Highlight: Postpartum Power: Sarah Duvall on Climbing, Core Strength, and Recovery After Pregnancy

In today's Lattice Podcast, host Maddy Cope sits down with Sarah Duvall to explore the critical need for improved postpartum care, protocols, support, and education for women. Together, they uncover the significant gaps in research and recovery protocols for postpartum women compared to other injuries.

Key Topics Include:

• Sarah’s Climbing Comeback: Sarah shares her personal journey of returning to climbing after pregnancy, highlighting the challenges she faced and valuable lessons learned.
• Core & Pelvic Floor Strength: Why prioritising core and pelvic floor strength is essential for postpartum recovery.
• Addressing Pubic Symphysis Pain: A discussion on common issues like pubic symphysis pain and the importance of addressing muscle imbalances before and during pregnancy.

The Lattice jingle is brought to you by Devin Dabney, music producer of the outdoor industry who also hosts the American Climbing Project.

Transcript

sarah (00:00)
And I know in our society, we do not want to call pregnancy an injury because it is a natural process. But from my perspective, I feel like if we had better care, better postpartum protocol,

better support, more education. I mean, do you know how many research studies are done on ACL repairs? And how fast we can get athletes back? Like if you tear your ACL, you're like, ah, well, that's protocol, it's fine, everything's good. But if something goes wrong during that postpartum period, maybe you're experiencing pelvic floor issues or dialysis recti, or just simply your body doesn't feel connected, there, the protocols are lacking and that was one reason why I...

really jumped into this is because there was no research for women and there was no research for getting back there. So we moved from my husband's work to the New England area, to Massachusetts when I was eight months pregnant. Well, then we moved to Virginia. But essentially before that I was in ocean sports, so I kite boarded a lot, surfed and wake boarded. And so I truly got back into climbing after climbing in college after having my first.

was the getting back into climbing. So it was all this fun, you know, that really fun progression of, okay, I did a 5.8, okay, I did a 5.9, oh, the next time I come, I did a 5.10. And then, so you get this lovely, and I think embracing that postpartum period for the lovely, like, oh, every week, you're going to probably feel a little bit stronger. And how many times do you get that gift?

you know, of being able to feel that. Because normally we're like inking out this tiny little bit of improvement that we see over a six week training program and it can be so frustrating. So I think just kind of sitting back and enjoying that coming back process and just know it's a process, know you're going to get back, I think can be really lovely. And then for my second, I climbed all the way through my pregnancy until I was 37 weeks pregnant.

And then I started getting a little bit too much pubic symphysis pain with big adductor moves. You know, you put your foot way out for a hold and then you pull yourself into it. I just had too much ligament laxity at that point to be able to safely climb well.

And so I stopped climbing around 37 weeks because of that ligament laxity, but then I had him at 39 weeks. So I really only took two weeks off of climbing. And then I went back to climbing around four weeks, climbing very gentle, very easy. So you don't have to take off that much time from climbing. And then I will say the second time coming back was definitely a lot different because my arms were strong and my legs were strong, but my core and pelvic floor needed time.

And so from that perspective, so the first time I didn't have all of that coming into it.

But the second time I needed to exercise a lot more self-control. And I think that is the part of the takeaway that you need to take a step back and ask yourself, okay, what is the lowest or weakest part of my body ready for? Not where is my finger strength or where is my arm strength? But where is my core strength? Where is my pelvic floor strength? What does that recovery look like? And you need to meet yourself where that last, I'm going to say last person, but last body part is.

sure you're keeping everything up and bringing it along. Because I think that's where we get into trouble. So we do a little too much too soon for that weakest link.

And so getting in for a good assessment. There's a lot of personal trainers now that are specializing in postpartum recovery. And I think they are well equipped to help with assessing these kind of weak links. And I think a physio or an occupational therapist or somebody who specializes in it, great. Get an appointment, go in to see somebody, talk to them about what you're feeling, let them do an assessment on you, let them give you some exercises because...

if you can get the right protocols in place for your body specifically, because everyone is very different, which is part of the hard part of this, and genetics plays a big role there too as well. But I think if you can get that right path, then you can come back a lot quicker than you think you can.

Maddy (04:10)
Yeah, there was lots of really interesting points in there. I think firstly reiterating that, I guess beginner's mindset really, that you had after your first pregnancy because you were actually sort of getting back into it, but maybe that is something we can nurture in ourselves, even if we are not a beginner. And that's probably a really nice takeaway for dealing with the kind of mindset part of it. But I guess the other tricky side

sarah (04:22)
Hehehe

Maddy (04:39)
to there.

is kind of having an awareness of what is okay and what's not. And actually, I thought it was interesting when you talked about stopping at 37 weeks, saying that you sort of had a bit too much pubic synthesis pain, which I don't know whether it's easy to describe this, but for someone listening, if they were climbing during pregnancy and they were starting to have some of that pain, is there a guide for how much is too much?

or at what point actually that is pulling back because just the way you phrased it as too much, I mean, I guess it said to me a bit like, oh, maybe a little bit is okay.

sarah (05:12)
Absolutely.

Ha ha

So yeah, so as a physical therapist, I think it's important for us to realize that pain is not always our enemy, but pain can give us a story. It can tell us what's going on. So I think pain is always something to pay attention to, but it's not always, pain doesn't always equate to, oh, I'm doing major damage. You could have a small amount of pain and be doing major damage, or you could have.

loads of pain and be doing no damage. So the body is really interesting when it comes to pain and trying to understand pain. So some people will have pubic symphysis pain because of, and that's pain like in the front of your pubic bone, so the front of your pelvis, kind of where your legs meet in the middle. So if like, if you take your, run your fingers down your lower belly, that when you hit that bone right there, that is a point that needs to spread to deliver the baby.

And so it is perfectly natural to have ligament laxity, especially late in pregnancy. And because of the nature of climbing, because we're pulling with one leg, to make moves, we end up stressing one side of the pelvis more than the other. So if you were doing a double leg squat, you would be putting significantly less stress on that pubic symphysis area than say a climbing move. So I keep working out all the way through delivery, I just stopped climbing. And so there's a difference.

Maddy (06:40)
more symmetrical way of working out.

sarah (06:42)
Yes, more symmetrical way because my body said you have too much ligament laxity right now. I have a family history of ligament laxity as well. And so my body said you have too much ligament laxity to safely do this and feel good after and not have it be something that progressively gets a little bit worse. And you only have a few more weeks. So I mean, you know, in your lifespan of climbing, like, come on, it's perfectly fine to do squats and breathing drills

So I think that there are, if you're having pubic symphysis and SI joint pain early on.

I would definitely say get somebody to look at you. You might have one hamstring that's stronger than the other. You might have one hip flexor that's stronger than the other. You may have one adductor that is full on checked out and one adductor that's strong and that's creating this opposite pulling at your pelvis and because of the introduction of new hormones causing ligament laxity that pulling is what's going to be causing pain and it's the uneven pulling that can cause the most pain. So if you can get somebody to get their hands on you to be like oh this left hamstring

week. We just need to strengthen the side and all of a sudden you start pulling more evenly and your pelvis will feel a lot better. So in a lot of ways in early pregnancy underlying issues start to show themselves.

And what I find when I talk to people is they're like, oh, I have some SI joint pain right around my period, or when I ovulate, or after a long car trip, but then it comes with a vengeance during pregnancy. So it was something that they occasionally had, maybe after a long hiking day, or something like that, but then it really flared its head up during pregnancy. So I would encourage people, if you're having some pelvis pain type things, to get in to see somebody

muscle imbalances so that you can kind of help suss that out before pregnancy can be really helpful.

Maddy (08:39)
Yeah, and actually that's really interesting. I sort of saved this for a bit of a closing note, but maybe we can tackle this question now and then get onto the breathing and sort of exercise and recovery postpartum. I guess the question I was gonna put to you is, if a climber was planning to be pregnant soon or to try, because this is often something that people know that they're going to want to do, then...

sarah (08:48)
Thanks for watching!

Maddy (09:06)
is there a set of exercises that you think could really benefit them going into it? And it sounds like potentially one thing could be doing, I guess, this more sort of unilateral work, things that kind of maybe are stressing the pelvis in an uneven way, but I'll let you sort of tackle that question, it just sounded like that could be something from what you just said.

sarah (09:32)
Well, I mean, honestly, I think that men should be doing this. I think people of any potential birthing situation, I think everybody should be working more planes of motion. I mean, I see so much pain just from people not moving their bodies in more ways. So thinking about...

fully moving your hip into all the way inside, all the way outside. I mean, it's so hard right now because I wanna use anatomy terms, but I know three fourths of the people listening will be like, what the heck does that mean? So I think that it can be challenging to describe these things.