The Barbell Mamas Podcast | Pregnancy, Postpartum, Pelvic Health

Stop Fearing Your Body's Feedback Loop

• Christina Prevett

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The shame and fear surrounding postpartum symptoms have gone unchecked for far too long. As a pelvic floor physical therapist and athletic mom, I'm here to dismantle the myth that leaking, coning, or feeling heaviness means you've done something wrong or caused permanent damage.

When we rehabilitate any other body part, we deliberately provoke symptoms within reasonable limits to build strength. Yet somehow, we've created a culture where postpartum women are told to avoid anything that triggers the slightest symptom—a standard that would be considered absurd in other rehabilitation contexts. Your symptoms aren't failures; they're valuable feedback about your body's current thresholds.

Think about it: you wouldn't expect to be symptom-free while recovering from surgery, so why do we place this impossible standard on postpartum bodies? Recovery isn't linear. You'll have good days and challenging days, but what matters is the overall trajectory of improvement. When you haven't jumped for 10 months, your body needs time to recalibrate—your center of gravity has changed, your joints feel different, and your pelvic floor must relearn how to respond.

The real issue isn't about avoiding symptoms but understanding your personal comfort with them. Some women don't mind a little leaking during runs if it means maintaining their fitness routine, while others prefer a more conservative approach. Problems arise when there's a mismatch between your risk tolerance and your healthcare provider's outlook. If you're ready to push boundaries while your provider focuses only on restrictions, it creates unnecessary frustration and shame.

Remember: you're making decisions with the information available to you right now. If symptoms appear, you haven't ruined anything—you've simply discovered where your current threshold lies. And I promise that threshold will change as you heal and strengthen. Want to feel empowered rather than fearful in your postpartum fitness journey? Subscribe to Barbell Mamas for guidance that respects both your body's needs and your athletic goals.

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Speaker 1:

Hello everyone and welcome to the Barbell Mamas podcast. My name is Christina Previtt. I'm a pelvic floor physical therapist, researcher in exercise and pregnancy, and a mom of two who has competed in CrossFit, powerlifting or weightlifting, pregnant, postpartum or both. In this podcast, we want to talk about the realities of being a mom who loves to exercise, whether you're a recreational exerciser or an athlete. We want to talk about all of the things that we go through as females, going into this motherhood journey. We're going to talk about fertility, pregnancy and postpartum topics that are relevant to the active individual. While I am a pelvic floor physical therapist, I am not your pelvic floor physical therapist and know that this podcast does not substitute medical advice. All right, come along for this journey with us while we navigate motherhood together, and I can't wait to get started. Hello everyone and welcome back to the Barbell Mamas podcast.

Speaker 1:

Christina Previtt here and I am finally in my own house Right now. We moved into our new house, so I hide in our bedroom to record these podcasts, though my hubby was working on a basement office slash podcast studio, which I'm super excited about, but that is still being created. So for now, I am home and it has been a really crazy month and I am so excited to be recording this podcast here at my house and not from a random hotel room in a random city around the United States, and you know it's so funny. I always feel like you know. There's this joke online that being an adult is saying that it's going to get less busy next week, every single week until you die, and I could not feel that more like last week. I was like, sweet, I'm home, it'll be so much smoother which it was like, not saying that it wasn't, but it was still crazy. So I think that I just need to let go of this expectation that it is not going to be busy, and I embrace chaos in so many parts of my life, but I think sometimes this expectation that it's going to slow down maybe it will in years to pass, but having several young kids at home, I feel like it's just one of those things where it's not going to get less busy.

Speaker 1:

And to my parents who are dealing with the roll out of daylight savings time, I am thinking about you all and I hope that that transition was not too brutal. I must say I feel really fortunate. Our kids are not that brutal when it comes to the time change. My son it did take a lot longer for him to get down to bed and I think that's my only big parenting trigger is when I know that I want to do things after I go to bed and he decides that he does not want to go to bed. And then I started thinking about all the times like that is probably my biggest, like I'm going to lose my mind, type of parenting trigger. But I am working on it and I will get better. And well, eventually my kids just won't need me to help them go down to sleep. But yeah, I'm, I'm starting to ramble.

Speaker 1:

Let's talk about today's episode. So today's episode is going to be a little bit different. It's going to be a little bit of a rant. You know that I've been kind of playing around with different styles and and it's more this message that I really want to get out to you all who are listening, like if you are an athlete or you are a mom, are you a person that likes to move your body and are in the postpartum period. I am titling today's podcast episode I am not afraid of your symptoms.

Speaker 1:

I am not afraid of your symptoms. Okay, in pelvic health, we can sometimes create this story that if you cone or dome or if you leak with exercise, especially in that early postpartum period, you are ruining something or you are going to make something worse, or that you are causing permanent, irreparable damage. I am here to tell you that when I am in rehab with a person, I am looking to create your symptoms so that I know where your symptoms are In rehab in general, if you were to come in with any type of injury not in pelvic health and orthopedics we would never, ever, ever say to you if you have pain in your shoulder, I want you to avoid all of the things that cause pain, because that is what's going to get you better. I should kind of asterisk that that there's definitely some people who say, well, just rest your shoulder for two weeks and it'll get better. But we're really trying to go against that narrative because we know that rest isn't the answer and we know that in order for our shoulder to get stronger, if we were coming in for a shoulder injury, that we would need to push into pain a little bit, because we need to strengthen the shoulder in the positions that it hurts. And so usually we kind of give a marker and we say you know two to three out of 10, I'm OK with you being there. But if it kind of becomes really sharp or it starts to creep up from that, then I am not OK with those things.

Speaker 1:

But we haven't trickled that, that message, as strongly yet into pelvic health and we are trying really hard to change that at the Barbell Mamas and with some of the work that I'm doing with the Institute of Clinical Excellence and really with my postdoctoral PhD work, we are trying to change that. And why? Why am I saying this One? You are not going to ruin anything. You are not going to ruin anything. You are making decisions as an adult and many times you don't know where your thresholds are until you test them. And especially, coming back to exercise after having a baby, we give you this recommendation at six weeks to just listen to your body. But you don't know what to listen for and these symptoms are signals of your body's thresholds. It is your body's way of telling it, telling us what you are ready for. And so you know.

Speaker 1:

I kind of have this thought when I'm working with anyone coming back postpartum. It's not that I would never expect you to be symptom free when you're recovering from surgery. When you're recovering from surgery, when you're recovering from an injury, we would never expect you to be symptom free. We would always expect rehab to be non-linear. There is going to be ups, there's going to be downs, there are going to be good days, there are going to be bad days, but we're hoping that the slope of that line is going in the right direction and that is the way that we need to conceptualize postpartum exercise right. When we are coming back to double unders.

Speaker 1:

After having a baby, especially after having a vaginal delivery, it is going to feel different to jump. You haven't maybe been jumping for 10 months. It's going to feel different on your joints. Your body is going to have to get used to it. You're not pregnant anymore, so you have to regain where your center is, because that center shifted so much during your pregnancy. And then your pelvic floor has to get ready and get used to jumping again. And so we can gradually increase your load. You know, with strength training, for example, we start with an empty bar. We add five or 10 pounds every single time.

Speaker 1:

We can do the same thing for impact, but you may bump into symptoms, you may bump into feelings of heaviness or pain, and it's not just pain in the pelvic floor. You may experience pain. You know we have all of these, these terms that we say are mom terms, like mom wrist and mommy and mom thumb. You may bump into all of these things. If you do, you have done nothing wrong and you have not ruined anything. You have just figured out where your threshold is for right now and I promise you, mama, that that threshold is going to change and you are going to get stronger.

Speaker 1:

What I really hope to bring with this message is that if you are experiencing symptoms one, if you have feelings of shame around that, I hope that they can start to slowly melt away because you did not do anything wrong. Even if you feel like you stack the deck in your favor and you then experience symptoms, you again did nothing wrong. It is an idea around where your thresholds are, and after having a baby, there is a rehab process that happens. We have to allow our body to get stronger. We have to push into things that we haven't done in a long time, and what that means is we don't know how our body is going to respond and it is trial and error and when we can move away from this feeling that if I cone or dome that I'm going to create issues with my core or if I have this heaviness, I'm going to spontaneously prolapse and think about it. More of my body is recovering. It is telling me that I am tired for today and the next time I do that exact same workout I'm probably going to feel a little bit stronger.

Speaker 1:

When we do that, we take, hopefully, what I'm trying to do is take the fear away from these symptoms and use it as information. Right, we do when we do a training log. We talk about our repetitions, our sets and our reps. How hard it felt. You know, when I'm doing one-on-one coaching, sometimes I'll do a sessional RPE. I'll get people to track their sleep. If I know they're not sleeping well, if they're in a cut, I'm going to ask about fatigue levels, like there's different markers that we can do to gain information. That may be does this feel good around your pelvis Like? Does this feel like you have support? Are you feeling a little bit less support today? Are you experiencing peeing when you are doing double unders? Those are things for us to track and pay attention to and to understand where your thresholds are at this moment and knowing that that is going to change.

Speaker 1:

We have done such a terrible job sometimes of making fear the predominant prevailing emotion when it comes to exercise in the pregnant and postpartum period, and I am sorry for that. That should not be the way. We should feel support and empowerment from your providers, those that are around you, around where and how you want to exercise, and the only thing that I can say about that is that there are going to be some people who are going to have different risk tolerance and symptom tolerance levels. So what do I mean by that? I am not afraid of your symptoms, because I know that those symptoms are giving me information. I know that some people are not going to have a high tolerance for pushing into those symptoms because they really don't like it. You know, I have some individuals who they completely pee during a run. They don't, it doesn't bother them that much. Um. And other people if they feel even the urge to go to the bathroom, even if they haven't eat a single drop, they really hate that feeling. That is their symptom tolerance.

Speaker 1:

Other people are going to have different risk tolerances with respect to their exercise, and so that risk tolerance is I don't really know about how fast I can progress. I have this plan that I want to do a weightlifting meet at five months postpartum. I'm going to push really hard, starting at four weeks postpartum in exercise. That's one person's risk tolerance. The other one is you know, I don't know if I should be running before 12 weeks, so I'm going to be doing zero running and only walking for 12 weeks postpartum and then start running. That is a different risk tolerance. Both of those are okay and both of your symptom tolerances are okay. So what we do in rehab is we take your symptom tolerance and your risk tolerance and we use those things to help guide the speed at which we progress your rehab. And everybody is going to be different, and this is the nuance point that we are missing online.

Speaker 1:

One is I am not afraid of your symptoms. You are not ruining anything, and we tend to say that this is bad, like I saw a reel that said oh you, this is what you should never do during pregnancy. It was like crunches, sit-ups and planks things that I would keep in a person's program if they feel comfortable and they're looking good, right up until delivery, and we need to move away from that narrative. If you have symptoms, if there are things that we need to work around, we will work around them In the postpartum period. I am not afraid of you developing symptoms postpartum. I'm actually kind of looking for them in that early postpartum period because I need to know how your body feels, how your body is responding postpartum, and that is going to be completely individualized to you. Then I need to figure out you know, what is your symptom. Tolerance Is your desire to get back to running and making it so that if you leak a couple of drops, you're fine with that, but if you're completely evacuating your bladder, you're not okay. Then we're going to use that as our barometer of how far we're going to push before we have to figure out where that threshold is and do some other accessory work, or scale back your volume or or do different things in order to keep your symptom threshold within your risk tolerance and allow you to go forward.

Speaker 1:

The mismatch happens online One, when we create this fear focused narrative, and two, when the person that you are working with does not have the same risk tolerance as you and cannot accept the discrepancy. And so you all, you all know me if you've been listening to me on the podcast, where I tend to be further on the aggressive side of rehab. I really believe that we should be trying to be as strong as we can. I should be supporting moms in that decision and I am okay pushing the envelope in a lot of different ways. That being said, I work with a lot of people who do not have that same like push, push, push challenge to that mindset to their postpartum journeys. And that is okay, cause I can meet individuals where they are at and bring my risk tolerance zone down. I hope to bring their fear down as well so that they can kind of push their their envelope in terms of their recovery, but respecting where they're at with respect to what they feel comfortable with in the postpartum period.

Speaker 1:

Where we see a lot of our listeners get frustrated is when their risk tolerance is further towards challenging the envelope and their providers are more conservative, because that is when that fear focused narrative can become the prevailing conversation. And if that is you and you are experiencing this mismatch, I don't want you to feel shame around pushing the envelope as long as there is nothing from a safety perspective. This is especially if you're pregnant or you know there isn't something that could put baby at harm, but you would know if there were those complications in your pregnancy. If you are a person who is experiencing a different okay zone from exercise than the person that you are working with, I think it warrants a conversation. You want to find the people on your team that are going to speak the same language as you, to make you feel supported and empowered. That isn't to say that you need to just ditch everybody that you're working with. I don't want you to do that at all. I just hope that you all have a conversation and I'm going to give you an example of where this can be really fruitful.

Speaker 1:

With my second kiddo, I did not want to birth on my back. I had had an unmedicated delivery with my daughter. I was hoping to go that way with my son and I did not want to deliver on my back. I wanted to be sacral free, et cetera, on my back. I want it to be sacral free, et cetera. I had that conversation with my provider and they were super open to that conversation and you know we were able to have this conversation where they said you know, the only thing is I haven't done a ton of deliveries in a different type of position. So, as we're delivering the shoulders, if you could come and roll onto your side, if at all possible, that would be something that would make me feel a bit more comfortable. And so it was this conversation of trying to figure out where the provider's risk tolerance was and where I wanted mine to be, and then figuring out if we could come to a common ground. But if we couldn't, then it was okay for me to ask for a different provider.

Speaker 1:

The hard part is when we feel like the messaging is making us feel so much shame that advocating for ourself is making us feel like we are doing something wrong, and so when I started this podcast and this is turning into a long-winded rant, I apologize for that I wanted to create episodes around all of the things I wish my clients would know about having conversations in pelvic health about these different conditions that try to move the needle away from fear towards empowerment and towards advocacy and conversations and gentle challenging of belief systems, in order for us to be able to support you and make it so that you feel confident in the decisions that you're making and supported by the people that are helping you through this journey, and I hope that I get to be a little part of of that help within this journey, so kind of bringing this full circle. I really do want to tell you that if you are all of a sudden peeing with double unders and you were not peeing before you have not done anything wrong. It may be that you've kicked up your volume. It may be that you've kicked up your volume. It may be that your abs have gotten stronger, so your brace is a bit stronger and your pelvic floor needs to catch up. It may be just a bad position. It may be that you know your training has had a lot more impact in it in the last little while and now all of a sudden you're peeing a bit more than you were before. Those symptoms are telling you what your body is ready for. What does your recovery look like? Are you eating enough? All of these things? It is information. It is not about ruining anything, and if you are getting the messaging from people that you are ruining something, it may be time to have a conversation without those individuals or find a different person to have a conversation with, and so I hope you all can kind of take my rant and and um. I hope that it helps. I hope it helps even one person feel a little bit less guilt about anything that they're experiencing.

Speaker 1:

If you went back early and all of a sudden you're experiencing heaviness symptoms, you did nothing wrong. You don't know that if you would have waited six weeks, that you would not have experienced those symptoms. You may have experienced them anyway, but your mental health was in a much better place because you went back to your people at three weeks and your baby is in a much better space with a mom who is feeling a little bit better. You did nothing wrong. You do not have a crystal ball. You do not know if you would have changed this decision, if you would have had a different outcome. You made decisions with the information that was in front of you at the time.

Speaker 1:

If we hit snags where we hit symptoms, recovery postpartum is never linear and it is okay. We know how to respond to those symptoms. I'm a pelvic floor physical therapist. I bump up to those symptoms all of the time and we get better. Our people get better. You will get better and you didn't cause anything. You're recovering from an injury and we are here to help you. All right, I hope you have a wonderful week, if you have any other questions, let me know. Otherwise we will see you all on the podcast next time. Bye.

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Christina Prevett

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