAKER_00 40:25

Yeah, I mean, even just talking about like obliques and rotation, I feel like obliques are having a moment these days. Um, and be like, yeah, you know, we don't have a lot of capacity to rotate because you know that baby's stuffed in there and your diaphragm's in lockdown and there's not a lot of place to move, and it carries over into that postpartum. Like, we need to find these movements again. Yeah.

SPEAKER_02 40:47

And and train the whole core, right? But it's always been about the whole core. I know I'm sure you saw on the rehab ultrasound as well, but I was like, as soon as you can activate transverse abdominis, I want you doing your six-pack abs or your rectus abdominis. I want you working your obliques. You have to be able to be strong in all of them. Yeah. And they all have had their moments in our in our history. You and I through our profession. But in all actual all actuality, I think they're all important. Um, they're just getting highlighted at different different parts of the decades.

SPEAKER_00 41:16

Yeah. Well, and again, it's the pendulum, though, because you've got you know the the weekend in influencer experts out there that are like only do it this way or only do it that way. And I very much know that again, the time that we were brought up in this space, that was very much, you know, the mindset that we were taught. And and I think the research now has allowed us, and our critical thinking has allowed us to be like, actually, no, that minutiae like doesn't help anybody. Yeah. Um, but that's what you're constantly fighting is like you want to do the right thing. And like, well, maybe the right thing isn't getting so in the weeds. But yeah our our profession likes to do that a little bit too.

SPEAKER_02 41:57

We do, or we grab a research article and then we take what we want out of it. And it's it's with it's with good intention for sure, but um, you always have to look at it through the lens of all the other research that's out there and kind of what we know from our clinical reasoning standpoints.

SPEAKER_00 42:15

Yeah. Well, and I think we also get our head buried in the sand about well, if if you're this way, it's because of this. And I'm like, okay, look at all the other people in the world that are that way and they don't have the same problem. So how can these two realities coexist? Well, maybe that's not it, you know. Yeah, um, but we don't like to take our head out of the sand sometimes.

SPEAKER_02 42:36

I think we're getting better. Are I feel like are we? Okay, good. Yeah. I really feel like um, you know, even teaching last night at the at the college, it they're so open to learning. They're so open to going, okay, well, that's different now. Great, let's let's teach it a different way. Versus, I feel like a few decades ago we did kind of have our ways. Social media has been good for that because we can share information a little faster. It's also been bad for you know publicity because I think there's a research article out there recently that said women go and seek thinking they have a diastasis recti because we've created a problem of it. And most women that come in actually don't have an interrect e distance that's problematic. So there's there's good and bad to being able to share things so quickly now.

SPEAKER_00 43:23

I joke that 90% of Northern Virginia thinks that they have a diastasis recti. Um, I get to be Oprah and be like, you get ab work and you get ab work. And but again, I it's a to me, it's a gateway diagnosis.

SPEAKER_02 43:36

Yeah.

SPEAKER_00 43:36

Because typically, if somebody thinks they have that or that's what they're searching for, it's an indicator of something else. Like, you know, they're on my expectations, body image, those sorts of things. And then when you get to start to have a conversation, do you find out, oh, they're having pain with sex, or oh, they're having leakage. Oh, I find these other things. So you get to give them their ab work back, yeah, but then you have an opportunity. to have a conversation about things that actually do matter. But again, like it's it's a situation and I I very much feel this way too. Like I I had um a decent diastasis after uh my second I've had two C sections so that's not shocking. My kids were big. Um but very much I was like oh I can't do this I can't do that. And then one day another PT, he's just like you're you're you're just weak. And I'm like, oh but to this day kids are 11 and almost 14. I still feel like that is such a big deficit for me. It's it it's that's what holds me back in CrossFit, which I I think that leads into other kind of running stuff that I had like and I look back at that and there's so much I'm just I wish we had known a lot of this stuff sooner and I wish there hadn't been so much fear. And I I can't imagine being a pro athlete and going down any of those fear-based rabbit holes where you shouldn't do X, Y, and Z, but here it is like your livelihood. I mean, I would hope that it's common sense to be like, oh no, now I have friends that have gone through this and it's okay. But like have you have you had to navigate that kind of line where yeah they're athletes and they understand movement but being pregnant is a whole different beast. Yeah.

SPEAKER_02 45:22

You know, I think um I was fortunate Jackie Whitaker was a researcher up in Canada. She came down and taught rehab ultrasound for our team. I had met her through the years and we really talked about kind of the posterior band of fascia underneath that interrectti distance. My orthopedic mentor him and I started doing some research on it early on. And so we were just seeing time and time again people would come in and it's like oh well you can activate your transverse you can activate your core well we see that interrecti distance um we see the good posterior band of fascia and so really pretty early on we were able to say we don't think this is a big deal. And I think there's only in two decades I've had two people that have undergone surgery for interrect e distance. Other than that you know that everybody else gets back to a point where they do really well. So it hasn't been I think in part because the ultrasound you can they come in and you say they're like I have a four finger width diastasis and I'm like well's the most reliable let's actually see what that looks like and and then you go look you have a great poster band of fascia you're good to go.

SPEAKER_00 46:31

Yeah it no I I I do feel like the ultrasound has been incredibly empowering because you're not just relying on somebody's opinion like you don't have to trust me. It's literally there in black and white you watch what's happening when you do this that's what happens um but I also feel like and and you grew up in the era of you learned biofeedback from your first Belvic floor course that I haven't touched since I got my ultrasound. You know, just having an ability to connect to that information and being like okay everybody's telling me all this but now I'm literally seeing what this looks like and now I have a way to get feedback on what I'm doing. I feel like it's far better and far more accurate and more functional.

SPEAKER_02 47:11

Yeah and and when you tell patients hey I'm gonna remeasure this they really do their exercises because they're like I know you're gonna bring that machine back out and and I get to see it again and see if I've made progress. So that's really really fun for them.

SPEAKER_00 47:24

I would imagine the athletes are very competitive.

SPEAKER_02 47:31

Yeah or definitely make sure that like that exactly was 30 seconds or we did exactly 12 on one side and 12 on the other so yeah attention to detail matters.

SPEAKER_00 47:41

We we do that here too that's awesome that's awesome. All right for for those that are listening that um I I think especially newer therapists and and and coaches and trainers that you know we come out of school and we're like we want to work with you know pro athletes and that kind of stuff. How did you get involved working with these higher level athletes that you know do go on and you know go to the Olympics and all that kind of stuff. What was that journey for you?

SPEAKER_02 48:08

Yeah um the I have to think back. The first athlete that I saw actually came from a sports agent. I had been seeing a sports agent for his own condition and he was super impressed and so he started sending me pro athletes that weren't in the running space but so kind of got that um I would say probably two or three years into my career. So fairly early did that start. And then kind of breaking into the pro um running space it really came because a colleague of mine knew I had the ultrasound and said hey let's explore like let's see what the core looks like on several of these athletes and knew and valued that pelvic health should be a component of the orthopedics. And so we just started playing around and seeing like how much does this matter what can we do to improve both core and pelvic health and then a few other of them came from their OBs when they were pregnant because the OBs um knew me in town and then word of mouth kind of just kept going from the athletes but I would say the biggest piece of that is having a strong orthopedic base. And you know the I went through the North American Institute of manual therapy and the amount of clinical reasoning and differential diagnosis you get from those, you can test every ligament in the ankle you really know your differential kind of medical diagnoses and you really can put together the biomechanics and say oh your Achilles issue is actually because thrust is fine rotation and this is happening in your gait. So I think really having that solid base would be my recommendation to anybody who wants to work in the athlete space because you know you can Google almost anything and find basic exercises that you really have to become a master of your craft.

SPEAKER_00 49:58

Yeah no I I feel like that is a point well taken um one that was my journey with yeah exactly and so I obviously that's gonna always be my bias. But um especially I think with the popularity of women running and doing CrossFit and yoga and Pilates and functional fitness and all this kind of stuff, I think there's a lore to it um from a lot of our younger professionals. Yeah. And um but I do see a gap because they if you're going just straight into pelvic health and you don't have additional background that's what I love about Sarah too with you know her her neuro background and that kind of stuff I'm like I feel like you have to have a little bit more comprehensive view. Yeah and really sort of understand running because if you don't I I see second and third opinions all the time. My my personal favorite is when people are told to kiggle before or while they're running and I'm like are you freaking kidding me like how is that even possible? Like concentrate really hard. I'm like yeah you can think that fast like those are some fast quick clicks like I just I I and and I that's some of the advice that I give sometimes to people when I'm like hey when you're looking to find somebody um in your area that might meet your needs like these are the questions that you want to ask and it's fine if they don't have that background but who do they work with that does?

SPEAKER_02 51:27

Yeah yep absolutely and and partnering in that team you know we've had athletes who are overhead athletes or XYZ and that's not my forte that's not my space. So when you're working at the top of your top of your skill set you want to make sure that they they have other team members that can help in that as well. Absolutely what's what's been the most bizarre or um not necessarily bizarre but the the the least popular sport that you've ever had to to work with oh least popular sport I wouldn't say least popular but the one I know the least about was a professional fencer and it was like I don't know the biomechanics of that like I'm not I I'm not even really sure. So I think kind of getting people back to those types of high level activities where if I haven't done it, if I haven't played the sport I want to make sure that they have the best advice that they can I I have a similar story.

SPEAKER_00 52:26

It was somebody who did sword fighting but they did a lot of the um like those Renaissance fairs so they would go sword fight every weekend I was like you're gonna have to walk me through this because I have no freaking idea what you're talking about.

SPEAKER_02 52:40

Yeah those are hard and it's really physical I'll be honest also a pickleball I have not picked up the sport yet I know everybody else has but when someone comes in and they go I go I do pickleball I'm like yep I don't know what to do we need to learn the biomechanics.

SPEAKER_00 52:57

We have um I'm sure you've heard of him we have a very famous ultra runner that lives here in Arlington Mike Wardian um and he's done like he like ran across America dressed like Forrest Gump like he's had like the um the marathon record of like the fastest stroller marathon or world record of fastest like he does all these things anyway point being he's in the pickleball now so I'm like I'm just like I mean he's still doing all these other things but like he's doing pickleball so I'm like all right let me see how this plays out maybe we should have a course that teaches us biomechanics of all the sports right like that would be amazing. I'm I'm also I would never did and you know you did track and cross country.

SPEAKER_02 53:38

Yeah I I wasn't a ball sport girl what did you do in the winter um I ran year round and I lived in North Dakota so that's saying something we would come back and our eyelashes would be frosted white and okay it'd be 50 below zero and you'd head out on a dirt road with the wind at your back and um so I was a year round one of those single channel sports. So but also did skiing and snowboarding for fun.

SPEAKER_00 54:06

I almost my first job was almost in North Dakota um in 99 I'm sure yeah I'm sure you would remember there was like no jobs in 99 like the bottom dropped out of the market and it was like a a pediatric travel gig in like Bismarck North Dakota. I'm like this seems like a bad idea that's where I'm from it's okay I had been to North Dakota before this it wasn't like I I hadn't before but I was like winter North Dakota and I'm I'm from uh western New York so like we're used to snow and that kind of stuff but we also don't have like 50 below temperatures. Needless to say that didn't work out but um we had we had Nordic skiing where I grew up and so I swam for a number of years and then switched high schools and then junior year I learned to Nordic ski um with a bunch like I was a junior and you're learning with like you know 10 year olds at this point.

SPEAKER_03 54:57

Yeah.

SPEAKER_00 54:58

And somehow got myself up to I was able to go to States my senior year and we um skied at Lake Placid on the Olympic biathlon range, which is freaking amazing. So cool. But you should do that because there's so many cool people that Nordic ski it's just not even funny.

SPEAKER_02 55:17

Especially where you are if you don't like my God like yeah we get we we always had to Nordic um just use the Nordic skier when we were injured um in high school. That's that's not the same. So that's my only experience with Nordic skiing.

SPEAKER_00 55:32

No no so okay so we need to to do that for you.

SPEAKER_02 55:36

No this morning it was funny uh uh the gym that I go to uh it was cold for here this morning it was 19 degrees which is weird for DC in December um and so they switched the workout it was supposed to be a bunch of running and they switched it like okay you can do bike or the ski erg I hate the ski erg it's not even remotely close to doing classic and by the way skate is way better than classic but I was like I'll go run you're like really it's not that much and they're like oh it's not a big deal but anyway we I will I will put you in the group of uh runners turn Nordic skiers that we have just converted I I I did say for 2025 my goal is to figure out something I like to do to cross train because you know we preach it all the time of you need to cross train you need to do some other activities aside from running and listing so I am gonna hook you up with uh Amy Leedham who's been on the podcast now twice.

SPEAKER_00 56:30

She uh and and she has gone over to the dark side of Nordic um and is loving it.

SPEAKER_02 56:37

It's the best Lats workout and the best butt workout you will ever ever have um maybe we'll do that like group we were talking about and we'll just get together and run and Nordic pee and talk PT. That sounds all good.

SPEAKER_00 56:52

That sounds we'll we'll have a winter retreat and then we'll have a summer retreat and so the winter retreat will be at a Nordic resort. So it's all just working out great.

SPEAKER_01 57:00

I love it.

SPEAKER_00 57:00

All right looking ahead where do you see the biggest opportunities um for advancement in navigating pregnancy postpartum runners? I mean it's it's been light speed I feel like the last couple of years especially where do you feel like the next big changes are going to be or the next big research topics are going to be I think clinically the biggest change that I think we can make is getting people in sooner.

SPEAKER_02 57:31

You know becoming the standard of care where you know after at least 12 weeks we're getting you in and we get to start all the things we want to do. So I think that's number one. And then more research is still needed on what exactly we can do postpartum. You know, it's a little vague on when should we start abdominal training, when should we go back to kind of these higher level sports I think we're gonna continue to see that um research evolve even more than it has. So I think those are two and then research I would love to see us push further down the road than that that fourth trimester you know really looking at all these other factors we talked about of sleep and nutrition and um calcium and even doing bone indexascans and other types of things so we can really understand the impacts of what it looks like for people when they return at six months, nine months, a year, two years out and see what what we can do to continue to make a difference. Because you wonder why you know you see patients five, 10 years down the road and they're like oh I have a hip labral tear or I have a you know femoral as tabular impingement now or I have this L5S1 that is of dysfunction and you go, could we have caught that post are kind of our big opportunities. And it'll be fun to watch and see what evolves.

SPEAKER_00 58:53

Yeah that continuum I think is yeah no I'm I'm totally in agreement there. Having kind of dove headfirst into into perimenopause this year, this last year, I turned around and looked back at postpartum in that low estrogen state and like oh my God look at all the stuff that we're missing. And to your point, if we have a better sense of what's going on in pregnancy postpartum, how can we carry that forward and have an even more productive perimenopause because we do it it it's not Blanche Devreau anymore. I mean I saw a meme the other day that she she was quoting herself as oh I'm 41 years old. I'm like wait what? Like where's my calf 10? Like yeah I I I think we have so much higher expectations and kind of what you're saying too like you're performing better than you ever have you're doing world majors and you know having great times yeah this was not the plan but you're not you're not you're not walking away you're diving into it further. So you know how can we take the lessons that that we're learning and flip it around and tell our earlier you know moms and postpartum our pregnant moms how can we go back and change the narrative with our kids from the beginning right on what their expectations are as they age. I think there's such a huge opportunity.

SPEAKER_02 1:00:21

Yeah. And and can they get the strength training you know uh like just anecdotally on myself I didn't start strength training until about three or four years ago and that's when I saw all my time start to drop right I started doing all the plyos and the strength training and you go what if I would have done that 10 years ago right postpartum after your second go really make sure that we get that strength and how could that have changed biomechanically how could that change orthopedic issues I think if people can get that information early that's going to be key.

SPEAKER_00 1:00:53

Yeah well and that's been a lovely I think parallel journey what we've seen in the orthopedic literature and the running literature and what we're understanding in postpartum is we do have data to say hey strength training lifting heavier is going to improve your performance heavy lifting over plyometrics heavy lifting will get you a faster 5k time like hey great who doesn't want that you know and if oh by the way if we can gear that towards improving bone density tendon health all those sorts of things again where where's the loss here yeah um I didn't start strength training until um so I had FAI surgery uh 18 years ago oh wow um and then yeah back back before Lady Gaga and A-Rod. Um I mean I I I didn't make it cool but clearly they did. Um but I didn't start strength training till my second was in preschool. So she would have been like three or four years old and I started doing CrossFit. And between the time of my surgery and that point I could run a little bit but like it was still that's what saved my hip like and and made it so that you know I did my first half like ever last year, you know, doing 10 milers all sorts of things like I like that was a game changer for me. And again how do we change the mindset of moms of like okay you need to be lifting heavier things sooner and I don't mean ankle weights and I don't mean hand weights like can we we need to take that you know image of that we grew up with in the 80s and the 90s of like these we don't worry about bulking up trust me I've tried I want to bulk up exactly I'm like can I build some muscle and by the way it's sexy. Yeah no I feel like there's such an opportunity to to kind of shift that but again it's been really cool to see the parallels and in being one foot in each camp to be able to be like hey this is gonna collide and just be good things going forward.

SPEAKER_02 1:03:04

So yeah yeah no and it and it's exciting that now we have social media and things that can push that faster to people so that they can get you know that knowledge because if if you don't know the knowledge you don't know that that's something you're supposed to do. And not just the lifting but you know the multiple plane movements playing pickleball playing basketball tennis all of our kind of lateral movement sports which help with their bone density for a long period of time.

SPEAKER_00 1:03:30

So well even um oh gosh I don't know if it was looking at like ACL or oh it was it was some paper looking at a comparison of um adult runners what sports they did growing up and the kids that were only runners um so you're in this crew I am 100% in that crew.

SPEAKER_02 1:03:48

I can't remember exactly what it was if they were more they they had more uh increased risk for injury or more injuries as opposed to the kids that did um ball sports so like soccer basketball like cutting those sorts of things um which I never did and I don't think well Nordic skiing it's it's not really cutting we we did we did diagonally yeah um so I don't think that counts but I'm like again these are things that gosh I wish we'd known this yeah um yeah sing single sport kids are the most prevalent right for injury and so just encouraging any other type of activity whether they're their teens or whether they're you know in their 40s and still kids playing playing their sports right like we are yeah are are your are your kids runners or they do other stuff you you know it's so funny is my oldest is really into soccer um and one day I said I I know biomechanics of running I said you're a really good runner I said you should go out for cross country and he's like no and I made the mistake I said I'll pay you if you play top three in any race because I really think that you're a really strong runner. So long story short the first three races he did he went out and either led them or got second place so the cross country season was very expensive for me. And um but he hates it he hates the individual sports and he's like nope I only want to play soccer I like the team sport so I I don't think I'd repeat that mom move again. But then my youngest he loves like short sprints um he loves playing tennis he loves soccer he loves swimming I think he'll be a hurdler someday he loves to go oh my mom would let me hurdle she's like no way you're not doing that he has no fear and he'll he jumps right over the 30 he'll even go over the 33 inch hurdle and he's 10. So he's he's got no fear there. So we'll see what he ends up loving.

SPEAKER_00 1:05:47

That's awesome.

SPEAKER_02 1:05:48

How about your kids?

SPEAKER_00 1:05:50

Uh my my youngest is my sporty girl. She in the fall she does uh field hockey which I'm still learning winter both kids do rec basketball. My daughter Does swim year round, but we we tone it back. She swims like once a week and then she'll do summer swim. Um she does softball in the spring. He used to do baseball, but around here everything gets so freaking serious by like age 11 that he didn't do that. And then they play golf and you know it's like a little bit of everything. Um, my daughter just did the turkey chat with me, and we just you know do fun run stuff. And I'm like, you know what? There's there's no pressure here. You just need to be active. That's all I care.

SPEAKER_02 1:06:28

Yep, and and just a lot of shuffling around, right?

SPEAKER_00 1:06:31

A lot of carpools and a lot of strategic uh activity. Well, because I'm not sitting on bleachers.

SPEAKER_02 1:06:37

I know, but I I'm the mom. I bring all I do all my core, my neuromuscular training when I'm watching the soccer game. So I have my band and I have my I bring a weight, and you know, you're there for a 90-minute game. So I know I do a full workout on the sideline. I'm sure my son's like embarrassed that his mom is the one doing plyos and jumping.

SPEAKER_00 1:06:58

And no, I did uh use that time wisely. I did a whole podcast last year on uh we have a group of summer swim moms that there was one mom that would just walk the property during practice. Yeah, and then other moms see and they would just join. And then, you know, when when their kid leaves and another mom joins, and like you just like it's just one of those things that, like, hey, we're here anyway, we might as well get in. Yeah, we gotta do our stuff anyway, and it's too too quick of a practice to run home and come back.

SPEAKER_02 1:07:26

And yeah, absolutely, yep. Or or they have to be 30 minutes early for a game and like, oh, that's great. I can run for 30 minutes and be back and then do your core work afterwards.

SPEAKER_00 1:07:35

So see, if if you have little kids to take these tips, trust me. It took us a while to figure it out, but we did it.

SPEAKER_02 1:07:42

Absolutely, and and to feel, you know, okay, this isn't awkward, I can do this, like seem awkward at first, but when you're gonna use and someone's like, Can I join you? I was like, sure. Exactly.

SPEAKER_00 1:07:54

Exactly. We're all in the same boat. So mom tips from Jess and Carrie.

unknown 1:07:57

Yeah, totally.

SPEAKER_02 1:07:59

Whole podcast could be on that boat.

SPEAKER_00 1:08:00

Exactly Oh my god, we told that's why I told you. I was like, we could have like seven podcasts. All right, so we're gonna have to wrap this one up, but at the end of every episode, I have um a couple questions for everybody. So, first one, um, book that you're reading or podcast that you're listening to right now.

SPEAKER_02 1:08:17

Oh, book. I just finished a book, um, and it's thanks for the feedback. It is absolutely phenomenal. Um, it's we do it as part of our business leadership series. I've got a group that we read, but it is applicable from business all the way to um your personal life. So highly recommend that book.

SPEAKER_00 1:08:36

Nice. I I like one that crosses uh multi-purpose, right?

SPEAKER_02 1:08:41

Yes.

SPEAKER_00 1:08:42

I I cried we had um uh James Clear on a couple years ago, um, who wrote Atomic Habits and he wrote it before he had kids. I was like, dude, this is not a business book, this is a parenting book. He's like, Yeah, I can see where you're coming from. All right, next one. Uh favorite activity since becoming a mom.

SPEAKER_02 1:09:02

Oh, favorite activity. There's so many. Um, I think the holidays come to mind just because that's what it is. You know, the holidays have such this like excitement and glamour with them again. They bring back the sparkle of the holidays. So I would say probably just holiday activities and then doing silly stuff like we went to go-kart racing the other day. And I would have never done that with I if I didn't have kids.

SPEAKER_00 1:09:26

And kids are brutal, they they want to win, they want to be and so do I. There's no competitiveness in your family, is there?

unknown 1:09:35

That at all.

SPEAKER_00 1:09:35

All right, I'm gonna tweak this one. One piece of advice for moms uh who are runners.

SPEAKER_02 1:09:41

Oh, um, can I do both? Because I have a really good one for moms too. Sure, go for um for moms, you know, you're the best mom that they know, right? I think sometimes you get wrapped up and you're like, am I doing this right? Am I nursing them right? Do am I putting them down at time? And you're the only mom that they know. So just know that you are the best that they know. Um, the best piece of advice for moms who are runners um is really listen to your body and know that running is going to be there for a really long time to come. You those you don't get those moments back, they're precious. If you don't start training, you know, on day six or day 12 or week 12, it doesn't matter in terms of like you never get the back that time with your young kids. And um, so don't put too much pressure on yourself to bounce back like society tells us to do.

SPEAKER_00 1:10:31

And easier said where we sit than we and we understand if you're in in the middle of it, we understand how hard it is to reconcile that.

unknown 1:10:39

Yeah, totally, totally.

SPEAKER_00 1:10:41

All right, who's somebody in the pregnancy postpartum running space that we should know about? Who's who are you fangirling right now?

SPEAKER_02 1:10:48

Who am I fangirling? Everybody. Um, I would say um I'm most intrigued about the female athlete um conference coming up next June. Yep. Um, I think Ackerman is doing an amazing job in the space. Um, I'm excited to see what comes out more from there. And I would say the other person is Taryn Holland. She's from Australia. Um, she's an Australian physio. And man, her courses and the amount of res time she spends looking at research. She has a gift. Absolutely. I mean, she has just absolutely changed the way that I practice, the way I look at research, the way I integrate it. And so I'm just super grateful for her and her space. And I think if everybody could attend her courses, yeah, um, our profession would really change fairly quickly.

SPEAKER_00 1:11:38

I I think it has, to be honest with you. Um I had heard about her several years ago from an Aussie friend of mine. Yeah. And um her making her stuff available for us in the States, um, I think it has allowed us a digestible way to get to the literature and have a discussion about it in a way that really needs to be had right now, especially when you have people that are cherry-picking stuff or just only reading abstract. So, yeah, Taryn Holm, if you guys don't know her, um, I I would love to have her on the podcast. I don't I don't think we have a long enough podcast to do.

SPEAKER_02 1:12:15

And that's what be my fear. She is just, I mean, I could listen to Taryn all day because research is a problem. Research is in my strong suit, and she just like she makes it so interesting. I'm like, how can you go through 200 slides in 200 minutes? And I just my brain is well, that's the thing is you have to listen to it multiple times.

SPEAKER_00 1:12:36

So, like her courses that she she might not have a recording for, I'm like, this is not good. I'm just like, I need to hear this again. So, yeah, I am with you. All right, and last one, what does it mean to you to be an active mom?

SPEAKER_02 1:12:49

Yeah, you know, I think more than anything, showing our kids that I they can lead an active lifestyle, that health is important. You know, my kids know that um I'm gonna carve out that time to be to be and fill my cup and fill my health so that they can um then be on the receiving end of that. Um, and then doing active things with your kids. You know, my son and I go to the gym now in the mornings and lift weights together because he's really interested in that. That's awesome. And go, I'm not very good at soccer, but you know, trying to go kick the soccer ball or make our family activities about things like skiing and snowboarding and hiking and just making sure that activity is kind of the center of all the things that we do. That's awesome.

SPEAKER_00 1:13:34

I love it. All right. If you want to know more about Jessica, she's occasionally on Instagram. You can find her over there.

SPEAKER_02 1:13:40

Not recently with writing a book. All my evenings are shaken up, but I'll try to.

SPEAKER_00 1:13:45

You will see more of her. We will have her back. Um, this was just introduction to Jessica, the episode. Um, and we'll we'll have you and and Shannon um on uh after you guys launch your book and all that other stuff um and get caught up with you. And I'm sure we'll have even more to talk about. Um so it was 18 months in the making, but Jessica Dorrington, thanks so much for joining me on the podcast.

SPEAKER_02 1:14:06

Absolutely wonderful. Had a great time and looking forward to the next one.

SPEAKER_00 1:14:11

Awesome. Thanks.

SPEAKER_02 1:14:12

Yeah. Bye.

SPEAKER_00 1:14:13

If you're navigating pregnancy, postpartum, or perimenopause, whether personally or professionally, check out all our free resources and upcoming courses at carypagliano.com. This podcast reflects the opinions of Dr. Carrie Pagliano and her guests, and it is for entertainment purposes only and should not be considered medical advice. Always consult your healthcare provider with any medical questions. If you enjoyed the episode, please take a moment to leave us a five-star review on your favorite podcast platform. And thanks for listening.