If you haven’t yet been to Pelvic Guru Academy’s Female Athlete course, don’t say that too loudly in a group of pelvic PTs. It’s entirely possible that those who have been to one will likely swarm you with praise for this awesome course. Hearing words like, “Amazing!”, “life-changing!”, and “made me question everything!” I decided to catch up with Antony. I was able to ask him some questions about his course and how he became interested in teaching this topic.
Want to join the club of Female Athlete enthusiasts? Here are your chances:
PG: What is the biggest misconception that pelvic floor PTs seems to have about CrossFit and high-intensity training?
Antony: That CrossFit is bad for the pelvic floor. We know that the so-called “PF-safe” exercises don’t actually protect the pelvic floor from pressure (Tian et al 2018). In nulliparous women, no difference was seen in POP-Q examination, PFMS and perineal descent between those who walked 20min vs those who did a 20min CrossFit workout which included heavy deadlifts, burpees, push ups, heavy overhead pressing and situps (Middlekauf et al 2016). Reducing activity in the hopes of saving a vagina is not holistic women’s health!
PG: And if nothing else, we’re certainly in the business of saving vaginas!
What seems to keep postpartum women away from high-intensity workout?
Antony: There are many reasons. They can be things like symptoms and pain but a lot of what I see is actually fear. Fear of “making things worse” because their pelvic PT told them it can. This can be a problem because the client might WANT to do HIIT but feel it is irresponsible to do so because their pelvic PT said not to. Now they have to decide if they are going to go against the advice of their pelvic PT or not. What I would love to see is pelvic PTs equipped with the knowledge on how to better help these women achieve their goals at returning to HIIT.
Everything in the world of strength and conditioning can be made suitable for the person in front of you. It is up to us to develop the skills to help women return to the sports and training they want to do. We can do this by providing appropriate advice, options, and modifications to help them achieve their goals.
PG: Is it safe to get back to high-intensity exercise if you have a rectus diastasis?
Antony: Nearly 100% of the time, I am going to say “yes”. The tide is turning! There are advantages to developing your abdominal muscles and loading the linea alba. We are moving beyond the focus of the “gap” and isolated TrAb contractions into function and using strength and coordination to help women return to high-intensity exercise.
PG: What are the biggest changes that participants have made in the way they practice PT after they take your course (that they have told you about)?
Antony: I like to think of my course in 3 different ways.
- Creating awareness of the role of Pelvic PT and PFD and how to manage those conditions.
- Making people aware of the role of moderate to high-intensity exercise and how to manage PFD within that context
- Bringing attention to the role of language, beliefs, the meaning we put on things and the stories we tell ourselves and others.
The changes I hear about are things like:
- Giving the client more space to talk about what they want to do
- Understanding what things have meaning for them
- Less cueing with the result of better performance and results,
- More excited clients because they are doing fun exercises instead of lying on a bed doing isolated contractions
- Having a better connection with their clients
This type of feedback really increased after I started opening with a demonstration client in the first couple of hours of the seminar.
PG: I took this course in February of 2017, before you made some of the changes, but these comments certainly ring true for me. I know I walked away with many of these ideas.
Why is it that you enjoy working with women’s health so much? How did the female athlete demographic become your focus?
Antony: I have naturally gotten on better talking with women than men…I am not really a blokey kind of bloke! When I first started working, part of my rotation included some time on the antenatal clinic and postnatal wards. From there, I started doing the antenatal education classes and then I continued to help women from there in my private practices. I have been helping women antenatally and postnatally for over 22 years now. From there comes the natural evolution to pelvic pain and pelvic floor dysfunction. Diastasis was simply part of being a musculoskeletal PT who helped clients with their “core” – I come from Australia where we invented this rehab!
Ultimately, I found that I was really good at helping people with these conditions and what I was doing was generally really different to what the standard pelvic PT was so I developed a name for what I was doing locally and eventually internationally. Interestingly, one of the biggest compliments I got was from a local OBGYN. They literally said “I don’t believe in physiotherapy for pregnant women but everyone I send to Antony comes back really happy so I guess he might be ok” hahaha.
PG: What is your favorite thing about teaching The Female Athlete: Focus on Core and Pelvic Floor?
Antony: Oh, so many things! Watching the discomfort of challenging beliefs is fun because it reminds me of how hard it was for me to change. I enjoy that moment when the penny drops for people. Sometimes it is a moment that you least expect it to happen but everything drops into place! The participant’s excitement, relief, and happiness that follow are amazing.
However, I think my favorite part of the course is when we lift heavy deadlifts. I tell all the participants that the average untrained person can lift about their bodyweight in a deadlift. The number of hands that go up for lifting more than they have ever lifted is amazingly high and the atmosphere in the room is so fantastic. It’s definitely one of their and my highlights of the weekend. It is at that moment that they truly understand why their clients like to lift heavy. They see that it is amazing to feel strong, capable, adaptable and resilient. Lots of the participants have had PFD of their own and yet are able to do so much more than they thought they could do.
PG: We know that it’s in the works. We know that people are requesting it. Can you give us an idea about what your Level 2 course will look like?
Antony: For sure! Level 2 is all about developing the practical skills that are there in Level 1 but we don’t have time to address. Loosely, the topics are as follows
- Subjective examination skills (interview skills)
- Deciding on how to do something different
- Dealing with pelvic pain
- Being able to apply the principles to a wide range of situations and exercises.
- More exercises mixed in like squats and upper body work
My hope is to be able to bring in a number of real clients so the practical sessions will have real interviews with feedback. This way, participants will be able to develop their skills with real clients. It won’t matter if the participant is a trainer or therapist because we all have to take an initial interview/assessment when we have a new client.
I’m quite excited about this and think it will complement the other new courses I am developing as well as the mentoring program I have that is online.
PG: This is fantastic, Antony! You’ve got so many amazing things going on and you offer a really great course. Pelvic Guru Academy looks forward to hosting more of your courses and we can’t wait to roll out a level 2 course! Antony will be in 3 locations in the United States in October of 2019.
For a full listing of all Pelvic Guru Academy courses, go to www.pelvicguru.com/courses.
For more information about Antony Lo:
Antony Lo is a physiotherapist from Australia and runs The Physio Detective service. He earned his degree from the University of Sydney and has been in practice for nearly 20 years. He completed his post-graduate Masters in Manual Therapy (Musculoskeletal Physiotherapy) from the University of Western Australia and has completed his Specialisation training in Musculoskeletal Physiotherapy.
Antony has been involved with treating CrossFit athletes for 5 years. In doing this, he has helped some of the world’s best CrossFitters at all levels and ages. He loves and participates in CrossFit and is a strong advocate for the sport. Through participation and through his work as a Physiotherapist at all levels of CrossFit, he has developed a model of treatment that utilizes the best from Sports Science, Musculoskeletal/Sports Physiotherapy, Pain Science, and Women’s Health research to provide a realistic holistic model of care balancing the biopsychosocial model of healthcare.
He is NOT an employee of CrossFit, he does not represent or work for them in any way and his views and opinions are entirely his own. He holds a CrossFit Level 1 – Trainer Certificate and is a CrossFit Football Coach/Consultant. Antony has a wife and 3 beautiful children in the best city in the world – Sydney, Australia!