Today was my first workout after hurting my back a few weeks ago.

Yep…after 6 years with no significant back pain, I lost my balance while trying to put pants on half-awake in the dark 🤦 and found myself suddenly with back pain & spasm. What did I do next?

I stayed calm.
I kept moving in ways that felt OK.
I avoided movements & positions that didn’t.
I respected my pain and let the dust settle.
And as it did, I kept moving & respecting my body.

I said no to certain things – even when I wanted to say yes – like when my husband suggested taking our girls skiing (they are just learning so likely lots of helping/lifting them back up on their skiis, all while not being a confident skiier myself). I also took a complete break from the gym.

And after feeling great, today was my first day back…So WHAT DID I DO?

I made “DO LESS THAN YOU THINK YOU CAN” my mantra & kept it on repeat with each decision I made.  I did this is to ensure early wins which I can then keep building on.

I warmed up appropriately, listening to my body.

I kept the load low.

When my brain wanted to say “GO!”, I reminded myself “SLOW.” I substituted movements, even if that meant doing something completely different from what was on the board.

I reminded myself that SOMETHING > NOTHING.

I accepted that right now, INTENTION > INTENSITY.

I respected my NOW body, so I can keep moving forward.

Because I can always add a bit more load/intensity/ROM/any other exercise variable tomorrow, IF today goes well.  But doing too much, too soon will set me back.

Because, you can’t rush it.

Instead:

Let the dust settle, then build it back up.

Identify your pain triggers & then avoid them (for now, not forever) – this may mean moving differently or it may mean avoiding something altogether.

Be assured that in the absence of any red flags (which should be screened for), you are going to be OK.

Respect your NOW body, while also applying intentional, progressive overload in a manner appropriate for YOU (and everything that comes with that). Need some help navigating your way back to the gym or whatever activity you love?
Need some help understanding the WHY & HOW?

I’m here.

Teresa Waser, RX Physio

Originally published on Jan 4, 2020 at Teresa Waser – RX Physio (@rxphysio) • Instagram photos and videos

In short, no.

And if you are telling women that their diastasis rectus abdominus (DRA) is going to cause pelvic floor issues, please don’t. I know you are well intentioned but we don’t have evidence to back that up and doing so can add more unnecessary fear onto their plate.

But seriously, if at some point you read the Spitznagle study (2007) that appeared to link DRA with pelvic floor dysfunction or someone has told you this, it’s important that you also read Kari Bo’s study (2016) which disputed those findings and discussed some of the methodological issues with the Spitznagle study.

If you don’t have time to read the article, here’s what Bo et al found: – Pelvic floor muscle (PFM strength) and endurance was BETTER in women with DRA than in women without during pregnancy. – There were NO significant differences in PFM function between women with or without DRA at 6weeks, 6months, and 12months postpartum. – At 6 weeks postpartum more women WITHOUT diastasis were diagnosed with POP stage 2.
In summary, during pregnancy and the 1st postpartum year, those with DRA were NOT more likely to have urinary incontinence or pelvic organ prolapse (POP) than those without. They were also NOT more likely to have weaker pelvic floor muscles.

With more research, things could change but until that time, we should not claim associations between DRA and pelvic floor dysfunction.

Find the Bo et al (2016) article, “Pelvic Floor Muscle Function, Pelvic Floor Dysfunction, and Diastasis Recti Abdominis: Prospective Cohort Study” here:
https://onlinelibrary.wiley.com/doi/abs/10.1002/nau.23005

#diastasisrecti #DRA #diastasisrectusabdominus #postpartum #pregnancy #prolapse #POP #incontinence #leaking #pelvichealth #pelvicphysiotherapy #pelvicfloor #womenshealth #femaleathlete

Y’all know how much I LOVE coffee.

Coffee is nectar to my soul, the elixir that promises that together we can accomplish ALL the things, and the comfort that I crave each morning.

BUUUUT……. Coffee is also a bladder IRRITANT.

It’s sad but true.

It can make you feel like you have to go pee more frequently, make the urge to go pee stronger, and it can worsen leaking.

Now I’m not hear to tell you to stop with the coffee. You get to make your own decisions and trust me, I get your love for that liquid black gold.
But I want you to be informed so that you can make your own decisions as to what is best for YOU.

Try abstaining from coffee for a week as see if your symptoms change. If they improve, well now you know!

Maybe that will mean that you stop drinking coffee (crickets chirping 🦗🦗🦗)
Maybe that will mean that you have just 1 cup rather than 2.
Maybe that will mean you switch to a lower acidity decaff coffee (which though still an irritant may be less so for you).
Maybe that will mean that when you look at the WOD and see double unders, you will skip your cup ‘o joe for that day, or just push it back until after your WOD.

For me personally, one cup is fine. But any more than that and my bladder is definitely irritated. This means that after 2 cups, I feel like I need to pee during double unders. For others, it might mean a leak. Everyone’s threshold is different. You might do better with none 😱. But once you know, then you get to make the choice based on that knowledge.

And coffee is just one of many potential bladder irritants. This is small part of what we often go through (amongst LOTS of other stuff) when dealing with concerns such as urinary urgency, frequency, bladder pain and leaking.

Need help with an unhappy bladder? Give me a call.

Teresa Waser, RX Physio

Sometimes well intentioned health and fitness professionals hurt people with their words.

They say things like…
“You have prolapse so you shouldn’t run anymore.”
“If you do those exercises, your diastasis will get worse. Only do the “safe” exercises.”
“You leak when you jump? Well that’s normal after having kids.”
“Why do you need to lift that heavy anyways?”
“You should just bike or swim, or take up yoga.”

The underlying message is that you are broken and if you aren’t careful you could end up more broken. Do less. Be less. Accept it.

Except that it’s bullshit.

Sometimes restrictions ARE needed. But even then, it’s often temporary and with appropriate modifications and progression, we can move forwards towards what you want to be able to do. We can find ways to manage and progress.

A lot of the time though, that well intentioned fear mongering restricts people unnecessarily – holding them back from pursuing the athletic endeavours that make their hearts sing, the ones that we know are best for optimal bone density, the ones that drive wondrous adaptation in our cardiovascular and musculoskeletal systems, and the quite frankly, the ones that keep many of us sane.

Athleticism brings us JOY.

And I’m ready to fight for that – for everyone who (good intentions aside) has been sidelined from life and from themselves, by unnecessary restrictions.

If you are looking for a physiotherapist who will work WITH you to help you do the things that bring you joy, give me a call.

Teresa Waser, RX Physio

The picture above is a throw back to August 2018, when I was at my leanest.

I had worked with a nutrition coach, measuring and tracking every macro, to get to a goal of “shredded” for a photoshoot. I wanted to “look the part”. I wanted to prove that I could do it. I wanted to be comfortable in my skin. I expected that being lean would mean I would have more credibility, more respect, and just maybe, more self love.

I got a lot praise at my leanest and – I won’t lie – the compliments felt great. I loved wearing whatever I wanted without worrying about my squishy bits showing. It felt good to have strangers approach me and ask what I did for fitness – as if I was suddenly more knowledgeable or credible based on my appearance. But aside from that, there was a lot that being leaner DIDN’T do for me.

Did it ACTUALLY make me more credible and respected? Nope. Being leaner didn’t make me more qualified to teach a deadlift, write an effective running program, or even to inspire my athletes or patients. They are more interested in hearing what I have to say than judging my waistline. And any that ARE judging? Well that has a lot more to do with their own baggage than it has anything to do with me.

Did it make me more loved? Nope. My little girls see me as the most beautiful, strong and awesome Mom in the world, no matter what. And bless his undiscerning heart, my husband thinks I’m sexy any day at any size. And my friends? My real, true friends don’t give a flying F how lean I am. They just want me to be happy. They love me for who I am, not what I look like.

Logically, this makes sense (duh). I don’t love or respect anyone else less based on their weight – so why should it be different for me? Oh… but it is, right? Don’t we hold ourselves up against different standards? Aren’t we often the harshest critics of ourselves, even while we bestow kindness, love and acceptance to those around us? I can’t be the only one!

Now, months later – I’m a bit heavier. I’m not as lean. I have noticed that I don’t get all the compliments anymore – and that’s OK. But other than that, nothing has changed. My family and friends still love me the same – perhaps more as I’m happier when I eat the damn chocolate. Maybe you are too.

If you have weight loss or body composition goals, I will NEVER shame you for that. Trust me, I get it and your body = your choice – ALWAYS. If you are like me, you were brought up in a society that tells us that as women, smaller is better. We have been programmed to believe that how we look matters more than it actually does and certainly more than it should. That programming doesn’t change overnight. We can’t just wish those beliefs away. They are interwoven into our values, our attitudes, and our concept of ourselves and our place in the world. But we can work on them.

My beliefs and the power that I give to my appearance in defining my self worth – those are things that I am working on every day. Some days I have all the self love… and other days, the dialogue in my head when I look in the mirror is not cool. It’s a process. So, wherever you are in this, I’m with you.
Perhaps losing weight is something that you are pursuing for health reasons, based on medical advice. If that’s the case, you have my full support in your journey towards a healthier weight if that’s your goal. And if you have these goals for other reasons including aesthetics, I will hold space for you. You are still welcome here.

But if you already ARE a healthy weight (whatever the hell that is – a conversation for another day as size does NOT dictate health!), perhaps it’s time you gently challenged your own beliefs regarding what defines your self worth. Perhaps it’s time you realized what being leaner DOESN’T do for you. And maybe then, you might be just a little more accepting of the person in your mirror as well.

Because you are so much more than your appearance.
You are more than your 6-pack abs or lack thereof.
You are more than the number on the scale.
You are amazing. You are beautiful. You are worthy.
Just as you are.

Originally published May 6, 2019 at Teresa Waser – RX Physio (@rxphysio) • Instagram photos and videos

#imwithyou #selfacceptance #selflove #ongoingprocess #notperfect #imperfectlyperfect #amazing #beautiful #worthy

I like to think of the analogy of heading out for a road trip, where knowing your risk factors is kind of like knowing what the road conditions are. If the roads are clear and dry, your risk of crashing is less than if it’s raining, foggy or icy, but there’s no guarantee. We might want to know the road conditions so that we can control what we can to help manage our risk (for instance, adjusting our speed, our level of attention to the road, maybe threw some winter tires on, or in some situations maybe even choosing to delay our trip), but we shouldn’t stay home every day because we are scared of crashing.

In the world of pelvic health, it appears that pelvic floor measurements are like the road conditions – they help us assess your relative risk for pelvic organ prolapse. Having a favourable gh+pb (<7cm) and great pelvic floor muscle function indicates that the roads are dry, but it doesn’t mean you are invincible. Just like HOW you drive matters, HOW you exercise matters! The road conditions are just ONE factor of MANY that will determine whether you end up in the ditch or not.

Just as you might want to check the road report before heading out on a roadtrip, you might consider getting a pelvic health check so that you can best manage your risk. The truth is, we don’t have all of the answers. We can never say that we can prevent POP, just as we could never say we can 100% prevent car crashes. But there are certainly things we can do to keep you safer on the road.

Maybe you want good brakes, grippy tires, and traction control in your car (improve your pelvic floor strength and coordination)… Maybe you will control how fast you drive and how you take your corners (manage how you exercise, your strategies and the loads/intensity that you use)… Maybe you will keep your eyes on the road (self monitor for signs and symptoms)… Maybe you will even put on some winter tires (use a pessary)… But you should still get out there and drive. Because out there…that’s where life happens. And I want you to live the fullest life imaginable, harnessed with knowledge that empowers you.

– Teresa Waser @rxphysio

Originally published April 30, 2019 at Teresa Waser – RX Physio (@rxphysio) • Instagram photos and videos

#pelvicorganprolapse #POP #pelvichealth #pelvicfloor #womenshealth #postpartumfitness #prenatalfitness #physiotherapy #physioswholift #fitmoms #femaleathletes #girlswholift #crossfit #fitness #physiosincrossfit

• 

What if what we actually needed to do was to cue for LESS tension?

Often times with pelvic floor symptoms, we may focus on cueing to contract the pelvic floor, to INCREASE the tension. Sometimes this works and often it doesn’t.

Do we check to see if the cues and strategies we are using are actually working for the person in front of you? And if we don’t check, how do we know that it’s actually helpful?
#testretest

And if your cueing isn’t working, what do you do? Do you tell them to keep working on it anyway? Do you try another cue to add tension elsewhere such as TA? Or do you try to incorporate an exhale?

What if the issue is that they already OVER-recruit relative to the demands of the task at hand?

Our pelvic floors need to be dynamic and responsive. They need to provide adequate support – not too little, but also not too much #goldilocksprinciple
The strategy matters because #tensiontotask matters.

Your pelvic floor may indeed need more tension but it might also need less. Check if the cues you are using are actually working and if they aren’t then #dosomethingdifferent

If you are a PT or coach working with women and you aren’t sure how to do this, let’s chat. Or better yet, come on a @physiodetective course such as The Female Athlete Level 1, 2 and Masterclass that I act as a Senior Teaching Assistant for, or come on my TIIPPSS-FC course with @reframerehab where we cover tension amongst many other factors that can optimize how we approach pain, pelvic symptoms of leaking and prolapse, and performance concerns.

If you are someone dealing with pain or pelvic floor issues , I’m here to help. Send me a DM or come and see me in clinic @rxphysio

Originally posted April 30, 2019 at Teresa Waser – RX Physio (@rxphysio) • Instagram photos and videos

#pelvichealth #pelvicfloor #pelvicorganprolapse #stressurinaryincontinence #incontinence #leaking #postpartumfitness #womenwholift #fitmoms #crossfitmoms #femaleathletes #physioswholift #physiotherapy #rxphysiotherapy #physiosincrossfit

“Oh Mommy…I’m so sorry,” my 6 year old said as her little fingers traced the long scar across my lower abdomen. “Why are you sorry, honey?” I asked, taken aback.

“Your scar…it must have really hurt…. Did it hurt to have your babies?” She looked up at me with her sweet blue eyes, conveying concern under her furrowed brow. “Well it did hurt a bit at the time,” I answered, “but it doesn’t hurt at all now. And I’m not sorry about it. I would have a hundred scars if that’s what it took to have my girls.” I smiled at her reassuringly.

She smiled back and planted a gentle kiss on my tummy, kissing me all better of course. And then she danced off to play.

I looked at myself in the mirror. I had stepped out of the shower moments ago and stood in my underwear and sports bra in front of the bathroom mirror. Along my tummy, a thin scar was strung from hip to hip, with a midline vertical extension of a few inches – as if pointing towards my odd-looking belly button. I looked at it and realized that I truly was not sorry for it. And yet, why then did I hide it?

I wear high waisted leggings – heck I even wear high waisted bikini bottoms. I wear cover-ups at the beach and one pieces at the swimming pool. I hide it so others don’t see. I hide it in case they feel that it is ugly…in case, the view makes them think that I am less. I don’t want their judgements to steal or dampen the acceptance and pride that I have in my journey.
But the truth is that hiding it to protect myself and my story from judgement, also means that I cover the triumph that my scars represent. It means that my daughter sees it as something to hide, something that I am sorry for and that is not what I want.

My scars are my reminder of my journey through motherhood – my reminder that my body carried my beautiful twins earthside. They remind me that my tummy grew and stretched as it held onto them, answering my prayers that they would not arrive before they were ready for the world. With this, my connective tissue gave way to them, accommodating their growth as nature intended.

I was brave in my journey, but I have not been fearless in the aftermath. I have hidden my scars and only shared my story with those that I trust. But in recent months, I have been reminded that we acquire courage by practicing our bravery. Sharing our stories – as raw and vulnerable as that can feel – can allow others to step into the light that our bravery creates, so that they may feel less in the dark.
So in case you haven’t seen my scar…here it is.
And no, I’m not sorry.

Originally published March 16, 2019 at Teresa Waser – RX Physio (@rxphysio) • Instagram photos and videos

#diastasisrecti #diastasisrectirepair #diastasis #twinmama #physiotherapy #postpartum #restore #strengthen #journey