From Babies and Barbells: Emma’s Postpartum CrossFit Story

Leading up to her pregnancy, Emma enjoyed training Crossfit 4 x week as well as trail running on the weekends.
Emma’s twin girls are now 2 years old, she is back in the gym 3 times a week and training for a half marathon

 

We spoke to Emma about her Exercise and activity before and during pregnancy and how she approached her postpartum rehab after giving birth.

What were your activity levels in the lead up to pregnancy and what was your activity like during?

 

I’ve always been very active, I did gymnastics when I was younger and have trained in the gym for the last 15 years. In the lead up to pregnancy I’d been doing Crossfit for about 4 years. I trained 3-4 times a week in the gym and would run trails or with a run club 1-2 times a week. I also saw a PT every few weeks for technique advice and strength with some lifting. 

When I found out I was pregnant I was already rehabbing a hip injury and needing to heavily modify crossfit workouts. I decided for this reason to stop crossfit and focus on my PT program in the gym. I know plenty of people who have done crossfit throughout their pregnancies, and there’s no contraindications of doing so while you’re pregnant, but I made the decision to stop so that I could focus on quality movement and training based on how my body felt.

It turns out that I was so sick during my first trimester that I didn’t train much at all anyway. I managed to get out to walk my dog around the block once a day and that was it.

During my second trimester I was able to get to the gym about twice a week. My PT had written me a pregnancy program to follow and I did what I was comfortable with, and what I felt like doing on the day. My training goals during this time were to move my body, so I didn’t place any great pressure on myself to train hard or get my programs done.

During my third trimester my training slowed down again. Carrying twins was taking its toll, and I needed to rest a lot during the day. Walking was causing pelvic pain, I tried some pregnancy yoga classes online but these did not feel comfortable though my pelvis or ribs and I was needing to modify so much in the gym that I felt it was no longer worth the energy of going. I felt during this time that swimming was the only type of exercise I could manage, and I really enjoyed this. I could get my heart rate up without fatiguing myself too much or causing pain, and I felt like the buoyancy of the water taking pressure off my joints felt really good. So I swam about once a week towards the end of my pregnancy.

For someone who is used to training high intensities most days of the week, this period of reduced activity was initially very challenging mentally. But over time I got good at listening to my body and it felt good being able to let go of the pressure I put on myself to train everyday, and to train intuitively based on how I felt. 

How long after birth did you start exercising?

The girls were born via planned cesarean, so I took my postpartum recovery very slowly.
I did nothing for the first 4 weeks except think about feeding and looking after the girls.
My mum was in the house to do all the washing and cleaning and she would push the pram for me when we went out for walks – which consisted of walking 15 minutes to get coffee then walking back.


After 4 weeks I started to feel more mobile and the pain from the surgery had reduced, so at this stage I started to work on my pelvic floor activation lying on my back. This is all I did for 4 weeks – practising pelvic floor activation, endurance and relaxation. I slowly began to add some leg movements in, and as I got more mobile I started to add in some gentle thoracic stretches. 

From about 8 weeks on I had a small home routine that I would try to complete 3-4 times a week while the girls napped. As anyone with babies knows this (mostly) didn’t go to plan, but I did what I could, when I could, and relied on the consistency of doing at lease one thing everyday to help with progress.

The program involved some body weight squats, low level core exercises and some banded rowing for my upper body. I started to add lunges in, slowly increased my walks and started to add in some small hills.

 I didn’t put pressure on myself at this stage, I moved because it felt good to have some control back of my body. I was also starting to notice aches in my lower back from feeding, holding and rocking the babies, so I wanted to prioritise strength to avoid an injury or further pain.

At about 4 months postpartum I was starting to feel like I had a bit more freedom and energy to leave the house, and I felt I’d built enough basic strength to start some exercises in the gym.
At this stage I wrote myself a postpartum gym program involving some basic machine exercises and light compound movements such as squats and deadlifts, bench presses and rowing, and completed this in the gym 2 times a week. I had great support from my sister who would train with me on those two days, and a lovely, supportive environment to train in (Anytime Caringbah).

I planned the next 6 months of training out in 8 weeks blocks, with the goal of returning to crossfit 1 year after giving birth. I completed this program consistently 2-3 times a week.

Running wasn’t a priority for me but when I reached 1 year postpartum I felt like getting outdoors and going for a run once a week balanced my training out. I started with 1 min intervals and built over 3 months until I could run 30 minutes without discomfort or issues.

My twins are 2 years old now, and I am back doing crossfit 2-3 times a week and running once a week on the weekends. 

What were some struggles you found when returning to exercise?

Because I planned my training well and took my time returning to exercise, I found that my physical capacity wasn’t an issue. I was able to return comfortably without injury or issues.
The challenge was more about finding the time during the week to train. Juggling babies with work schedules, either finding gyms with creches or training very early or very late in the day, and the lack of sleep affecting training quality and recovery was the biggest challenge. 

I again had to let go of pressures I put on myself to get to the gym and had to accept that some sessions may not go to plan, if they happen at all!
I was still able to progress and reach my goals, I had to learn patience and trusting the process.

Would you do anything differently?

I was quite proud of how I managed my rehab, I felt like I was equally able to enjoy newborn life and watching my girls grow while simultaneously taking time to look after myself and build my body back again. 

I had stages where I worried if my body would ever be able to do the things it used to do again, but knowing now that for the most part it will and that it just takes time, maybe next time I’d take even longer to get back.

It’s amazing how capable the body is of adapting to change, I have a new appreciation for it and these days enjoy training to nurture it rather than smash it.
I hope to pass on these healthy exercise and activity habits to my girls and hope to be active myself throughout their lifetime.

If you’re looking to get back to activity after childbirth, or interested in a postpartum gym or running program, our Physios specialise in women’s health conditions, pre and postpartum rehab and strength and conditioning programs.
Get in contact with the clinic today to make an appointment.

4 Strategies for Managing Frozen Shoulder

Frozen shoulder, also known as adhesive capsulitis, is a condition that affects the connective tissues around the shoulder joint causing it to become stiff and painful.

This condition is more common in women, it is more prevalent in individuals with type 2 diabetes, and some medications can also increase the risk. Most cases of frozen shoulder resolve on their own over time. Some people may continue to have mild symptoms even after the condition has run its course, but these are usually less severe.

What often surprises people is just how long frozen shoulder can persist – lasting anywhere from 2 to 3 years, with some cases lasting up to 5 years. The condition progresses through three distinct stages: first, a phase of pain and increasing stiffness; then, a stage where stiffness remains but pain lessens; and finally, a ‘thawing’ phase where range of motion gradually improves.

There’s no one treatment that fixes it quickly, over time the condition improves on its own. However a combination of interventions can help improve shoulder function as the condition progresses and outcomes as it resolves.

We’ve put together 4 techniques to help manage frozen shoulder and reduce the impact it has on your daily life.

 

1. Exercise


Although the long term benefits of exercise in the management of frozen shoulder is unclear, the short term benefits of exercise include a reduction in pain, increases in range of motion, strengthening of the rotator cuff and reduction in the stiffness associated with avoidance of using the shoulder.

Exercising with frozen shoulder can include gentle stretching, active assisted movements and strengthening the rotator cuff within the range of motion that is available. 

Exercise also provides the individual with a level of control and ownership of their injury which can reduce depression and anxiety scores, helping to manage pain. 

 2. Manual Therapy

Manual therapy can include massage, joint mobilisations and dry needling. Although manual therapy is unlikely to change the range of motion of the shoulder joint and frozen shoulder itself, it can have an impact on the joints and muscles around the shoulder.
Due to a decrease in range, compensatory patterns of movement are usually developed in order to move around pain and stiffness. This can create further issues in areas such as the neck, thoracic spine or elbow and wrist.
Treatment here can help improve the quality of movement at these joints, and reduce pain and injury.

3. Education

Understanding frozen shoulder as a condition can help manage the extent at which the condition affects the individual’s mental health and therefore their pain and disability.

It can assist with setting realistic expectations, which boosts motivation and improves mood. This, in turn, supports adherence to a management plan and exercise, while also helping the individual feel more in control of both the condition and their body.
All of these will help with the management of pain and reduce disability associated with frozen shoulder.

4. Injections

Cortisone and/or saline and anaesthetic injections can be administered into the joint to help reduce the pain associated with frozen shoulder. However these have been shown to have short term effects (about 3 months) and don’t appear to affect long term recovery. These could be an option for short term management of pain, along with exercise and education as a holistic approach to management.

Although frozen shoulder is unfortunately a limiting and painful condition, there are still plenty of management options that can significantly reduce the pain and functional limitations associated with the condition. Not one intervention alone can significantly affect the progression of the condition, however it is clear that a holistic approach to managing frozen shoulder can help to decrease the pain and disability associated with the condition. 

 

If you suspect you may be developing frozen shoulder, or know someone who may be experiencing it, please be encouraged to come and see us to create a plan for management.

Getting back to running after a baby

After having a baby, many mums are keen to get their fitness back—running is often a big goal. But, pregnancy and childbirth can take a serious toll on your body, so getting back to running takes time, patience, and a bit of preparation. While there’s plenty of advice and return-to-run programs available, how ready you are to run will depend on your individual recovery and meeting a few key milestones.

How Pregnancy and Birth Affect Your Body

Pregnancy puts a lot of pressure on your body. Your abdominal muscles stretch and separate, your pelvic floor gets stretched, and your joints become looser. As exercise intensity usually decreases during pregnancy, you may lose some strength and fitness, too.

After birth, estrogen levels drop, especially if you’re breastfeeding, which can weaken the pelvic floor further. This makes it harder for your pelvic floor to support organs like your bladder and uterus. Joint laxity can also stick around, making your hips, knees, and pelvis more vulnerable to strain or injury. That’s why it’s so important to focus on rebuilding strength and control in your muscles and joints before considering higher-impact activities like running.

Abdominal separation (where the muscles in your belly stretch apart) happens to all mums who carry to full term, and while it’s necessary for baby’s growth, it means less support in your abdominal wall after birth. Without this support, running or any impact activity can place extra stress on your pelvic floor and spine.

On top of all this, the general decrease in fitness during pregnancy and the demands of caring for a newborn (hello, sleep deprivation!) can make it even harder to get back on track.

What You Need to Consider Before Running Again

 

1. Rest and Recovery

Your body needs time to recover before jumping back into exercise. Pregnancy and childbirth cause a lot of changes, and it takes time for things to settle. For vaginal births, about a third of first-time mums experience perineal tearing, and there’s a risk of pelvic organ prolapse (when your pelvic organs drop down), especially if labour was long or complicated. While prolapse is common, most cases aren’t serious and often improve within a few months. That’s why it’s generally recommended to wait at least three months before returning to high-impact activities like running.

For C-sections, it’s important to remember that it’s major abdominal surgery. Recovery typically takes 6-8 weeks, during which time your body is healing. No lifting or strenuous activity during that time—wait until you’ve had enough healing before thinking about strength exercises or impact activities.

2. Abdominal Strength and Healing

The first few months postpartum are crucial for your abdominal recovery. Wearing compression garments can help your abdominal muscles heal by supporting them and reducing unnecessary pressure. Strengthening deep core muscles, like the transverse abdominis and pelvic floor, is key to rebuilding your abdominal wall. This will help prevent unnecessary strain during impact activities like running.

If you notice your belly “doming” (bulging in the middle) or experience bladder leakage during activities, it’s a sign your core isn’t ready for high-impact exercises yet. Focus on deep core strengthening before progressing to more intense exercises.

 

3. Pelvic Floor Strength

Your pelvic floor plays a huge role in supporting your bladder, bowel, uterus, and helps manage abdominal pressure during activities like running, jumping, or even coughing and sneezing. If your pelvic floor isn’t strong enough, you might experience incontinence, pelvic pain, or feelings of heaviness down below.

Before returning to running, your pelvic floor needs to be strong enough to cope with the impact. This means being able to perform pelvic floor contractions quickly and hold them for a reasonable amount of time. If you’re experiencing any pelvic floor symptoms, such as leaking, pain, or heaviness, it’s important to address those before considering running.

4. Lower Limb Strength and Control

To run without injury, your legs and joints need a baseline level of strength and control. There are a few basic tests to check if you’re ready for running, such as:

  • Walking for 30 minutes
  • Balancing on one leg for 10 seconds
  • 10 single-leg squats
  • Jogging on the spot for 1 minute
  • 10 forward bounds or 
  • 10 single-leg hops
  • 10 Running mans

If you’re able to do these without issues, you’re on the right track. But don’t rush it—gradually build up strength and control before adding the impact of running.

 

5. Gradual Build-Up and Structured Program

When you’re ready to start running again, it’s important to ease into it with a structured program. Start with short, easy runs and gradually increase the distance and intensity. This helps your body adjust to the demands of running without risking injury. Patience is key here—don’t rush the process.

 

6. Supportive Gear

Wearing supportive underwear and a good sports bra can help protect your pelvic floor while you run. Research shows these can reduce strain on the pelvic floor and lower the risk of dysfunction. There are also compression garments designed specifically for postpartum recovery that can provide extra support, especially for the pelvic region.

The Risks of Rushing Back into Running

It’s important to follow a proper return-to-run program to avoid long-term issues like pelvic organ prolapse, incontinence, or musculoskeletal injuries (such as tendinitis or stress fractures). Working with a physio can help ensure your return to running is safe and effective, based on your individual recovery and fitness level.

The key is to take your time, rebuild strength and control, and only progress to running when your body is truly ready. You’ve got this—just make sure to listen to your body and move at your own pace!

How to ‘heel’ your plantar fasciitis

What is plantar fasciitis?

The plantar fascia is the connective tissue that runs along the bottom of the foot from the heel to the toe bones. This makes up the arch of your foot. Plantar fasciitis is the overload of this tissue, and causes pain primarily at the base of your heel, however can occasionally be felt along the line of the plantar fascia.The plantar fascia is an extension of the fascia that connects your calf muscle to your foot. So often an overload or tightness in your calves will contribute to plantar fasciitis.

Common signs and symptoms

Pain in the plantar fascia is typically felt underneath the heel, especially during activities that put stress on the calves, such as walking or running. The discomfort often worsens after periods of rest, feeling more intense in the morning but improving with movement. In some cases, there may be tenderness when touching the base of the heel, and while the pain can vary from day to day, it usually diminishes as you move and the muscles warm up.

How does it happen?

Overload of the plantar fascia can occur in a number of ways, but when daily loads exceed the capacity of the plantar fascia, it will respond in pain.
Overload can occur suddenly, for example a person may jump off a step and feel immediate pain at the base of the heel. Or it can happen gradually over time, such as increasing running kilometers to prepare for a marathon. The accumulative load of progressively running longer distances can eventually exceed the foot’s ability to cope, leading to pain.

Overload can also occur indirectly. For example, if you’re limping because of an injury, you may put extra strain on your uninjured leg. This increased reliance can lead to overuse and ultimately result in pain in the plantar fascia.

Switching footwear can lead to increased strain on the calves, which may, in turn, overload the heel. This is often seen with high heels, where the foot is positioned in plantar flexion, causing the calves to work harder and putting extra stress on the fascia. Additionally, changing to sneakers that promote a more forefoot-striking pattern can also raise the load on both the calves and the plantar fascia.

Hormonal fluctuations can weaken tendons and raise their risk of overuse injuries. For instance, a decrease in estrogen around menopause leads to tendon stiffness, reducing their flexibility and making them more susceptible to injury. As a result, there is an increase in tendinopathies, including plantar fasciitis, among women aged 40 to 60 during the perimenopausal phase. 

Additionally, some medications can have a similar effect on tendons, causing degeneration over time without inflammation. This includes statins, which are often prescribed for cholesterol management, and long-term use of steroids to treat inflammation.

How to fix it


1. Pain management

Our initial goal in treating plantar fasciitis is to reduce the pain. There are a number of strategies Physio’s use to aid in pain management.
Firstly we recommend modifying the activities that cause pain. These will often be weight bearing activities such as walking or running, and although it may not be realistic or helpful to completely eliminate these activities from someone’s day, it may be as simple as opting for a lift to work instead of walking to and from the station, or reducing daily walks by half and taking a break from running temporarily.
Plantar fasciitis is typically worse after periods or rest and particularly with your feet resting in a plantar flexed (pointed) position. So a footrest at your desk chair, little exercises to perform at your desk or regularly getting up to move may help in controlling pain.

There are certain taping strategies we can use to better support the plantar fascia which may reduce loading and help with pain. The same goes for arch support in your shoes, or opting for more supportive shoes during the day.

Occasionally other interventions are used to more aggressively manage pain. These can include corticosteriod injections which allow a period of reduced pain, and when used in conjunction with activity modification, strength and mobility, can be a helpful contribution to the overall rehab journey.

2. Mobility

Mobility is an important factor in controlling plantar fasciitis, especially calf mobility. Massage, foam rolling and stretching are all strategies employed to help maintain calf length which can reduce pain, manage the injury and prevent its recurrence in the future.

3. Strength.

At the end of the day, the stronger your calves and feet are, and therefore your tendons and plantar fascia are, the more load they can tolerate and the less chance of them being overloaded. Strength is key in treating plantar fascia, however loading needs to be appropriate for the individual. Strengthening exercises shouldn’t cause pain, or overload the plantar fascia more than it already is. They should replicate and prepare the feet and calves for the type of activity the individual needs to get back to, and be maintained at a certain level to prevent overload occuring again in the future.

How to avoid it

Injuries like this can be challenging to avoid, especially if the triggering factor is something out of your control such as hormones fluctuations, rapid gain in weight similar to what happens in pregnancy, or an unaccounted increase in daily loads. But recognising the warning signs and addressing them immediately, sets you up better for a successful recovery.

Headaches – Can Physiotherapy Help?

Headaches can be challenging to manage due to their various causes and the different ways they manifest in individuals. Triggers can be physical such as an irritated joint or a tight muscle, psychological such as stress or anxiety, or related to lifestyle factors like dehydration, food intolerances, or lack of sleep. This variety is what often complicates effective management.

 

Identifying common factors associated with headaches can help you recognise their specific causes, allowing for more targeted management strategies.

Understanding the sources of headaches

Musculoskeletal headaches

Headaches can originate from musculoskeletal structures, such as joints or nerves in the spine. The upper three cervical joints (C1-3) refer to the head, so irritation at these levels can lead to headaches, nausea, or dizziness. 

Muscle tension is another common trigger for headaches. Certain muscles in the neck, jaw, and shoulders connect to the base of the skull, and if these muscles become tense or overactive, they can produce pain that manifests as a headache. 

Additionally, poor posture or physical overexertion can lead to muscle tension, contributing to this type of headache.

 

Preventing Tension-Related Headaches

Preventing these types of headaches often involves improving posture, especially in work-related settings where many people spend most of their day. An ergonomic assessment of your workplace can help identify poor habits that may be contributing to muscle tension and fatigue.

New mothers often experience neck and head pain from hours spent nursing or rocking their babies in awkward, repetitive positions. Various nursing pillows and chairs can provide support, along with changing feeding positions, incorporating muscle stretches and releases, and engaging in strength exercises to help manage discomfort.

For those who are active, reviewing your exercise routine may reveal movement patterns that place extra strain on the muscles at the base of your head. A physiotherapist can assist in identifying these issues and targeting specific muscles and movements to reduce the load on your head.

Migraines

Migraines are primarily a genetic neurological condition that can cause moderate to severe pain, often accompanied by nausea and sensitivity to light and sound. Typically, an aura precedes a migraine, which may result in visual disturbances like spots or stars, ringing in the ears, or escalating head pain. While migraines are usually one-sided, they can affect both sides of the head.

Because migraines stem from changes in blood flow and nerve sensitivity within the central nervous system, medication is often necessary for management. Keeping a headache diary can also help identify potential migraine triggers, such as hormonal fluctuations, specific foods, or exposure to light and sound.

Physiotherapy can assist in managing the musculoskeletal tension and pain associated with migraines, complimenting medication as part of treatment.

Lifestyle-related headaches

Dehydration can influence blood pressure, leading to headaches that are typically experienced as a diffuse pain across the whole head. To differentiate a blood pressure-related headache, it’s important to assess factors such as fluid intake, alcohol and caffeine consumption, medications, and exercise habits.

Mental health significantly contributes to the incidence of headaches. Increased cortisol levels during stressful periods can trigger headaches, while stress can also reduce pain tolerance and lead to muscle tension that radiates to the head. Similarly, lack of sleep decreases pain tolerance, often resulting in more intense headaches. Quality sleep is essential for the brain to rest and function properly; disruptions can lead to mood and hormonal imbalances that contribute to headaches.

In addition to stress management techniques, physiotherapy can help relieve tension in the neck and jaw, which may reduce the severity of stress-related headaches.

Certain medications and food intolerances can lead to headaches as a side effect. Your doctor may evaluate your medications to help manage these side effects, while a dietitian might suggest keeping a food and headache diary to pinpoint potential triggers. This approach can help you find suitable alternatives while still meeting your nutrition needs.

 

The most effective management of headaches involves a multidisciplinary team of healthcare professionals. Doctors play a crucial role in referring patients for scans, specialists, and prescribing medications to alleviate headache symptoms. Physiotherapists can address muscle tension related to headaches, assess posture and movement, and provide corrective exercises to reduce recurrence. Psychologists contribute by offering stress management strategies, which can help mitigate headache triggers. Meanwhile, dietitians can identify food-related triggers and recommend suitable alternatives to improve overall well-being.



All professionals involved have the expertise to identify headache triggers, manage symptoms within their area of expertise, and refer you to the appropriate healthcare provider for issues they cannot address. If you are experiencing recurrent headaches, please don’t hesitate to seek help.