CROSSFIT POST BABY CASE STUDY

“New mama, please help me carry 60Kg down the hallway. I’ve found out that you can manage it on your own… but I can’t!”

I recently assessed a woman whose second baby is 4.5 months old.

• Both births were vaginal
• The kids are 2 years apart
• 1^st birth: episiotomy
• 2^nd birth: small perineal tear – can’t recall whether 1^st or 2^nd degree
• Stage 2 prolapses of her anterior and posterior vaginal walls were diagnosed after her 1^st born when she went to investigate symptoms of heaviness. These are also sometimes called cystocele and rectocele.
• With rehab, she got back to full cross-fit and her symptoms all resolved

She returned to Alchemy in Motion after her 2^nd born for a post-partum physiotherapy check-up because she can sense that it feels different again: prolapse symptoms returned.

Symptoms weren’t severe, but very concerning to her because cross-fit is her passion. She didn’t want to make anything worse with the heavy lifting, high impact and abdominal exercises involved.

I assessed and measured the prolapses lying down and standing up. I checked pelvic floor function during coughs, various abdominal exercises, and bodyweight squats. She had fantastic pelvic floor function in every domain. The shape and dimensions of her pelvic floor also meant she has an extremely low risk profile for prolapse worsening.

I offered to do a vaginal examination during heavy lifting. She was comfortable with this and curious to find out if it seemed safe. I was thinking 20Kg… but she told me she had recently been lifting 55Kg at cross-fit, so we tested 60Kg with the squat rack. That is heavier than some of the physios I work with! This is what the weight looks like when I’m pretending to lift it in the gym:

I asked my colleague to help me carry it down the hall into the treatment room so we could assess the pelvic floor during the lift in privacy.

My patient proceeded to lift it 6 times in a row with ease whilst I felt how her prolapse/anatomy coped. Nothing was moving in a remotely concerning way. Even if she didn’t consciously recruit her pelvic floor, the slight movement wasn’t enough to worsen prolapse or cause her any incontinence.

Despite being a moderately fit physiotherapist, I couldn’t carry the weight she lifted back out to the gym. I had to ask her to help me!

Sometimes the versatility and strength of the female body astounds me. The variety from person to person is incredible. How can someone push out a 3.5Kg baby and lift 60Kg safely 4 months later!?!

Disclaimer: this is not common scenario, and most women shouldn’t do this… but some can.

I have assessed many postnatal women with no prolapse, who are at much higher risk of a more severe prolapse if they lifted 60Kg.

Prolapse is not a diagnosis that determines what you can/can’t/should/shouldn’t do – except that it’s ideal to have it assessed. Individual assessment hugely alters what I recommend to each mum. The mum’s individual circumstances and fitness goals also have a huge influence.

Confused by all the different suggestions online? Come to Alchemy in Motion and get some personalised advice from a pelvic floor physio. Maybe you should be holding back more or doing a lot more management to reach your fitness goals. Maybe you’re holding back unnecessarily, and you could be doing all the double unders and box jumps and heavy weights that you love.