Pelvic Health in Women's Football, with Melanie Leupolz & Emma Brockwell - 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.

Hello. How are you, bits? Welcome to the season five finale, and something a bit different. I'm excited for this. So a couple of years ago I remember seeing the manager of Chelsea Women's football club, who was Emma Hayes, talking about pelvic health in a documentary. And I was so excited to hear that term in a conversation around women's sport that I shared it on social media. Because as you'll know when you're trying to end taboos around pelvic floor issues that have for so long been hidden and stigmatised, any hint of it going mainstream is huge because it just makes it a conversation that is possible to have for everyone else who follows.

And since then, it's something that has cropped up more and more in discussions around women's sport, along with menstrual health and breast health. And don't get me wrong, we're just beginning to scratch the surface. But it's exciting, right? It feels like change is coming.

So I am delighted to be able to bring you this episode with two people who've been trailblazers in all of this the german footballer Melanie Leupolz, who returned to play for Chelsea just months after giving birth to her son, and the pelvic health physio (and friend of Why Mums Don't Jump) Emma Brockwell, who worked with Melanie at the club. It's a good one. Back in a sec.

Why Mums Don't Jump is sponsored by iMEDicare - Pelvic Health Naturally. IMEDicare provides devices or products for pelvic health that are safe and easy to use, helping you to manage your symptoms while you're on the way to recovery. Products like Lumana activewear - fitness leggings and running shorts that have absorbent underwear built-in, for protection from leaks. Whether that's wee or sweat or period blood or discharge. And the leggings have a phone pocket, which is music to my ears. You can find Lumana via the affiliate shop on the Why Mums Don't Jump website, where you'll also find a discount code. Thanks to the team at iMEDicare.

Here we go then, the final episode of season five with the pelvic health physiotherapist Emma Brockwell and Melanie Leupolz, former Germany international who recently left Chelsea for Real Madrid, and who is one of only a small number of female players who have returned to top flight football after giving birth.

Melanie

Yes. So there are still a few players who came back after their pregnancy. Alex Morgan was like a role model for me. Her daughter is, I don't know, four or five years old already, but I could just see that it's possible. She did such a great job taking her child everywhere she went. And yeah, that was one of my goals as well. So coming back after pregnancy, combining my family life with having a child and being a professional football player on the highest level - that was my motivation.

But at the same time, I was also super chilled throughout the pregnancy and also coming back after, because I knew even if I won't be able to play on this level again, I have a son. I'm happy. I'm okay with that. I was aware that I risked my career or playing on this level again, but that was okay for me because I always wanted to become a mom when I'm still young, 28, I think. So it's not super young, but still, I didn't want to wait until I have finished my career.

So, yeah, I decided to get pregnant. I was super happy because Chelsea was so supportive. Emma, my manager, she has a son herself and she understood and the whole club was amazing. Yeah, I'm really grateful for their help throughout the pregnancy. Also coming back, introducing Emma (Brockwell) to me, that was a game changer because I was fit after the pregnancy so quickly and I have no problems at all. And I just also enjoyed pregnancy. I didn't have much pain because of the exercises, because of staying in contact with Emma. She had so many good advices and yeah, the journey was just amazing.

Helen

And how did you train differently when you were pregnant versus before you were pregnant? What was the biggest of difference?

Melanie

So when I knew I'm pregnant, I told my manager straight away because I didn't want to risk my health and the baby's health. And I played football, but not with contact, so that I don't like, get hit from the ball or that my teammates can hit me. So I did some passing exercises, I did some running, everything, but we also monitored my heart rate, that it doesn't get too high. The doctor knew as well, so he was always looking...yeah, that everything is fine. And I had Covid at this point and I had an inflammation at the heart and that was like, an excuse why I couldn't do everything. So my teammates didn't know until you could really see that I'm pregnant. So then my manager told me, Melly, we have to tell the team now because you look pregnant. And then we told them and everyone was so happy for me.

But, yeah, I still did a lot of gym work, also with heavy weights. But I think it's also important to mention that I'm not, like...I would say...like a woman who doesn't do that much sports because, like, our levels are different and you shouldn't do more in your pregnancy. It's more about maintaining and doing specific work. But because I was super fit before, I was able to do a lot of strengthening as well, but always with the advices of my trainers and doctors and everything.

Helen

Yeah, sure. And, Emma, I mean, I'll ask you a bit more about your time at Chelsea in a minute. But you obviously worked with Melanie. What was your approach to getting her back to being match fit? Because, as we said, you know, it's relatively uncommon thing to have to do. So you're sort of writing your own rules a bit, I suppose.

Emma

Yeah, I think at the moment we still are, because there's still so much we don't know and understand. We still lack a lot of research, certainly for the elite female athlete. But I think the thing that stood out for me the most was it has to be a team effort.

So, you know, it's very amazing that I'm here talking to you about this, but it really. There was a lot of us involved. There was Laura Bettinelli, who's the head physio, Ally Barlow...there was, at the time, Dr Sean Carmody. I think Mike took over during your pregnancy. Maybe Melly? Did he? I can't remember

Melanie

Yes

Emma

Because Mike is now the Chelsea doctor, Mike Harrison. And then we had Georgie Bruinvels, who is an amazing applied researcher who specialises in female health, particularly the menstrual cycle. And, of course, then we had all of the performance team as well. And we had a really, really, really strong voice in Emma Hayes.

So when you've got all of those people working and you're working with an athlete like Melanie - who is driven, incredibly focused, but also prepared to take our advice on board - then you can't really go wrong.

But I guess ultimately, the centre of all of this was what Melanie wanted. We had to focus her pregnancy wants and needs on her. And then her return to play was very much really driven by what she wanted. And I think it's fair to say, Melanie, that you had some flexibility and when you returned to play, to a point, because you had such an understanding coach, manager and team around you? She's nodding yes.

Helen

I think we've got a slight delay going on, but it's fine, we're getting there. And Emma, just like for normal people - non professional athletes listening - is it the same approach to get an athlete back to, to full physical health after pregnancy and childbirth as it is for someone who's not? Like, what are the, just the basics that you're trying to get right?

Emma

The basics you have to get right are that the player's healing well or the woman is healing well, and that they are getting as much rest as possible, as well as. As much support from their inner family as well as from the team. So with all of those things, it's very similar. But the difference, I guess, that you have with athletes is they exercise every day. That is, alongside their baby, a priority.

You know, Melanie had access to top nutritionists, she had access to the best doctors, to the best physios. So that's a big difference to someone like yourself or me, who might see a pelvic health physiotherapist maybe once every few months if they're lucky. I went out to Germany, I think, when Melanie was two weeks postpartum. And, you know, we...I mean, you must have been bored of me at your home?! I was there for about 3 hours assessing...

Melanie

Yeah, that was amazing.

Emma

Yeah, that was so cool, wasn't it, that I could just go out, fly out, spend time with you and really, really address not just your physical needs, but make sure psychologically you were feeling well and then report back to the team. We met every week online during her pregnancy, when eventually Melanie decided to return to Germany. So the access that you have for elite athletes is insane compared to us mere mortals who perhaps see someone like myself once or twice, so it's very different. But then this is their job, and this is what's needed to get to that level of athleticism, for sure.

Helen

Yeah. And Melanie, what was it like working with Emma (Brockwell)? Did you even know there was such a thing as a pelvic health physiotherapist? Did you imagine that it would take that amount of effort for you to get back to where you were?

Melanie

No, I wasn't really aware of that until Emma, my manager, told me that she got to know Emma (Brockwell) and was working with her and she was such a big help for her. So she recommended it, to do some sessions with Emma and she brought her into the club and she was really supportive because she just knew how much value it is for me and also that I'm healthy afterwards, not just back to playing football, but also healthy.

And at the same time, Emma, my manager, she said, I just have to come back to football when I'm ready, not when I'm like, she doesn't want to tell me when I have to be back. I have to be ready mentally, physically. And that was super important that I hadn't had any pressure. I just came back to England when I was ready to play football again.

And also what is super important with Emma (Brockwell) is that we didn't lose any time because she assessed me before my pregnancy and also after the two weeks when she came to Germany and then we didn't waste time waiting until I can start running or doing exercises. That's different for non professional women because they have a little bit more time. But for me, as an athlete, like, almost every day matters because, yeah, you have to get back into your training and stay fit and build some strength again. And when you... not waste... but when you. Yeah, when you need more time until you return to football, then it's harder to, like, go back to your old level. And that's why it is a little bit of pressure. But it was absolutely fine. I didn't have any pressure from my club.

So when I was ready, I told them, I really want to start training hard and intensive now. And Emma (Brockwell) assessed me again. She said, okay, she's ready, so we can start again. And that was amazing. So we didn't lose any time.

Helen

This is amazing. And Emma Hayes is such a hero, isn't she? She's been such an incredible advocate for women's health and it's a bit confusing because we've got two Emmas - Emma Brockwell, obviously, and Emma Hayes, former manager of Chelsea up until very recently, now the USA team coach. And, yeah, I mean, I've seen her in the news over the past couple of years being outspoken in a way that...a way that you rarely see, let alone in sport. Criticising gynaecology waiting lists, saying it's like a political choice not to invest in women's health. Every time I'm just like, oh, my goodness, she's amazing.

Emma

Yeah.

Helen

So it kind of like, in that context, it doesn't surprise me that she was so cool about your whole thing. And how important, I suppose, is it for someone like yourself to come back into football, to have that kind of support? I mean, I suppose it just wouldn't be possible without it, would it?

Melanie

Yeah, absolutely. And Emma is always someone who wants to be the first in something and the best in something, and we heard so many bad, like, stories about pregnant footballers in Europe. So I think she also wanted to be the first club and person who supports the player from the beginning to the end. And she did. Absolutely. It wasn't just like that she said she will do, but she also did it.

And also, when my son was here, I could bring him to training, to games. He was always welcome, also from the players. So that was also really important for me - the support after. Not just financial or whatever, the facilities or whatever, it was more that he was welcome at the club and that I had no pressure. Like when I struggled with childcare, that I was just able to bring him and I knew everyone will be fine and will be happy. Sometimes they said I'm a little bit selfish because I didn't bring him often enough, but at the same time, I just wanted to be a footballer as well.

Like, when I was at training, I was concentrating on football and I knew he's fine at home with his dad, with his nanny or at the nursery, but I just didn't want to think about what should he eat now, do I have to change the nappies or whatever when I'm at training. And then when I went home, I was a mom 100%, and just enjoyed playing with him and, yeah, discovered the world with him.

Emma

I love that.

Helen

Yeah, they really created that culture where you could thrive, didn't they?

Melanie

Yes, they did.

Helen

And Emma, I mean, I can't imagine it's been standard for women's football teams to have a pelvic health specialist on the books. How did you come to be at Chelsea and what sorts of issues were you treating? Obviously, you work with Melanie, but I presume there's other stuff that comes up as well.

Emma

Yeah, well, actually, Melanie was really the reason that I am still at Chelsea. So I think Laura Bettinelli, she touched base with me. She just contacted me and said, look, we have a pregnant player, we need some support. Would you be willing to help us? And of course, I jumped at the chance.

And what that then allowed was for me to expose the whole medical team, the whole performance and coaching staff as to what a pelvic health physiotherapist is. So I gave them an education talk, and I remember Emma Hayes sitting in the talk and obviously she'd had her little boy a few years before Melanie had hers. And she sat there and she went, oh, my God, why haven't I seen a pelvic health physiotherapist? And we got talking about that and then - I mean, it's on record that I treated Emma following her hysterectomy - and the thing is, when someone like Emma gets it, it's a game changer, it's magic.

And Emma recognises that female footballers aren't male footballers, and we have to think about the female health considerations. And, you know, at Melanie's level, at this elite level, it's all about marginal gains. And Emma recognises that pelvic health, menstrual health, breast health, these could be things that are game changers for...not just the players physical and mental well being ...but also for their performance as well. So when someone like Emma gets it, then, of course that's going to expose me then to the optimal opportunity to address pelvic health within the whole team.

So Laura then got me back in, really, after Melanie had returned to play, actually, and it's still early days, but we started screening, educating around pelvic health, treating the players that want to be treated. You know, it's not something they're forced to do, because, as you know, pelvic health is quite an intimate, still a taboo, still an embarrassing topic, especially amongst women who haven't had babies. It's easier for us, we've had children, we can potentially appreciate why our pelvic floors have potentially been compromised. But when you're an elite athlete and you're leaking urine, for example, you might be thinking, my God, what on earth is this? Or in the changing room, if there's five or six of you leaking urine, perhaps that becomes the norm. And when you normalise something, you don't address it.

And because, as we know, lots of pelvic floor issues don't cause pain, they're just not nice and they're embarrassing and uncomfortable, lots of women, as we know, will just not admit that they're having those issues. And also, as an athlete, you don't realise that potentially, the impact that pelvic health has on the rest of your system is huge.

So it really is Melanie and my involvement that's allowed that exposure to pelvic health within Chelsea and then it's like a domino effect. Now more and more teams are interested, and now the FA has really passed regulations that pelvic health, menstrual health, breast health, should be educated among or discussed amongst all teams from grassroots up, which is amazing. But we're really just scratching the surface at the moment, as you know. But it's, it's really exciting and it's really down to athletes like Melanie. So you, Melanie, you are one of my heroes.

Helen

You're all trailblazers, aren't you? Like totally changing the landscape. And Melanie, you're at Real Madrid now. You don't have to reveal if you don't want to. But can I ask, like, is pelvic health or women's health more generally, is that part of the conversation there? Are you seeing that?

Melanie

No, not really. Also, I don't know many clubs that speak about pelvic floor or the menstrual cycle or stuff like that. So it's just beginning. And also there, Chelsea was one of the first and I hope that we talk about it even more because it is so important, not just when you get pregnant, also just for women or also men, I think. So it's important to speak about it, but I think also in Spain, I wasn't there yet, but I think it's not a big topic there.

Helen

And how did it go down in the changing rooms when you talked about it at Chelsea? Like behind the scenes where people's mind being blown by the idea of how important it was? Or were they quite accepting of it?

Melanie

I think, because you don't know many about it. I think many were like, oh, I don't need that, or I don't want to talk about it. But when you have positive examples like me and when I tell my story, how much it helped me, I think they are happy to try and then you have to feel the impact that it does.

So, yeah, I think also throughout the pregnancy, I was so fit and it wasn't intense to train the pelvic floor. It was more, for me, it was more important to get to know how to release it, because we as athletes, I think we are super, most of them are super strong and it's more important that we learn to release it with our breathing and combining it with strengthening work and, yeah, it was super amazing. And I'm still doing the exercises because I feel much stronger in my whole core and healthier and yeah, so everyone should be open minded about the topic and just try it and then they will see how much it helps.

Helen

And again, like, the more, the more Melanies we have, the more time this...the more times this happens, the more these conversations are had, the more people will see. I mean, apart from anything else, Chelsea won like five consecutive women's super league championships while all this was going on, didn't they, Melanie? So it wasn't, you know...you can really fly that flag and say, we did this, and we still absolutely nailed it out on the pitch.

And I wonder if we look at women's sport more widely. Like, I'm hearing conversations more and more about women's health, about pelvic health coming up more and more. Melanie, do you feel like things are changing for the better? Do you think it's a conversation that's more acceptable to have?

Melanie

Yes, absolutely. But I think that's also related to the education we have now and that it's quite normal to speak about things like that. Also to speak about psychology, because our stress levels are always so, are always so high or the pressure we have. And I think in the past, everyone was scared to talk about depression or stuff like that. And I think now we are, yeah, more open minded for everything and also about talking about pelvic floor even more.

Helen

Yeah. What about you, Emma? Have you seen. I mean, you must have seen changes. I know you were over in Australia doing something relating to all this recently, weren't you?

Emma

Yeah. So I work as a female health expert for FIFA, and FIFA are now creating an education platform for all girls and women to access, as well as coaches, managers, physios, anyone that wants to access this information, it will be free to access. And that is incredibly exciting.

And essentially, they treated us to a trip to Australia to go and see the final for the World Cup last year, the Women's World Cup. And it was insane. It was amazing. These things don't happen in physio world, but it was amazing. But really, the ultimate thing is that this is for everyone, so that it's not just the likes of the real 1%, like Melanie, to access, it's for every girl and woman to access so that they can better their general physical and mental health.

But the one thing I was going to just say that Melanie hasn't mentioned is that she made a it back postpartum and played in the World Cup as well for her country. So she didn't just, you know, win the WSL with Chelsea, she also played for Germany, which I think I remember having a conversation with you at two weeks postpartum. And do you remember, Melanie, you said, I definitely, I've got to get back and play for Chelsea. I probably won't make it to the World Cup, but that's okay. I'm okay with that. And then, lo and behold, you did. I mean, it's crazy what you've achieved. I think you underplay it because it's really quite remarkable.

Melanie

Yeah, but that is what I meant with that. I didn't put pressure on myself. It was a goal, but I was still relaxed. And I think that helps as well, if you listen to your body. At the same time, I didn't want to waste time, but I didn't force it too much and I think it was just perfect.

Yeah, it was a really proud moment to represent my country again. And after the World Cup, I retired just to have more time with my son, focusing on club football because it is exhausting having a child and playing like Champions League in the WSL and everything. And I have so high expectations on myself, so, yeah, and I also want to enjoy football. And when I played for the national team, for Chelsea and had my son, it was just too much for me.

I was able to do everything, which is still crazy what the women like the body can be able to do, but I didn't enjoy it that much. So I decided to retire from national team, focusing on my son, on club level. And, yeah, I'm super happy since then because I still have time to recover during the international breaks and then giving everything at the club again. So, yeah, that is also something where I have to be honest to myself that sometimes it is too much and, yeah, I needed some breaks and yeah, now I just enjoy my life. It's amazing to do both.

Helen

Melanie, you are so wise and so inspiring because I, you know, I think so. I've got a daughter think similar age to Emma's and it's so amazing for them to hear people at your level speaking openly about this kind of stuff, you know, same with Emma Hayes. And it just makes it so much easier for them, growing up through PE and sports and changing rooms to be able to have those honest conversations with their friends and things.

Melanie

I think it's just like I said, it is super important to speak about topics like that and to share my experience because like you said, there are small girls who become women at one point, and then they see that they are not alone with their thoughts, with their...if they are scared about something. So there are always people who feel the same, who do the same, and it's important to talk about it and that's why I'm here. So I just want to share my experience and help other women to do the same.

Yeah, there's this quote. It says, 'you can just be what you see'. So I want to show people what's possible and then they can decide if they want to have the same way or pathway. If it's something for them, is it right for them or not? And then you have to take the decision. But I just want to share my experience.

Helen

So that feels like a good place to end the episode and the season. Please keep in mind that as ever, none of this is intended as medical advice, please seek out your own professional help. But do get in touch. Let me know what you think.

Thank you for listening to season five and if you've enjoyed the podcast, please take a couple of minutes to review it or share it with a friend. It all really helps others to find it. I'm taking a break, but don't forget there's a book and an audiobook if you need something else to listen to. And do sign up for emails through my website so I can keep you posted on future developments.

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.

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