Advertise on podcast: Active Mom Podcast: Pregnancy, Postpartum, Perimenopause, Menopause & Beyond

Send us Fan Mail Your baby is NOT sucking the calcium out of your bones.  That's the line all over social. What's actually happening is your body mobilizing a small amount of calcium from bone to help make milk. And across 14 studies, it looks a lot more like a temporary loan than a permanent loss. This week I sat down with two first-time podcasters from Duke.  Dr. Emma Kosbab started this systematic review and meta-analysis as a PT student. Dr. Laura Pietrosimone was her research mentor. Together with their team they screened 6,568 citations to land on 14 studies about breastfeeding and bone density, and we get into what that means for the mom who wants to run and lift. 🔹 Why breastfeeding touches bone at all (and why "mobilizing" is a much less scary word)  🔹 What happens at the low back, the hip, and the whole body, from early postpartum through weaning  🔹 Whether breastfeeding longer changes the picture  🔹 Who may want to pay closer attention, like moms with a history of bone stress injury or under-fueling  🔹 Who belongs on your care team if that's you  🔹 The questions nobody has answered yet, starting with how many extra calories breastfeeding actually takes If you're nursing and wondering whether your bones can handle getting back to running or lifting, this one's for you.  Read the paper:  Kosbab E, Christopher S, Horn ME, et al. Changes in Bone Mineral Density in Postpartum People During Lactation: A Systematic Review and Meta-Analysis. J Athl Train. 2025. https://doi.org/10.4085/1062-6050-0497.25  About Emma: Emma Kosbab, PT, DPT, LAT, ATC is an outpatient ortho and sports PT and outreach athletic trainer with Duke Health, and a contract PT/AT with USA Paralympic Swim. She loves working with female athletes and moms through pregnancy and postpartum. Off the clock: volleyball, running, lifting, and anything outside (Utah roots). Connect with Emma: Instagram @em_kosbab12 · https://www.linkedin.com/in/emma-kosbab/  About Laura: Dr. Laura Pietrosimone, PT, DPT, PhD is an Assistant Professor and clinical researcher in Duke's Doctor of Physical Therapy Division. She studies how movement and physical activity change after lower extremity injury, and she's passionate about female athlete health across the lifespan. She's a mom of three, a runner, and happiest in the mountains. Connect with Laura: Instagram @lstanpietro · https://www.linkedin.com/in/laura-stanley-pietrosimone-4ba30615/  This episode is education, not individualized medical advice.  The Active Mom Podcast — a real mom's guide to pregnancy, postpartum, perimenopause & beyond, for active moms and the professionals who help them get there. Quick-hit conversations with moms, providers, and researchers... because you don't have a lot of free time (you're probably listening at 1.5x right now). Follow so you don't miss an episode. Rate & review ⭐⭐⭐⭐⭐ — it's how the next mom searching for these answers actually finds them. Share it with the friend who needs it. Questions or topic requests? DM me 💌

Send us Fan Mail Same run. Same treadmill. Same impact. So why do some women leak and others don’t? That’s the question Natália Cardoso Campos, PT, MSc, couldn’t let go of. She’s a physio and PhD researcher from the Federal University of Minas Gerais (UFMG) in Brazil, here in the US for ten months at UMass Motor Control Lab, Amherst on a Fulbright Scholarship under the supervision of Dr. Richard Van Emmerick to analyze new data. Her Master's study put 32 female runners on a treadmill with force plates built in and had them run for 30 minutes. Half of them leak and half did not.  The runners who leaked had pelvic floors just as strong as the ones who didn’t. The difference showed up further down the chain, in how their ankles and hips handled impact. (We recorded this right before we finally got to meet in person at ICS 2026 in Maastricht!) We talked about: 🔹 How a biomechanics lab full of male runners led her to study women who leak  🔹 What “high impact” even means when everyone is doing the exact same run  🔹 Less energy absorbed at the ankle, more at the hip. What that might mean for the pelvis  🔹 Do women who leak hit the ground harder? (Nope.)  🔹 Equifinality: why your leak and my leak can have totally different recipes  🔹 What you can and CAN’T take into the clinic from one study  🔹 What her PhD is chasing next If you’ve been told your pelvic floor is strong and you’re still leaking on your runs, this one is for you. And if you’re a PT treating runners, Natália put it best: “We need to stop treating symptoms and start treating women.” 📄 Campos NC et al. Inefficient impact absorption and reduced shock attenuation in female runners with stress urinary incontinence. Journal of Biomechanics, 2025. https://doi.org/10.1016/j.jbiomech.2025.112753 👋 Find Natália: Instagram @nataliacardosofisio · ResearchGate This episode is education, not medical advice. The Active Mom Podcast — a real mom's guide to pregnancy, postpartum, perimenopause & beyond, for active moms and the professionals who help them get there. Quick-hit conversations with moms, providers, and researchers... because you don't have a lot of free time (you're probably listening at 1.5x right now). Follow so you don't miss an episode. Rate & review ⭐⭐⭐⭐⭐ — it's how the next mom searching for these answers actually finds them. Share it with the friend who needs it. Questions or topic requests? DM me 💌

Send us Fan Mail What do you do when there’s no evidence to build evidence-based practice? Dr. Chris Edwards has an answer: “We have conversations.” Chris, PhD, clinical exercise physiologist and researcher, works with tactical athletes: military, police, fire and paramedic teams. She once sold her company and her house, packed her car with her dog, and drove across Canada to do this work. Her PhD asked a question almost nobody was asking: does having a baby change injury risk for women whose job is to carry heavy things, fast, under pressure? Spoiler alert, in her words: it does. In this episode we get into:  🔹 How patterns she saw in veterans’ movement sent her across the country  🔹 What her research found about childbirth and repetitive strain injuries  🔹 Why telling your chain of command you’re pregnant still feels risky for a lot of servicewomen  🔹 What return to duty looks like after a baby, and who gets to decide  🔹 Leakage, prolapse and the pelvic floor demands of rucks, fitness tests and parachute jumps  🔹 Why a trauma-informed approach matters with this population  🔹 Where her research goes next, including menopause Whether you wear a uniform, carry a toddler, or treat the women who do both, this one’s for you. Find Chris: Instagram @drchrismedwards | drchrismedwards.com The Active Mom Podcast — a real mom's guide to pregnancy, postpartum, perimenopause & beyond, for active moms and the professionals who help them get there. Quick-hit conversations with moms, providers, and researchers... because you don't have a lot of free time (you're probably listening at 1.5x right now). Follow so you don't miss an episode. Rate & review ⭐⭐⭐⭐⭐ — it's how the next mom searching for these answers actually finds them. Share it with the friend who needs it. Questions or topic requests? DM me 💌

Send us Fan Mail Brand new PT. Skilled nursing. Asking her patients what kind of exercise they enjoy. Women there for heart disease, osteoporosis, a broken hip. And over and over, the same answer. They hadn't exercised since they had a baby. That's where Dr. Lisa VanWiel's research started. She's a pelvic health PT and researcher at the University of Wisconsin La Crosse, and her work links leaking to a lot more than your bladder. Mental health. How women see themselves. Even heart health. Not to scare you. Because if leaking is a signal, it's also a chance to get in early. What we get into:  🔹 Why Lisa sees leaking as a signal about the whole body, not just the pelvic floor  🔹 What her research found about leaking, postpartum mental health, and how women see themselves  🔹 Whether every mom actually needs pelvic floor PT (my answer might surprise you)  🔹 Why nobody needs permission to move their own body  🔹 20,000 medical records and a surprising link between leaking and heart health  🔹 Association vs causation, in plain English If you've ever wondered whether leaking means you should stop moving, press play. Then tell me: did anyone talk to you about your pelvic floor before you had your baby? Find Lisa on Instagram at @empower_lab. This episode is education, not individualized medical advice. Talk with your own provider or pelvic floor PT about your situation. Chapters: 00:00 Welcome 00:36 Meet Lisa 02:19 Taking PT boards eight months pregnant 03:20 From pediatrics to pelvic health 05:50 Why prevention became the mission 10:04 Reproductive transitions and lifespan health 12:21 Leaking as an alarm signal, not the ending 14:21 Leaking and postpartum mental health 17:32 Leaking and identity 20:57 Active moms, and a system not built for them 22:28 Awareness vs actually getting care 27:01 Does every mom need pelvic floor PT? 28:53 Why gatekeeping activity is paternalistic 33:55 Pelvic floor PT is strength training 36:05 20,000 charts: leaking and heart health 39:12 Association vs causation, explained 41:25 The two competing theories 42:45 What’s next: female athletes and return to exercise 44:39 Teaching our daughters about their bodies 47:53 What it means to be an active mom 49:24 Where to find Lisa The Active Mom Podcast — a real mom's guide to pregnancy, postpartum, perimenopause & beyond, for active moms and the professionals who help them get there. Quick-hit conversations with moms, providers, and researchers... because you don't have a lot of free time (you're probably listening at 1.5x right now). Follow so you don't miss an episode. Rate & review ⭐⭐⭐⭐⭐ — it's how the next mom searching for these answers actually finds them. Share it with the friend who needs it. Questions or topic requests? DM me 💌

Send us Fan Mail She booked the appointment. She showed up. She wants something to change. And she still hasn't done her exercises. Sónia Coelho Cristóvão, physiotherapist and PhD researcher at the University of Gothenburg, kept seeing that in her clinic. So when she started building a digital pelvic floor program for Sweden's public healthcare system, she went to the research first. Her new review pulled together 18 studies to ask two questions: do digital pelvic floor programs actually work in pregnancy and postpartum, and what do women say helps or gets in the way? 🔹 Why pregnancy and postpartum told two different stories in the research  🔹 The surprise: women using digital programs stuck with their training more, and got stronger  🔹 The 5 things women say make or break their pelvic floor training (spoiler: they WANT to do it)  🔹 Why tracking features can turn into one more burden  🔹 Why women still want a real person in their care, not just an app  🔹 Where AI could help programs adapt to YOU, and why she's a little more cautious lately  🔹 Kegels vs no Kegels, and why that's the wrong fight  🔹 What's next: exercise dosing and C-section recovery If your home exercise program lives in a drawer somewhere, press play. And clinicians… when a patient tells you she didn't do her exercises, what do you say next? This episode is education, not medical advice. Talk with your own maternity care team or pelvic floor PT about your situation. The Active Mom Podcast — a real mom's guide to pregnancy, postpartum, perimenopause & beyond, for active moms and the professionals who help them get there. Quick-hit conversations with moms, providers, and researchers... because you don't have a lot of free time (you're probably listening at 1.5x right now). Follow so you don't miss an episode. Rate & review ⭐⭐⭐⭐⭐ — it's how the next mom searching for these answers actually finds them. Share it with the friend who needs it. Questions or topic requests? DM me 💌

Send us Fan Mail Don't jump. Don't lift heavy. Exhale on the way up. Protect your pelvic floor from all that pressure. Funny thing, though. Nobody ever tells you not to cough. So where did the "too much pressure" advice actually come from? Dr. Sabine Vesting, a physio in Gothenburg, Sweden, and researcher with the MFM lab at the University of Ottawa, went back through studies dating to 1978 to find out. More than 4,000 papers screened. 52 that measured it. And not one measured it directly inside the abdomen. She's back on the show (Ep 184 was her first visit), and we get into: 🔹 What a sensor in the vagina, rectum, stomach or bladder is really picking up when you move  🔹 Why the scary jumping numbers don't mean what you've been told  🔹 Coughing vs running, and why how LONG matters as much as how high  🔹 What the pressure data can and can't tell us about leaking on the run  🔹 How urethral support changes after a run, in runners who leak AND runners who don't  🔹 Why passive support may matter more than strength for some runners who leak  🔹 Pessaries for active women, and why "isn't that for old women?" needs to retire  🔹 Over-the-counter devices, sizing kits, and why bigger isn't better If you've ever been told to skip something "because of the pressure," press play before you take that advice. What's one thing you've been told to avoid because of pressure? Find Sabine on Instagram: @BineVesting Research mentioned: -Vesting S, Rodrigues MP, McLean L. Measurement and interpretation of intra-abdominal pressure during physical activity: a scoping review. Int Urogynecol J. 2026. doi:10.1007/s00192-026-06635-2  -Rodrigues MP, Vesting S, Bérubé MÈ, Collins G, McLean L. The posterior urethrovesical angle in continent and incontinent women before and after a treadmill run. Int Urogynecol J. 2025. doi:10.1007/s00192-025-06460-z This episode is education, not medical advice. Talk with your own care team or pelvic floor PT about what's right for you. The Active Mom Podcast — a real mom's guide to pregnancy, postpartum, perimenopause & beyond, for active moms and the professionals who help them get there. Quick-hit conversations with moms, providers, and researchers... because you don't have a lot of free time (you're probably listening at 1.5x right now). Follow so you don't miss an episode. Rate & review ⭐⭐⭐⭐⭐ — it's how the next mom searching for these answers actually finds them. Share it with the friend who needs it. Questions or topic requests? DM me 💌

Send us Fan Mail In June, my very first mom friend texted me about a relay for her 50th. I said yes. THEN I asked what I'd signed up for. 3 running legs in less than 24 hours including night running. And I'm a morning runner, because over the years, evenings are exactly when leakage sneaks in for me, even on a walk. So I did what I'd do with any patient. I fit myself for a pessary. It took 4 devices, a lot of frustration, self-talk, and a brain trust of PT friends talking me off the ledge.  This is a solo, fully TMI episode (you've been warned) about the whole process, start to finish line. What we get into:  🔹 Why I stopped blaming "endurance" for leakage that shows up later in the day  🔹 Support pessaries vs space-occupying pessaries, and why that difference ended up mattering for me  🔹 The dish, the ring, the Soma and the cube: what each one did (and didn't do) for MY anatomy  🔹 Why "that didn't work for me" says nothing about what will work for you  🔹 What it was actually like wearing a cube through a relay, including the one gravel stretch where I wondered if I was about to lose it (literally)  🔹 The running research out of Linda McLean's lab in Ottawa that changed how I looked at my own problem If you've ever been offered a pessary and thought "not for me," or tried one, hated it and quit... listen to this one. And clinicians, this one's for you too. Oh, and our team of masters women came in second. We also brought the music. Leave it to the moms to make it fun. Have you ever been offered a pessary? Tell me how that conversation went. Questions about my pessary journey, or trying to find someone near you who fits them? Email me at [email protected] or DM me on Instagram @carriepagliano. I'm happy to help. This episode is education, not individualized medical advice. My anatomy, my solution. Yours may be completely different.  Chapters (approximate) 00:00 Why a solo pessary episode 02:21 How I learned to fit pessaries 05:30 My history: 2 C-sections, perimenopause, evening leakage 07:40 Is later-day leakage really just endurance? 09:40 Support vs space-occupying pessaries 12:00 Trial 1: the dish 13:00 Trial 2: the ring 18:00 Trial 3: the Soma, and why "it didn't work for me" isn't a verdict 20:30 Trial 4: the cube 24:00 Race logistics: when to put it in and take it out 27:25 Night leg: 5 miles downhill in the dark 30:30 A 5:30 a.m. porta potty and posterior wall support 34:36 Final leg: 7 miles uphill 37:00 Awareness vs discomfort 38:30 The research that changed how I saw my own problem 41:54 Your story isn't my story, and where to get help 44:16 Next up: the DC half  The Active Mom Podcast — a real mom's guide to pregnancy, postpartum, perimenopause & beyond, for active moms and the professionals who help them get there. Quick-hit conversations with moms, providers, and researchers... because you don't have a lot of free time (you're probably listening at 1.5x right now). Follow so you don't miss an episode. Rate & review ⭐⭐⭐⭐⭐ — it's how the next mom searching for these answers actually finds them. Share it with the friend who needs it. Questions or topic requests? DM me 💌

Send us Fan Mail Carrie was taught to go gentle. Brianna was taught to go harder. Neither one worked. Bri Battles reached out and said let's chat about history. I said okay. So here we are, two podcasts running as one episode, looking back at the last 10, 15, 20 years of how pregnant and postpartum athletes have been advised. And I promise you, we barely scratch the surface. Bri came up through the barbell side. I came up through the clinic side. Same women, opposite ends of the field, and for most of those years the two sides were not talking to each other at all. So we get into where we've come from and what's ahead. Which is funny timing, because I'm already in peri and Bri is over there hoping we get it figured out by the time she gets here. 🔷 The Theraband-around-the-belly era of diastasis "rehab," and the logic that made grown clinicians think it would work  🔷 Where the six week rule got its power (hint: it was a paperwork problem before it was a healing timeline)  🔷 Kegels, SI belts, and what pelvic health looked like when it was its own silo  🔷 The CrossFit video that pulled pelvic PTs into the conversation, and why "that's bad" was all we had  🔷 Performative pregnancy, performative postpartum, and what I'm calling performative perimenopause  🔷 Why some women need a kick in the ass to do MORE, while athletes need permission to adapt, and why those are two completely different conversations  🔷 The trouble with "listen to your body" when you've trained yourself to override it  🔷 What I'm screening for now that I wasn't asking about a year and a half ago  🔷 The weighted vest conversation I had with my neighbor, and what it says about all of this History matters here because it repeats. If you want to know whether the rule you were handed is current or just old, you have to know where it came from. Bri is at @briannabattles and @pregnant.postpartum.athlete. Her show is Practice Brave. So what decade is YOUR advice from? Come tell us. The Active Mom Podcast — a real mom's guide to pregnancy, postpartum, perimenopause & beyond, for active moms and the professionals who help them get there. Quick-hit conversations with moms, providers, and researchers... because you don't have a lot of free time (you're probably listening at 1.5x right now). Follow so you don't miss an episode. Rate & review ⭐⭐⭐⭐⭐ — it's how the next mom searching for these answers actually finds them. Share it with the friend who needs it. Questions or topic requests? DM me 💌

Send us Fan Mail Three years ago Joy Black came on this show to talk about climbing in pregnancy and postpartum, and quite honestly, we had almost no research to point at. She came back this time as a published researcher. Two papers, both in Sports Medicine, both with Dr. Margie Davenport's lab at University of Alberta. So we sat down and broke them open. The first is qualitative: 11 elite climbers, Olympic and World Cup level, on how they actually made decisions while pregnant. Not "is climbing risky, yes or no." Something much more interesting. They're assessing risk continuously, move to move, inside a single climb. The second one is big. 692 climbers. Roughly 64,000 hours of climbing during pregnancy. And it gives us numbers we have never had before. More than half of those climbers were never given a single recommendation about climbing during pregnancy by a practitioner. Not "here's how to modify." Not "here's what to watch." Nothing. And fewer than 40% were offered any rehab at all postpartum. We did not tell them no. We said nothing. Which they heard, correctly, as we have no idea what you do. 🔹 Why a fall in climbing is not what you think it is, and why that distinction changes everything  🔹 What the fall rate and adverse event rate actually were across 64,000 hours  🔹 The modifications climbers make on their own, top roping, vertical over steep, lower grades, not topping out  🔹 Controlled impact versus chaotic impact, and why a six week okay is not clearance for either  🔹 What to ask a climber in your clinic when you have never climbed in your life  🔹 The prolapse story that made me want to stand up and cheer, and maybe throw something I promise you, you do not have to be a climber to help a climber. Joy says it better than I do, and she says it about halfway in. Guest: Joy Black, climbing coach for pregnant and postpartum climbers, @climbingwithjoy, trainedbyjoy.com.  Her first time on the show was Season 2, Episode 12. Research collaborator: Dr. Margie Davenport, @drmargiedavenport Studies discussed:  🔹Davenport MH, Ray L, Black J, McHugh TL. "An Informed Risk Assessment": A Qualitative Exploration of Elite Climbers' Experiences During Pregnancy and the Postpartum Period. Sports Medicine. 2025. 🔹Davenport MH, Osachoff L, Ray L, Black J, Cheung NKY, McHugh TL. To Climb or Not to Climb: A Cross-Sectional Investigation of Risks and Benefits During Pregnancy and Postpartum. Sports Medicine. 2026. The Active Mom Podcast — a real mom's guide to pregnancy, postpartum, perimenopause & beyond, for active moms and the professionals who help them get there. Quick-hit conversations with moms, providers, and researchers... because you don't have a lot of free time (you're probably listening at 1.5x right now). Follow so you don't miss an episode. Rate & review ⭐⭐⭐⭐⭐ — it's how the next mom searching for these answers actually finds them. Share it with the friend who needs it. Questions or topic requests? DM me 💌

Send us Fan Mail Labor Day is in the rearview, the temps are finally doing what they're supposed to do, and this is the last rewind of the summer. Quite honestly, this is the one I wanted to close out on. When Margie came on for this one, she spent a good chunk of the hour telling me she couldn't tell me things. I'd ask, she'd dodge. I'd ask sideways, she'd dodge nicer. At one point I told her she was like a mystery novel and I just wanted to know what happened on the next page. She said she'd love to tell me, but she can't. She wasn't being precious about it. The Canadian postpartum guidelines were still in peer review, and she walked me through exactly why researchers go quiet. Until a paper has been through that process, she is not going to stand up and tell you something is safe. She also told me the first draft went out to postpartum women for feedback and came back with a note that it was going to cause a lot of mom guilt. So they went back and reworked the messaging. As a mom herself, that was not a message she was willing to send. Listening back now, with the guideline published and Margie already back on the show this past summer to walk us through it, this one plays completely differently. This is the hour right before. 🔹 Why the assumption that elite athletes have the best of everything is mostly wrong, and what happens to the ones who get told they're done at the first trimester  🔹 The athletes nobody has studied: the ones who wanted to come back and couldn't. Margie's team put out the invitation and got almost nothing back.  🔹 The one thing Margie says she'd go back and do more of, in pregnancy, in postpartum, and now heading into perimenopause  🔹 Postpartum and perimenopause showing up in the same body at the same time, and how little we currently have to offer either one  🔹 In Canada, 7% of all grant funding goes to women's health. The postpartum guideline got none of it. It got built by volunteers and undergrads.  🔹 The PhD student she says to watch, and why sleep may turn out to matter as much as exercise in this window Margie is one of my favorite people to just throw questions at, and this is her at her most honest about what we still don't know. Margie first came on the show back in Ep 38 in 2022, and she was back this summer on Ep 252 to walk through the guideline once it published. If this one leaves you wanting the answers, that's the episode with them. Find her on Instagram at @drmargiedavenport. One thing this whole hour keeps circling: screening before somebody hands you a program. Nobody can tell you what your body is ready for without looking at it first. If you're in the Arlington area, come see me in the clinic. If you're anywhere else, telehealth and virtual consults are open.  This is education, not individualized medical advice. If you're having symptoms, get eyes on it. The Active Mom Podcast — a real mom's guide to pregnancy, postpartum, perimenopause & beyond, for active moms and the professionals who help them get there. Quick-hit conversations with moms, providers, and researchers... because you don't have a lot of free time (you're probably listening at 1.5x right now). Follow so you don't miss an episode. Rate & review ⭐⭐⭐⭐⭐ — it's how the next mom searching for these answers actually finds them. Share it with the friend who needs it. Questions or topic requests? DM me 💌

Send us Fan Mail Somewhere between 2019 and now, "wait 12 weeks" turned into a rule. It is not a rule. It never was. I have been in pelvic health for 26 plus years, and right now I am watching that number get handed around in Facebook groups, on social, and quite honestly by a lot of professionals who are leaning really hard on it. I don't know that the foundation exists to do that. So this is a solo episode where I walk you back through how we got here. 🔹 Why the six week visit was a medical checkpoint, not a green light to run 🔹 What the 2019 UK document really is, and what it isn't 🔹 The 2024 international Delphi: 95 professionals, 12 countries, seven professions, and what they actually agreed on 🔹 Why "returning before 12 weeks is possible" is the line that keeps getting missed 🔹 The one in a hundred outlier, and why I will not shut her down 🔹 Gatekeeping. My own profession has been doing it, and I was a product of it 🔹 The 2025 Canadian postpartum guidelines, including why sleep got named a movement behavior 🔹 The four variables nobody puts on a timeline: sleep, fueling, support, mental health 🔹 What you control and what you absolutely do not 🔹 The line a kindergarten teacher gave me that I now use with patients If you are a mom trying to figure out when, this one gives you better questions than a date on the calendar. If you are a pro who has been leaning hard on 12 weeks, this one is an invitation to step back. And if what you really want to know is where YOU are right now, that is what the free Return to Run Readiness Screen is for. Balance, strength, impact. https://course.carriepagliano.com/R2Rreadyscreen IN THIS EPISODE (00:00) Why we are talking about 12 weeks right now (02:44) Where the six week mark came from (03:55) The 2019 UK document that was never a guideline (05:22) ACOG moved off six weeks in 2018 (08:50) The 2024 Delphi: what 95 professionals agreed on (11:16) The one in a hundred outlier (14:07) Gatekeeping movement in pregnancy and postpartum (16:08) The 2025 Canadian postpartum guidelines (18:06) Phase based instead of date based (20:26) All roads end up in the same place (22:03) Sleep (22:50) Fueling and energy availability (25:13) Support, childcare and logistics (28:32) Mental health, and what is going on physically (31:51) What you control and what you do not (39:28) Episodes to listen to next STUDIES MENTIONED Christopher SM, et al. Br J Sports Med. 2024;58(6):299-312. Deering RE, et al. Br J Sports Med. 2024;58(4):183-195. Davenport MH, et al. Br J Sports Med. 2025;59:515-526. Schulz JM, Thornton JS. Br J Sports Med. 2024;58:511-512. Christopher SM, Cook CE, Snodgrass SJ. PLoS One. 2021;16(8):e0255383. ACOG Committee Opinion No. 736. Obstet Gynecol. 2018;131(5):e140-e150. The Active Mom Podcast — a real mom's guide to pregnancy, postpartum, perimenopause & beyond, for active moms and the professionals who help them get there. Quick-hit conversations with moms, providers, and researchers... because you don't have a lot of free time (you're probably listening at 1.5x right now). Follow so you don't miss an episode. Rate & review ⭐⭐⭐⭐⭐ — it's how the next mom searching for these answers actually finds them. Share it with the friend who needs it. Questions or topic requests? DM me 💌

Send us Fan Mail Shefali got hate mail. Not a snarky comment on a post. Emails. From other people who work with postpartum runners, coming at her over a single number in a consensus paper. The number was three. As in, after a minimum three week period of rest and recovery, some people might be ready to start doing some things. Drills. Not a 5K. Not a race. Some things. And she wasn't even giving her opinion. She surveyed clinicians and exercise professionals, coded what they said, and reported it back. That is the entire job of a Delphi. I'm bringing this one back for the Summer Rewind because there are so many new moms getting back to running right now, and the six week clearance conversation has not moved an inch. It is still the default. It is still a date instead of a plan. And I promise you it is still costing women the strength they walked in with. 🔹 What a Delphi study actually is, and why it exists when the research is thin 🔹 Where the six week rule came from and what it never accounted for 🔹 The consensus on what "postpartum" means, and on who gets to call herself a runner (you'll like this one) 🔹 Why detraining is a real cost and not a theoretical one 🔹 The bias every one of us carries: the moms who were doing great were never in your caseload 🔹 Shefali on her own two pregnancies, and what changed between them If you have ever been handed a date instead of a plan, press play. And if you're the one handing out the dates, I especially want you in this one. Which date were you given, and did anybody explain it? The Active Mom Podcast — a real mom's guide to pregnancy, postpartum, perimenopause & beyond, for active moms and the professionals who help them get there. Quick-hit conversations with moms, providers, and researchers... because you don't have a lot of free time (you're probably listening at 1.5x right now). Follow so you don't miss an episode. Rate & review ⭐⭐⭐⭐⭐ — it's how the next mom searching for these answers actually finds them. Share it with the friend who needs it. Questions or topic requests? DM me 💌

Send us Fan Mail This one is going to ruffle some feathers. Hypopressives. Low pressure fitness. Whatever your algorithm is calling them this week. The theory has been the same since 1984: you do the breath, you hold the posture, your intra-abdominal pressure drops, and your pelvic floor switches on because of that pressure drop. Nobody had measured the pressure. Silvia Saraiva did. She trained 36 women who had never done a hypopressive in their lives, gave them two weeks to practice, then brought them into the Motor Function Measurement lab at the University of Ottawa with an intra-abdominal pressure sensor, EMG inside and out, and ultrasound running. Supine and standing. With the hypopressive posture and without it. The pressure didn't drop.  The pelvic floor did turn on. Just not through the mechanism we have all been teaching. Here's what makes this conversation worth your time: Silvia is hypopressives-trained. She still teaches them. She has patients who seek her out specifically to learn them. She is not here to tell you to stop. She is here to tell you the explanation doesn't hold up. 🔹 What a hypopressive actually is, broken all the way down  🔹 The theory, and where it came from  🔹 Why the measurement tools matter more than most of us want to admit  🔹 What happened to intra-abdominal pressure lying down versus standing  🔹 How hard the pelvic floor actually worked, compared to a max contraction  🔹 Whether nailing the posture changed anything  🔹 If the pressure didn't drop, what IS causing the contraction  🔹 What Silvia tells the patients who ask her to teach them  🔹 Where hypopressives fit if strength is the goal Silvia Saraiva, BScPT, MScHK, is a pelvic health physiotherapist and researcher who completed her Master of Science in Human Kinetics at the University of Ottawa under Dr. Linda McLean. Her paper is out now in Physiotherapy, and there is a second one coming. When you learned hypopressives, or taught them, was the pressure drop the whole point? I want to know what you were told and what you think after listening to the pod! Saraiva S, McLean L. Intra-abdominal pressure and pelvic floor muscle activation observed during hypopressive exercises performed in supine and standing: An observational cohort study. Physiotherapy. 2026 Sep;132:102316. Silvia on Instagram: @thepelvicgirl The lab: @mfm_lab  00:00 Intro  01:00 Why we have never covered hypopressives  01:45 Meet Silvia Saraiva  02:25 Ottawa to northern Ontario  05:45 How far the nearest pelvic floor physio really is  06:55 Why hypopressives are big in Brazil, Spain and France  07:35 What a hypopressive actually is, step by step  09:00 The theory: pressure drops, pelvic floor turns on  10:00 Why how you measure it matters  10:50 The tools: pressure sensor, EMG, ultrasound, dynamometry  14:40 Crosstalk, motion artifact, and the problem with earlier studies  16:15 What clinicians miss when we skim to the conclusion  18:45 Who was in the study  21:05 Training beginners, and the expert who flew in  23:45 Are hypopressives easy? No.  28:15 The findings  30:00 Did position or posture matter?  31:30 If the pressure didn't drop, what is causing the contraction?  32:40 "You're just not doing it right"  33:30 What Silvia tells patients now  35:35 What about a high tone pelvic floor?  37:40 Prolapse and first line care  38:20 What she would study next  42:30 When the explanation is wrong but the results are real  43:40 Where to find Silvia  The Active Mom Podcast — a real mom's guide to pregnancy, postpartum, perimenopause & beyond, for active moms and the professionals who help them get there. Quick-hit conversations with moms, providers, and researchers... because you don't have a lot of free time (you're probably listening at 1.5x right now). Follow so you don't miss an episode. Rate & review ⭐⭐⭐⭐⭐ — it's how the next mom searching for these answers actually finds them. Share it with the friend who needs it. Questions or topic requests? DM me 💌

Send us Fan Mail Okay, so this one is a Summer Rewind, and I'll be honest with you, I went back and forth on which episodes to bring back. This one wasn't a hard call. The original aired in September 2022. I re-listened before we re-ran it and quite honestly? I'm still hearing every single one of these myths in clinic. Every one. A couple of years later. Rich Willy has spent 20+ years treating injured runners and publishing the research the rest of us end up citing. And the thing I love about him is that he opens by admitting he used to believe most of these myths himself. That's the whole reason it holds up. So I asked him to name the running myths he most wishes would just disappear. Stretch more. Strengthen your glutes. Land softer. You're running wrong. Here's what we get into: 🔹 Why stretching isn't the thing standing between you and an injury, and what to do with that warm-up time instead  🔹 The calf, not the glute. Running is a plantar flexor sport, and Rich tells you exactly where to spend your strength minutes if you only have a few  🔹 The bone force number that flips "just land soft" completely on its head (this one genuinely changed how I talk to runners)  🔹 Why your single biggest injury risk factor is the injury you already had, back in your 20s, in high school, in a body you don't have anymore  🔹 REDs, energy availability, and why a normal body weight tells you almost nothing  🔹 Return to participation, return to sport, return to performance. The three-stage model most of us skip right past  🔹 What actually happens when you tell a runner to change the way she runs And I promise you, this is a pelvic health episode. If the calf and the quad and the hip aren't holding up their end of the bargain, the pelvic floor is left holding the ball. You can hyperfocus on the pelvic floor and still completely miss the boat. So if you're a mom who's five or ten years out and still hasn't gotten back to running, this is for you. And if you're a clinician who's been quietly wondering whether the thing you've taught for a decade is actually still true... this one's for you too. No judgment. I've been there. Come find Rich on Instagram: @montanarunninglab The Active Mom Podcast — a real mom's guide to pregnancy, postpartum, perimenopause & beyond, for active moms and the professionals who help them get there. Quick-hit conversations with moms, providers, and researchers... because you don't have a lot of free time (you're probably listening at 1.5x right now). Follow so you don't miss an episode. Rate & review ⭐⭐⭐⭐⭐ — it's how the next mom searching for these answers actually finds them. Share it with the friend who needs it. Questions or topic requests? DM me 💌

Send us Fan Mail Hilary Cairns races Hyrox at the pro weights, which means the farmer's carry is a pair of 53 pound kettlebells and she is essentially hauling her own body weight down the floor. She is the top ranked American in her age group. She also has three kids in their twenties and has been racing in DC since 1993. Now the part nobody handed her. She nursed all three kids for years and trained hard the whole time. She got a stress fracture after her second. Nobody sat her down and talked to her about how to eat while doing both, because back then almost nobody was having that conversation at all. This is the first in a new series where we sit down with the athletes in our own backyard here in the DMV. Hilary is a very good place to start. 🔹 What running through three pregnancies looked like when there was no information to work with  🔹 The stress fracture after baby two, and what she says she would eat differently now  🔹 The eating disorder she had in high school and college, what doctors offered her instead of answers, and what she wishes she had understood about long term cost  🔹 The commute stacking trick that made training possible when the kids were small  🔹 Going through menopause and having no idea what to attribute anything to  🔹 Raising a 26 year old competitive runner and hoping she gets the longevity without the glitches  🔹 Starting the Aging Athletically podcast with ultrarunner Michael Wardian, and the one question they keep asking older athletes If you are deep in the baby years doing the math on whether you get to keep any of this, Hilary is what the far side can look like. Not because she got lucky. She will tell you she has been fortunate on injuries, and then she will tell you about 30 years of showing up. Come find me after and tell me which part of her week you would steal first!  CHAPTERS  0:00 A new DC series, and meet Hilary Cairns  0:58 Minnesota to DC, tennis to track to triathlon to Hyrox  2:22 Ranking the three sports she is doing right now  4:08 The workout you dread is usually the one you need  5:38 Ten kinds of gel and the old school one she keeps picking  7:36 What she eats after: chocolate milk and salty things  8:29 Running in DC, Rock Creek and the Tilden hill  9:48 Banneker track and the free Wednesday workout  10:57 What she has now that her 30 year old self did not  12:08 Her Cherry Blossom result this year  12:34 Running through three pregnancies with no information  15:39 What changed in 26 years of postpartum advice  19:12 A stress fracture after baby two and the fueling gap  20:37 Strength training before it was standard  22:13 Energy availability, REDs and lactation  23:31 Going through menopause and not knowing what to attribute  25:36 Why peers stop racing, and why she has not  27:23 Eight ten mile races, all within 80 seconds  29:12 Her full training week, including the 100 burpees  32:05 What training looked like when the kids were little  34:04 Commute stacking and being the low maintenance queen  36:05 The eating disorder in high school and college, and what she wishes she had known about REDs  39:17 Raising a competitive 26 year old runner  40:24 The mental piece she works on with her kids  45:13 Starting Aging Athletically with Michael Wardian  49:05 Feeling 30 at 55  50:41 Why Hyrox, and what a first race is like  53:41 Pro weights, world championships and top American times  55:01 Station by station: erg, farmer's carry, sled, burpee broad jump  59:25 Shoes, and why not Alpha Flies  1:02:08 The thing she never could have planned  1:04:51 Where to find Aging Athletically and Track Pack DC  LINKS Pelvic floor assessment, Arlington VA clinic Telehealth PT and virtual consults All free resources and courses Hilary Cairns on Instagram Track Pack DC on Instagram Aging Athletically Podcast This podcast is education, not medical advice. Always consult your healthcare provider with medical questions. The Active Mom Podcast — a real mom's guide to pregnancy, postpartum, perimenopause & beyond, for active moms and the professionals who help them get there. Quick-hit conversations with moms, providers, and researchers... because you don't have a lot of free time (you're probably listening at 1.5x right now). Follow so you don't miss an episode. Rate & review ⭐⭐⭐⭐⭐ — it's how the next mom searching for these answers actually finds them. Share it with the friend who needs it. Questions or topic requests? DM me 💌