Bounce Back Culture in Postpartum with Arielle Martone [Ep. 81]

This is the Eat Well, Think Well, Live Well podcast. I'm Lisa Salsbury, and this is episode 81 bounce back culture in postpartum with Arielle Martin. If you've had a baby, you've heard the term bounce back. How quickly you bounced back into your body or your life is often celebrated, but does this hinder our recovery? And more importantly for my clients. And for you listeners, are you still carrying some of those thoughts about trying to get your body back? Into your weight loss today. Listen as Dr. Ariel Martin and I discuss what true recovery looks like in postpartum and how we can avoid this talk of bouncing back and keep listening. Even if you are multiple years postpartum, like I am, it is never too late. Spoiler alert. We are going to talk about peeing with sneezing. Welcome to Eat Well, Think Well, Live Well; the podcast for women who want to lose weight, but are tired of counting and calculating all the food. I'm your host, Lisa Salsbury. I'm a certified health and weight loss coach and life coach, and most importantly a recovered chronic dieter. I'll teach you to figure out why you are eating when you aren't hungry, instead of worrying so much about what you are eating. Welcome back to the eat well, think well, live well podcast. I am excited to have Ariel Martone. She is a physical therapist and a postpartum wellness coach here on the podcast today. Welcome Ariel.

Hi, thank you.

So we are going to be talking all about her expertise in postpartum wellness. So I'm going to let her get started with introducing herself a little bit about what she does, and then we'll jump into our conversation.

Yes, sure. So thank you for having me, Lisa. I am a doctor of physical therapy, a yoga teacher, pre and postnatal coach. And I've shifted fully into postpartum wellness coaching. After having my two kids, I had to do IVF for both of them. And so it was a long process to get there. And through that process, and really through my own postpartum, phase and postpartum journey. I, you know, being a physical therapist and having some training in women's health and pelvic health prior to my own motherhood journey, and having, you know, strong interest there, I sort of knew what to expect, at least from, from the physical recovery aspect. I knew that one, I needed to physically recover, which I feel is something that It's not really well, well known after having a baby. We kind of just brush through it and gloss over it and we think that, Oh, it's just this natural process that happens. And so we just kind of go back to how we were. Without having to do anything, but you know, our body was adjusting and growing and shifting for the entire, you know, nine, closer to 10 months of carrying the baby, then the actual delivery process, however that occurs, and then afterwards, so it does need to heal, and then we do need to go through an active recovery to really kind of Thank you. really move forward with how our body is moving and functioning properly. So I had, you know, I had some background in that. I had some awareness, um, but I wasn't really prepared for kind of one, the difficulty of it and two. I was kind of expecting a little bit more guidance on it. You know, I was a physical therapist. I've been practicing for close to 15 years now. And I've worked in almost every setting. I've worked in a hospital and after any type of surgery, you are met with a physical therapist for pretty much any surgery. With my son, I had a C section. Major abdominal surgery, not a single therapist came into the room. Again, fortunately, because I knew how to move around after a surgery, I was able to, you know, get myself out of bed rolling to my side and all, and all of that. Um, but I was kind of surprised that there really was no guidance on What we should be doing. We were giving kind of a brief list of what not to do for that six week time frame and then Basically, you're like good to go

I feel like the only thing I was given is like, don't have sex for six weeks. That was like the only instruction. Like, take it easy. Don't have sex. Then you're good to go.

yeah with so with with my daughter because I was able to have the V back vaginal birth after That was basically the instruction no sex for six weeks and no exercising for six weeks but like But what does that even mean, Grace? We should have a little bit of guidance on that. Um, but after the C section, there was a little bit longer of a list. Basically, it was no, um, you know, not too much twisting and lifting. Nothing heavier than the baby, but the baby in the car seat carrier, pretty much, which is actually quite heavy.

Pretty heavy and awkward. Cause it's to the side. It's like a weird motion.

I know, and I practice, I know there's a way that you're supposed to carry it, where your arm is kind of straight, and it's, your hand is hooked on the side, I like, I've tried so many times, and I don't know if it's just my proportions, I'm a little shorter, I could not get it,

Yeah. I never could get that either.

it was always, awkward and heavy to carry, um, but those, those are basically, you know, the instructions that I was, I was given an abdominal binder, but how long should I be wearing it? How tight should I be wearing it? There really wasn't any education around that, or really like what to look for, for signs of infection with the incision or how to take care of the incision there's a lot of information that, that could be given and should be given out to mothers after a C section specifically, but really, you know, after a vaginal birth as well on like what to do, what to expect for, you know, going to the bathroom for the first few times and how to make that easier and, you know, just. just simple things that we really take for granted that when you come home with your baby, you're like, okay, and now what? And now what do I do?

Okay. So that is amazing. I think we all can tell stories about our postpartum and pretty much no one has a story of like, Oh yes. And they offer me physical therapy and it was so easy to recover. So nobody has that, but specifically, why are we talking about this today on my podcast being that Primarily I focus on weight loss and, and, you know, health and stuff. And one of the things Ariel and I wanted to discuss is the bounce back culture, the bounce back culture, which has a lot to do, not just with your physical shape and strength and those kinds of things, but also with your actual scale weight, a lot of my listeners know I have four kids. And so I basically was pregnant or nursing for like nine years. So. Of my 20s, like for most of my 20s. Right. And I had these like breaks in between. I'd have like a year in between. I'd have nine months in between. And my major thought was like, I've got to get my body back. Like, where did it go? Did I lose it? Like what? And I felt a lot of pressure. Uh, there was a lot of stories back then, specifically from my mother. Um, love her, never want to throw her under the bus. But, you know, oh, well, so and so, she wore her pre pregnancy jeans right out of the hospital. I, I know who she's talking about. She's told me this story a lot of times. And, you know, she mentioned how, how long it took her to get back into her jeans. All of those kinds of stories. And so it was a lot of pressure. And then with my last, and I knew she was going to be my last, my youngest, I got pregnant. And I was like, okay, This is the last time I can be fat. And this painful thought is etched in my brain. Even though I know pregnancy is not the same as being overweight, even though I know that what I should have done is really take care of my body. But what my brain said is this is the last time you have permission to eat all the cupcakes. And not worry that it's going to put on pounds. And so I had a lot of, you know, this was well before I found coaching well before I was, um, much healthier in my thoughts about my body and my weight and what I eat. And so not only was I. Overeating during pregnancy, because I thought I had the permission to, but I also thought I had the permission to not exercise and not do any kind of training to really prepare my body. And I know you are primarily in postpartum, but there's gotta be some, some issues there as well with like going into this, you know, major feet, physical feet, which is birth with. You know, zero, zero strength basically in my abdominal region. So aerial. sent me a message and was like, I think I'd be great on your podcast. And I'm like, yes, because we have all this like pent up stuff about this bounce back stuff. And all of these things that we did not get when we were pregnant and in that postpartum. So first of all, I just want to. Establish the baseline of is formal recovery needed in postpartum. Is it true that we're just like, Oh, it's natural. So everybody recovers normally there, you know, we don't really need anything formal. That's, that's what everybody believes, but what do you believe?

Right. No, I, I believe that everybody needs formal recovery, at least to some extent after having a baby. Um, yes, it is a natural process and there are natural changes that occur, but they do not always just bounce back together. Um, You know, we can look at a sprained ankle, you're running and you twist your ankle, sure that happens naturally as well, right? And there's a natural process with inflammation and all of that, that kind of helps to mend it a little bit. And you could, depending on the degree of the sprain and all that, you could potentially not do anything about it. I know a lot of people that don't do anything about it, right? They are told to just walk it off and they let it go, whatever. And. The ankle heals, but it doesn't heal the way that it did or the way that it was before, right? There, there's going to be limitations and restrictions in that foot and ankle if you don't rehab it properly afterwards. And it's the same with our pelvis and our body after childbirth. So do things go back together? Yes, not always. Sometimes the pelvis itself doesn't go back into that pre pregnancy positioning without assistance after having a baby, and it could be because of, you know, just the, um, you know, the ligament laxity and, the positioning that it needs to be in to hold the baby, and then as the baby is delivering, our pelvis kind of shifts again, and the, um, You know, the lower portion of the pelvis kind of wings outward to make room for the baby to pass through. Uh, that can sometimes Kind of get stuck there. Usually it goes back together, but it doesn't for everyone and the same with the sacrum the flat bone In the back of the pelvis like where your tailbone is Um that tends to kind of go into flexion So it tips forward so that that tailbone piece is kind of pointing out towards your backside Again to make room for the baby's head and body to go through and usually again It kind of goes back into place, but it doesn't always go back into place. And it can kind of get stuck in that forward position, which can lead to a lot of pain and discomfort when you're sitting. It can lead to issues with, um, bowel and bladder, um, whether it, you know, be a constipation because you're not able to kind of fully empty or, you know, allow your, your bowel movement to pass. so I, I would say that, yes, everybody needs some type of recovery. After having a baby, definitely if there was a cesarean, birth that had to occur because again, that is a major abdominal surgery that happens. So it absolutely needs to be recovered and, and be really treated and kind of honored as such. We kind of just brush it off as like, Oh, well, you know, we just, just had a baby. Uh, it's just another way of doing it. It's almost so routine now that it is, I mean, it is the most common, most common surgical procedure in our hospitals today. so it is very routine. but because of that, it doesn't really get the attention that it really deserves for the care afterwards.

On some of those things, I'm. Hearing some of myself in, in those issues you're describing and I'm 15 years postpartum almost 16, she's about to turn 16. My youngest is, is it ever too late?

no. So It's ideally, it's always better to happen sooner rather than later because the recovery process. will be quicker, the closer to the event. Um, but it's, it's, it is never too late. You can go back, especially if you're having any type of issues, which a lot of times women do, you know, it's so common to have urinary incontinence. If you're laughing or sneezing to just, pee a little bit. And again, it's one of those things that's, it's so common that it's normalized. And because it's normalized, people don't do anything about it. They just kind of laugh it off and be like, Oh, you know, mom life.

Well, we laugh it off with our legs crossed.

Exactly. but yeah, because it, it's, it's normalized and a lot of, you know, it is so common, I believe because we are neglecting that postpartum care that our bodies really deserve afterwards or to the point of bounce back culture. We're trying to. To get back or, you know, into either the activity that we were doing prior to that we really enjoyed for our own sanity or to get our body back, um, and rushing into exercises that we're not really prepared for, and that can cause issues, down the road, but no, it's, it's definitely not too late.

Yeah, I, I have a few spots in my body that I just know, like, and I'm like, well, that's from childbirth. Like I was doing these plate adduction things where basically, you know, you're bringing a plate in on the, the plates on the floor and you're pulling it in with your foot. And so it's an adduction movement. Every time I do that or any of those things, I feel it in the pubic symphysis, which is the, the little pad in the middle of the, well, you can explain it better, but it's in the front of the pelvis and it really gets soft. So that it spreads apart there. And I feel like somehow that piece never really healed, right. Because I can feel it in the, and it's like, I can't, I can't do a heavy enough weight to feel it in my adductors and my thighs because it kind of hurts that little spot. And then I have this other, like, I've been told it's called the round ligament and it, um, and it hurts every time I like do a certain cough movement or, you know, if I cough or, and I'm like. I, and I remember because it, I first noticed it after childbirth and I asked my doctor and they're like, Oh yeah, you know, that's from pregnancy. And I'm like, okay, but it's been 16 years.

Yeah. Yeah. Just like the, you just have to deal with it. Yes. But yeah. So with your pubic synthesis specifically, it could, it, you know, there's a chance that it is still wider, that it never like, closed up like it should, or if it shifted at all. So sometimes what happens is, you know, one half of the pelvis, depending on the positions that you gave birth, you can have one side of your pelvis kind of shift up higher than the other. So there might be some more separation that way too.

Yeah. So don't ignore this stuff. I know I've been talking a lot on the podcast about don't not ignoring our, um, perimenopause symptoms. And now I'm like back to childbirth. I'm all over the place, but I mean, as women, this is, this is how it is. There's, there's issues from childbirth and then you just really get right into your hormonal issues.

I was gonna say it's it's all related and if we're used to just kind of brushing those things under the rug and being like, Oh, well, you know, those first few weeks or, or months or a year or so after having a baby, my hormones are going to be all over the place. And we just kind of, we normalize that we normalize these like big mood swings, because we think that Again, that it's just normal and it's going to happen, uh, but it doesn't need to happen, you know, to the extent that we're, we're feeling it.

Yeah. So why do you think that new moms have this, like, feeling like they have to, like, they must get their bodies back postpartum? And is, is that an issue to be thinking that?

So I, I think it's kind of twofold. One, I think we have a lot of society pressure on us. Um, that's very, um, kind of over and covert at the same time. Like there's, there's certain messaging out there that is just. Very obvious, tons of marketing towards getting your body back after baby, lots of, you know, dieting to do even a lot of, you know, I see talk of healing your diastasis, um, the separation of your abdominal muscles and healing your pelvic floor after baby in relation to getting your body back.

Right. To the shape of your body, not to the health of your body, but like, get this back so that you can get back into your jeans or look

yeah. Get rid of your mom belly and yep. so there's, there's a lot of that that we're getting and there's also. You know, you get six weeks, and if you're lucky, you get maybe 12 weeks of time off, uh, and then you're expected to kind of just be back at work and, you know, just kind of bounce back into your, your roles. With your relationships change after having a baby, and there's really no time or space that we allow for that to kind of develop or for us to kind of look in, in words to it and kind of see and allow shifts to happen. But we're expected that, you know, our relationship with our partner is just Exactly like it was before, but now there's this baby in there. Or if you have multiple kids, you know, your relationships are constantly adjusting between, you know, you and, and all of your children making room for this new baby that's coming in. And we don't really allow for that. We don't talk about that. It's just kind of like, okay, you have this baby, you go home and everything is going to be great and wonderful and good luck. but I think, you know, there's also. I feel like because the transition into motherhood is such This big abrupt transition. you know, hormonally, our, our roles are changing as well, and, you know, physically we're having a lot of changes. Our brain changes, after having a baby, and it all happens like very quickly. and the, the hormone shifts are, you know, the greatest that we experience in the shortest amount of time. As women so, you know, puberty and menopause being the other really big shifts, but they're a little bit more. Yeah, they're more gradual as opposed to like you have the baby and it's this abrupt change, even you know pregnancy or hormones are shifting but again it's kind of gradually over that, you know, nine to 10 month period.

Mm hmm. That makes sense. I've never thought about that. Like that. Yeah. All of our other hormone changes really occur over time, but

Yes. So we're, we're like slowly adjusting to them. I mean, they can, they're, they're

it's still hard.

well. But yeah, so it's still hard. It's still impactful. You need to make adjustments and kind of change. but I feel like, you know, with motherhood, there's, you know, the physical and the hormonal changes, but then our role changes as well and how we're identifying ourself changes. And it's, it's a lot at once, and I feel like it's harder to kind of pinpoint your, your role change and your, how you're identifying yourself. And it's easier to kind of put all of that onto something physical that you can see, and it's kind of our body that takes the brunt of it. Like, I'm not feeling like myself. I'm feeling a little bit lost. I'm feeling disconnected. Like, oh, it's because my body. Is squishy now, you know, and I had the baby in there, but now it's all squishy And I just want it to be back to normal in quotes Because once that happens then i'm going to feel good once that happens then i'm going to feel confident You know once that happens then I can do xyz or my relationship with my partner is going to be great again And it's not really the case um, because there's a lot of kind of inner work and digging that we need to do to really Allow ourselves to develop into that role as mother as well as still seeing ourself as a whole person which is really important because we can kind of Narrow in on like now i'm a mom and that is that's like everything blinders on but we really have to account for, you know, for all of us, our, our whole being, um,

I can,

at, at that role adjusting.

I can see how to, like when you're describing that thinking how, you know, basically everything will be different when my body goes back to. Again, we're putting a lot of things in air quotes here, meaning normal, right? When my body goes back to how it was before or pre pregnancy. And I think this so easily just, trickles into five, 10 years down the road when you're feeling overweight and you're like. Everything will be solved if I could just get this weight off. And I would just, if I could just get this weight off, I'll love my body again. And it's just not how it works. I see it time and time again, that we think all of our problems are going to be solved. And I am just starting to wonder as you're talking, if This is where it starts for us with this whole, like need to get our bodies back postpartum. Yeah.

Yeah. I think, I think it's a big factor in it for sure.

Yeah. So how do you think bounce back culture hinders recovery,

So in, in so many ways, I think it, it doesn't allow for recovery to start with.

right? Because Bounce back. Isn't, healing. Bounce back is just go back to how you were as if nothing has happened. That's not recovery.

It's this big life altering, physically, emotionally, you know, role, structure change. We just kind of brush it under the rug, and, you know, it's something you wanted, so you're gonna be just thrilled with it, right? So just deal with it, and get back to everything you

You signed up for this.

exactly. Yes. but yeah, so it, it doesn't allow for recovery to happen. It doesn't allow for us to let our body kind of heal first and then rebuild. Um, it, we kind of go from that like six week mark where we're not supposed to do anything. And people tend to not do anything. And I mean, I've seen, I've seen it go both ways. I've seen it where people do absolutely nothing for those six weeks, which isn't really helpful either because we do need to be active to allow some recovery. We have to really balance that with, with rest. Like walking from day one is one of the best things you can do for yourself postpartum. Of course, you want to kind of gradually build up to what you're tolerating, um, but you don't want to be super sedentary, and you want to change positions often because that really helps with recovery as well, and helps from things like getting tight, especially in postpartum, where so much of those early days are really kind of in that rounded forward. Curled in position. You're curled in around your baby constantly with, you know, feeding, rocking them to sleep, you know, all of that. So you do want to allow for, you know, your chest area to stretch out a little bit, to bring some motion back to your pelvis. but with Bounce Back, so people are, you know, sedentary for those six weeks, or they're pushing and doing too much because they really feel that kind of anxiety. of not getting their body back. And so they try to start things too soon. without talking to their doctor about it, without really discussing it. but even if they're waiting until that six week mark, and then, you know, you're, you're given the green light, so you just jump into everything, you know, quite literally, your body is not prepared for that. You've done no, you know, no real healing, no recovery, no rebuilding. And so that really puts you at risk for some of the issues we're talking about before of like having leaks in your bladder or having symptoms of prolapse where you're feeling kind of that heaviness in your pelvis. Um, if you're, you know, your uterus can kind of lower down. Or symptoms of, bowel issues where you're either constipated or, you know, having a lot of difficulty wiping clean a lot of those issues, you know, pelvic pain, pain with intercourse can be avoided if we allow for our bodies to heal and then rebuild first rather than just jumping right into activity that our body is really not. prepared for and not ready for. our ligaments are still lax for a period of time after having a baby. And if you're breastfeeding, there's some laxity there throughout the whole breastfeeding process as well. So it's just needing to be really mindful of those things as you're kind of progressing forward in what you're doing.

Perfect. That's really helpful. And I know most of my listeners are past this postpartum era, but I think it's really important to think about how we did heal and what things we might still be carrying from this time. And What kind of things that we might have sort of gotten stuck in that bounce back type thing and getting our bodies back. You have your body, your body's beautiful. It can do amazing things. And I always say we can't hate ourselves then. Gotta love what it's doing now. As one extra little bonus question for those of us that are well past our postpartum years, curious if there's anything that we can do for that. Urinary incontinence that you mentioned laughing, coughing, sneezing, an inability to get on my kids trampoline.

Yes.

So what I mean, because I think a lot of us are like, well, it's just, like, welcome to having four babies, you know, like at, at this stage, if you're 10 or 15 or, you know, maybe beyond your postpartum, is there anything we can do for that?

yes. So it's, a lot of it is the same kind of protocol, the same stuff that you would do if it was happening early on. a lot of it is, focusing on your breath first, So as you were saying before of kind of like holding onto some of the stuff that happened, During your postpartum, we hold a lot of tension in our pelvic floor. So we often think, you know, we hold a lot in our shoulders and our necks, but to the same extent, we're holding a lot of that in our, pelvic floor. Uh, and you can just check in on yourself and notice, you know, when you're standing, if you're doing the dishes or something. Pause for a minute and just bring your attention to your glutes because that is An area where people tend to really clench in if you're standing for a while and that all of that clenching So kind of tucking that tailbone under squeezing your butt cheeks together It's kind of building up tension. So kind of bringing awareness to that to how you're standing how you're doing different activities And just kind of notice it, first of all, and then again, position changes and changing positions often is really helpful. To kind of prevent things from getting tighter. So if you're standing for a while, you know, using a step stool to put one foot up for a few minutes and then switching and doing the other one. Or just going from sitting to standing often throughout the day, you know, making sure that you're not stuck at your desk for too long without taking standing breaks or walking breaks. and starting to, focus on your breath. And, you know, we talk about for, you know, relaxation, and things like that, kind of doing these deep belly breaths where you're really using your diaphragm. but instead of just thinking about breathing and having your belly kind of expand on the inhale, you want to think about breathing all the way down to your pelvic floor, as well as kind of out to the backsides of your ribs. So you really want to do a. Full kind of like 360 breath. so it's not just your belly that's going forward and back, but it's, you know, your ribs are going out to the side and you're thinking of your pelvic floor lowering down as your diaphragm lowers down on that inhale. And then on that passive exhale, everything kind of coming in together, can be really helpful if you're having a lot of symptoms again, because the further out you are, the longer that it may take to fix some of those issues is getting in to see a pelvic floor physical therapist. whether it's, you know, there are some that do in homework, uh, and there are others that are in outpatient settings. So, kind of, you know, doing some Google searches, finding someone there. You can ask your OB. They should have at least a couple of, people in the area that you're in that can provide you with some good quality care.

I think it's so important just to know that pelvic floor physical therapist is a thing. Like again, with women's health, it's like, well, we just deal with it. Like, no, tell your OB, tell your gynecologist, like, Hey, this is still an issue for me. It's been 15 years and I still pee when I cough. Like it's very annoying. Like tell them it's not normal. I constantly say this just because it's common. Does not make it normal.

Oh my god, I say it all the time! All the time.

It's not. You don't have to deal with these things. And so it's not too late for you if you're still having some of these issues from postpartum. And it's just I think really important whether you're just a few months out or several years out like me. So I think I'll still be healing when my I get my first grandchild

to that point, make sure you let them know too that, you know, like you were saying, you might be past that, that, you know, postpartum period of life, but chances are, you know someone who is going through it right now. So check in on them and ask them how they're doing when you're asking how the baby's doing. Really check in on the mother and let her know. To your point, Lisa, that what is common is not always normal, and there is a lot that you can do about it.

yeah. Yeah. And, and for those of us in the older age range, really take this knowledge for your daughters and your daughter in laws and be a resource for them also just be aware of your language. Like don't ever ask them. If they're bouncing back. Don't like, let's just stop using these words. Let's stop using this, this language of getting your body back and really shifting into recovery language. I think it's just so important for ourselves to kind of rewrite our past, but also as we move forward in our next generation, just, you know, I'm always wanting to be a good influence and a force for good on my children and my future grandchildren. And I think this is one of the ways that we can really do that.

Yeah, absolutely.

So thank you so much, for being here. I really appreciate it. Why don't you tell people where they can find you online? I assume you can do some of this, some of these services for us remote.

Yes. Yeah, so I do do in person PT, you know, local in my area, so north of Boston, but otherwise I have. Online virtual services available. So you can find all of that information at my website, which is findyourwaymama. com And you can also find out Some more information and helpful tips on my instagram, which is at ariel martone.

Perfect. Thank you so much. And we'll put those links in the show notes so people can find you easily. All right. Thanks again for listening today to the eat well, think well, live well podcast.