Amanda Fisher Coaching

I help women get crazy strong - physically AND mentally - through strength training, sustainable eating habits, and a heathy mindset.

Category: Training (page 1 of 69)

Postpartum: My Experience With A Pelvic Floor Physical Therapist

Last week, I made a case for getting your postpartum body to a women’s health physical therapist.  

This week, I’m doubling down on that same subject to tell you about my own personal experience working with a women’s health PT.

While I was researching a good one in my area, I learned pretty quickly that these professionals aren’t just laying around for a quick visit.  They are pretty specialized, for a variety of reasons, and when you try to get into visit them, they seem to be generally booked out fairly far (considering they are pretty specialized, this makes sense).  So I booked my first appointment with my PT when I was two weeks postpartum, and had it set for when I was almost five weeks postpartum.  I visited the Institute for Athletic Medicine.

To be completely transparent, I knew I needed to make this appointment based on all the new writings and research in strength and conditioning world.  I knew I wanted to get back into strength training COMPLETELY ready to begin training smartly and progressing smartly.  I knew, after last time when I didn’t really know better, that I needed to take this seriously.

And to be completely honest, I booked my visit with the attitude that I was doing my due diligence in my postpartum health, but that I was only going to have to “clock it in” because I was probably one of those women who didn’t have any issues.

Did you know that women’s health PT’s want to know EVERYTHING about your core and pelvic floor health?  How many times a day do you go #1 and #2, can you hold it, for how long, do you ever leak, does it ever hurt, do you have back pain, how were your babies born, how many babies, how long were labors, any assistance during birth, EVERYTHING.

Upon talking about all these things with my PT, we began biofeedback testing.  Which basically means, I got undressed from the waist down, and got hooked up to little electrode thingies on my butt, on my thigh, and on my hip, and then she began coaching me on contracting my pelvic floor.  Then my core.  Then my core AND pelvic floor.  And we found out pretty quickly that my pelvic floor was hypertonic.  Meaning, it was ALWAYS working – contracted – and trying to do the job my transverse abdominis wasn’t.  A strong muscle is one that can contract AND relax.  My pelvic floor could not relax….thus, it was very weak.  Apparently this is very common, and especially common in those who lift.  Who knew?  Ha!

So, my first appointment was basically getting me to recognize coordinating JUST my pelvic floor and JUST my core, and then the two together via seeing a computer screen and the use of biofeedback to show me when I was contracting, relaxing, and the like.  And, my PT sent me home with some exercises to do daily to work on this.  We found that I could get my best contraction and coordination in a seated position versus a side lying position.  My PT also coached me on the importance of posture – sitting up straight, stacking ribs over hips, etc – in all of my daily life to support healthy core and pelvic floor function.  Feeding and nursing positions with baby especially, since that’s where a bulk of my time was spent.  She also gave me a hefty reminder to sit the hell down a TON during the day, because my pelvic floor needed rest and recovery, and getting up and doing a lot just made it work all that much harder.  She also recommended a follow up visit in two weeks to assess strength and coordination.

It was quite the coincidence that a few days after my first visit, I was at home, and began thinking I had symptoms of prolapse.  I felt weird.  I felt like I had something possibly lower than it should be.  I could feel something lower than it should be.  Cue all the freaking out on the planet.  I’m going to spare you about two weeks of drama until I saw my PT again, but the Cliff’s Notes are that I sat my ass off, I saw my midwife for my final PP check, and I also sought out an OB to double check, and to establish care since my care with the birth center was complete.  I also had emotional meltdown after emotional meltdown.  I knew that a prolapse would change a lot of things for me, strength training wise and work wise, and to be honest, it sorta felt like I was majorly getting betrayed by my body.  After visiting the OB, I had a sort of sigh of relief.  She was pretty confident after an exam that I didn’t have a prolapse of uterus or bladder, but since I had some symptoms (like I couldn’t go #1 all the way gone), that it could possibly be very mild prolapse, OR it could be par for the course of being only six weeks PP and still nursing, with very loose joints and connective tissue.  She advised continuing on with PT, and checking back in sooner (versus a year later for an annual visit) if I felt like things were getting worse instead of better.  I was happy to have this feedback, but to be honest, I trusted the expertise of my PT over the OB.  Not because the OB doesn’t know anything.  The OB knows women’s health, and specializes in the overall health of me and my female anatomy.  However, she doesn’t have the expertise of how specific muscles and systems work, and how those muscles and systems need to be treated, how they need to function, and how they respond to force during daily activities (I’m not saying any of this “right” but I hope you get my gist).  Her job ISN’T to know those things, and so the help of someone who’s job it IS (the PT) is vital.

Upon visiting my PT for my third visit, she agreed with the OB.  Not a prolapse, but potentially a very mild one IF symptoms continued.  She also very optimistic that with additional exercises, we could take care of any issues. That visit was internal.  She checked the strength of my pelvic floor muscles, and rated them at a 2 out of 5 for strength.  We also checked coordination of them – could I contract them and not my TA, could I contract my TA and not my PF, and could I contract both together.  I was definitely getting way better at this.  Because I had good coordination, and because I was actually doing my exercises, she said I could begin strength training smartly, and without any additional load (aside from floor presses) than my bodyweight.  You KNOW I was jacked up to begin this!  I think that was somewhere around 7-8 weeks PP.  She also explained that while I thought I was feeling symptoms of prolapse, that it was likely my pelvic floor was just on overdrive, and that I needed to be diligent about relaxing it as much as I could.  I did that in various ways – laying on my back with my legs supported on a couch above me, and letting my legs have zero tension, doing some child’s pose stuff and breathing drills, and some other things I’m forgetting at this point.

Over the course of 14 weeks, I had five PT visits.  Each one, I could tell I was getting stronger and stronger.  I was also learning that those weird prolapse symptom feelings had way more to do with having an overactive PF, PLUS they were really present when I was overtired, and when my hormones were changing.  For instance, I work really long days on Mondays and Wednesdays, and could pretty much bank on prolapse symptoms those days, and then most of the rest of the week was fine.  And also, I quit nursing at 12 weeks, and not long after that I could tell that my body was trying to generate some sort of cycle, and that made me feel off again.  I guess this is all normal stuff with tiredness, stress, hormonal changes, and a host of other things.  I’ve also been very diligent about introducing “new” exercises into my strength training to test for a few times to see if any of THOSE generate weirdness.  So, basically, I’m just really freaking aware all the time about this stuff.

My last visit with the PT was learning how to make intense exercises – think jumping, running, and those type things….pelvic floor friendly.  How to add a PF contraction and when.  How to incorporate breathing.  My PT also said since I had good awareness and good PF and core coordination, that I was safe to begin pushing the envelope a bit and testing myself.  On a full bladder, try jumping.  Stand in weird positions and side lunges and try doing my contractions, etc.  It’s super interesting stuff.

I’m about four months PP at this point, and can tell you that each week is getting better and better.  My coordination is good with my core and PF.  My PF is beginning to do it’s job without me having to mentally think through it during every exercise, every sneeze, every lifting of the infant seat, etc.  I also still have those weird tired days sometimes where I can feel that it’s exhausted.  I’ve been working out with lighter weights for two weeks, and this week have begun increasing the load so long as that each exercise, each rep, feels good, feels coordinated with core and floor, and as long as I can pass the 3 P’s (no pain, pee, or pressure).

All in all, I would categorize working with a women’s health PT as self-care.  I had a reason to work with one for five visits.  I think every woman should visit at least once to get an assessment.  I wasn’t referred by an OB or midwife, so this was self-refer classification.  I think people should know the ins and outs of that too, financially.  Each visit was approximately $200-225, and everything except $32 each visit was covered by our insurance.  I know everyone and everyone’s insurance was different, but that’s the kind of info I wanted to know before visiting and couldn’t really find so I had no clue what to expect.  Here’s how I’m doing the math on this one – if I DID NOT go this route, I would likely be having the bladder/sling surgery (that has a 70% fail rate and/or has to be re-done every 10 years) down the road.  At who knows what cost, but also losing my ability to work for a minimum of six weeks in my profession.  So for roughly $150 out of pocket, I’m very confident in the workings of my body and managing this stuff on my own, and know what to do next if something pops up, and will likely avoid any type of surgery.  $150 feels like pocket change considering all that.

I also feel pretty strongly that even if prolapse is a diagnosis for someone, this can very much help the severity of it, or help things almost completely.  And if prolapse isn’t, but incontinence or other things are issues, this is what should be the first step – not “just accepting it as normal” or waiting until you are done having kids to have the surgery, or considering surgery as the only cure.

This is NOT a sexy topic, but it’s a necessary one.  Running a gym, I see about 60 faces a week.  During my post natal fitness certification, I learned that 50% of women deal with this stuff.  You know what?  That’s 30 of my weekly faces, and I’m one of them.  So….it’s pretty damn common, and there is a HUGELY helpful resource available that really isn’t talked about.

So I’m talking about it.  If you have questions, I’m an open book on this one…..I pretty passionate about it at this point.  So, feel free to PM me on Facebook for questions, or just to get pointed in the right direction of a PT, and I’ll do what I can to help you out!

Reshape Your Workouts: Why You Should Choose Purpose Over Beast Mode

You guys.  Last week we talked about reshaping your workout routine and dropping our Cardio Queen status a few workouts each week.  Did you catch it?  If not, feel free to read it here.  Cliff’s Notes on that post is that doing ONLY cardio won’t get you the body you want.  But, being smart, and dropping a few cardio days for some strength training days WILL.

Here’s the thing though.  For some reason with fitness….doesn’t matter if it’s cardio or lifting or WHATEVER, we can convince ourselves that every day MUST be a hard day.  A “leave everything in a pile of sweat on the floor” type of feeling.  Or, as I like to refer to it…..Beast Mode.  It’s also easy to get fitness A.D.D. and try to Beast Mode at too many fitness things at once.  

And here’s the truth.  Beast Mode DOES have a place sometimes.  That’s the keyword….sometimes.  There are certainly days when we are feeling friggin’ amazing, and it’s a good day to test the limits.  And there are also certain times in your year where you just wanna go with the flow for a month or two and do random workouts and fun shit and not focus on something specific because life.

But, EVERY WORKOUT is not a Beast Mode day.  There is no way to improve when Beast Mode is every day.  Your body gets fried, your muscles don’t recover, your nervous system becomes a wreck, and to be honest….you are injuries (yes plural) waiting to happen.  And it’s also a good way to NOT get better.  And every day, if you want to improve your strength game, is also not a “just wing it” sort of day either.

So, I have a little way to secretly still date Beast Mode sometimes, BUT still stay healthy and injury free and still improving (and liking!) your workouts.  

Become BFF’s with being PURPOSEFUL about your workouts.  

Most of us never stop and think about the purpose behind our workouts.  That’s actually really pretty normal.  We are all just trying to get more fit, right?  And maybe we see a cool workout or move on YouTube that looks amazing, and we try to copy it, whether or not it’s a good thing for us to be doing.  I know I used to never consider WHY I did WHAT.  Then I started learning, and eventually became an RKC and personal trainer and learned that holy buckets, WHY we do what we do in the gym is really freaking important, lol.

When I started paying attention and learning how to program my workouts intelligently, I got better at the skills I was working on.  A LOT better.  I started learning that I can’t just throw a bunch of stuff into a workout and call it good if my purpose was really to get better at whatever my focus was at the time. 

Here are a few examples:

  • After Emma was born, I struggled for a good year with my workouts and getting them in consistently.  I also struggled with wanting to just beast on the days I DID actually work out, and that wasn’t a very healthy approach to a postpartum body….my body needed a tuning up of strength and awareness BEFORE beasting.  And so, my purpose wasn’t necessarily getting more awesome at a few skills, my goal was to get more consistent with my fitness again.  This was easy to plan and program, as I was just focusing on general fitness.  Strength training three times a week, with plenty of walking on off days.  My strength workouts were the basic movement patterns, mostly kettlebells, dumbbells, and bodyweight as tools, and mostly just a good honest mix of hinges, lunging, squatting, pushing, and pulling three days each week.  I began nailing consistency because I took away the need to beast.  I also got stronger overall…..which was perfect because………
  • I began training for the RKC with a body that was READY for more.  The RKC is demanding, and tests six kettlebell skills for THREE DAYS STRAIGHT.  I was lucky to have a kettlebell coach to help me prepare.  For the RKC, I trained those six skills five days a week, rotating between medium intensity days, hard days (eff that snatch test practice), and swing volume days (OMG). I trained HARD with purpose for about five months before hitting the RKC.  My training program was basically three strength days (with waving the volume of lifts each week), plus a weekly snatch test, and a weekly complex day, where I basically cussed for 25 minutes straight with heavy double kettlebells in the darkness of early January mornings.  I was in the right frame of mind for that training, I had a deadline, and my purpose was be awesome and freaking pass.  
  • After the RKC, I was done mentally with JUST kettlebells for a bit.  I completely switched my approach, and found a powerlifting coach.  For three months, my purpose was get better at the big three of powerlifting – bench, squat, deadlift.  I LOVED this change after the RKC.  I was mentally ready to do something different, and because of the base of amazing strength and conditioning I had built up from RKC prep, not to mention alllllll the movement patterns I had worked to perfect, my body was like EFFFFFF YASSSSS, let’s go heavy.  

Here’s the point of all these words I’m rambling through.  

I had a purpose with each fitness “thing” I wanted to do.  While I was training for the RKC, I wasn’t ALSO trying to train for a 5K.  My body would have rebelled, and that would have been too much, and a road to injury. My PURPOSE was the RKC.

While I was focused on powerlifting, I wasn’t doing an RKC snatch test once a week.  I was using kettlebell lifts as assistance work, but NOT training to train kettlebell skills PLUS my powerlifting program.  Again, would have been too much.  My PURPOSE was getting better at powerlifting.

Another example – my best fitness friend Jen and I have a coaching group going on right now called Jacked Runner.  Our Jacked Runner crew has the PURPOSE of becoming stronger runners, and so yes, they still lift, BUT how their program is put together is different from just straight strength training to allow them to prioritize their running while still staying strong.  

Here’s why I’m telling you this.  Because it’s easy to want to get better at alllll the things and do alllll the cool things that we see on the Crossfit Games, on Youtube, on social media.  And they are all cool, and that’s awesome.  BUT, if you want to get better at something, you can’t always do that PLUS 10 other fitness things.  Your workouts program needs to all flow together to make you BETTER, more PURPOSEFUL, at the few things you want to improve at.  If you are going hard in the gym 4-5x per week and still trying to sprint on your off days, we need to take a look at your true purpose, and cut the meaningless stuff while focusing on getting you better at what you want.  You know?

And I want to tie this all back together with Beast Mode.  You CAN Beast Mode some days here and there when you’ve been purposeful with your training.  Because your body has built this amazing base of skills, and strength, and you’ve worked on those skills over and over and over and your body is WIRED to do them well, and probably in your sleep.  So when it’s that unicorn day in the gym, and things are feeling easy, your body is READY to push the limits that day to maybe set a new PR.  Your body is NOT ready to Beast Mode when you’ve haphazardly thrown together your workouts for a year, and now you want to do a Crossfit workout that combines working up to a max effort push press, a rope climb, 75 deadlifts, and 200 box jumps.  That’s an injury waiting to happen on an untrained body with no solid base of preparation in sight.

So, what’s your purpose?  General fitness improvement?  Powerlifting?  A faster 10K time?  A figure competition?  Twelve weeks of focused fat loss?  Rehabbing a postpartum body and working at safely re-entering the weight room?  Choose ONE thing and focus on it for a while.

We need to identify the purpose and not just throw fitness shiz at the wall and hope it sticks and we magically pull a 300 pound deadlift off the ground.  

A coach can help you here, BIG TIME.  Because coaches have a way of taking out the BS, finding your weaknesses that, if trained properly, will help you get better at what you want to get better at.  We can also help you be purposeful with what your overall training picture looks like.  Finding a good coach sounds scary, and really it’s not.  It’s a really smart way to help you lock down your purpose and plan to get from Point A to Point B with a smart and realistic plan.

Think about what you want to get better at…..your PURPOSE.

Plan 2-3 months of training surrounding just that.

Execute and enjoy the journey.

Get better, take some notes, keep record of what you learned so you know what to do next.

That’s the secret recipe.  

What things are YOU working on in your training?  What’s your purpose?  Let’s chat about it on my Facebook page!

Reshape Your Workouts: Ditch Constant Cardio For The Weight Room

You guys.  Would you call yourself a Cardio Queen?  Like, cardio all day everyday, gotta get it in?

I used to be that girl.  I drove to the gym to walk and/or run on the dreadmill.  Or furiously spin on the elliptical.  For a good hour or so, or a certain number of calories burned.  And then, that was it.  That was my workout program.  I was furiously working up a sweat and burning calories, but outside the gym, to be honest, I wasn’t seeing much change on my physical appearance.  Maybe a slight decrease in weight, but nothing really that I could *see* in the mirror, and that slight decrease on the scale didn’t really seem worth the effort I was putting forth in the gym.

I felt intimidated as shit to try visiting the “other side” of the gym….where all the weights were housed.  Did I dare leave my comfort zone of the treadmill and elliptical?

I did eventually dare :).  And I’m so freaking happy I did.  I found a love affair in the weight room (obviously, lol, or I wouldn’t be here writing a blog alllll about strength training), but I also found a few things I wasn’t expecting.  And I think you might want to know about my findings in case you are stuck in Cardio Queen status like I was.

  • I found out that allllll the cardio I was doing was just kinda making me hungrier.  I was burning calories (probably like 400-700 per session based on the day) BUT that activity was making me HUNGRY over time, and I was just eating those calories back, which derp….makes sense, because my weight didn’t change much.  Spinning my wheels, so to speak.
  • I was NOT looking any different in the mirror, in fact, I think I was looking FLABBIER.  Welp, upon learning more about exercise, nutrition, and how each plays their role in body and hormone regulation, I learned that I was just constantly elevating cortisol ALL THE TIME.  Elevated cortisol isn’t bad BUT constantly elevated cortisol is sorta like a fat loss blocker.  I was basically stopping my body from the ability to burn fat.
  • I was burning calories to burn calories.  The work I was doing in the gym stopped after I left the gym.

And so, here’s what happened when I traded in 2-3 cardio sessions each week for strength training……

  • My appetite began to level out.  Look, I’m a hungry person naturally, but I noticed that I wasn’t having the SWINGS of hunger like I used to.  Part of this was because I was able to see that food wasn’t an enemy, and that by lifting I NEEDED to eat healthy sized meals to actually get the job done in the weight room.
  • My appearance DID absolutely change.  I began to see muscles.  I dropped a size or two without much of a scale change.  I would say I’m a more compact version of myself.  Not soft.  Definition in my muscles for sure.  And….when I walk past a mirror now, I flex.  A TON.
  • My body began working for me OUTSIDE the gym.  After strength training session, my body was in repair and recovery mode, meaning….I was burning additional calories 24 hours AFTER I was done in the gym.

Now, don’t get me wrong.  Cardio is important, and I’m not hating on it.  I’m really just hating on the idea that JUST cardio is the way to go.  We DO need cardio, we just need it strategically, NOT all day EVERY day.  You know?

So, the way I see it, if you are a Cardio Queen like I was, you have two options right now:

  1. Keep doing what you are doing.  If you like it, keep going!  If you feel like you are spinning your wheels, it might be time to get off this ride.
  2. Trade 2-3 cardio days for strength training days.  Get to the OTHER side of the gym and do some work!  If you aren’t sure how to slay the strength training beast, and you need a wing(wo)man, let me know, and I’ll get you squared away on a strength training program that works FOR YOU and YOUR GOALS.

And can I just say this…. strength training was THE THING that helped me realize that I am a friggin’ capable individual, and made me confident in the fact that I can do the hard stuff in life – move the furniture, carry the kids, get alllll 80 grocery bags in the house in one stinkin’ trip, and feel (at 34 years old)  stronger and more agile than I did as a 17-year-old punk athlete.

I want that capable and strong feeling for YOU!

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