Hi from back in Hong Kong!
After a quick, not at all environmentally friendly, weekend trip in Vancouver I landed back in Hong Kong on Tuesday afternoon. Luckily the trip was short enough that I didn't have time to adjust to time difference so there was no jetlag. I made the most of a toddler-less flight by starting a book on the way over, finishing it on the way back, and doing the same with a binge-worthy Netflix show.
This week marked the first sibling interaction, Noah accidentally barrelled into the side of my stomach and approximately 2.4 seconds later I felt a little kick in the same spot Noah hit me/him. So it begins...at least the little one is standing up for himself!
The week ended with an event I haven't been to in 4 years (thanks COVID), the Valley RFC Black Tie Ball! That's right, the bump got all dressed up, heels and all and lasted right through until 11:30pm.
The second half of the week wasn't super eventful but I did finally have a physio session with the incredible Jenny Fielding of Joint Dynamics. Back in 2020 I did a 30/32 week women's health physio check up so I could get a sense of pre-birth pelvic floor strength and therefore had something to compare my postnatal pelvic floor strength to. My physio at the time and I used this comparison to gauge and appropriate return to sport/run protocol. This time around I've decided to do a halfway (ish) check up as my pelvic floor has taken quite a hit from being sick, coughing lots, being quite run down, and still having to carry a toddler around. It wasn't so much that I felt heaviness or like something was wrong, more that I was anticipating that something was going to happen so wanted to do a status check. Turns out I made a good call, my entire pelvic floor was not contracting perfectly, certain sections were doing more of the work while others decided to be lazy. Jenny helped me change how I cue my own pelvic floor engagements to make sure I fully engage appropriately and gave me a little program to do daily/especially before I lift.
I'll head back to see her around the 32 week mark to see how I'm getting on and then potentially again at 36 weeks to learn how to do a proper perineal massage (I made it up last time). On that note, this week I'd like to discuss how a women's health physio can help and why it's important to see one in a little more depth.
Women's Health Physio
I always recommend that clients see a women's health physio at least once during pregnancy and at least once postnatally. This is regardless as to whether or not you are seeking to return to a sport or not. If you are seeking to return to a sport or return to running then a few visits to a women's health physio is almost a non-negotiable in my books.
A women's health physio will provide a comprehensive assessment of your pelvic floor and deep core during pregnancy and post-birth. We all know the massive hit both areas take during pregnancy and it is of utmost importance that these muscle groups are trained properly during pregnancy and rehabbed appropriately postnatally, regardless as to whether your birth was vaginal or via c-section. A "normal" physio will not have the same understanding and assessment abilities to properly determine your pelvic floor and deep core contraction quality and strength.
At the bear minimum I highly advise you see a women's health physio at these points in your pre-natal and post-natal journey.
Prenatal week 20-30: To determine pre-birth pelvic floor contraction strength and assess your ability to "bear down". This pre-birth strength can be used to provide a sort of baseline for you to return to post-natally.
Postnatal week 6: To assess your post-birth deep core and pelvic floor state and provide an appropriate and specific rehab protocol. For athletes/people who want to return to running:
Postnatal month 3: To assess rehab status and develop appropriate return to impact (ie running, skipping, and jumping) protocol.
Very interestingly Jenny did say that research is increasingly pointing towards the fact that the status check at week 32 can actually help predict birth outcomes. This is based on how much your pelvic floor is able to expand when you bear down and where it expands the most. For example, if the anal section of your pelvic floor looks very tight at week 32 then perineal massages are almost essential and it may even be advised that you consider an episiotomy in order to avoid a tear towards your anus. It's remarkable that considering women have been birthing humans for millennia that science and knowledge like this is only just being uncovered. This is a whole other conversation that I won't get into here though...
Obviously depending on your status at various stages of your journey your physio may ask you to return to see them more frequently and at that point I highly advise you heed their advice.
Unfortunately there are not many good women's health physios in Hong Kong who stay up to date with current research and are fully invested in your pelvic floor health. If you'd like recommendations please feel free to reach out. I had a very bad experience with a "women's health physio" who I immediately knew did not know what she was talking about, I won't name names but I just want to say that unfortunately there are bad physios in Hong Kong.
Training
Short but sweet training week this week.
Monday and Tuesday were rest/travel days. Wednesday I opted for a seated upper body session ahead of the pelvic floor internal and external exam I had in the later morning.
Thursday was a long day of lots of walking, I don't even know what I was walking for but somehow did almost 20,000 steps. I did do my physio prehab work too.
Friday I did some prehab before a lower body lifting session.
Saturday was a day of life and work admin followed by my first black tie event since 2019!
Sunday saw the resurgence of family full body training day before family breakfast.
All in all a great week of lots of fun things. Excited to see what next week has in store!
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