Strong Like Mum, with Shakira Akabusi - Episode Transcript

Helen

Hi, I'm Helen, and this is Why Mums Don't Jump: busting taboos about leaks and lumps after childbirth. All the stuff that happens to your pelvic floor that no one ever talks about - incontinence prolapse, pelvic pain. Problems that affect millions of women, one-in-three! I'm one of them. I have a prolapse. My pelvic organs fell out of place after the birth of my second child. And if you had told me back then that I would be speaking about this stuff out loud, I would have told you to give your head a wobble.

Hi, welcome back. Pleased to say that normal service has resumed after a much needed holiday in the sun. Thank you Grand Canaria - pool, beach, good food. Managed to somehow read three books in a week, which is a record for me. And now I'm back to it and I'm loving seeing the book, Why Mums Don't Jump book pop up in libraries around and about the place. Didn't think of that, did I? Shout out to the listener who ordered it from her local library in New South Wales, Australia! I was very excited about that. People send me these pictures of a book out in the wild and I love it.

Welcome to anyone who's new to the podcast. Maybe you came via the book. Yeah, just welcome. Thank you. You have found your people. We're going to help you navigate your way through your pelvic floor problems. Please do also go back and listen to some of the earlier episodes because they are as relevant now as they ever were. I'm not sure if that's a good thing or not, but it's a good thing for you. So go back and check them out.

Today's episode is about fitness and exercise and postpartum rehabilitation at any stage of motherhood, whether or not you have pelvic floor problems. It's about getting you back to where you want to be or maybe even stronger than you were before you had kids. What about that as an idea?

I've been speaking to Shakira Akabusi who is a pre and postnatal exercise specialist. She's a public speaker, she's a track athlete. You might have seen a pop up on TV as a fitness expert on This Morning. And a few years ago she founded the maternal wellbeing platform Strong Like Mum. She's also written the book recently, which is the Strong Like Mum Method. And this is what I kind of wanted to talk to her about, really. So this is how all of that started for her.

Shakira

I found that during my first pregnancy - and I'm now a mum of four - I was constantly told of all the things I would never do again after becoming a mum. And a lot of that was to do sort of with physical activity and sports. And I've always really been into sports. I've loved it and I almost felt like people were telling me, well, now you're a mum, you can't be who you are. And to me, I started thinking, it doesn't really matter what your thing is, whether that's exercise or a job that you love or a hobby that you have. The idea that motherhood should mean the end of something, and the end of who you are just didn't really resonate with me.

So I just shared my journey of how I sort of continued to continue with my passions alongside motherhood, and I think that resonated with quite a few women, so it grew and expanded. I specialise in pre and postnatal exercise, so my focus initially was on sort of physical rehabilitation after pregnancy, and then it evolved as I went through motherhood. I had my own sort of maternal mental health experiences and I realised that we can't really be talking about physical health if we're not also addressing our mental well being. So the two really go hand in hand. And then it's evolved. I've now written a book and I'm just on the brink of releasing my first set of programmes for pre and postnatal women. So it's now sort of developing into...I like to think of Strong Like Mum as a community of women who just shatter those stereotypes and share honest and real accounts of motherhood.

Helen

And you've got four children, you've got twins. Just that in itself, I can't even get my head around. But anyway, how did you find your physical and mental rehabilitation? I guess we could talk all day about it, but you're obviously in incredible shape and seemingly in a good place. How did you manage your own postpartum recovery?

Shakira

I am now in a really good place, I feel...I was going to say content. I don't know. Things are always up and down. Life's always up and down, isn't it? So there's lots going on, but I feel like I'm managing and I'm coping with really positive coping strategies when I do encounter something. So I feel in a good place. But it has been a roller coaster and certainly, I mean, people ask me all the time, how do you manage with four children? And honestly, for me, the biggest challenge was number one. By far, the biggest challenge, like twins, is exhausting in a different way because it's double everything, double the time to do everything. But that first pregnancy and that first postpartum experience, it really was a shock to the system. And I knew how to recover physically if we're looking at sort of physical recovery, I knew the things that I should and shouldn't do during pregnancy and how to rehabilitate properly postpartum, because that was my job. But I was shocked at how little information there was out there. And it was during my first pregnancy that I remember reading a statistic on sort of like a fitness professional platform that only five, I think it was 5.5% of fitness industry professionals at that time were trained in pre and postnatal. And that just blew my mind because I wasn't given the accurate support via my medical team throughout that process. And then to think that women might approach, I don't know, a gym or whatever health setting that they're visiting and there's still not the support there just felt like a real failing on women.

So that was something that I found really shocking. And then my mental health journey was quite extensive and I suffered really severely with postnatal anxiety and OCD and it was really, really extreme and I've got myself through that. And as I said, I now feel like I'm in a really good place with really positive coping strategies for my mental wellbeing and I feel strong physically, but it's been a long journey.

Helen

And I think that probably just makes you so much better at your job, right? Because whenever... if I see a trainer or whoever I want to see...if they can relate to what I'm going through and I can learn from their experience. That's just going to get you so much further down the path, isn't it? And it's so important that you're honest, you're not just like, yeah, I'm a fitness trainer so of course I knew what I was doing and of course I bounced back. Like, no, that's just not a thing, is it? No, not for anyone. Not even if you've got all the knowledge?

Shakira

No. And also I think there's so many...when you're pregnant, when you're postpartum, you're constantly bombarded with messages that the only fitness goal you will have is wanting to lose weight and there's just so much more to it and there's nothing wrong...I think we do have to also say that there's nothing wrong with having aesthetic goals. I certainly had weight that I wanted to lose after pregnancy and there's nothing wrong with that, but there is more to the picture than just wanting to lose weight and there's so many more benefits to exercise than just losing weight.

For me, it's about obviously about my mental well being and the effect exercise has on that. But even when we're looking at physical health, it's about being able to manage daily motherhood tasks without aches and pains. If I'm constantly lifting my car seat and I'm like, oh gosh, it always hurts my lower back, what can we do to address that? Because otherwise in 30 years time we're going to have we might have a slipped disc or we might need a knee replacement or a hip replacement or whatever else we need. And so really looking at our body in a way that we can help to lay those strong foundations for a healthy, sustainable, active lifestyle as opposed to just like get back into your pre-baby jeans at eight weeks.

Helen

It's so important, isn't it? Like you say, I don't remember... so my eldest has just turned ten and I don't remember hearing anything about rehabilitating a postpartum body when I was pregnant or even after I'd had her. And like you say, just having a little bit of information just to get you through the sort of functional day to day life that can get you so far down the track. I did like...embarrassingly Shakira. I did actually take my pre pregnancy jeans to hospital with me when I had my baby and how embarrassing is that? That was the level of knowledge that I had about what was going on with my body.

Shakira

Yeah. And also we generally live in a world at the moment where fast information is what we want or not what we necessarily want, but it's what everyone's conditioned to have. You look at algorithms of all these social media platforms, the faster you get that information out there, the more engagement you're going to get. And to try to challenge that in today's world is difficult because no one wants a slow recovery or... but actually there's real power and strength in slowing down and not everything has to be fast and quick. And in my mind, fast and quick is not sustainable and I'm much more interested in sustainable.

Helen

And we'll get on to obviously, like pelvic floor dysfunction and all the kind of complications that people can have after birth and forever afterwards. But what's the sort of approach with someone who perhaps has had a relatively straightforward pregnancy and birth? How would you outline the process for someone getting back to real fitness and strength?

Shakira

Well, I would approach them all the same. I would approach them all the same. I just think the time that you spend through these phases of recovery, if you like, you might feel more confident in certain areas. The first thing, and it sounds so boring, honestly, I think you've got to find like, I don't know, a crazier like sexier way of saying words like posture or breathing. But honestly, this is really important.

And the first thing would be learning to take a deep breath. And the reasoning behind that is because if we don't learn to inhale...sorry, I'm already making a fist. I know you can see me here, but if we don't take that proper inhale, we can't get that full work through our core. So if you imagine your core like a fist, then once we've released our fist and opened our hand, we can pick things up and we can have a nice strong grip. If I don't ever fully let go, or if I'm only half letting my fist go, it becomes really dysfunctional. I can't pick anything up, I can't use my hands, so we have to let go. And it's the same with the core. When we take that deep inhale and learn how to breathe right, we're going to access so much more power through our core when we do engage it. So, number one, I'd be looking at learning to breathe right with your shoulders down, if you're lifting your shoulders up when you're breathing, or if you're not expanding your ribcage, or if you're not releasing your pelvic floor, you're not going to get that full work through the core. So that would be the first step.

And then posture specifically, particularly postnatally, I would be looking at, what are the glutes doing? So when we go through pregnancy and the bump expands and the uterus expands, the bump grows, the arch in the lower back that that can create can put our glutes into sort of an overstretched position and we lose the functionality of our glutes. And we should always make sure that we're clear on the difference between weak glutes and clenching. So sometimes people think if they're clenching their glutes that they're strong, but again, that makes your glutes really inactive if you're just constantly clenching. So it's about really being able to have efficiently functioning glutes. And so I'd be looking at what is the glute strength doing? Because when we strengthen our glutes, that's going to help us realign our pelvis after that bump has grown, and that's going to help us get our posture right. And once we've got that good posture again, then our core can function properly.

Helen

Let's talk about the pelvic floor dysfunction side of things. Presumably you have women coming through your door who maybe leak, who maybe have pelvic pain, who maybe have prolapse. What is the progress that they can see? Because it's so easy to feel like I had a baby and now I'm a bit broken and it's always going to be like this forever. And then I guess they walk into your fitness studio or wherever you work from and then actually they realise that they can make progress.

Shakira

Yeah, I think. And what's so important is, like you said, and this is why working with a professional who specialises in pre and postnatal exercise, or working with a woman's health physio, why this is so important, because there can be so many different reasons as to why you might have urinary incontinence. It might be that they've had some sort of tear during delivery, or that they've had an episiotomy, and we need to be working on getting the pelvic floor working with that muscle group itself. It might be a hamstring issue, or it might be that it is a weakening in the front of the abdominal walls. We're looking at something like diastasis recti. So there can be so many different reasons. What I would say is that if this is something you're experiencing, there will be a reason and you will be able to work on that reason. So I would definitely push women... you know I have a friend I go running with, and we've been friends for years, and we've got our children are almost nine, eight and a half, nine. And I was running and just last week she said she made some comment to me... and we've been running together for ages and I don't know why we've never had this discussion. And she said, oh, yeah, oh, I've always leaked. I just always leak when I'm running. And that's just the way that it is. This way that it's been for the last eight years. And I was like, I can't believe we've been friends for so long. Never had this discussion. And she had just accepted, that's just the way that it is.

Helen

I think that happens so often.

Shakira

Yeah, people will just go, I've got two kids, I've had three kids. Oh, that's just the way it is. And that doesn't need to be the way that it is. And for now, it might be something that you feel you can manage, you could just put a pad in and that's just the way that you are. But what we want to do, like I said, banging on about sustainable change, we want to be focusing on that sustainable change because we want to be able to still have a fully functioning frame in 20 years time, in 40 years time. My mum is 60. I once did an interview, I said she was 68. She is not. She is 63. My mum is 63. She wasn't happy about that. My mum is 63 and she doesn't have any aches or pains because she's really laid those strong foundations. So there can be so many reasons.

It might be for example, with urinary incontinence, I work with some women who have an overactive pelvic floor, so I see a lot of women who are like, oh, I bought a pelvic floor trainer and they're using these pelvic floor trainers. Squeeze, squeeze, squeeze, squeeze, squeeze. And then they're like, but I still have urinary incontinence. Well, again, if your pelvic floor is partially contracted., constantly engaged, it also can't function properly. As I was saying, you need to release the pelvic floor to get the full function. Then we can see urinary incontinence that way. So there can just be so many reasons.

Helen

And it's so important. And the messages that we get around this... well we don't get any good ones, we still don't get any good ones. Our lack of knowledge around this is phenomenal. I'd been talking about this for a while before I really even understood about, as you say, the overactive pelvic floor, or sometimes called the hypertonic pelvic floor, and how it's not just all about kegels. You talk so much about your whole core and your pelvic floor and how it all works together. And it does my head in that people don't talk more about this stuff. You can get sick of saying it, can't you? But it's just like, you have a baby and then you just kind of left to figure it out. And if you have complications, well, it's just...that's what happens. That's what happens with your friend who goes running and leaks and just puts a pad on and doesn't realise that she can potentially do something about that.

Shakira

Yeah, absolutely. And I think that, like you said, it's about the knowledge. Because what's tricky with this type of thing is that there is no one answer. So you can't stand up there and say, yes, everybody postnatally is going to have bad posture. And once you've fixed that, you'll be good to go. There's just so many more things that could be impacting your recovery. And that's why I think the best advice you can give is just like, keep pushing for your answer, because there will be a reason and there will be work that you can do to help to manage the symptoms that you're experiencing. But it's about finding those answers and making that a priority. I think you're right. I think so often, healthcare professionals, we are looking to get women to a level where they can survive. But the concept that you might thrive after having a baby...and that's what my first pregnancy experience, what I said at the beginning, that's kind of what I really noticed, that everyone was like, oh, you might run, but you're never going to run as fast, you're never going to this, you're never going to that. Whereas actually, I have never been stronger than I have after having a baby. Because a really special thing that pregnancy and postpartum gives you is this opportunity to really look at the foundations in a way that I never did when I was a teenager or in my 20s, really look at the foundations and building them back up. And since then, I've run a personal best and I've had all sorts of different physical achievements. And that can be so many women. That doesn't have to be the exception.

Helen

Absolutely. Can we talk about fear of movement for a minute? Because as well, that's been a really big one for me, because the medical advice at the time when it happened eight years ago was very much no running, nor jumping, no heavy lifting, no standing for long periods of time. And you're like, oh, my gosh, I'm 36, what can I actually do? So then I stopped doing the kitchen discos and the gardening and lifting my kids and it just left me afraid to do anything at all, really. And I know that's really common and I know that things are changing. The advice now is more sensible. It's about the importance of exercise and modifying it if you're experiencing symptoms. But it's prolific. It's still what's the word? Pervasive. And I heard just from a woman yesterday who had been told the same thing, don't run, don't jump, don't lift heavy. You must hear that a lot from women who come to see you.

Shakira

Yeah, exactly. You hear that type of thing all the time. And I think, like you said, the the focus needs to switch to how do we modify movements and, you know, in a way to help us build strength to get back to where we want to be. Fear of movement is a big one. I remember I spoke to someone else on another podcast. I can't remember who it was now who talked about they did a poll on their Instagram about who was afraid to lift their baby, and it was over 75% of the women afraid to lift their own baby.

Shakira

And it's because there is so much uncertainty and it's so difficult to take away the uncertainty because you can't give a direct answer like, no, you'll be fine. There is so much more to it. But that does not need to be a part of your reality, is absolutely a message we can put out there. It's about learning how to modify movements and how to lift properly, how to rehabilitate our pelvic floor to a place where we are feeling more confident. And like I said, it will take work and it will take time.

Helen

So I got back to running a bit. And when I say running, I mean in the park a couple of times a week, no more than 5K. I'm not doing marathons or anything.

Shakira

That's like Everest to me. What you've just described.

Helen

That surprises me. I thought you'd be out legging it up mountains.

Shakira

5k is my absolute max, and that is on a good day. And I probably walked, like, forever. I do track running, so I'm much more comfortable with distances. So if I'm on a 5K, I feel like I've run a marathon.

Helen

Okay, all right. But, yeah, a lot of people get in touch and they're like, how have you done it? How do you run and manage your symptoms and do all this kind of stuff? And it has been, like, you say, a really slow road to build up to doing that. And I always am really clear, like, that's my journey. It doesn't mean that it's everybody else's journey. And I'm aware that there's a risk, but you listen to your body. I've learned to trust my body. The first time I went out for that first couch to 5K training session, I was so scared, I thought I would take a few steps and all my insides would fall out. Like, literally. That's what your brain is telling you and you're trying to be like, no, it's going to be all right. So, yeah, I like that idea about it's learning to trust your body. And it is the slow road, and that's not exciting and it's not a quick fix. It's just real.

Shakira

No. And what is so hard is it's about if I'm working with women who want to get back into running, specifically, you said it's knowledge. It is knowledge. It's listening to things like this or speaking to experts in this field. Because when I'm working with women who are running, sometimes it's their feet. So if you've had either a twin pregnancy like I had, and I did experience this after my twins, or if you've just had, I don't know, a larger bump pregnancies. But it can be anybody, really. It can flatten that additional weight can flatten the arch in the sole of your foot and if that happens and you're running and you're taking a step, the way that your feet absorb that impact, your feet are directly connected to your pelvic floor via sort of deep myofascia, deep body tissue. If that impact is hitting your feet in a different way because you've now got a flatter arch of your foot that could be impacted, that could be one of the key triggers with your pelvic floor. So are you looking at your foot health? How's your jaw? Again after my twins I had really bad locked jaw and I was like why am I? And I kept saying every morning I'd wake up and I remember boiling the kettle, I'd say to myself my jaw is really hurting and the jaw again is connected to the pelvic floor via deep myofascia. Which is why during labour many women are asked to relax their jaw because it helps to relax your pelvic floor, it's that interconnected and so working on I had to do jaw release exercises, working on the muscles either side of my jaw to help release my jaw and then again it had a massive impact. So it's about the knowledge and opening our minds to understand that if you've met someone and they said do 100 kegels and you're doing 100 kegels and you're still experiencing urinary incontinence, that doesn't need to be the end of the road.

Helen

I was just thinking about the fitness industry, right? Because I remember going to a spin class once when I was trying to figure out how to get back to fitness when I had a prolapse and I'm bit lost with it all and the fitness trainer had never heard of prolapse. I was like I was embarrassed. Quiet little corner, I just want to let you know have this prolapse and she had no idea what that was and I don't blame her for that. I didn't know what one was until it happened to me, but it didn't fill me with confidence. I didn't want to do it again. And I just feel like, for me, if you want to see a pelvic health physio, brilliant, please do if you get the opportunity. But you're probably going to have to wait a really long time or you're going to have to go privately. And I always kind of think, like, the fitness industry is the perfect, like, there's a gap here that could be filled if only the knowledge base was there. I don't know what level of knowledge your average fitness trainer has about pelvic health and specifically pelvic floor dysfunction and stuff, I don't know if you have thoughts about that?

Shakira

No. So as I said when I first started working in this industry, only 5% of industry professionals were training in that and I also think there is what you learn in a textbook and then there is what you learn from lived experience and also what you learn from working with women. So, so much comes from working with women.

Every time I meet a new client, I learn something new without a shadow of a doubt, which is also what I love about the industry, is constantly learning. But also...and I'm now speaking to the professionals...there's nothing wrong with not knowing. There is something wrong with then not seeking to learn. So, like I said, I meet women all the time where I'll encounter something and I'll think, oh my gosh, okay, I need to do my research. And as an expert, if you already have a basic understanding of the human body, when you read credible, whether that be books or there's lots of different fitness of professional magazines that you can subscribe to or something, you can learn, so be open to learning. There's nothing wrong with still needing to learn.

I think that the fitness industry should be focused on supporting women more. And I don't know whether this means that there needs to be more funded courses that people can attend that can learn, whether it is about doing specific workshops, going in and training. I know that I covered in my initial personal trainer qualification, the most basic certificate I think there was in specialist populations, or whatever they're called. And you learn not just about pre and postnatal, you learn about all different types of specialist populations, but there really is no in depth understanding. And gosh, I'm talking to you about feet, jaw, deep myofascia. Yeah, that stuff I did not learn. I didn't even learn that when I first trained as a pre and postnatal specialist. I have learned that through years of loving this subject matter and learning and researching and working with women. So a lot of it does come with time.

Women's health physios are fantastic. And yes, as you said on the NHS, that can be a wait. You can see one privately. There are also fantastic physios out there that are sharing general information and you might just suddenly read something where it applies to you. And I think I say that in my book. It might be that you read my book through pregnancy one and you pick up on some things, and then the second pregnancy you go back and you're like, oh, now I get that, because now I'm really resonates. So, yeah, I think we all could just do with exploring this more.

I think what is most important is that this shouldn't just be something that flies under the radar and it's like, oh, maybe you will address it. It takes a village. There are a lot of people that need to take responsibility for this. I think GPs could know more, midwives could know more. I was given, even when I had my twins two years ago, I was given an A4 piece of paper which told me about one pelvic floor exercise and then contraception, and that was it.

Helen

Oh no, don't get me on that.

Shakira

There was nothing. It's about looking for those answers and lots of women aren't even going out there and looking for those answers.

Helen

Yeah, that would be the dream, wouldn't it? Like just a link up between good quality information that you can access simply on the internet, bite-sized stuff from a trusted source. That also links up with your local fitness professionals. You want to go to a fitness class? They've got a level of understanding that will help you to learn what's appropriate. They'll be able to advise you or recommend pathways to physios or maybe suggest you go to your GP, who then would also have this real knowledge base, maybe that might end up you've been referred to a urogynaecologist or whatever it is. And if all of that just worked together, it would be amazing. That would be the dream, wouldn't it?

Shakira

Absolutely. And things are changing. There is more of a conversation now around women's health, female empowerment and understanding the importance of supporting women in general, mothers and caregivers in general, and the impact that that can have, the ripple effect it can have on the next generation. So things are changing, but as most good things, it is slow progress. But hopefully we are laying those good foundations with conversations like this.

Helen

Shakira Akabusi. Founder of Strong Like Mum. I love that sentiment. If you don't follow Shakira on Instagram, then you should. She is @shakira.akabusi. I'll add it to the show notes along with a link to her website.

As ever, please be aware that I am not a health professional. So please don't take any of what you've heard today as medical advice but do seek out your own support.

I'll be back next week and in the meantime, thanks to everyone who has bought the book, or ordered it to a local library. Still love that. And if you've read it and you liked it, then please do leave a review so that others can do the same. Thanks so much to everyone who has done that so far. You are amazing. You've been listening to Why Mums Don't Jump with me, Helen Ledwick. You can find me on socials @whymumsdontjump or online at whymumsdontjump.com. Bye for now.