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Here’s a little glimpse into my last trimester of pregnancy and my postpartum recovery journey. I’ve learned a lot during and after pregnancy with the main lesson being: the human body is amazing! Full Disclaimer: this blog is NOT intended to be a prescription for return to Crossift postpartum. Everyone’s recovery will vary tremendously as a result of MULTIPLE different factors such as pre-pregnancy fitness levels, age, weight, pelvic floor strength, core stability, and vaginal vs cesarean deliveries to name a FEW. This is just MY experience and how I progressed back to CrossFit. I fully recommend seeking help and direction from an experienced rehab professional for detailed guidelines specific to yourself before trying any of this on your own. This will prevent speed bumps in recovery and future complications from arising!
**check out our instagram post to see what exactly this “stacked” position is** During the 3rd trimester, I didn’t max out on any lifts, although I did PR my 3 rep front squat. And no, I didn't pee myself, wear a belt, or strain too hard to do it. It just felt good that day! Double dumbbell or heavy thrusters became more difficult for me to control my core so I usually only used one dumbbell or a lighter weight for thrusters. I actually stopped doing handstand push ups, not because it was unsafe, but because they got really hard the heavier I got. As a substitution, I did single arm overhead presses. I did end up rowing a couple times because I got tired of biking, but I just didn’t lean back at the end of the pull in order to prevent my core from coning.  In general, extracurriculars were a bit more challenging. My husband and I like to spend a lot of time outdoors with our friends so we planned a trip to the mountains around week 34. We went tubing down a shallow creek and in order to not get slammed by rocks, I’d have to lift my body up out of my tube, which was really difficult to do without coning. My friend ended up switching tubes with me (his had a net bottom and back support) which helped tremendously! Hiking was a bit more difficult because I was basically wearing a weight vest. The trail we picked ended up having a lot of actual rock climbing and uphill/uneven ground so I was REALLY fatigued. We did about 4-5miles and even those who weren’t pregnant were exhausted. Fun fact: my fingers started tingling after writing a lot of thank you cards after our baby showers, but the doctor said that was normal and it was just swelling in my hands that mimics carpal tunnel. It would get worse being at work and performing a lot of hands on work on athletes. I would also sometimes wake up with that same numbness, but as long as I kept my wrist neutral, as opposed to bent, it would be fine. (All of this has completely subsided now that I’m not pregnant.) As my due date approached, I felt like the doctors started trying to scare me into an induction. I really preferred to have my baby naturally, even without an epidural, so the thought of an induction didn’t sit right with me. They kept telling me the risk of stillbirth, C-sections, and complications continue to increase the longer we wait. At 39 weeks, for the health of my baby, I decided to go ahead and schedule the induction for 41 weeks. I wanted to give my body a chance to go into labor on its own. The week of my due date, I tried everything I could to make her arrive without the induction. My OBGYN did a membrane sweep at 39 weeks + 2 days. She said it should help me go into labor in 24-48 hours. It didn't. I walked for 2 hours that night and did some deep air squats. That didn't work either. I ate Hawthorne's “The Inducer” pizza two nights in a row..still didn't work. I tried hot wings and other spicy foods. I even went and got a pedicure because I heard that was supposed to help. Eventually, Saturday night, the day before I was due, I started experiencing labor pains. I ended up having baby Harper right on time, September 19th at 5:15 in the morning, without an induction and without an epidural..ouch! She was 6 pounds, 6 ounces, and had a head full of hair!
 The doctors told me not to workout for 6 weeks and with how sore I was directly after, I agreed! But as the days went by with me just sitting on the couch, I started to get all kinds of aches and pains in my low back and neck and just became uncomfortable. I soon decided that I just needed to MOVE! I started walking around the neighborhood 3 days later and then 4 days after I gave birth, I went to the gym. Yes, the gym. I skied very lightly because the idea of sitting on a bike or rower seemed uncomfortable. I did some slow air squats, slam balls, and light kettlebell deadlifts. It felt great to move again! I continued to go to the gym daily, but for the first couple of weeks, I did my own workouts or modified the one that was programmed. I started back jogging pretty soon after delivery and it felt great! I kept weights pretty light and didn’t do any rig or core work and especially no jumping. However, I did start incorporating some simple core stability exercises like lying on my back while holding my legs 6 inches off the ground, controlled sit ups, and hanging from the rig to name a few. Return to Rig Work (ie. toes to bar, butterfly pull ups, bar muscle ups) My return to the rig had a couple of progressions. I started with hanging from the rig and controlled (from a breathing and coning prevention standpoint) sit ups on the ground. Once those became easier, I started to incorporate some controlled hanging knee raises. I did this for a couple of weeks until I started to add a small kip and some momentum to the knee raises. It took about a month for me to feel comfortable enough/ready to do that and then I eventually worked my way up to toes-to-bar.
Videoing all of my progressions on my phone was a HUGE help to myself! With some of these movements, it became difficult to watch and make sure everything was functioning the way it needed to, so being able to watch it back directly after helped tremendously! At about 1.5 months postpartum, I tried some small butterfly pull ups which actually looked (from a coning perspective) and felt really good. It took about 2 months for me to feel comfortable/confident enough to try out bar muscle ups. But once I did, they ended up being successful. My kip felt awful from not doing them for months, but each time I did them, they felt better and better.
Return to Jumping As my body continued to heal and feel more normal again, I progressed the exercises and weights. I was able to perform box jumps at about a month postpartum, but rebounding took just a little bit longer. The repetitive jumping increased the risk of leakage. Also at about a month postpartum, I tried out some light hops in place in order to test out jumping rope. My body wasn’t quite ready at that point. After that, for the next couple of weeks, I kept testing them out periodically and eventually tried out single unders as they continued to be successful (no leakage). At 2.5 months postpartum, I did double unders in a workout. The workout was a 14 min AMRAP (as many rounds/reps as possible) of 21 double unders, 12 single arm dumbbell hang clean and jerks, and 9 toes to bar. The focus of this workout for me wasn’t how fast I could go, but how successful I could be at the double unders. I started off by keeping in mind that “stacked” position I mentioned previously and broke the double unders up into 2 sets. By the end of the 14 minutes, I was able to perform all 21 reps without issue! Fun fact: I have been and still am breastfeeding my baby while working out at a high intensity and have not had any change in milk supply. We’ve had check ups and have visited her pediatrician who says she’s growing perfectly and is getting enough to eat! I’m now currently at 3 months postpartum and am 95% unlimited in the gym. I am back handstand walking, performing butterfly chest to bar, strict and kipping handstand push ups, and doing bar/ring muscle ups. I am still not 100% back to double unders, but I understand this will take time, especially since I had a vaginal delivery. Typically vaginal deliveries have a longer “return to jumping/running” time period while cesarean deliveries have a longer “return to core work” recovery period. I also haven’t tried GHDs yet because they seem too advanced for me at this point, but I’ve been AMAZED at how quickly I was able to return to some of these activities and how good I’ve been feeling while doing them.
While postpartum recovery is a journey in itself, so is returning to a sport or activity you love! It’s never too late to rehab the effects of pregnancy and you don't have to do it on your own! Whether you just had a baby or if your child is 10 years old, there’s likely something that can be done! If you’re looking for guidance, even if you’re one of the moms that is STILL struggling with double unders and leaking multiple years after giving birth, don’t hesitate to reach out! You don’t have to suffer or avoid movements forever!  Thanks for reading! - Aerial B.
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 If you’ve ever spent any amount of time in the gym, you’ve probably heard your coach tell you not to let your knees come together while you’re squatting. This “knee-knocking” motion during the squat or deadlift is called a Valgus position. While this movement pattern can have a detrimental effect on your knees (and hips and ankles for that matter) over a long period of time, it can be advantageous in certain scenarios! If you’ve ever spent any amount of time in the gym, you’ve probably heard your coach tell you not to let your knees come together while you are squatting. This “knee-knocking” motion during the squat or deadlift is called a Valgus position. This can have a detrimental effect on not just your knee, but your hip and your ankle as well! So, let’s jump right into the top 5 detrimental effects valgus can have on your body! 1. Let's first kick this off with how the valgus motion affects the knee itself. During the squat, the knees pinch inwards toward each other but the hips and feet stay relatively stable. By losing the straight line between your hip, knee, and toe, you introduce a lot of rotational stress to the knee joint. Unfortunately, the knee is a hinge joint meaning that it is really made to only bend and straighten with some slight rotation. Over time, this extra rotation results in an aggravation to the sensitive structures of the knee and can begin to cause pain around the kneecap or especially the inside of the knee. If left unchecked, this can become a structural issue resulting in persistent pain, early onset arthritis, or ligament over lengthening and tears.  2. Now moving up to the hip. When the knees pinch it forces the femur, or thigh bone, to move into adduction and internal rotation. This motion of the hip increases pressure within the joint and on the structures immediately surrounding the joint. Oftentimes, this will result in a painful pinching at the front of the hip especially when squatting is repeated many times under high levels of fatigue. If this motion is allowed to continue, it will not only cause decreased hip mobility but could be potentially the cause of a hip labral tear altering the structural integrity of the hip.  . Still up at the hip, there is a secondary result of the forced adduction and internal rotation position of the hip. With the femur moving into this position, it results in over lengthening of the glutes. As a muscle is lengthened, it loses the ability to contract powerfully. Thinking about Olympic lifts, we need the quick and forceful contribution of the glutes to hit triple extension. Without as much contribution from the glutes, the quads and muscles of the low back are tasked with lifting greater loads and can result in knee pain, low back pain, or even radicular pain down the sciatic nerve. 4. The last two shift down toward the foot and ankle. Number four is regarding the ankle. While the knees pinch, the ankle no longer moves with appropriate mechanics and results in a loss of pure dorsiflexion which is the toes toward the nose direction. By not getting into pure dorsiflexion with squats, stairs, or step ups we begin to lose this motion and result in stiff ankles. So how do stiff ankles cause knee pain?? When you go to squat, your center of gravity will be shifted forward from the middle of the foot toward your toes. In doing so, it further causes the glutes to be much less active throughout the exercise but also places more demand on the quad muscle resulting in a “quad dominant” squat that can lead to pain surrounding the knee cap and patellar tendon. 5. Lastly, as the knees move into valgus the arch of the foot collapses. Similar to what happens with the glutes, loss of our arch places the muscles that support it in a lengthened position and they become unable to maintain the neutral position of the foot. So not only do we lose the stable foundation of the foot at this point, but with the arches collapsing the knee is driven FURTHER into more valgus. Extra valgus stress and an unstable base set the stage for increased pain or creation of symptoms at any joint along the leg or low back.  While there is all kinds of negativity surrounding the knee valgus position, what is rarely talked about is the BENEFIT of this position. When loading up toward your 1-3 rep max during squat or getting ready to do a max effort vertical jump, you may notice that you naturally move into and out of this position to get out of the hole. While this is still technically a valgus position, the quick movement in and out of it results in a “quick stretch” to glutes. This quick stretch is a technique the body naturally uses to increase the neuromuscular drive of that particular muscle resulting in a more forceful contraction. This is something that you will see all the time during competitions and is completely normal! Looking at the picture below, you can see his front knee is wayyyy inside the hip and ankle and he is the proud owner of 2 gold medals as well as the world record holder in Snatch, Clean and Jerk, and Total.  To wrap it up, Valgus stress at the knee can be beneficial in the well trained athlete to achieve greater max output. However, the use of this position should generally be limited. With lower percentage squat/snatch/clean work, lunges, step ups, or anything similar that pops up in a WOD we should be working to avoid the knee valgus position. For the most part, the undesirable effects of the valgus position tend to occur if we are repeatedly moving into it over long periods of time. In regards to more traditional sports athletes (such as soccer, football, or lacrosse), this position is one we need to master and even strengthen. While planting, cutting, or changing directions the knee is required to move into valgus and when uncontrolled over periods of time can lead to non-contact ACL tears. If you have had an ACL reconstruction, you were probably beat over the head by your PT and/or AT about avoiding this position, however when trying to return to sport this is absolutely something we have to train as its a normal position assumed during competition. Thanks for reading,
Dr. Mike |
This is where we share our expert opinion on hot topics in physical therapy, injury prevention, sports performance, strength and conditioning, nutrition, and sometimes other random thoughts. Enjoy.
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