January 2, 2024

#16: The Physiology of Pregnancy with Jen Ryan

As pregnant women, we go through A LOT of physical changes to accommodate our growing baby, but how often are we actually told why they’re happening and how to manage those changes? If you’ve ever struggled with sciatic pain, round ligament pain, lightning crotch, or anything in between, today’s guest Dr. Jen Ryan answers all of your questions and provides actionable ways to feel your best during pregnancy, no matter what symptoms you experience. She also debunks a few myths about common stretching routines during pregnancy and shares some advice for how to advocate for yourself with your medical provider.

About this episode

What you'll learn

  1. All the different ways your body adapts to pregnancy, including your spine, organs, uterus, and muscles
  2. The benefits of preemptive stretching and strength training prior to and during pregnancy
  3. The physiology that causes common physical symptoms like round ligament pain, sciatic pain, pelvic girdle pain, and carpal tunnel syndrome
  4. How to manage common pregnancy pains
  5. Tips for speaking with your medical provider about pregnancy symptoms you experience

About Dr. Jen Ryan

Doc Jen is a pelvic floor physical therapist and strength and conditioning coach who works with moms to feel their strongest through pregnancy, postpartum, and every season of life. 



Connect with Jen on Instagram and TikTok: @docjenfitness 

Connect with Jen on her website:


Hey, Mama. Welcome back to another episode of the Well -Nurse Mama podcast. I am so, so stoked for you to listen to today's conversation because I have been fangirling over this guest for months and I am like still in shock that she agreed to be on the podcast and she's just absolutely incredible.

Her name is Jen. She is a pelvic floor physical therapist and pre and postnatal trainer and she has such a unique take on how she teaches everything that she teaches. I'm friends with a couple pelvic floor physical therapists and pre and postnatal certified personal trainers and I've never heard somebody talk about this part of health the way that Jen does or explain it the way that Jen does and Jen also has a whole added depth of knowledge because she is putting puzzle pieces together and like just really coming at it from such a different angle and it is so refreshing.

So in today's episode we are diving into the physiology of pregnancy. So basically everything that you experience from a physical standpoint during pregnancy, the changes that your body goes through, the different symptoms you may experience like pelvic girdle pain, sciatic pain, lightning crotch, carpal tunnel syndrome, whatever it is, she not only tells us how to manage or alleviate those symptoms but she also teaches us the why behind those symptoms.

I don't know about you but a lot of the things that I experience when I'm pregnant, I ask my doctor and he's like well you're just pregnant and that's just how it is when you're pregnant and I hate that answer.

It drives me nuts. That's a conversation for another day but what Jen is going to do is she's going to answer that question for you of hey why is this happening? She knows why and because she knows why she's going to teach you actually effective ways to manage those.

symptoms rather than just say tough it out, give birth, and it'll go away kind of the thing. So I really, really hope that you love today's episode. If you are trying to conceive or you are currently pregnant, this is going to be your bread and butter.

You are going to fall in love with Jen and just feel so much better as a pregnant woman after listening to this episode. And if you're newly postpartum, that's okay. Don't feel like you missed the boat.

You now know what to do next time you're pregnant. And Jen is also really, really heavy into the postpartum stuff as well. So you'll get a feel for the kind of specialist that she is in this episode.

And you'll be like, Oh my gosh, if this is what she talks about during pregnancy, I can only imagine what she talks about during postpartum. And then you're going to go check her out and see all the amazing things that she does for her postpartum clients too.

And don't worry, I already invited her back to do an entire postpartum physiology. section. So she will definitely be back to cover your bases as well. But all of that being said, this conversation is just so incredible.

And Jen and I had so much fun. And there are so many things that we talk about in here that nobody is talking about right now. So I really hope that you love this episode as much as I do. If you know a mama who needs to hear what we talk about in this episode, please send it to her so that she can listen and have her life changed.

And then please leave a five star rating and review so that I know how much you liked the episode. And Jen knows how much she was able to help you. And we can continue to help the podcast grow. So with all that, let's jump into today's episode with Jen, all about the physiology of pregnancy.

Doc Jen is a pelvic floor physical therapist and strength and conditioning coach who works with moms to feel their strongest throughout pregnancy, postpartum, and every season of life.

Hey, Jen. Thanks so much for joining us on the podcast today.

Yeah, so glad to be here.

I have been like really, really fan girly excited about our interview today ever since I discovered you on TikTok and so I'm especially excited for today's episode but I know a lot of my mamas are going to be excited to hear from you because while I do focus on nutrition, I get a lot of questions about exercise in all stages of motherhood and you are the expert for pregnancy and postpartum fitness.

So today's episode is going to be really good. But before we dive into that, can you just tell us a little bit about yourself and how you got into your field of work? Yeah, so I am a pelvic floor physical therapist and I started out in the sports physical therapy world and as I started working, I just was getting a lot of really active women and active moms coming to me and when they were coming to me with one issue, I would ask them about pelvic floor stuff and almost all of them, almost all of them also had pelvic floor stuff going on.

And so I would try to refer them out and could not find someone to refer them out to and so I I decided to just start learning about it a little bit because we barely learned about it in PT school. And as I started to learn more about the pelvic floor, I just thought it was so cool.

And also noticed that the pregnancy and postpartum recovery and support is very lacking in our current medical system. So I just kind of stumbled into it out of necessity and ended up absolutely loving it.

So very glad that I found my way here. Me too. And I'm curious, you mentioned that you didn't learn a lot about this in your PT school. Is this because this is like a new science, a new kind of form of physical therapy or is it just not something we've paid much attention to until recently?

So it is not new at all, but it is something that is becoming more of a focus, but is still very much not paid attention to at all. And I always feel like it's getting more notice than it is because a lot of my online world gets algorithmed into people who do know about the pelvic floor, but then when I'm out and about talking to people in real life, most people don't know about it.

So, but in PT school, we had one two week class about women's health, and it was twice a week for the two weeks. We barely learned about the pelvic floor. And when I went through that class, I said, who would ever want to do this?

And here I am. But they don't teach much about it except for what's needed for the physical therapy exam. And it's so crazy to me now knowing what I know, because the pelvic floor is involved in every single thing that we do.

So to consider, so for physical therapists to consider themselves movement experts and not know a bit more about the pelvic floor, not everyone needs to be a specialist, but I think is a mistake and hopefully will change in the future.

Yeah, I 100% agree. So did you have to go on to get like an independent certification just for pelvic floor to really learn all of this and be an expert? Yes, it was a lot of extra time, a lot of extra money, a lot of extra courses to be able to understand the pelvic floor to the level that I do.

It's very much a specialty and it's an extra thing that you need to go seek out. So if you don't seek it out, you're not going to get it. Gotcha. Well, I'm very glad that you went through all that extra training because I know a lot of personal trainers that are pre and post natal certified, they teach about the pelvic floor, you know, they might have a six week recovery program.

I did one with my first baby, so I know it's out there, but I have never met somebody that knows as much as you do. about the pelvic floor and how it integrates with the rest of the body. And so that's why I was like, I have to have Jen on the podcast because I've never heard somebody talk about all of these things that I've heard you talk about.

And that's what I want our conversation to focus on today. So to start off, let's jump into the physiology of pregnancy. Can you just give a quick overview of some of the basic physical changes that we experienced during pregnancy in general that just kind of like affect us as a whole?

Yeah, for sure. And also thank you for the kind words. I appreciate that. So with pregnancy, with with this explanation, I'm going to focus a bit more on the physical changes because I think that, you know, the hormones side of things gets a bit more attention and also that is not my expertise is I'm not like a hormone expert.

Yeah. So I'm going to focus more a little bit more on the physical. But the big musculoskeletal change that happens from the hormones as everyone I'm sure has heard is the relaxin. So everything gets a little bit looser, able to move and stretch a little bit more.

And gets the relaxin gets the blame for a lot of issues. Yeah, they're like, oh, relax and makes it so that I can't do this or I can't do this. Yes, right. But besides that, so the biggest things that happen with pregnancy as far as your muscles and joints are obviously the uterus that you want to grow that makes your abs lengthen and so.

those are the things that most people hear a lot about. Yeah. The other things that happen, not quite as much. So as that summit grows, your center of gravity moves forward. And that is going to change how you stand.

That's gonna change how you walk. That's gonna change how you move all throughout the day. And in, because of those changes, a lot of your muscles get worked very differently all throughout pregnancy.

And people can end up getting some weaknesses that they may not have even realized were happening. The other big thing that really happens is your low back muscles shorten and get very tight. Your hip flexors shorten and get very tight.

And your upper back gets very rounded. And I, find that those changes can be caused some issues and are often ignored or just not taken into consideration. Yeah, that's a lot that our body goes through.

And I mean, I'm going to say a short period of time in the sense that we live for 80 years and it's what, nine months, maybe three times on average for a woman. But like that is a lot that happens in a short period of time.

And so how do these changes affect us postpartum? Do they like, does our body kind of go back to normal after we have our baby? Or do we have to like do rehab and recovery to reset everything the way that it was before getting pregnant?

Yeah, so the changes, the physical changes that happen to your muscles and joints and skeleton that happened during pregnancy are forced to happen because of your baby growing in your abdomen, right?

And so our body responds to whatever forces and inputs we put to it. And so postpartum, you overnight have a completely different body than you had the night before. And then also some of those changes will go back just from you being able to move a bit more regularly.

But some of those changes are not being forced to go back the way that they were forced to happen. And so we need to force it via exercise. Gotcha. And I'm just curious, off the top of your head, what are some common symptoms that we might experience postpartum, like physically, that are a result of changes in pregnancy that haven't been fixed since we had our baby?

Back pain, shoulder pain, neck pain, hip pain, pelvic pain. So, discomfort in those different areas. But I'd say that the biggest thing that happens overall is just that from the muscle length changes that happen during pregnancy and maybe lower level of exercise for some people, then plus the trauma of giving birth, then plus the postpartum recovery period that's required.

Every single woman is going to lose strength and muscle mass. And so a lot of women do not do the things needed to actually build that muscle back. And so they feel weaker overall. They things feel harder.

It just doesn't feel right. And I'd say that is what a lot of people tell me. Yeah, that's what I experienced after my first baby. I learned about the core and pelvic floor and how to modify pregnancy exercises while I was pregnant.

And so I did the best with what I knew. And then, you know, I did my six week recovery. I recovered my pelvic floor and core and, you know, tried to give myself a break. And then I just found myself getting back into strength training over time.

And I was like, I still just don't quite feel right. And I was like, but I recovered. I spent more time than I wanted to taking a break and trying to go back to the basics and all of that. And yeah, it just, it never quite felt right until I finally figured out what to do.

And then this next time when I was pregnant, I was very different in my approach of how I exercised, how I lifted weights. And I feel incredible right now at six weeks postpartum. So it really does make a difference when you understand the physiology of what happens to your body during pregnancy and how to combat that during pregnancy and postpartum.

So with that being said, is there a way to minimize what we experienced postpartum during pregnancy when we exercise? For sure. For sure. And so One thing that I always like to mention when this conversation comes up is that some people, just because of genetics, because of luck, or lack thereof, there's a million million reasons why someone during pregnancy may not be able to do these things.

And it's not their fault. So I personally have never been pregnant, and I hope to one day in the future. My whole thing is exercise. I love exercise. I help people exercise. It's my whole thing. I'm planning to hopefully be able to exercise my whole pregnancy, but that baby may have a totally different plan.

And I may not be able to exercise a single day. And it wouldn't be because I was doing anything wrong, but sometimes that can happen. So I always like to just mention that because sometimes people feel like they've done something wrong if they can't.

So, and that's not the case. But for those who don't have symptoms or whatever that's keeping them from doing something, the biggest game changer is gonna be that strength training. And it's so funny to me that the general advice given to women when they're pregnant is like, oh, just take it easy, go lighter, like don't lift, keep with walking.

And it's like that is the opposite of what we wanna do because we want to be lifting, challenging enough weights to be combating the muscle strength changes that are happening. And the things that I like to focus on with people most during pregnancy is going to be the glutes, the inner thigh muscles, the core in whatever way that we can, and then also the shoulder muscles as well.

Those are really my big focuses with my, when I work with pregnant clients. Yeah, and I wanna dive into the why behind those and how they connect to a lot of the pregnancy symptoms that we experience.

But just to add on to what you were saying before we do that, I often think about, I can't remember his name, but the man from the movie Holes or the movie Holes, the book I guess, whichever one you refer to, but how he had to carry the little piglet up the mountain.

And at first he's like, this is stupid. Why am I carrying a five pound piglet up the mountain to like win this girl over or whatever. But then the piglet kept getting bigger and he would still carry the pig every single day.

And so by the time the pig was this giant pig, it wasn't a problem for him to carry the pig up the mountain because he'd been training since the pig was a little tiny baby. And I try and share that with women that are like, well, I just, I don't know about strength training during pregnancy.

My doctor told me not to lift more than 20 pounds. And I sit there and I say, how are you supposed to feed or how are you supposed to function at nine months pregnant? If you're not helping yourself build up the resiliency as you get up to nine months pregnant and take care of your body in a way that it can handle the demands of being nine months pregnant.

So that's the analogy that I try. and bring it back to you because that's really what it is. We are very, very slowly growing over time, and you're not going to notice how it feels to be nine months pregnant until all of a sudden you're there.

And so you have to be prepared for when that day comes when you're like, oh my gosh, I'm nine months pregnant. Because I've been there and it's not fun. Yes, totally, totally. And when you have the leg strength to get yourself and your nine month pregnant belly off the couch, it makes a big difference.

And chase your toddler after that, if you have more kids. Yes, for sure. Okay, so let's jump into a lot of physical symptoms or inconveniences that we experienced during pregnancy. The root cause of why that's happening and how we can combat that, like you said, you've got some core muscle groups that you really have your clients focus on.

So I polled a lot of my followers on Instagram and asked them what some of their most common symptoms were during pregnancy, just to get like a wide range. Because luckily for me, I didn't experience a ton.

So I tried to get lots of different inputs. So let's just go right down the list. I think the most that I heard was round legament pain. Can you tell us what that is, why it's happening and how we can manage that symptom?

Yeah, so the round legament is the legament that attaches from the years to your body. So it kind of helps your uterus stay in place. And as your uterus grows, it is getting pulled on. So the legament is getting a lot more.

tension and that can be quite painful and uncomfortable. Round ligament pain is a tough one. So I do have some different movements that I have people do that is often very helpful that gets to take some of the tension off.

And so in general, the side that you're going to get your feeling the round ligament pain on, you actually want to work on the other side. To try and pull it back into place? Kind of. So the side that you're feeling it on usually is being pulled at.

That round ligament is having tension. Got you. And that's because the opposite side is... Tight or kind of pulling it that way. Okay, and so if you work on the same side To like stretch or whatever then you're pulling on something that is painful because it's being pulled on Yeah, that's not good So if you instead try to loosen up relax the opposite side That can sometimes take some of the tension off of the painful side and feel better So a lot of people when they feel that pain they're like, oh, I need to stretch it and Usually that's kind of the opposite of what we want to do So if you look at if you try stuff on the opposite side, that's usually the better move for you And is this something that we should be Incorporating like every single day or only when it's symptomatic like only when we're feeling it.

What do you think? I? Would say only if it becomes symptomatic because that is very Anatomy dependent and baby size dependent and it may never be an issue and a lot of the Things that you would do to kind of help it are Working at decreasing the symptoms as opposed to fixing it so I Of all the things I don't think that is worth the Time or energy unless it becomes a problem.

Okay, that's good to know I'm sure lots of moms are gonna be very happy to hear that And they're probably kicking themselves saying oh my gosh, I've been stretching the side that hurts this whole time.

No wonder Yeah, that happens a lot when I tell people that and they're like oh this feels a lot better Oh, so good. Okay, let's jump to number two, sciatic nerve pain. Okay, this one is a favorite of mine.

So most people, pregnant or not, when they get sciatic nerve pain and go to the doctor or the PT, they're given the same exact sheet of the same exact stretches. They're going to do a figure four stretch.

They're going to do a knee to chest stretch and maybe one more other useless thing. And so in pregnancy, especially, there are a couple of things that can be why it's happening. One of those things can be because your baby is pressing on the sciatic nerve from the inside of your pelvis.

So no stretching in the world is going to help that, right? Can you click before we jump in, can you quick remind everyone where the sciatic nerve is, just in case they don't know? Good point. So the sciatic nerve comes out of your sacrum, kind of by your, almost by your tailbone a little bit, and then goes across your glute and then makes a turn to come down your leg all the way into your toes.

And is that on both sides? So we have a sciatic nerve on like essentially our right bum and our left bum that goes all the way down? Correct. OK, that's exactly. So to go back to what you were saying, one of the symptoms could be that baby is pushing on it from the inside out and so stretching won't necessarily help that.

That's what you were saying, right? Yes. Yes. And then the other thing is nerves hate being stretched, being pulled on, and they hate being compressed. And doing the stretches that most people are given are going to do both of those things.

So instead, what we want to do is try to ease some of that stretching and relax some of that compression. And so as opposed to doing big stretches where we're trying to yank on it as hard as we can, I have people do more gentle movement where they're staying in a range that I call the happy range.

I should really come up with something cooler than that. But a range where you're just starting to feel that sciatic tension and then you ease off of it, because that's going to get you get that blood flow that it wants it's gonna ease some of that compression and it's gonna help it move just a little bit to not be as stuck.

Gotcha. So would like heat or ice either one help with this as well? Like if I put out if I put a rice pack on my bum would that help kind of relax everything or is that either going to make the problem worse or not do anything at all?

So heat and ice in general, what they do is make your nervous system not give as strong of a pain signal for a short time. They don't really do much to actually physically change what's going on in that area which is a good thing because think about it, if it was that easy to change the temperature of the, or change our muscles by heat, it would be tough to go live outside.

In Arizona. So yeah, so the heat and ice can sometimes feel nice for a short while. And so if that's the case, I'm never gonna say like, don't do that. But as far as for actually making a longer, lasting symptom relief, it's gonna be movement.

It's gonna be movement. Okay, good to know. Cause in my head I was like, oh well if it needs to relax, then maybe I'll just put heat on it. Okay, well that might help if it's really bad and I need an hour where it doesn't hurt, right?

So that might be a good time to do it. Gotcha. Exactly, exactly. Yes, if you're looking for just a short -term pain relief thing that can sometimes be helpful. Okay, good to know. All right, let's jump into number three.

The next one is pelvic girdle pain. I had a lot of people comment on one of my reels on Instagram. I posted a stretching reel that went viral and a lot of people were like, this doesn't work cause I have pelvic girdle pain.

So let's talk about what that is and why we might be experiencing it and what actually is gonna help it. Yeah, so pelvic girdle pain is extremely painful. It is in the pubic bone, so in the front of your pelvis, where your right hip basically and left hip kind of come together in the front.

And that joint usually is very, very strong and stable and barely has any movement. And so with pregnancy, the relaxin' and hormones give that joint a little bit more movement. And when our body feels movement where there usually isn't any, it can send very, very strong pain signals.

Even though nothing really is, much is happening. Right. And so with all joints, but the pubic joint in general, it has the ligamentous support, which is getting affected by the relaxin'. So that's like the ligament holding it together.

And then it has the just shape support of just how it's shaped. That's the other way that you get support in that area. And the... Third way you get support in that area are your muscles. And so one way to help minimize the likelihood that you'll get that, that of the girdle pain, is to get your muscles that give support in that area very strong so that they are more ready to kind of pick up the slack of the ligaments during pregnancy.

And then to help dirt, if you already have that issue, sometimes doing the inner thigh strengthening can help during and also some like kegels can help as well. But it is tough once you have that to just strengthen the muscles enough to make it go away during pregnancy.

So that is one thing that I try to say, like just get them real strong and it'll help support it and hopefully not be painful for you. Absolutely, so would that be our pelvic floor muscles then that we need to strengthen to help prevent pelvic girdle pain as much as possible?

Or is it a different set of muscles? It is the pelvic floor muscles. It's also the inner thigh muscles. Your adductors are huge, huge, huge, huge with this. And then also just our hip muscles as well.

Gotcha, okay, so this one, if we want to get ahead of the game and get on top of it, is this something that you would recommend trying to work on like before you even get pregnant? Like strengthening those muscles?

Yes, yes, and yes, that can be very helpful. Okay, good to know. I feel like something you and I are trying to teach women and I wish more women understood is that a lot of things that we experience in pregnancy are just due to a lack of preparation, whether it's nutritionally or physiologically.

And I heard someone say this in a podcast recently. It was like, you spend a year planning your wedding. You might go to the gym and hire a personal trainer so you're in shape for your wedding. You are planning the venue, the menu, the cake, the dress, like all these things.

You're planning a year in advance for your wedding and yet you're ready to just be pregnant on the drop of a hat when you actually decide that that's what you want for your family. And then you expect to have everything go as smooth as possible.

Why aren't we planning for pregnancy? physiologically and nutritionally the same way that we're planning for our wedding a year in advance. So I think this is a really good example of, okay, well, we can't always avoid pelvic girdle pain, but if we know that this is something that we can't super fix like once we have it, we might as well get ahead of the game and try and get those muscles ready before we get pregnant and then continue that on to help combat that.

Are sure and I love that analogy. I'm totally going to steal it. Please do. Because a lot of women that hear that they're like, oops. Yeah, that was me. I'm like not to pour salt in the wound, but yeah, it's a lot.

Yeah, that's so true. And I think part of the issue is that in the medical community, so people, you know, when they're thinking about getting pregnant, you know, they go to their doctor to talk about it.

And people in the medical community, I don't think in general take the physical and physiologic changes that happen to a woman, to women during pregnancy and in postpartum seriously. Yeah, it's just, it's fine.

But it is a big thing. Yeah, like literally our whole body changes. Everything about our body changes our gut, our brain. Did you know that our brain literally changes shape and loses gray matter during pregnancy?

It's wild. Yep. Like no one talks about that, but that's what happens. And so, you know, you talk about mom brain. Well, we lose gray matter. So, but yeah, I agree. It's not taken seriously. And so I guess that's why you and I are here doing what we do.

It's because we want to do that. Yeah. One fun fact about bomb brain, this is still, they're still like figuring all this out, but they say that that loss of gray matter, like your brain's kind of processing memory power is because you're pruning old information to get ready for all the new things that you need to learn and get ready for as a mother.

To take care of your baby. That's awesome. I love that so much. That makes me feel a little bit better about my mom brain. Just think about all the things that you know about your children immediately.

It's like, oh, I know that if they make this sound, they need X, Y, Z, and then, you know, my toddler needs their toast made exactly like this. It's like so many new things that you're remembering that you don't even, I think a lot of people don't even recognize how much stuff it is.

Yeah, like right now I don't know if everyone listening can hear my baby. She's sleeping next to me. She started to make noises. I'm like, she's about to poop in her sleep. She just pooped in her sleep.

She's sleeping and we're like, grunting one out. Oh man. Okay, that was a fun tangent. We could talk about that all day long. Let's jump to number four. This one I wanted to include because you did a TikTok about it and it literally blew my mind.

Let's talk about carpal tunnel syndrome and or tingly fingers and arms. Why is that happening and what should we be doing to minimize that? So there's a few things that could be going on. Definitely the swelling and stuff like that can affect it too, like in your wrist.

But a lot of times people are given a wrist brace for carpal tunnel and just blindly they go to the doctor and they just get thrown a wrist brace and kicked out the door. And often that those tingly hands and arms are not even coming from your wrist.

So you're just putting on a brace for no reason. So the nerves that go down into your wrist start up in your neck and then go through your shoulder and come all the way down your arm. And during pregnancy, your upper back rounds more and that closes off a lot of that ass way.

up in the neck and shoulder area. And so often the issue is the neck and shoulder area, you're just feeling it down in your hand. That is so fascinating. So it's essentially maybe not like a pinched nerve, but like it's being compressed, right?

By our shoulders rounding forward and everything that's supposed to be going down to our fingers is now shorter and almost like being compressed and pushed on, right? Exactly. So what do we do to fix that?

Or minimize it as much as possible? Yeah, so to help it and minimize it, oftentimes doing movements that are more chest opening can be really helpful for that to kind of, undo some of that rounding that's happening.

Also doing some upper back movement and extension as well. So it flexes and rounds. So we want to do some extension and opening. And then the other thing is with that rounding, our shoulder blade kind of tips forwards.

And so doing some strengthening that can help tip it backwards, can help open up some of that as well. So yeah, having a strong back and then having a mobile chest is what you're saying will help with this.

Am I understanding that right? Yes, but more than a mobile chest is a mobile upper back. That's like a big, big one that I need to work on with almost everyone. Yeah, I'm sitting here saying. So I know we can't demo these exercises because it's a podcast, it's audio.

But in my head, I'm trying to think of exercises that I would do with weights at the gym that would do that. Are lat pull downs a good place to start with that? Like what kinds of exercises are we talking about?

I'm really curious. Yeah, a lat pull down can help any sort of row, any sort of pulling where you're pulling on anything. So a row, lat pull down, ring row, anything like that can be really helpful. And then also balancing it out with some pushing where you let your shoulder blade come forward.

So that pulling with that pushing can help kind of move everything to where we you want it to be. Gotcha. And for the shoulder aspect, I know you just mentioned that, but could we do like lateral raises on the side, or front raises, or y raises?

Are those all good to help strengthen the shoulders and the delts and the traps to like provide that structure in our shoulders and our upper back? Yeah, I, and again, this isn't something that needs to be avoided.

This is if someone was already having this issue. I probably wouldn't go for the front raises, just because it kind of compresses that, and then compresses it more as that muscle works to bring it up.

But everything else that you mentioned is gravy. And again, front raises are great. strengthen them, but if you're having that issue already, that might just be a little bit compressing to it. Okay, good to know.

Ladies, I hope you are paying attention to this because this is like so fascinating. I love it. It made me feel so validated that I was still doing chest exercises while I was pregnant. I was like, this is stupid.

I hate bench press. I hate this, but like it was helping. Okay, number five is lightning crotch. Is this something that we can do or manage? That's a tough one to. So that is often either from nerve compression or actually could be from ligament pain as well.

When people describe it to me, they they use the same term, lightning crotch, but it's usually one of those two things. And the nerve pain, especially sometimes doing some like pelvic floor relaxation type stuff can be helpful.

It is a little bit tough with the if it is more ligament pain though, unfortunately. And how can we tell the difference between the two? Is it just trial and error or is there a way to tell? Trial and error and also I usually ask when they, when you feel it.

Okay, so if it's a little bit more position dependent in a certain way, it's usually more ligamenty. If it's not, if it doesn't follow quite as much of a positiony pattern, it's probably a little bit more nerdy.

And with the nerves without just be like maybe baby is shifting in the uterus and all of a sudden they put pressure down there and that's when we feel it? Is that where I'm getting that from? Exactly.

Yes, and that's why it's a tough one because it's kind of more of an internal nerve. So there's not as much that can be done for it. Some things are just baby pressing on stuff and that is really hard to like do anything for.

Those ding kids. Oh my gosh. Okay, well at least for me that makes me feel a little bit better that now I know why it's happening. It's not just like oh you're pregnant. Okay, yes obviously I'm pregnant but like now we have a better understanding of why it's happening.

-- AD BREAK --

Did you know that the current standards for prenatal vitamins are only based on the minimum requirements to avoid disease and that pregnant women were not included in the initial research? On top of that, it's estimated that although 97% of pregnant women take a daily prenatal, 95% of pregnant women are nutritionally depleted both during and after pregnancy.

Last time I checked, we deserve to thrive, not just survive during pregnancy. That's why I choose needed, a nutrition -based supplement complex that nourishes moms through fertility, pregnancy, and postpartum.

Their prenatal vitamins have 23 essential nutrients for pregnancy that have been dosed in optimal levels and methylated for better absorption. They also provide their products in both pill and powder form, so nausea and supplements.

Get 20% off your first month of needed using the code MAMA20. That's M -A -M -A -2 -0 at the link in the show notes.


Okay, we touched on this at the beginning. Let's get into low back pain. This one, I feel like has a lot that goes into it, but it's also a very big issue for most women.

Let's talk about low back pain, why it's happening, and what you recommend to all of your clients to do about it. Low back pain is not something that I can say, this is exactly why it's happening. There's always so many different factors.

Everyone is so different as to why that's happening. So it is a little bit tough to say, this is why it's happening, this is the thing that you should do for it. But with pregnancy in particular. One thing that I have noticed is often a contributor is that with as your stomach grows, your lower back, your spine, your lower spine has to compress and become more extended just to be able to not topple over.

And so that whole lower heart of your spine is more compressed all the time. And then those muscles that's attached to the spine there are also shortening as well. And so during pregnancy, the spine is also getting more extended.

Back pain is often, you know, just from having all that extra weight out front. The muscles aren't strong enough to handle it. You're getting all that compression. The postpartum, a lot of times that can linger because the your low back is still in that compressed position.

And those muscles are still tightened and shortened. And so a lot of times one piece of the puzzle is that I'm working with people to try to lengthen those muscles as we strengthen them and get that low back to be able to be a little bit less compressed.

So in this case, is it more stretching or strength training that should be our solution if we are struggling with really bad low back pain? Yes. So with a lot of my postpartum clients, the first thing that we do to help to help things move in the right direction is different breathing exercises because we use kind of the your positioning and your breathing to move things where we want them to and just allow them to relax a little bit more.

But I always am following it with strengthening because the mobility stuff doesn't really lock in and carry over. Unless we also then strengthen those positions. Gotcha. OK, so. Basically, your best bet is to work with a certified personal trainer so they can help you through this and really understand what's going on with you just because it's so multifaceted, right?

Yes, yes. And I know that's a frustrating answer for people, but I would start with trying to lengthen and strengthen that area and getting strong overall. And if that's not enough to help for you, then getting a professional to help you troubleshoot and figure out what you need is just what you got to do.

Gotcha. So does working our core and pelvic floor help a little bit with low back pain? Absolutely, yes. So when people think core, they think, you know, there are abs, like those six -pack muscles, maybe like your side ab muscles, all that good stuff.

But what our core really is, is those muscles plus our pelvic floor, plus our back muscles, plus our diaphragm. So it almost makes like a soda can kind of shape. And that is what our core is. And though all of those things together, working together, is what gives us the stability that we need and just keeps us feeling good.

Gotcha. Yeah, I, when I was pregnant, I found that something that helped my low back pain was focusing, obviously like on stretching and stuff, but focusing on core and pelvic floor work and then also glutes.

I felt like every time I was intentional about my leg day and the exercises that I did during my leg day, it just made my body feel stronger so I could handle the demands that were being put on my lower back.

And I know those are a lot of the muscles that you talked about in the beginning, you're like, yep, I tell all my clients to do glutes, add doctors core and upper back. And I feel like focusing on all of those and being really intentional with those exercises is going to, is going to help with that low back pain.

And then making sure that we stretch at the end of it and really try and lengthen that out and relax what we just worked with strength training should help alleviate some of the, obviously we can't make it all go away because our spine is changing and our baby is getting bigger.

So there's only so much we can do, but. hopefully that helps a little bit. Yes for sure and like the hip muscles and glute muscles like that whole the glutes hips pelvic floor is all so interconnected that like when I'm working with people I don't even really separate them in my mind they all kind of work together so yeah and getting those strong just allows your back muscles to not have to do quite as much of the work and so can be really helpful.

Okay I love that that's a really good point to not try and separate it and just be like no we're just kind of doing it all together that's a good way of putting in. Okay, the very last one I wanted to touch on is hypermobility.

I know this is a little bit more niche. It's not necessarily something a lot of women struggle with, but I have had multiple people on social media message me and ask, how do I, how do I strength train?

How do I stretch? How do I do all these things that people are telling me to do if I'm struggling with hypermobility during pregnancy? What would you say to them? Yeah, so firstly, one of my colleagues, hypermobile Cairo on Instagram, she is amazing and with hypermobility.

So if anyone's having issues with hypermobility in general, she's like my go -to gal. I highly recommend. Okay, we'll link her in the show notes in case anyone wants to check her out. Okay, yeah, because she has helped me understand how to help people with hypermobility so much.

So like whenever I get a hypermobile question, I always have to shout her out because she has been a huge resource to me. But so with hypermobility, with, because a lot of the things, especially in pregnancy that people see are like, oh, I need to do these stretches and stuff for labor and these stretches for my hips and whatever.

And with hypermobility, I like to think of it more as using getting comfortable and familiar with those different positions, as opposed to trying to go as far and as deep as you possibly can or stretch those positions.

Because you just want to get your body used to moving in that way that you'll want to be moving during labor. So as opposed to thinking about needing to do stretches, think of it more as just getting to know those positions.

That makes sense. Yeah, because a lot of the women that reached out to me about hypermobility came because of a labor prep stretching video that I posted. And they're like, this isn't helpful because I'm hypermobile.

So how am I supposed to prepare for labor? And I was like, well, I'm not the expert, go talk to Jen. But yeah, I would say the same thing. Just more so focus on, OK, if you're planning on getting an epidural, are you planning on being in bed the entire time, like once labor starts?

Or are you going to move around? And if you're moving around, are you going to bounce on a birthing ball? Are you going to go on hands and knees? Are you just going to walk? What's going to help you feel comfortable, as much as you can be during labor, and then facilitate the process of labor without?

Yeah, putting too much strain on your body. Exactly. And then the other thing with hypermobility is that with hypermobility is when it's most important to do strength training. Unless we're talking, there are some, you know, hypermobility diagnoses that you do have to be a bit more cautious around lifting.

They're quite rare and people who have them know. But for most people with hypermobility, the strength training is the most important thing because you have so much extra, no, you just have so much movement.

And so having the muscles to be able to control that movement and not necessarily decrease that movement, but just be able to handle and control it is a game changer. So I always am encouraging people with hypermobility to strengthen as much as possible.

And I often will. So if I was to give someone a like rotational mobility movement, if I had someone who was hypermobile, I might make that a resisted rotation mobility. So that they're having to pull against something and use their muscles to control that motion as opposed to just like a stretch.

Gotcha. That makes a lot of sense. Okay, I have an off the book question and if you don't know the answer, that's totally fine, but it just popped into my head. Is hypermobility, something that is caused by relaxing or is it usually like someone already has hypermobility and it's exacerbated by pregnancy and relaxing?

Like how like how many women do you think are going to struggle with hypermobility? Is it something we develop or is it just something that like gets worse because we're pregnant? So pure hypermobility is a diagnosis and there is like a diagnosis criteria.

You have to have like X number of joints that move really far and so most people that is something they genetically have to begin with and then they might be exacerbated by the relaxin because now they have even more movement when they already had way more than most people have.

And then other people who were not hypermobile prior to pregnancy may gain more range of motion, more movement, more mobility, but that wouldn't be considered hypermobility. It's more so pregnancy related increase in mobility.

If it did for some reason stick around postpartum, I don't think that's very common, like real hypermobility, not just like a bit of extra motion. I think that's very common to develop and have forever, but you may while you're pregnant and getting back your relaxin levels postpartum have a bit of extra movement.

Okay, so to summarize what you're saying, if you're hypermobile, you know it. Like it's not just something that becomes so dramatic just because of relaxin, it's most usually going to be you've already had it, you know about it, and it just becomes worse.

So you can't just assume, oh well because I'm pregnant now I'm hypermobile. It's like something you kind of know about beforehand. Exactly, yes. Okay, that makes a lot of sense because I figured someone was going to ask, okay, well then how do I know?

You're going to know if you have it. Yeah, yeah, and people will, some people will throw that term around. Yeah. you know, loosely like, oh, I'm hypermobile, but they're using it a bit loosely. But if you have real hypermobility, you likely know it.

Okay, good to know. All right, so with all of these symptoms that we've talked about, and just all the things that we deal with during pregnancy, I'm sure there are going to be some women that, you know, ask their doctor for advice or, you know, bring up their concerns or their symptoms to their doctor to see if there's something the doctor can help with.

And even if it's not like, you know, physical things like, oh, we just need to strength train. I know that there's always things that we're going to ask our doctor and they're like, sorry, you're just pregnant or no, I don't think that's a big deal.

And I know you talk about this a lot on your page, but I really want to talk about advocating for ourselves with our healthcare provider. because I feel like our moms, and maybe even our grandmas, grew up in this era where the doctors were the know -it -alls, in the sense that they're the experts, they went to school, and for that reason, they're infallible, and you just take everything that they say, you know, like, without question, and just go with it.

And I think we're getting to a point in society where that's not really working anymore, and you talk about that a lot. So how can we advocate for ourselves while still respecting our healthcare provider and their expertise, but also saying, actually, I learned this from, you know, a pelvic floor physical therapist, or actually, this concern is really valid, I want to explore it, how do we do that in a really professional way?

Yeah, and this could be a whole other podcast. I could talk about this for a whole year, I think. But so the first thing to keep in mind is a lot of people are worried about asking questions and worried about pushing back a little bit because they don't want to seem difficult, or they're scared, or for a million different reasons.

Or that they don't respect their doctor. Yes, exactly. And what I like to point out is, you know, if you're doing it in a, you know, if you're not yelling at them or calling them stupid, or you know, if you're doing it in a respectable way, any doctor, NP, PA, anyone worth their salt is not going to be mad that you're asking questions.

If they're not going to be mad, are then they are not good doctors because it is as a medical professional it is the onus is on them to explain things well enough and explain their plan of care well enough that you understand it and you feel comfortable with it so if you're asking questions or pushing back a little bit and getting you know a bad response that is a sign of a bad doctor and you know also keep in mind that even amazing doctors are currently working in a very bad system they are not given enough time with you they have to see so many people in one day and even the most well -intentioned, smartest people in the world can sometimes get into, become complacent or miss something because of that system they're working in.

And so it is unfortunately up to us to maybe make them pause and make them think about something. If you have a concern or if there's something that you don't think that they've taken into consideration.

So I always tell people like if they have a problem with it, they're a bad doctor. And if you have the ability, go find another one. I know that's not the case for everybody, but if it's within your financial abilities or just where you live and there's options, then you should go find somebody else that will listen to you.

Absolutely. And again, I know this is not an option for everyone. But for the people for who it is an option, you should be continuing to change your doctor until you find one that is right for you. Like I just moved to North Carolina and it took me three primary care visits to find one that I liked.

And the first one was an absolute no. Second one was okay, but I was like, I'm not getting good feeling from you. This isn't right. Third one, oh my gosh, when you find a good doctor, you know. Like I felt so good leaving that appointment.

I was like, I feel hurt. Yes. So I always encourage everyone if they are able to, if they feel uncomfortable with their doctor for any reason, go down the street, find a new one. And it's not that they aren't qualified to be a doctor.

It's not like you're saying, oh, you went to this medical school, so you can't be my doctor or whatever. It's not a reflection on their credentials necessarily. It's more how they interact with their knowledge, how they use that knowledge to interact with you.

It's, yeah, it's more of like a relationship thing, right? The goal is that we have a relationship with our doctor and we feel safe enough to bring up concerns and know that they're going to listen and say, oh, well, normally I do it this way, but...

you know, if that doesn't align with what you're comfortable with, let's see if we can find another way to fix this. That's what we're going for, is someone who wants to have a relationship with you as a patient, I think.

Exactly. And oftentimes for non -emergency, non -life or death situations, there are many, many options of what can be done. And so being able to work together to figure out the one that they feel comfortable and good about and you feel comfortable and good about is really important.

Yeah, and it will make all the difference in your health. Like it honestly will. Whether you are like pregnant or postpartum or you're just trying to be healthy and have a doctor that you can go to for whatever, it seriously will make all the difference in your health if you find a doctor that you actually like and trust and feel heard from.

Yes, definitely. So if your spidey senses are tingling, you need to listen to them though. Yeah, and like you said, we could talk about this all day long, but let's go ahead and wrap up. We had such a good conversation today.

I learned a lot. I thought I knew like more than the average Jane, but I learned so much today. So I'm so excited for everyone listening to just like walk away from this conversation. Okay, so the final question that I have for you is a question that I ask all of my guests.

And that question is, what is a non -negotiable for you to living a well -nerished life? Movement. Movement. Whether that be you know, lifting and harder workouts or walking through the woods or going for a walk with my family or with my dogs or yeah movement.

That's a great one. It's something so simple right? We don't have to make it a complicated thing. It really is I'm gonna park farther away from the grocery store so that I walk more or my office is on the third floor.

I'm gonna challenge myself to take the stairs instead of the elevator. It's incorporating that in all that we do. That's a really great answer. Well Jen, thank you so so much for taking the time to come on the podcast.

I'm sure we are gonna have to have you back to do a postpartum focus because we were all about pregnancy today but obviously pregnancy leads into postpartum and you've got a whole nother set of things to talk about for pregnancy.

I'm going to go out of limb and speak on behalf of my audience and say we would love to invite you back for another episode. Sounds good. I had a lot of fun. You're a great host. So thanks so much for having me.

Oh, thank you. Okay, so you're obviously a wealth of knowledge. And I want everyone to be able to connect with you as best they can. So where can we find you on social media? How can we learn more? And then how can we work with you if that's something that we want to do?

On Instagram, I am DocGenFitness. And then on TikTok, I am at DocGenB. And those are two great resources. When I make content, I literally think, what is the most helpful thing I can put out today? So I do my best to really put a lot of useful information there.

As far as for working with me, right now I am only doing one -to -one coaching, which is very high support and very individualized. But in the near future, we'll be opening up to do some small group stuff for people who need a little less individualization, a little less constant support, but still get that support and resource.

But right now, just the one -on -one. Perfect. And if we do want that one -on -one, do we just message you? Is there an email or a website that we can go to to get in touch with that? Yes, you can either message me on Instagram or if you go to docgenfitness .com you can find how to apply for coaching there.

Perfect. Okay, mama's go give her a follow. If you haven't noticed from her conversation today, she's awesome. For all of my postpartum mamas, she recently did a series. I believe it was for postpartum recovery, right?

For both vaginal and C -section deliveries, how you to get back into movement. So definitely go check that out on her pages because that was really helpful for me. She just so happened to start it right as I was giving birth.

So I'd like to think it was just for me. Perfect. I love when the stars align. Okay, thank you so much, Jen. Mamas, we will see you in the next episode.