Prenatal PT Appointment: shifting from strengthening the pelvic floor to relaxing it

Proactive Pelvic floor health and preparing for childbirth.

A few weeks ago made a prenatal appointment with my women’s health physical therapist. I first met with Cristin Zames, PT DPT, owner of Oceanside Physical Therapy after the delivery of my son Jack in 2012. I had returned to running three weeks postpartum, but was experiencing a “falling out” sensation and was leaking during every run. I was worried I had developed a some sort of uterine prolapse. Thankfully that was not the case, and thanks to a regular routine of strengthening exercises I was back to running and no leaking a few months later.

For the last two years, pelvic floor, hip and glute strengthening exercises have been central to my cross training regime. I knew going into this (my third) pregnancy that, although I was much stronger than I was during previous pregnancies, I wanted to run conservatively and probably not as late into my pregnancy as I had with Jack.

So at 35 weeks (four weeks ago) I paid a proactive visit to Cristin to check-in and see what her thoughts were about where I was at in terms of pelvic floor, hip and glute strength. I was also looking for her opinion on whether or not it was prudent to keep running or if I should stop altogether for the remaining weeks of pregnancy.

I’m so glad I met with her because up until 35 weeks I had been incorporating the pelvic floor strengthening exercises of the Hab-It DVD into my weekly cross training regimen. The exercises on this DVD are focused on tightening the pelvic floor through various abdominal, back, glute, adductor and yes, kegel exercises.

What Cristin informed me of was that in the remaining weeks of pregnancy I should be more focused on learning to “relax” the pelvic floor and should  back off or put the strengthening exercises on hold until after labor and delivery.

She gave me several simple seated exercises that mostly involved deep breathing and focused relaxation of the pelvic floor, exercises similar to the ones I recall from my hypnobirthing classes we took years ago prior to the birth of our daughter (who is now five). The shift from strengthening to relaxing seems a natural progression to prepare for childbirth, but it’s one I hadn’t thought of. I was so focused on the postpartum return and being more prepared than I have been in the past that I’d forgotten that learning to relax the pelvic floor is just as important.

As for her opinion on continuing to run: if it feels fine there’s no problem. But if it’s uncomfortable, don’t push it. At 35 weeks running had become increasingly uncomfortable so I decided to call it quits after a beautiful (and not too uncomfortable) run along the beach at 35 weeks. I also drew the conclusion on my own that if I’m starting to focus on relaxing the pelvic floor (in preparation for labor and delivery…the baby has to come out somehow…better if there’s less resistance) I probably don’t want to be pounding the pavement just for the sake of a short run.

My focus as of late has been on preparing for childbirth mentally and physically. I’m glad that I made a proactive appointment with my physical therapist and I’ll be seeing her again postpartum before I return to any running.

Have you ever had an appointment with a PT who specializes in women’s health? If you’ve experienced leakage during running, I’d highly recommend you see someone. Physical therapy can make a big difference.

–Sarah

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RUN’STOCK 24: New England’s Newest Relay

If you’ve ever run a relay then you know the fun that can be had when you bring a bunch of running friends (or running strangers) together. And if you’ve never run a relay then it needs to go on your bucket list. The camaraderie and fun you’ll experience will have you looking up the next possible relay moments after your team crosses the finish line.

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If you’re looking for a relay to run this summer, there’s a new kid on the block: RUN’STOCK 24, a 24 hour relay held at the Gunstock Ski Area in Gilford, NH this June 20th and 21st.

The concept is simple: gather your friends (or a few stranger who will soon become friends) and see how many five-mile loops your team can run in a 24 hour period. No need for rental vans or gas money or driving through the night or getting lost, since you’ll be going in and out of the same transition area with every loop. And the race starts at noon on Saturday, so no pre-dawn drive to the start line! Just set up camp, run and have fun!

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View from atop Gunstock Mountain.

View from atop Gunstock Mountain.

RUN’STOCK 24  is put on by Big Lake Events, the same event company that puts on my favorite half marathon: the Big Lake Half Marathon. Always well organized, well staffed, runner and family friendly, their races are a must-run. And I’m sure RUN’STOCK 24 will be no exception. I’ve teamed up with them to offer you an exclusive registration discount. So if you’re thinking about it be sure to pull your team together and register by May 10th to take advantage of the discount!

Sound like fun? Here are the details:

Location: Gunstock Mountain Resort Gilford, New Hampshire

Date and Time: Start on Saturday 6/20 at 12pm and finish on Sunday 6/21 at 12pm–then join in fun at the after party!

Cost: An eight person team is $920 and a four person team is $500

Register by 5/10/15 using code: RUN FAR 5 [please include the spaces] and receive 5% off your registration fee!

To register click HERE.

Not only is RUN’STOCK 24 a fun event, but they are also helping Wounded Wear a charity whose mission is to help wounded soldiers by providing free clothing and modifications.

Be sure to head on over to Big Lake Event’s Facebook page for up to date race information and other great events!

Have you ever done a relay?

–Sarah

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How to Pace your next Marathon or Half Marathon: 5 foolproof tips

The ability to properly pace a marathon or half marathon can sometimes feel elusive. We all know that the smart thing to do is start slower and finish faster, but actually executing that plan is a totally different thing.

How to Pace your next Marathon or Half Marathon

Runner’s World broke down Desiree Linden‘s pacing from the Boston Marathon and she pretty much paced herself perfectly. Her last 5K split was only two seconds slower than her first 5K split. She ran even mile splits on a tough course in less-than-ideal conditions. The way in which she controlled her pacing is really impressive, a skill that takes a lot of mental and physical training.

Even if you’re not running 5:30 min/miles you can still execute good pacing, here are some tips for pacing your next marathon or half marathon:

Incorporate Race Pace Runs into your Training: Running at your goal race pace, the pace at which you need to run to reach your goal, is important to learning proper pacing. If you’re looking to run a 1:45 half marathon then your “goal race pace” would be 8:00 min/mile. You can incorporate race pace miles into your weekly long runs. For example if you training plan calls for a 10 mile run. Warm up with three miles at your easy run pace, then run four miles at goal race pace and finish off your run with three more easy miles. You can also “tune up” on race week with a 5K at race pace four to five days before your race.

Start Slow: Unless you have done extensive training at your goal race pace, then you really need to start conservatively in the first few miles. It can be hard to start slow, especially when you’re coming off your taper and have all the adrenaline and excitement of race day tempting you to let your legs go. But going a little slower at the start can make a huge difference with how you feel in the final miles of your race.

Half Marathon: Run the first two to three miles 10-20 seconds slower than your goal race pace.

Marathon: Run the first three miles 30-60 seconds slower than your goal race pace.

Break it Down: With long distance races like the marathon and half marathon it’s best to break down the race into manageable chunks. Often you can do this by studying the race course. The terrain can often dictate how you run the race. Here are few suggestions as to how to break down your next marathon or half marathon, however you should really consider the course.

Half Marathon: Miles 1-3 go easy; Miles 3-7 focus on steady effort; Miles 8&9 check in and gauge whether or not you’ll be able to pick up the pace for the last three miles; Miles 10-13.1 pick up the pace and finish strong.

Marathon: Miles 1-3 start easy; Miles 3-16 break these down by the course terrain: if it’s flat focus on steady pace. If it’s rolling hills focus on consistent effort on the up hill and recovering on the downhills; Mile 16 with ten miles to go this is the point at which you want to start breaking down the race into even smaller 2-3 miles chunks. Mile 20-23 often the toughest miles mentally you have run 20 miles but still have a 10K to run, this is where visualization prior to race day can really help. Miles 23-26.2 focus on a strong finish and pick up the pace or hold it stead if you can.

Don’t be a Slave to Your Watch: Sometimes when you’re shooting for a PR you have a specific pace in mind and your eyes are glued to your watch trying to stick to that pace. Most courses feature varied terrain, you’ll run up some hills and you’ll run down some hills. When faced with varied terrain it’s best to go by percieved effort for your middle miles. Yes, you want stay close to your goal pace, but if you’re struggling to keep that pace up a hill you’ll be hurting in the end. Your middle miles should be as consistent as possible, but guided by perceived effort.

Finishing Strong: The ultimately goal is to feel strong as you approach the finish, instead of slowing down. If you’ve started slow, paced evenly thorugh the middle of the race then you should still have something left to give in the final miles of your race. I’m not saying those final miles will be easy, you’ll probably have to fight and dig deep. But smart pacing for the first part of the race should allow you give more at the finish.

Half Marathon: Mile 10-13.1 try to pick up the pace with each mile. Choose a runner ahead of you and “real them in” one step at a time. Choosing small landmarks along the way can also help you to push for a short time.

Marathon: Mile 23-26.2 with three miles to go in the marathon, your legs can often feel dead. Focusing on an a steady effort or choosing small landmarks to push to can be helpful.

It’s important to remember that even the best pacing strategy cannot make up for a lack of training. If you’re shooting for a specific goal it’s critical that your training adequately prepare you, otherwise you’ll end up disappointed race after race. Your training should include the weekly mileage and pace-specific workouts to support your goal. And “training” doesn’t just mean running, it also includes the mental preparation required to perform on race day. Mental training can include visualization and mental rehearsal of how you want to run on race day. And that’s not just picturing yourself crossing the finish line triumphant, it’s picturing yourself dragging at mile 23 of the marathon and despite feeling tired, digging down deep and finding a way to run faster on tired legs. These mental pictures are the ones you can call on when the going gets tough on race day.

 

Have your run a marathon or half marathon recently? How was your pacing? What factors do you think influenced your pace?

Have more questions about training and pacing? I’m a certified running coach through the RRCA and USATF, I’d be happy to coach you toward your next goal!

–Sarah

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Mark you Calendar: National Stroller Running Day May 31st

Some of my best miles have been logged behind my single and double BOB Gear Stroller. Running with my kids in the stroller, though they might not be the fastest miles, are always the most fun. They are usually filled with countless questions and little discoveries.

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Katie McFarland, of Mom’s Little Running Buddy, decided last year that stroller running needed to be celebrated and so she created National Stroller Running Day a day dedicated to stroller runners and their commitment to living a healthy lifestyle with their families in tow.

This year National Stroller Running Day falls on May 31st, just over a month away. And Katie has assembled a team of industry leaders to sponsor some amazing giveaways, including the manufacturer of the my favorite running stroller, BOB Gear.

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There are some great ways to get involved, including the “Stroll N’ Run 5K” sponsored by BOB Gear in LA, California. If you live in the area, here are the details:

Event: Club MomMe “Stroll n Run 5K Family Event” presented by BOBDate: Sunday, May 31, 2015

Time: 9:00 AM to 12:30 PM (PDT)

Location: South Coast Botanic Garden (26300 Crenshaw Boulevard, Palos Verdes Peninsula, CA 90274)

For more information visit the 5K website HERE.

In addition to running with your stroller on the May 31st, you’ll also have a chance to participate in a twitter chat and other contests to win great prizes from BOB Gear. Join the twitter chat on 5/26 and use the hashtag #StrollerRun15.

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Be sure to check out the National Stroller Running website for complete details on contests HERE. And follow all their social media channels as well for more ways to participate and win!

National Stroller Running Day Twitter

National Stroller Running Day Instagram

BOB Gear/Britax

 

Did you participate in National Stroller Running Day last year? Do you run with a stroller? What are some of your favorite memories of running with your kids?

–Sarah

I love connecting with readers! You can find me here:

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Walk it Out: 37 Weeks Pregnancy Update

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Walk it out. Now that I’m full term it’s time to walk this baby out. I had my last run along the beach two weeks ago and it was a gloriously good run in equally glorious weather and I had no reason to follow that up with a potentially crappy and uncomfortable run. So I’ve been walking and it’s been good.

I’ve had some good solo walks and some walks pushing the kids in the double stroller and a handful of treadmill walks while the kids let out the crazy in the basement. I’ve toyed with the idea of taking along music or a podcast for my solo walks, but I just like the solitude and thinking time.

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Exploring WWII bunkers at a local state park.

Exploring WWII bunkers at a local state park.

My focus lately has been less about maintaining fitness and more on preparing mentally and physically for labor and delivery. Which means a lot of meditation and visualization. Prior to Sophia’s birth, my husband and I took a hypnobirthing class and while actual hypnosis has nothing to do with the method, the techniques I learned have stuck with me and I have returned to the relaxation exercises for each birth. I know I’ll tap into them again for this birth and now is the time to really start preparing.

I’ve also been checking things of my spring cleaning/nesting to-do list like a crazy person. All the cleaning, organizing and getting ready has been a workout in itself.

We took a little bit of a break this weekend to go to the Great Wolfe Lodge as a family. It was a blast and as relaxing as you’d expect a vacation at an indoor water park with a five and 2.5 year old to be. I was exhausted, but we all took a two hour nap each afternoon, so that helped balance out the craziness. The only bummer: me. I really couldn’t do much: no slides or hot tub. We will have to go back when I’m not pregnant and can partake in all the fun stuff instead of just wading ankle deep into the kiddie pool with my hands clutching my contracting belly.

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When the photo booth costs 15 Paws you take a family selfie instead.

When the photo booth costs “15 Paws” you take a family selfie instead.

Running: None! Walking.

Cross Training: Mostly cleaning, organizing, hefting 2.5 year olds around. A few pull ups, push ups and squats here and there. Have stopped the Hab-It DVD (more on that later and my pretnatal visit to the Women’s Health Physical Therapist).

Energy: Low. I’ve been spending a lot of it on organizing and cleaning. After an exhausting weekend I had a surprising burst of energy yesterday…maybe it was watching the Boston Marathon.

Emotions: Much more even keeled. I feel ready and relaxed. Not quite as anxious as before. I know I’ll figure it out one day, one moment at a time and help will be there when I need it. I have a few anxieties about the birth: what if something goes wrong? what if he has a birth defect like Jack? etc. But I don’t think they are anything beyond what I’ve normally felt prior to each labor and delivery.

Cravings: None really. The cravings have kind of ceased.

Baby: Head down, but still all up in my ribs and kicking away. There have been some pretty strong warm-up contractions and on a few occasions they have been regular, but they seem to fade once I go to bed. I feel like my body is entering “get ready to have a baby” mode.

If you listen to podcasts, what would you recommend?

–Sarah

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