Finding purpose with prolapse (interview with Kylianne Farrell)

I’ve got to admit …this was one of my favourite interviews.

(and yes…I was a little misty-eyed at the end. I could lie and say that I had been cutting onions, but I must admit that I got a little emotional).

Why did I love this interview so much?

In part it was just because Kylianne is just a lovely person to talk to – we could have chatted for hours and hours. But also I just loved hearing about her journey in living with pelvic organ prolapse (POP) and how she has created an incredible business helping other women.

When I talk to Kylianne I am reminded of how POP is influenced by so many things – not just the muscles and connective tissue (something I discussed in this recent video), but also things like stress, support networks (or lack thereof), sleep and general health.

I feel like women do need more emotional support when dealing with a diagnosis like POP, but this doesn’t always seem to be possible within the health care system. We need to get better at finding ways to support women …

So, hope you enjoy the video and definitely go and check out her website and FB page below!

Some classic statements from KA:

“You have prolapse, you are NOT prolapse”

“Don’t pin your happiness on the healing of your prolapse”

 

 


To learn more about Kylianne, you can follow her on FB and learn more through her website.

The Movement Room website

Facebook page

If you want to learn more about Robin Kerr and Ian O’Dwyer, you can head to their websites.

Robin Kerr – Alchemy in Motion

Ian O’Dwyer – OD on Movement

What you need to know about the early days post C-section…

C-section recovery advice is often pretty rubbish. It just amazes me that my clients get given a couple of token exercises and then are told

  • don’t lift anything for 6 weeks (ummm…what about my baby?)
  • don’t drive for 4-6 weeks
  • after 6 weeks, just “gradually get back into doing what you did before”

 

Now, as someone who has worked with literally hundreds of new mums, I get that it is difficult to give more specific guidelines. Some women find that they have minimal pain after a c-section and are up and about quite quickly. Others have a lot of pain and find that their day-to-day activities are a real struggle. There is no one answer.

But I reckon we can do better.

Let’s just think a little bit about tissue recovery first.

So let’s go through the first 6 weeks

But first, let’s just take into account the actual surgery itself. We’ve got some superficial skin cuts to heal, but also the deeper layers of the abdominal wall. The linea alba (the connective tissue between your 6-pack muscles) is separated, but often not stitched back together. Now mother nature does do a wonderful job at scarring this tissue back up again, but I’m fairly certain that that tissue isn’t back to normal strength by 6 weeks!

In these early stages we want:

  • lots of rest. I don’t want to get all preachy here ladies, but you’ve GOT to rest in the early weeks wherever possible. Listen to your body and don’t feel guilty about lying down and putting your feet up (literally!). Pregnancy, labour (some will labour prior to having c-section), surgery, general anaesthetic, sleep deprivation, feeding your baby, hormones ….woah, that is a LOT for someone to go through. So please please please…give yourself the time and space to rest and heal. I find that women actually recover FASTER by starting out SLOWER!
  • optimal breathing patterns. I find that many women have altered breathing patterns postnatally (well – at any stage of life, but definitely postnatally!). I do think part of this is due to the changes that occur during pregnancy – the rib cage lifts and separates, and the diaphragm is pushed up by the baby, placenta, extra fluid etc! After birth, it can take a little while for the rib cage to settle back down again. Also, postnatally many new mums like to suck their tummies in! Yes, yes I get it – we all look a little pregnant after giving birth and the temptation is to pull your belly in. But you’ve gotta let it go, mamas! Tensing your abdominal wall makes it very difficult to breathe naturally and may put more pressure down through the pelvic floor. Discomfort after abdominal surgery can also make people nervous about taking deep breaths, but these are super important for our lungs and should definitely be encouraged! So try taking different types of breaths – feel your tummy move, feel your rib cage move, take shallow breaths and take deeper breaths. Try them all!
  • some effort on posture. Now I don’t mean “sit up straight and pull your shoulders back”. Those that know me know that I am not rigid when it comes to posture. I believe that there are many different variations of posture that are suitable and I don’t prescribe to there being a “perfect posture”. However… post abdominal surgery, the temptation can be to curl up into a ball on the couch in an effort to “protect” the scar. Grow tall through your spine when you are sitting and standing. Change postures frequently. Slumping from time to time is a-okay! Just don’t do in 24/7!
  • some pelvic floor muscle activation. I can hear you thinking, “but I didn’t have a vaginal delivery!” But guess what? You’ve had the weight of the baby sitting on your pelvic floor for 9 months. New mums also have to contend with a pretty physical new role in life – lifting and carrying for the new few years! We need and want good pelvic floor muscle control. In the early few weeks you can try and get some connection happening between your brain and the pelvic floor muscles and work on the endurance of these muscles. Please note that many women have pelvic floor muscles that are too active though, so if you can’t feel a difference between “on” and “off” then go see your friendly Women’s Health Physio!
  • to start some gentle walking…as able.  Many women will find that ten minutes is the maximum that they can handle in one bout when they first start walking. Start with a small walk in your neighbourhood and then gradually increase this as your energy allows. You may find it easier to do two lots of short walks rather than a long walk. If you can get out and about sometimes without your pram, that is a bonus. Get the arm swing happening and feel that beautiful rotation through your spine as you walk.
  • look after your bowels. It is really important that you avoid constipation and adopt good pooping habits early on. Have you seen the Squatty Potty unicorn video? Get yourself a stool (I use the ikea kids stool) to get those knees up high. Make sure that you stay well hydrated (esp if you are breastfeeding). If your poop starts to get hard and cracked, go see your doctor or pharmacist for advice. Do NOT strain to empty your bowels!

  • get moving…gently! Our bodies like to move, so adding some basic movements and stretches will probably make you feel better. This might mean some pelvic tilts and shoulder rolls when you’re sitting down. It might be some of your pregnancy pilates/yoga stretches in standing. Try moving your body gently in all directions and see how you feel.

Once you crack that six week mark, then yes you are probably more likely to be ready for a structured exercise program. But this doesn’t mean that you are ready to jump straight back into boot camp or running!

Want to learn more about creating your exercise program, then contact [email protected]

 

 

The story of my back pain (the hardest blog I’ve ever written)

Ok, so this post has been one YEAR in the making. Yep, a whole year to get myself together to write this.

Every time I have sat down to write about how I recovered from back pain, I have stopped myself.

You see, when you have experienced agonising pain that has affected your job, lifestyle, mood (well, everything)… you never really feel like you’re cured/healed/recovered. There’s always this little part of your brain that tells you “pfff, you aren’t better. It will only take one bad movement and bam…that pain is back”.

You live in fear. Fear of that pain. Fear of that disability.

So I couldn’t bring myself to write about it for such a long time…because I felt that somehow the Universe would say “who the hell do you think you are?” and curse me with another acute episode. Yep, I know how crazy that sounds, but this is what happens to your brain when you have experienced significant pain. It re-wires itself – and not in a helpful way.

But yet here I am. So how did I get to this point? How did I get confidence in my body again? Why do I finally feel like I can write about it now?

I want to tell my story (and it is a long one!) so that perhaps it might help others who are experiencing something similar. Even as a physiotherapist, working with people in pain and knowing something about the science of pain and how the brain works…I still found it really challenging to experience it myself.

But I did get through it and here is my story…

The back story

Marika Corporate

Me in my professional gear ;)

I have been working as a physiotherapist for a fair few years now – mostly in private practice, treating back, neck and knee pain – so it is fair to say that the concept of back pain is not new to me. I had a few acute episodes of low back pain in my younger days (20s!) but never lasting for longer than a few days and usually requiring minimal treatment.

Fast forward a few years (and a couple of pregnancies and births later!) and I had my first episode of severe back pain. Given that my current job is teaching pre and postnatal exercise (it wasn’t back then), I can kind of shake my head at my stupidity in retrospect.

Hitting the slopes with family and friends in Colorado

So, I was about 8 months postnatal…I had been doing some basic postnatal pilates and gentle gym work. We went on holiday to Colorado and I desperately wanted to go snowboarding. Never one to take things lightly, I went hard core – off piste, moguls, you name it.

I was so friggin excited to be boarding again – nothing was going to hold me back! Unfortunately my body didn’t react so well from this workout and I couldn’t move for about 3 days. Literally couldn’t walk (challenging looking after a little baby, but luckily I had lots of family with me at the time!).

Things settled with time, gentle exercise and movement…and I felt pretty normal again within a few weeks.

After we moved to Melbourne, I decided that I missed my old Taekwondo life and found an amazing school that enabled me to jump back into it (about 18 months after number 2!).

With Master Spiridon Cariotis – USMA Melbourne– achieving my Second Dan in ITF TaeKwonDo

I found it challenging physically, as I had taken 11 years off martial arts and had had a couple of babies – my flexibility was poor and my core strength was…well, not great. Even though I taught pilates at a sports medicine clinic at the time, I found it hard to find time to do much for myself. I worked part-time, had two small children, no family nearby and a husband who worked away a lot. It was difficult to prioritise myself (something I hear from my clients all the time!).

But I LOVED TaeKwonDo – I loved the movement, the intensity, the people, the philosophy. I worked hard, I sweated, I burned and I smiled.

Bit too far away ;)

I somehow found myself competing in some tournaments. Even though I didn’t know the rules and perhaps lost a few points on penalties (you aren’t allowed to grab people’s legs and sweep them…I must have watched too much Karate Kid!), I managed to win the sparring in my first ever tournament! It was the Victorian championships and most of my competitors were at least 10-15 years younger than me (and much fitter), so I was stoked to come away with the gold … (plus some bruised ribs).

 

The Big One

As with many people with back pain, I had one episode that eclipsed all others. One that dropped me to the floor. One that stopped me sleeping, had me taking strong medication…one that made me cry.

Selling a house while still living in it with two small children = stressful!

In retrospect, of course I can see how all the pieces of the puzzle slotted together to create the perfect storm. We had just auctioned our house in Melbourne (HUGE amount of stress getting everything perfect for that) and we had purchased a house in Perth and were moving our life there. The Dockers had just lost the Grand Final of the AFL (ok, not so relevant but may have added to my mental state!).

I had made the Australian team for the World Championships in ITF TaeKwonDo! I had booked my flights to Rome and had chosen a club in Perth to train with. I had enrolled my daughter into her new school and started to settle into life here. Oh..and I decided to start a new business teaching pre and postnatal pilates.

Yeah…to say that it was a stressful six months is an understatement.

So one weekend I did a myofascial release half -day course. We foam rolled and stretched – my back went into positions that it hadn’t for a long time. It felt a bit sore, but wasn’t too bad.

I drove straight to a three-hour training session after that. We did heavy kicking on bags – I basically tried to kick a 100kg male from one end of the gym to the other. I felt sore, I stopped. That night my back felt pretty darn achy.

The next day I tried to ride my bike. As I went to push down on my pedal with my right leg, something went “clunk” and I couldn’t move. I was stuck straddling my bike by the side of the road, trying to yell at my husband to come and help. I literally couldn’t lift my leg over the cross bar.

I went home and cried. Took some anti-inflammatories, rested and did some gentle movement. I was devastated. I felt that Rome was out of the picture. I worried that I wasn’t going to be able to teach pilates in my new business. I was also doing a locum for a sports physio clinic – would I be able to work? How was I going to get the kids to and from school. I felt sick with the stress and the pain. My physio thought I had a stress fracture and wanted scans. I didn’t want scans as I knew that I would have degenerative changes (because pretty much everyone does!) and I thought they would impact negatively on my recovery. Long and short of it – I had scans, there was no fracture and of course there were degenerative changes.

I had treatment on my back over the next few months – I had manipulation, acupuncture, massage and craniosacral treatment. All helped a small amount. I felt better bit by bit and week by week…but it was slow going. Every day I would have a few episodes where I would move and an electric shock would shoot through me. It would take my breath away and kept me on edge. I pulled out of the World Champs…and cried some more.

Perth has so many beautiful places to walk!

I could sense that my anxiety about the pain was really ramping up my nervous system and I needed to do something to calm it down. So here’s what I did:

I started walking mindfully. Sounds weird I know, but I just put my headphones on and walked down to the river.I focused on my arm swing first – and I noticed it was completely asymmetrical. My right arm pretty much didn’t move! So I got my swagger on (as Robin Kerr – physio extraordinaire calls it!) and felt my thoracic spine start to move again.

I learnt to breathe again. Yes of course I was breathing …but I was so tense through my abdominals that my belly didn’t move! I learnt to relax my abs and get my lower ribs to expand. This style of breathing helped calm my mind and my body (and I’m sure I got better oxygenation as a result!)

I danced. I had a friend’s wedding during this time. I remember

At a friend’s wedding, I found that dancing really helped my pain.

going out to buy some flatter shoes as I knew that I wasn’t going to be able to manage heels! At the wedding I felt consumed by thoughts of my back. I worried that I wouldn’t be able to sit down. I couldn’t concentrate on the conversations around me. Then the music came on…

Once a started dancing, I felt things start to ease. The rhythmical movements soothed my nerves. The pelvic tilting and weight shifting eased my spine. The endorphins released by having such a great time with my friends and moving with the music calmed my soul.

I started dancing more at home with the kids. We put on funky tunes and just grooved away in our living room (yes, we still do!).

With two of my buddies from TKD

I got back into TaeKwonDo. This was a big challenge. I was really nervous about starting up again, but I have wonderful instructors at Platinum TaeKwonDo who supported me and encouraged me to come along and just do whatever I could. They knew that it was important for me to build my confidence again, but to also be surrounded by my friends in the club. Those who have experienced pain, know all too well how isolating it is to be removed from the social circles that are linked to physical activity.

So I started up again really slowly (it was many months after the “big one”) and realised that I was ok. Sure some days I ached afterwards, but I didn’t get crippling pain. Yes I couldn’t sprint or kick high, but that was ok. I was there. I was moving. I found ways to move that weren’t painful….and I did more of them.

One of the great things about martial arts, yoga, qi-gong and tai-chi are the sequences of movement. In TaeKwonDo we call them patterns. In Karate they are called katas. They can be almost meditative in nature, depending on speed and focus, and I certainly found them helpful in my recovery.

I challenged myself. When we were putting our new pool in, we had to move wheelbarrow loads of cement from the front to the back of the house (via a ramp that went down a few steps). My first thought was “I can’t do that, it will hurt”. I took a few minutes to think about it and realised that I was completely capable of the task and I gave it a crack. I was tired, but fine. I learnt so much about my body that day – I was NOT broken!

Beautiful trails in Dwellingup, Western Australia.

So we tried hiking. I just carried a smaller pack (poor hubby carried the big one!) and just did about 20km in 2 days. Sleeping on a hard surface was pretty uncomfortable and I woke up stiff and sore. But guess what? I was fine!

I went mountainbiking  – well, no real mountains in Western Australia, so let’s just call it cross-country cycling! I was a bit nervous about the bumps and how it might jarr my spine. I reminded myself that if I tensed up, I was not going to be a good shock absorber, so I chilled out and had a brilliant time.

I started to lift. I really felt that if I wanted to continue doing TKD (and certainly if I wanted to get back into competing), then I needed to be a LOT stronger. I contacted an exercise physiologist (Tristan Hellings) and started doing weights at home. At first, I was kinda shitting myself (technical term) at the thought of deadlifting…especially off the floor. But I started with light weights and soon afterwards could easily pull 40kg off the floor. The knowledge of that achievement gave me great confidence. If I can lift 40kg easily off the floor, then I certainly can lift the laundry basket without too much difficulty!

The snow in Japan is so forgiving… very different to the icy roads in France that I learnt on!

I asked Tristan for a snowboarding program around 12 weeks out from a trip to Japan. Believe you me, I was focused on being in great condition for that trip! I worked hard in my home gym and managed to snowboard 10 days in our 14 day holiday (I still can’t believe it – really grateful that our kids loved the snow!). Again, my back was great. I had so much more strength through my whole body and I felt relaxed. It was amazing!!

I did a course with the amazing Antony Lo (Physio Detective) who further not only challenged my thinking, but taught me some strategies for how to use alignment, deep muscle activation and breath in lifting (#spreadtheload).

Do you notice a theme here?

Do you see that for every new thing I tried, I had to overcome my own fear and limiting beliefs? I had to try the movement and prove to myself that I wasn’t broken. With every new thing that I tried, my confidence in my body grew and grew.

So where am I at now?

Well, it’s now three years since the “big one” and I continue on. I do TaeKwonDo and I have my sights set on the World Cup in Queensland in 2018. My plan is to build up my muscle strength and power so that I can increase my kicking speed.

I’m keen to try CrossFit and have been working on my lifting technique in order to be able to do so safely.

I no longer live in constant fear of pain. I can play soccer in the backyard with my son without discomfort. If the kids want to go for a ride on their bikes around the river, I am happy to jump on mine without thinking twice.

We are planning a hike in New Zealand at the end of the year, plus another ski trip to Japan (I need to work my butt off this year to earn some money for these holidays haha!).

I have to continue to work on my breathing and relaxation techniques every day. I try and make sure that every week I do something for myself that is enjoyable, whether it is coffee with friends, reading my book outside or going for a walk.

And I use this experience to help my physiotherapy clients. I see women every week who have pain during pregnancy or the postnatal period and I can truly empathise with what they are going through. I help them manage their pain and find ways of moving comfortably.  I have just started working in a personal training studio in Perth and I love seeing people achieve goals that they never believed were possible – whether it is just moving without pain or running a marathon.

I can’t say that I am never going to experience pain again. I probably will, because I am alive! But I no longer live in fear everyday, and I now feel that I have the tools to manage the pain if it does return.

 

Do you love to run and also love your pelvic floor?

Today I had a great chat with Julie Wiebe, a Physical Therapist from Los Angeles who combines the two worlds of sports and women’s health physical therapy. I really wanted to pick Julie’s brain about exercise and the pelvic floor, as she loves working with athletes and has a passion for getting women back to doing all the things that love doing, despite having a history of incontinence or prolapse.

Let’s talk about sex…

Susan Clinton answers the common questions that people have regarding sex during pregnancy and after the birth.

Wrist and Hand Conditions in the Pregnant/Postnatal Population

Are you pregnant and suffering pain or pins and needles in the hand? Are you a new mum suffering from wrist and thumb pain? Check out this info

Workout with your pram or buggy

Got an unsettled baby? Trying to fit in an exercise program while at the park with your baby?
Here is a little work out you can do at home or outside, whilst rocking your baby in his/her pram.

When can I start running after having a baby?

Ooohhh….the million dollar question. As a physiotherapist working with the postnatal population, I get asked this a lot. My answer is always…it depends.
Gosh, that is a bit vague isn’t? Let’s discuss some of the variables that we need to consider.

Pregnancy Stretches – Get your spine moving!

Many women complain of back aches and stiffness during pregnancy and the postnatal period, and find that even a very brief session of stretching is extremely beneficial. I have created a little video just for you – you can do it at home every day if you like.

The CrossFit Controversy – do you pee when you work out?

You might have been shocked when you watched that video – I know I was!

I first saw this video one week ago, in a room full of physiotherapists who specialise in treating women with incontinence. A loud *gasp* went through the room, followed by much headshaking in disbelief.