Game Changers Empowering Women and Young Girls in Sport with Former Medalist and

6:05AM Jun 27, 2023

Speakers:

Angela Foster

Baz Moffat

Keywords:

girls

sport

women

pelvic floor

talk

work

period

puberty

training

toilet

body

menstrual cycle

athletes

part

day

bladder

support

space

year

happening

pelvic floor is supposed to keep us dry, but you don't notice when it does, because that's what it's supposed to be doing. But when it doesn't work, it's basically it's leaking. You're in having irresistible urges to empty your bowels or empty your bladder, and it's painful sex.

My friend friends we're gonna be talking today about how we can support both young girls and women of all ages and sport much more than we currently are doing. Women in sport recently found that more than 1 million teenage girls are 43%, who wants to consider themselves sporty, actually ended up disengaging from sport following Primary School. The reasons cited were a feeling of being judged by others lack of confidence, pressures of schoolwork and not feeling safe outside. women's sport actually surveyed 4000 teenage girls and boys as part of its research work, reframing sport for teenage girls and this was funded by Sport England. It found that 43% of teenage girls who wants actively engaged with and enjoyed sport were being sidelined in their teenage years. And they felt they were being made to feel not good enough compared with just 24% of boys the same age. The research also found that there's a complex barrier and some deep rooted negative attitudes that are really affecting girls enjoyment of sport. Both body image and puberty are significant factors. And unfortunately, 78% of girls said that they avoid sport when they have their period, and 73% of them don't like others watching them. Now my daughter is currently very into her sport. So this is very close to my heart, and I'm keen to see more support in schools and clubs to support young girls. So I'm really delighted to welcome to the show Bowers Moffat, who is an inspiring women's health and fitness coach specialising in the areas of pelvic floor Core Nutrition and women's wellness. But as is also a former elite rower and medalist with GB rowing. She has a tonne of experience and her holistic approach focuses on prenatal postnatal pre menopausal and menopausal women, with one common goal to help women move freely and embrace life. She is also one of the authors of the brand new book the female body Bible, a revolution in women's health and fitness, which recently made the Sunday Times bestseller list. I learned a tonne on this podcast. I hope you enjoy it. And if you do, can I ask a favour, please share it with others you think it may help so we can better support both young girls and women of all ages. Without further delay. Let me introduce you now to basmati so bad it's absolutely wonderful to have you here. We were just chatting offline. And I'm really excited. But I think we had anyone come on the show before and talk about women's health from from quite the angle that you're looking at it in particular I want to dive into pelvic health. But firstly, welcome to the show. It's great to have you here today.

Thank you very much for having me.

Let's start with your background because I know you were an elite athlete, you were a rower for many years competing in the Olympics. Tell us a little bit about your story and your journey and how you've kind of arrived at where you are today with the release of a new book the female body Bible

Yeah, thank you. So I've always been sporty always love sport I had an absolute just just dream as a child to like be an international athlete. I thought I was going to do it with athletics that was kind of like the thing that I did as a teenager did not know it at the time absolutely in hindsight massively suffered with red like as a as a teenager going into my early 20s So gave up sport and got this got this corporate job and started rowing and just like this, did it for fun just wanted to kind of I didn't think I'd ever I thought I started too old in my life. I didn't really think I'd get on to any kind of like programme or talent ID programme actually was alright it and kind of like gave it a really good go and managed to get onto the British team in the women's aid. And it was the time of, you know, Lottery Funding had Oh, it was all in we were fully funded. The British rowing team were doing absolutely brilliantly well, like everyone was meddling at World championship level and the Olympic level. And so it was a really exciting time to be part of that squad. I was I always described myself as like, probably the last person to be selected into that team. And then so psychologically, that puts you in a very different situation to anyone that kind of feels that they are definitely in the team. I was very well aware that I had, you know, a good a good number of girls like clambering below me to get into that spot. So it was a quite a nervous place for me to be in. And but I yeah, I adored it and it was the it was the mean that the training was brutal. As you can imagine, it was kind of you know, six, seven days a week, two, three sessions a day, like hundreds of kilometres on the rowing machine hundreds of kilometres long on the water strength and conditioning everything all in. But yeah, so that's that was my that was my experience of elite sport and then I retired from sports in 2008 Set up a personal training business how to children a few years later and got very into pelvic health after having those children but very cool. quickly moved out, not out of but but broadened my work from that sort of pre and postnatal pelvic health zone into menopause, post hysterectomy, young women people that were doing loads of high performance sport and having pelvic health issues. And that's where my passion was really ignited in this space.

Awesome. Oh my goodness, there's a lot of air that I think we could talk about. That's so fascinating. And really, like, it's such an inspiring story that you came to the sport. So, so late and cross selected, that's really incredible. You talk there about the fact that you like the psychology of being selected late and how that affected you. I think as women quite often, we kind of undervalue ourselves. Anyway, tell me a bit more about that and how you felt and how you kind of did you have professional psychologists and people helping you to really master your kind of inner game? Or what did that look?

Yeah, I mean, I don't think it was probably as good as you thought it should be. You know, like, I think it was kind of there was a bit of that, but it was very focused on there wasn't much space for me as an individual, if that makes sense. It was very, the sports psychology was very focused on like, how do you stay focused in a race? How do we get how do we get our game face on like, how do we bring it was very sports psychology orientated that space for like me to go, I don't know if I want to do this anymore. Or I don't know if I'm good enough, or I'm really worried that I'm not gonna get sued. I get really nervous at trials. And I get so nervous that it's affecting my performance. I didn't feel there was a space to address that. And I think that and I, I do feel that that has massively shifted in that world of elite sport now over the last sort of 1015 years that people are able to bring their true authentic self into those spaces and don't have to pretend the whole time then a system that they're coping just fine.

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Yeah, so I think I would there was only one year when I was doing that there was one year where I was kind of on the edge of the squad and you're like having to pretend that you're not where you have to kind of pretend that you're not working because you have to be fully available for that team selection for that team situation. And then so you are absolutely having to balance everything and that but then once you were in the squad I was fully funded so I wasn't having to work. And that was it. That was the big difference that lottery funding made was meant that basically you just were able to do more rest and recovery and you're able to do more. You're able to go more training camps and you're able to you're able to have those support systems in place which you just don't get if you are not fully funded and part of a centralised programme. So you find in the likes of women's football and women's Rugby, then women's cricket. Actually, most of those players do not earn a salary or income from their sport, which allows them not to work. And so they are part time PE teachers part time, policeman part time, whatever, and then having to manage those shifts and that work pattern and having to train around it. And that is that is really, really huge.

Yeah, hugely challenging. And what about looking at kind of that, that load, if you like in terms of that physiological load, the amount and the volume of training that you're doing? How did you find kind of balancing your hormones at that point? Were you encouraged to take things like birth control, to limit kind of fluctuations.

I mean, I was in, I was in a lucky sport where you, there were, there weren't there is disordered eating. And there are people people do have tricky relationships with food. But broadly speaking, rowing is a really healthy sport without respect because the body, the body image of an elite rower is like a powerhouse and absolute powerhouse. And you don't have that really lean aesthetic that everyone is attempting to be. Oh, yeah, that tiny, tiny aesthetic. And also, you're not wearing a bra and a pair of pants, you're wearing like a full on rowing suit that kind of likes that you don't really get that necessarily. Though there was there was no discussion, there was no discussions around menstrual cycles, there was no discussions around hormonal contraception, I started to get some sort of acne on my back. And there was literally just a girl in the change rooms at all bars, you've got some spots in your back to go to GP and ask for this. I'm like, Okay, then. But at no point did I then tell the sports doctor that I was doing this? Or tell my coach that I was doing this? Or even open up that conversations? Like, what what are the pros of taking that? And what are the cons of taking that, that that was just like, Oh, I've got spots on my back? And I don't want them I'll go and sort that out with my NHS GP? I won't, I won't bring that into the system. Whereas now when we're working with the elite teams, that is happening, like we are saying, right, you know, it's a drug you're taking it, let's let's weigh up, like the pros and the cons of this. And let's work through that. But I think that from a menstrual cycle, so I did go on the pill. Before the pill, I had a regular cycle, even with that training load. And I think that was because you just eat, you have to eat so much. And there's a and everyone is so there's not a there's not a mentality of like deprivation or faster training or any of that. Like there's just this culture of like, you know, you have, there's a thing about the this total second breakfast and I still have we always have Bretton Woods in our house, the second, the second largest second dinner, it's just a culture where, you know, people do eat a lot.

And we're given specific macros at that point. Were you encouraged to eat a certain amount of protein certain amount of carbs to fuel that training? Or what did that look like?

So I think the we were, it wasn't down to like your grammes or that kind of, you know, how much do you weigh compared to how much how many, how much you should be eating, it was definitely a timing thing. So we're definitely encouraged to like have, you know, a certain kind of drink before, like, within 15 minutes of finishing our training, and then working with the, and then going straight into breakfast and making sure eating enough, but it wasn't, it wasn't prescribed. And I think that, you know, again, I think it's because we were eating so much. And they did very much focus on food, which was just brilliant. So there was a real, again, it was a long time ago, we forget how this space has evolved. Like, there were there was Lucas aid, and there was si s, but that was kind of it like there wasn't that many brands or products in this space into like, giving you all of this all, you know, all of these products that were available, really, it was mostly coming from food, it was kind of like and I think we were quite we didn't have that much. There wasn't that much stuff available. And also everyone was, you know, back then again, the drugs thing was it was the first time that that the drugs testing came in and kind of the spot check testing. And so everyone just absolutely paranoid of like, anything that like not consuming anything that wasn't food because like the fear of like, yeah, getting a positive drug test.

Interesting. Yeah, of course. So what about let we were talking earlier about, you've got kids, I've got kids, my daughter is very much into a range of sports. So they say she's she's 11 years old. I think it'd be interesting for listeners who maybe have daughters themselves who are very athletic and they're doing a high volume of training. I know that you go and you speak to organisations and you speak to schools and you're trying to educate the female audience really to inspire them and and educate and, and change the conversation if you like. What do you think young girls need to be thinking about when they come to a

primary school, I've come from a primary school I've just talked with year five and year sixes and girls need to be given a space to understand their bodies. And I think there is such like Sophia, some of the girls I was talking to in year five and six have already started their periods. Now some of them in that class will not be starting their periods till they're more like in year eight or year nine or in even later, because there's a huge timeline in terms of like what when puberty happens, and when some girl's breasts are developing. and quite quite, you know, quite quickly and others haven't started yet that this is real. You're not, it's not all happening to everybody in that same year group. It can be like, what's normal? What's not normal? I don't understand this. And I think they, they need to be given lots and lots of time and space and practical examples and practical support about what can they be what what's going to be happening to their bodies, and what can they do to make sure that, that they keep doing sport, and they keep being active, and they keep doing exercise and an understanding of coaches, that actually, when girls go through puberty, that like, their bodies are totally different, it's not, it's a totally different experience to a boys experience of going through puberty, when they get stronger, and their bones get denser. And at all, like for girls, they they get longer, and they get less coordinated. And so if you've got a girl who's on a talent pathway, or even even believes she is, you know, has that ambition to be or actually is actually there, they need to be really managed well, to keep them to keep them active and keep them on, keep them in that system. And I think that's something that we've, we've got the statistic about how 64% of girls will drop out of sport by the end of puberty, we actually don't really have those solutions. But I think that and that, but from the talks were doing in schools, there's a huge amount of energy to really support those girls, especially in years nine and 10, when we just seen like the participation rates absolutely plummet?

And is that indoor sports or specific sports? So I can imagine for girls, girls probably become less keen on swimming, for example, because yeah, I mean,

those people, like everyone is dead, there are swimming periods, swimming period, costumes, which are an absolute game changer. So like period pants, you can get so many costume, which girls can wear in the pool, no one knows about it, you know, it works exactly the same as period pants. And that really, really helps. But yeah, there are, I think the sports were, I don't know, I don't know, I can't throw statistics at you. But the sports where you've got it the sports where girls like wearing really tight fitting clothing, when girls are wearing light clothing, they, you they've had an athlete, they've leaked, like they've come on their period playing tennis, and it's a really like, you know, and they weren't allowed to leave the court to go to the toilet, or they were they were horse riding or something where they kind of like they leaked and they weren't allowed to stop, then they're not going to come back because like they're not going to come back like It's too embarrassing for them. So there. Yeah, I think that there's a huge it's a huge issue when it comes to girls going through puberty. And I think we're kind of we've been addressing it with it with brilliant health promotion campaigns with kind of like more diversity, more diverse imagery, more kind of like options available to them. But what we haven't done is really gone in any depth with the female health piece.

And what about puberty? Obviously, you're talking about there is a huge disparity in terms of when a girl goes through puberty. Do you think that that age? Is there? I mean, my understanding is that actually we've always had girls go through puberty at quite a young age. You know, I think there's a lot of talk about whether that's to do with chemicals and toxins and oestrogen mimickers, what have you found from your research? What what are the key factors that are determining the age at which a girl goes through puberty?

I think genetics plays a large part in it. So like when you're when your mother went through puberty, or when your sisters or you know, those connected with you goes through it. i And I think that, you know, girls are big girls are bigger. So we're eating more like that we're eating more, which is having an impact on when people are going through puberty. I think it's just what were its I don't know what the what the reasons I think it's multifactorial, and the things that you mentioned, obviously a factor within that. But it's definitely true. And especially in certain cultures, that actually those girls do also go through puberty much earlier. And they also mature much earlier. So you find in netball, you just said that actually certain cultures will develop, like quicker, and then suddenly they're always playing in defence. And it's like, well, they're always playing defence, but only then they play defence. But then that's only because they develop quicker, but then they stay in defence. So it's that kind of like how can we just really understand like, what it's not is because that they're early in puberty, not because that's where they're going to end up. Does that make sense? It just we kind of have to really have an open mind and support girls going through this entire life stage.

And why would that affect them playing in defence? Because their biggest so if

you've got a girl that's gone through puberty and as growing bigger and like it's getting stronger, like she's gonna be kind of like two years ahead, if that makes sense, or the girl that hasn't done it and so she she's just taller and bigger, being able to play that position better. And then But then she just stays there.

One of the many benefits of being part of my membership, the female biohacker Collective is that you get to ask my special podcast guests your questions, and my members have the wonderful opportunity of asking Dr. Mindy bout their questions in relation to fasting often lysing around the menstrual cycle, and perimenopause and a whole lot more. If you'd like to be part of an amazing community of women and get your questions answered alongside monthly live masterclasses, biohacking toolkits and live challenges with me and my team, then head over to www dot female bio hacker.com. To learn more, that's WWW dot female bio hacker.com. To learn more. And what about you, when you're when you're educating girls in terms of staying in sport? What do you think are going to be the key factors that we as mothers, as you know, people going in working any personal trainers listening to this any coaches, teachers? How can we help girls?

Yeah, I think it's not dealing with the situation when it happens. So it's not dealing with someone coming on that period. Obviously, you do have to deal in it moment, but it's being really proactive. So it's proactively having a talk at the start of the year about how important it is to wear a sports bra. And it's saying like, you know what, we know that many of you aren't wearing sports bras, we all need to be wearing sports bras, put it on the kit list, put it on the school, put it in the school uniform shop, put it have an expectation that we wear bras, have a conversation have have free and available sanitary products all over the place, not just in a lot, not just in a locker behind reception. But all wherever a girl is moving. I'm doing sport, make sure that she knows she doesn't have to ask anybody she has access to that kit. Make sure no one's playing in white kit, make sure we just get rid of all white shorts, job per that Oh, like jumpers, cricket weights, all of that we just get, because that produces a lot of anxiety for girls. And then having having really okay, I you know, I've just been to the school today. I know that, Oh, you took the boys and the girls together? I said, No, I won't. Because it's not because the boys don't need to know this. I absolutely I'll do an assembly with everybody in that room. But the girls need really, really safe places where they can ask every single question they want to without the fear of people laughing or mocking them. And I think we have to actively manage and just open up these conversations and create spaces where girls can talk the whole time. And instead of instead of a girl saying, I've got my period, I'm not coming today. Go deeper with that say, oh, like why is that stopping you? But why? Why is that? Is it because you you're you know you're in that third of the population that has heavy menstrual bleeding? And actually, you have to change your product every hour or every hour and a half. And you can't work out practically how to do that? Is it because you have big tummy cramps? And and that's you're in a lot of pain with that? Is it because you just feel really bloated? And I'm motivated to train today? But what what what is what is the effect the period is having on you? And how can I as someone who's coaching and supporting you help you manage that? And I think that we just say I've got my period done, and we need to go deeper into that conversation.

Wouldn't that be amazing if they had everything available? And as you say, I think I already noticed that my they do do that because I already noticed my daughter sin in year six and she's talking about you know, some of the girls don't feel comfortable coming in in their cricket whites. And it did occur to me I was like, there could be a you know, a very, very valid reason for this. And that's really uncomfortable because you're out on the cricket pitch for two, three hours. They're not short matches. No they're not it's a lie. Things are wrong. 11 year old maybe to cope with

the rule is that you can't leave. It will be different at school level. But like when you get to like count, you know, proper level. You can't leave a field of play to go to the toilet. So just imagine, you know, we know that 90% of women will come on their period girls and women will have come on their period unexpectedly at some point in their life. Now that's not because they're unorganised or don't understand their bodies. It's just because that's our bodies are not robots. And yes, sometimes especially during puberty, especially during perimenopause, it's a hormonal roller coaster, isn't it and I bought it. We just don't know when these periods are going to be coming. And I took into the school today like loads of period pants and I just threw them around the room I said does fill this fill these period pants how amazing are these period pants, you can wear these period pants they absorb for tampons worth of blood or for sanitary pads worth of blood, you can put that on at the start of the day and not have a worry in the world about the fact that you can get through a cricket match you can get through your school day with one product and and they can and they're like oh my goodness, that's incredible. That's amazing. You could see that they were feeling it going glass really thin. It's slightly thicker than a gusset on a normal pair of pants but it's not that much thicker. And they and it just really gave them the reassurance that no one would see or smell. They've got these period pants on it would just be like something that they could put on and you could wear them under cricket whites and you could wear them under P kit and it would be absolutely fine. Is there any

concern with pair of pants around chemicals? I saw something about one company having I think a lawsuit against them because of the chemicals and my concern as a parent would be this is an area that's very intimate. And obviously we think about things like laundry powders and things being exposed and get dermatological reactions and other things. Is that a concern with period pants?

You know what I haven't I haven't picked. I mean, I have read a few things about that. But I haven't picked up on that as a massive as a massive concern, because you're you. I've said a whole day, you wouldn't really normally wear them for a whole day, but you can eat, you know, the overnight period pants you can wear on it, etc. It's specifically designed for that. But I haven't heard anything about that. No. And I don't think from all the experts that I'm talking with, it's not that that has never come up as a concern with these with these products

with these products. Okay. And what about, is there anything that obviously when you go and you talk to girls in primary school, I imagine one of their questions is, well, how do I know? But how do I know when that first period is going to come? Is that Are there signs that girls can be looking for that actually indicate? I think that might might?

I think that question came up a lot today. And it was and we talked about the you know, they talked, we talked a lot about discharges. So like the fact that like your body like other like the moisture will be coming out, like like thicker fluid will be coming out. And that's your body just practising and getting ready and going through it. And do you know like, for the first, as your body's getting getting used to this puberty, some people go straight into regular cycle for other people, it takes years to get their regular cycle, you won't, sometimes it will really shock you other times, you'll be like, oh, like, I've got a bit crampy the day before, I've got my periods. So it does take a while for your body for you to work out what the signs are that your body's going to be having a period and for you to pick up on those signs. But now, but you know, but you and I like as women, I know that if I just know like, you know, first of all I'm tracking but even if I wasn't tracking, I know that this happens week three, all the symptoms, and then a day before I kind of you know, I can't sleep as well. And then like, oh, yeah, my periods come in the next day. And so I'm really, really in tune with that. But at the start during that hormonal roller coaster of puberty, you just you don't know. And I think that, and that's why period pants, no, we were saying just put, you know, if you've got a big event, and you think, Oh, I might be in that. So just put them on doesn't it's not, it doesn't matter. It's not going to affect anything, like just just put them on and be prepared. And I think that's the let's not just go oh my gosh, that's a shock. And it's like it's bringing it up into the open.

And what about sports bras you mentioned there should just be on the bucket list. From what ag you Are you suggesting?

Well, again, it's very different depending on, you know, how big the breasts are. But I said, you know, I always say that as soon as you start to notice your breasts, like in terms of like you're, you're suddenly either a bit more conscious of the fact lots of girls wear white polo shirts, don't they for for school sport. And it's like as soon as you start to notice that you're like, Oh, are they a bit conscious that people might be able to see your breasts or that you can feel them, then that's when you need to be wearing a sports bra. Or if someone else notices, so that could be maybe like a teacher or a parent notices, then that's the time to be getting the scores, but as but I think we need to normalise it and get it in sooner rather than later. So it's not kind of you know, so they get used to it because a lot of girls don't like getting changed at schools, they don't want to change out of a normal Briar into a sports bra. They don't want to they think they think everyone can see they're wearing a sports bra, it might feel a little bit tighter than their normal bra. So it's just kind of going okay, like how do we how do we make that easier for you? And I think the the earlier you bring it in the better.

Yeah, I think I think you're right. I think we've got quite a way to go on this.

And I think today, they will they're always like, Yeah, but the huge thing for girls is that the fact that often one breast will develop, like faster than the other. So there'll be a note. And they are really conscious of that. And so today, they're like, when does that stop? And I was like, look, it's not like one breast goes boom, and one breasts like stays tiny, tiny, tiny, but in a girl's mind. They think oh my god, I want one of my breasts is much bigger than the other like no one else probably notices. But for them, it's massive. But just for me to explain to them, that's totally normal. Everyone's breasts, like I'm not the same shape or size. But like when you're developing, it can be a little bit more obvious, but most cases only to you. But there are things you can do. You can pop things into your browser to kind of even out and that's really standard a normal No. Okay, great. That sounds like a great idea. So they were, you know, you just have to talk it through with them.

Yeah, sounds like you're really reassuring them which is amazing. Let's, let's change that a little bit. Let's talk about pelvic health. It's not something we've talked about yet on the show. And I know this is an area you really specialise in. And I think most women think about this, don't they kind of post pregnancy when they're trying to get things back on track or around the time of menopause if there are issues but actually it's a it's something I think we should be thinking about all the way through our lives. Tell us know about how that how

Yeah, so 40% of athletes will be wetting themselves during training or competition and that's an average level. So that's, that's, that's 40% across all sports. So if Have you kind of wanted to individualise it, it would be like one to 2% of golfers and it will be 90% of gymnasts. So 90% of gymnasts and trampoline, gymnasts, gymnastics and trampolining is the worst. And then gymnastics is second. Huge, huge prevalence rates. And these are young, athletic, top of their game girls who've never had a baby. And going down the way, it's kind of like volleyball, netball, sprinting, basketball, anything that involves a lot of jumping, and twisting and turning will also have high prevalence rates. And then, you know, and then everyone is cold, everyone listening to this will know that like, you know, running downhill, or kind of, you know, like, anything that involves impact will have high prevalence rates as well. And we're not talking about it, because I think that the menstrual cycle is having its moment right now. And I think it's far less of a taboo topic than it was. I believe that's because you're meant to have a menstrual cycle. And so it's kind of okay to start discussing, like issues you might be having around it. When the pelvic floor doesn't work, when the pelvic the pelvic floor is like a roof on a house in a totally different position. But it's like the roof on a house, when it rains, you don't congratulate your roof, you don't go oh my gosh, well done roof, you've done a great job today, you, you just assume it's going to do its job. The pelvic floor is supposed to keep us dry. And but you don't notice when it does, because that's what it's supposed to be doing. But when it doesn't work, it's basically it's leaking, you're in having irresistible urges to empty your bowels or empty your bladder, and it's painful sex, or it's painful, you know, internal examinations from a doctor or that kind of thing. And, and that stuff that you think especially as athletes, especially as high performing women who are nailing certain parts of their life, you're like, Well, I'm doing extraordinarily well in all of this stuff. How can my body not be doing something that it's it's pretty fundamental. And I feel that that's where a lot of the shame and embarrassment comes from. And it's also the thing that we can put up with, it's not, it's not like a painful knee in terms of like he doesn't like it doesn't stop us from it takes up a lot of headspace. But which is a problem. But it's, it's not the same as having like a niggle or an injury. But I think we've got a you know, I did a big article in The Telegraph last year. And I was working with a journalist I was like, oh, yeah, we're working with this national governing body, this national governing body, this national governing body absolutely go to them. We're working with them on this. Could they get anyone to talk? No, they were like the the press teams were like, We don't want any of our athletes associated with that. And athletes wouldn't talk about it. I'll talk about periods. I talked about training on their periods, the levers day, they've got a sports bra that fits them. It was really hard to find people that were talking about this

understandably, right, I suppose it feels it makes people feel self conscious, because it isn't spoken about. I'm curious as to what really determines that the strength of pelvic floor when you're mentioning it in relation to athletes, for example, because I guess I'd assumed that until you've carried a baby, you know, your pelvic floor should be performing and performing that job as proof. What Why might it not be?

So there are two working theories, no one actually knows because no one does any research on women, as I'm sure you discussed many times on this podcast that only 6% of sports science research is done exclusively on females. And so that's that's everything to do with females. So the pelvic floor research is even you know, it's far less than that. But the two working theories are either and you are doing so much what your body is doing so much work that you're that your pelvic floor is so tight and so strong, it can't actually resist any pressure because it can't, it doesn't have that flexibility, and it can't respond. So it's too tight and strong. And actually, that's why. So when there's an increase in pressure it, it leads that you get these, you get this leaking, or you get this pain. The other theory is kind of the opposite of that is that you're training, you're training so hard that your pelvic floor is exhausted. So it's kind of we're not we're just not sure what absolutely not sure that there's a brilliant researcher over in Norway that's doing that there's lots of research groups around around trying to work it out. To be quite honest. A lot of the work is on like how what we do to fix the problem, like people are trying to work out like Why Why are athletes have much higher prevalence rates, but a lot of the work is in like, what do we do to prevent this from happening in the what we do in this prevention space, but people don't know. And it's one of the only systems in our body that it's kind of, it's not negatively correlated with physical activity, but it's more but it's, it's not as it's not positively correlated, like our cardiovascular system or our muscle strength or our bone health is, you know, that says, the more exercise you do, the better. The healthier your body is actually with pelvic floor, the prevalence rates are much higher in athletic populations. And it's and we're just not totally sure why. But it's because there's a lot of there's a lot of impact and pressure being put through that system. And we're not training, we are not training the pelvic floors. We're not, we're not doing isolated work in that space. Because there are very specialists gynaecologist and women's health physiotherapist, they tend to not be working as part of a strength and conditioning team, they will work with women, when they have issues. And so it's in that kind of like, let's, let's sort out the problem. And this is very much what we're attempting to do at the well is say, actually, strength and conditioning coaches can cope with this personal trainers can cope with this normal person, normal fitness instructors and sports coaches and cope with this, let's incorporate it into the session. So with your 11 year old, it's like, they don't, they don't, they just need to have an awareness of what good bladder health is, what good bowel health is, and how to relax and let go and how to feel that part of their body when they're doing their stretches, we don't need to get them on a pelvic floor exercise programme unless they're in kind of very, very high impact sports. But that's not happening. That's not happening. It's kind of really left until you've got a problem.

A sweeper entity and our daughter's a gymnast as well. And I think, you know, she's in squad now competing. And it's really interesting that you say that, because it had never occurred to me that having too strong of pelvic floor could be part of the problem. And I do wonder, you know, most things seem to be lifestyle dictated and not genetics. But I do wonder whether that plays a part having looked at, you know, when as a mother when your kids are growing up, and you have toddlers, and you look at the ability of one child to hold for a long period of time versus another child. And I felt very fortunate, I've always been someone that's been able to do that. And my kids were easy, you know, they were always dry at night. And we could go on a long car journey and not worry about it. And I wonder whether there is some just inherent by geneticists and related to that, and your ability to hold the pressure.

Yeah, and I, I'm sure there is. But there's also we need to understand that like, it's not that this iron bladder, this kind of bladder that never needs to release and let go actually is not a badge of honour. And it's not something that kind of a problem, it could be a problem a year from what you're saying can be a problem. So I went to the school today again, and I was like saying, right, so everyone needs to be going emptying their bladders five to seven times a day. And so like, basically, every three hours, and about eight to 12 seconds of urine should be coming out. And you can and I had a line of girls at the end 10 year old girls who's like, the toilet at school, I don't go enough. And I actually don't drink because I don't want to go to the toilet at school. So they are training themselves not to go, and it just means we're not. So as the bladder expands, it's covered in stretch receptors. And those stretch receptors give the signal to the brain that you need, you need the toilet, actually, you can train yourself to override listening to that signal. And that's not a healthy place to be because the bladder is meant to keep, you know, you're supposed to really go between 202 150 mils of urine, it's supposed to come out. Now, if your bladder is over, you're over stretching that bladder every single day. It's not a few instances, it's not going to be a big problem. But actually, as we age, our connective tissue loses its elasticity. So we don't have that ability to bounce back into a kind of really nice contained shape. It just kind of stops being able to do that. So we just have to be really encouraging Reg, not not all the time. We don't have to overdo it, we'd have to be hypersensitive, but it's that balance, isn't it, it's getting that balanced approach to it. And just making sure that girls, everybody feels comfortable going to the toilet, wherever they are, it's not a kind of I only go at home, because then they won't go on play dates, they won't, they won't, they'll they'll be really worried about going on a camping trip, they won't want to go on a school trip, they won't want to go away with their squat to their teams. And it's really making sure that we just have they understand how important it is to be going to the toilet regularly.

Well, I tell you, what's interesting is I can share something very personal here that that maybe isn't that talked about in relation to pelvic floor. So I have been, as I just said, there was someone who as a kid just didn't, I used to hold on to it all the time. And then when I had my first child, it was an emergency C section. And so we were kind of really rushed through. And in that situation, one of the things that can happen is damage to the bladder. And so they never really got to the bottom of what it was. But after having had my son, I went into full retention. So I had absolutely no idea that that had occurred. I thought it was pain from the C section. And when the midwife came round, she was like you can't walk what's going on you taking the pain relief? And I'm like, yeah, she's really, really struggling to walk. Have you emptied your bladder? No, not really. I was then taken back into hospital, because it was getting close to potential renal failure and had huge amounts of liquid drawn off. And they they don't know if the receptors were messed up in terms of that, you know, the surgery, but obviously, as you say, there's a communication to the brain. Yeah, I wasn't receiving any communication at all, but there was water in my bladder. And it led to problems in pregnancy to significant stays at a hospital trying to get it back. And I think that's the thing isn't it is I think we underestimate we think oh great. Yeah, it's really good. If you can hold it actually. There are potential problems and things that can happen down the line that may even be related from what you're saying. To that constant holding,

yeah, and I, for me, it's the, it's, it's the whole piece when our body and athletes are so well, high performance athletes are so bad at listening to their body, we are brilliant at telling our body what to do, were brilliant at saying, we want to do this. Therefore, to do this, I must do this. And I, I'll train, even if I don't want to, I will train when I'm tired, I will push through pain, I'm so driven. But the consequences of that is that we were not that good at listening to the signals our body is genuinely giving us and, and believing and trusting them. And a really basic example of that is I need to go to the loo like that is that is just us connecting in with what our body's telling us. And it's and the consequences of not doing that. I mean, yours is a really extreme, you know, story in case there. But the consequences of not doing that our girls choosing not to do sport athletes to athletes stopping drinking at lunchtime in the in the belief that they won't they won't be leaking girl being really constipated and constipation and you know, has a huge we're not excreting the waste products from our body. And because they you know, because we're so because women are so constipated most of what you know, especially when we get into midlife women a lot a lot more constipated than men. And it impacts their pelvic floor but pelvic health but also their overall health because we're not excreting all the waste products.

But we're not allowed to their children are not allowed to leave the classroom often to go to the toilet like that. Yeah, I was, like I say, I can't go to the toilet.

No. And there's there was I think it was Bristol. There was there were riots outside a school or some kind of protest outside of school, because they were saying they said well, you can go to the girls can go to the toilet if they if they're on their period, and they hold up a red flag. Like Sorry, what, like so now. So the rule was, don't go to toilet break times. And don't disrupt lessons. But they're like, if you're on your period, hold up a red flag, or use a code word, we're like, No, we need to stop this nonsense, we need to call it what it is. Call it a period, don't give a don't use a euphemism, don't tell girls to hold up a red flag, which will give the sign they need. Let's just be mature and grownup about it. And I absolutely know that that system will be abused or like, you know, like, some people will be taking the mick out of it. But the honestly, there's a whole chapter in this book about going to the toilet. And my kids are like seven and eight that I can't believe you've written a book about toilet. It's essential. It's absolutely essential. And it's something that it has such an impact on people on people's health and enjoyment of their bodies. And we're just when you shouldn't have to read a chapter in a book about how to go to the toilet, but we just we don't instinctively know enough about it.

No, we don't. And you're avoiding me because honestly, I hadn't realised that that wasn't actually a bad thing. What about women that, obviously, pregnancy itself puts a lot of pressure delivery puts pressure? What should women in that kind of postnatal category be thinking about in terms of exercises? Because in this case, I think we want to kind of strengthen it back up a bit.

Hmm, absolutely. And I think that, you know, again, for people that are in that high performance space, they'll often have decided before they have the baby, what they're going to do so they might be like, like, I'm entering an Ironman at this time, or I, you know, I want to get back in the squad by this time, or this is, I don't want to get back into regular training by this time, I think like, but you can prepare yourself for childbirth, regardless of how many books you read how many like classes you go to. It's like, it's nothing like you can prepare yourself for. And I think just giving yourself like that breathing space and really connecting in with you and saying that where am I at? Like, where? Where am I at? How much sleep Am I getting? How much support do I have? How was my like, you know, you've ascribed your birth. That's that's true that is full on and traumatic, there is zero chance you would be any place mentally or physically to do anything like you know, like you had done post pregnancy with that, that takes a long time to recover from an emergency C section going back to hospitals, bladders that haven't emptied except you and you're looking and you're trying to keep a Baby Alive and care for them or work out how on earth to be a new mom. There's a there's an absolutely brilliant research published in 2019 by a group of Irish physios, which was like called Return to running, which is all about running, return to winning guidance. postnatally and it was the first time that it's that anyone has really boldly gone out there and said, Right. Basically everybody unless you have a really individualised support team around you who have highly specialists. Nobody should be doing any impact before 12 weeks, and then everyone after 12 Then after 12 weeks, you can then kind of like start staggered return to exercise and training. That is really big news for many people. Mike I think they really underestimate how long it takes to recover. There's a lot of injury ACL On injuries, isn't that happening in football right now. And the article squad I've got like four people out four players out in the last five months with an ACL, the ACL tears, we know that the return to play guidance for ACL is like nine to 10 months. And that's it. That's if you're in arsenal, I can get a, you know, an operation the next day, the expectation of mothers to return to sport or training is weeks is like, oh, yeah, no, I'll be back on court, or I'll be back in the gym like six to eight weeks later. And that's, that's a mass that's not okay. So, we, you can start your pelvic floor exercises as soon as you are ready. But that doesn't mean you know, that's just where is it? Kind of feel it? Can I connect with it? Can I breathe? Like, where is it, you can start that as soon as you're ready. And, like, broadly, you know, you and also that people are babies, and they've got other kids at home. So we have to be active, we have to be moving around. But in terms of returning we we call it like return to exercise, return to exercise is kind of the same protocol. And that takes 12 weeks, but broadly speaking, everybody, well, weeks, 12 weeks or 12 months is your return to training and competition. And that's kind of how we like to seek to explain it. And that kind of like then then just calms everyone down. Because birth, birth and being a new mum is huge, huge, huge, huge. And it's not something that we can and I I have a real bee in my bonnet about people being celebrated, like bouncing back. So that kind of like, Oh, look at so and so she's like, gone to the Olympics, or she's like a world champion within like, okay, like, well done you. But that's not, but we don't know how she's done it. We don't know how much support she's got. We don't know what a birth was like, we don't know what support team she's got around it. And I think if we understood that bit, it would really reassure those people that are like not in that situation that they you know, they need a bit more time.

Absolutely. I couldn't agree more. I mean, I think it's just such a massive change having been through it myself. And you know, we need to support women much more on every level. I don't I don't think women in general, my experience are supported on any of the changes that are happening in that respect. You know, right through to things I suffer every with postnatal depression. I don't think there is enough support, I think, oh, yeah, so hormones are it's this and, you know, eventually it will just go kind of thing I think

I used to, and I imagine lots of people listening to this podcast, have a great game face, you know, like, they kind of have a great game face. And they've been really successful in most areas of their lives. And I remember the health visitor coming in with a great big beaming smile on her face. Oh, wow, you're doing really well. And she didn't even give me a thing. Give me a beat to go. I doesn't feel like I'm like, I'm, I'm not I didn't have postnatal depression. I wasn't there was I was really struggling. But wow, for your baby. It's amazing. Oh, gosh, you're doing really well. I'm like, yeah, no, this this, okay, you're telling me I'm doing well, okay. It is well, okay, right. Great. Fine. I must be okay. But I'm like, I am I am not okay here. And it took me years. It took me years to then go and ask for help. But and I, I had I went and got like therapy to kind of get over my birth experience four years after having my baby. And I just think if someone had just said bad, how are you? Actually Are you sure you're okay? It just slow the conversation down and allowed me to not be this bad. That's an athlete that's a businesswoman posits that and just say God like you all right? Because you that that birth sounds pretty full on. Either literally gushed either literally or all come out. But no one did good. And I'm not blaming you. I am. But I think that when you're in a space of height, when you're when you come when you're in a high achieving space, it actually does take quite, it's quite hard to kind of get through to people, isn't it like us to say you show your I think I think

you're absolutely I think you're absolutely right, I think as you say you have a game face and you put it on and you think you should cope with everything. And I sometimes think for a woman who has been performed really well. There's an expectation from some of the medical professionals. I remember falling pregnant, actually, very quickly after my first a bit like you, you want to be very close together. And because of all the problems I'd had with retention in that second pregnancy, it was showing up and I had pelvic disproportion so they'd figured out I was going to have to have C sections going forward. But I was told well, there's problems with your bladder, and this is really risky. So you're going to need yourself catheterized at home, I was horrified. I was like, I don't even understand how to do that. I'm not medically trained. I'm a lawyer. I don't know what you're talking about. And it was it was horrible. It was really, really, as you say traumatic and stressful. And I think that there is an expectation that as women, whatever just comes along we have to get on with and I think more support is needed on every level all the way through. Everyone's get very good, as you say, talking about the menstrual cycle and about menopause. But we're not talking about all the in between stuff, the teenage years, and then the kind of postpartum the pregnancy and the middle bit right. There's a whole bit leading up to it. So I'm glad that you're doing this. The book the female body Bible is is an amazing book. It's it's that it's a best seller, I believe isn't on both times. And Sunday Times bestseller. Yeah. Which is pretty amazing. And it's going to educate women. Just before you go tell us what are the things we've talked about pelvic floor, we've talked about girls, what other kinds of things can listeners expect from the book

from the book? Yeah, so we cover hormonal contraception as well. And we cover a brilliant chapter on injury. And but not it's called bodies that move well, and it focuses on like, Why are women more likely to get injured than men? But also, what can we do about it. And so there's a whole section on strength and conditioning for females, which is just fantastic. And then concussion, we talk, we talk a lot about concussion and the gender gaps in concussion. And the research around that there's obviously stuff on nutrition, how we, how women respond to coaching and how, you know, we like there isn't there isn't a different there isn't a male brain and a female brain. But there are there are huge differences in terms of like how females respond to coaching. So it's a real broad, but brush, and we also get a bit ranty against the patriarchy at some stages in it as well. But we don't indulge in that too much.

Amazing, amazing. It sounds like you've covered everything like with concussion as well, because that's just such a common problem that people are dealing with. And the thing with the concussion, right, it's it's always unexpected. You never expected to be concussed. And it can happen at any point in your life, not just from sport.

And that's the problem with injury, you know, working out how often do people get injured? And how often do people get concussed? It's always retrospective. And it's that kind of, and it's really hard to gather the evidence around like, around concussion. Yeah. Can you think of all the games and all the matches and everything that's happening every day of the week? It's really hard to work out actually. Like, what yeah, how many people are getting concussed and what's the impact of it, but we know that girls are twice as likely as boys to be contrast, and they are less likely to be removed from the field of play. And their symptoms are more extreme and then returned to play is longer. But that is that conversation is not happening as often as it should be?

No, and that's an important conversation that needs to happen. Before you go give me three things that girls should be thinking about. And three things as mothers to Kate to take care of ourselves and our daughters, what should we be thinking about what the top three for each category? So three

things that girls should be thinking about? Yeah, so three things that the girl that should be thinking about is a menstrual cycle is that their period is their superpower. So like their period is an absolute vital sign of health. Food is fuel. And like if you're if you're not eating, well, doesn't matter how much training how much academic families music practice you're doing, none of it's going to work unless you're eating really, really well. And that, and that, and I'm going to say I've got to try and put it into a third point around going to the going to the toilet and like yeah, being comfortable going into the toilet, I think those would be my Three Things for girls. And for mothers. I'm gonna say for mums and dads, I think that like, you know, we can't I think we need to really broaden out to say that, we need to get away from the fact that only women can talk to girls or women can only talk to women about this stuff, we need to broaden it out. I think that anyone supporting girls or being active, we all need to stay in the room. So like whenever a conversation comes up around breasts or pill, the pill or like, the men might not be able to talk about it, but they need to stay in the room. That's what I really feel they need to they when when I'm doing schools talk to dad about what can I do, I'm like, stay in the room don't leave when the period chat happened. You might not be able to have anything, but like two days later, you can say, Oh God, like Yeah, and I heard about that, like, can we ever talk about it like to stay manly to stay in the room. And I think as mothers, we need to check in with our relationship with food. And we need to be really conscious of what are the things we are saying or giving out when we're not in nutrition mode. So like when we're not in like, you know, when we're not in, like, positively affirming, like everything around food? What is like leaking out of us and what are our kids actually listening to and seeing I think our relationship with food is like, yeah, has a huge influence on our family's relationships with food. And then I think the third thing I would do for women would be like being able to like, is that kind of being is exercising in a way that makes you feel brilliant and just being and being really honest about that not exercising or training or being a part of a sport that you feel you have to be but what is what really tapping into what is working for you at this life stage, whether that's a hormonal lifestyle, or whether that's just like, you know, a practical life stage at what is working for you and how can exercise really enhance like, you know, the experience of life you're having.

I love that surgery and it changes all the way through and I love what you say about men staying in the room I tried to keep Why do you keep my boys in the room? My daughter's got two brothers. In fact, we were talking about periods at breakfast this morning, just in general conversation. And her brother's there because actually, that's going to change the future generations. Right he's listening to it. He's gonna have a girlfriend he's it you know, and I just think, yeah, I agree with you. Why can't it is normal. Why can't we talk about everywhere? I love it. I love your approach. I've had so much fun chatting to you. Thank you so much for coming on the show. And to everyone listening. Go and grab your coffee before it sells out. It's a Sunday time and best sellers. Thanks bad. Thank you for listening to today's show and for your interest in health optimization for high performance. If you're new to my podcast, you may be interested to know that you can get a free health score and report complete with personalised recommendations on how to optimise your sleep, nutrition, fitness and resilience in the top link in the show notes below. I hope you enjoyed this episode. Links to everything we talked about are also in the show notes and if you enjoyed today's show, please subscribe for more