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Personal Trainer Clare Hozack On How To Prevent Pelvic Injury After Pregnancy

Personal Trainer Clare Hozack with one of hr kids

A stage one prolapse was a significant turning point in Clare Hozack’s attitude toward fitness, health and her body.

Clare, 36, has been a personal trainer since 2001, has run her own studio and trained sailing athletes over the course of her fitness career.

Despite training women for more than 15 years, the mum of Evie, 5, and Maia, 2, still wound up with a host of post-natal body issues.

Today she runs IntoYou, specialising in pre and post natal women, deep core and back injury, and providing education for other trainers on modern pre and post natal training techniques.

I am lucky that I have no stretch marks, stitches, or scars. My boobs however…

…are like two extra bits of skin that pool at the bottom of my bras. I am the same bra size (got measured professionally because of the awkward fit), but I don’t fill them the same way anymore. The skin on my belly will crinkle when I bend over. My hair went grey after having kids, and the lines in my forehead deepened overnight (or so it seemed – I was SO TIRED!). I am the same weight as I was pre babies, but slightly thicker around my waist, so subtle that other people probably don’t notice, but my clothes fit awkwardly. The plus side is that my legs are thinner!

Clare Hozack runs IntoYou, to provide education on modern pre and post natal training techniques
Clare Hozack runs IntoYou, to provide education on modern pre and post natal training techniques

I no longer run long distances because I don’t want to stress my pelvic floor

Even after training women for 15 years, I still ended up with a stage one prolapse and stress incontinence if I don’t keep up my pelvic floor training. I suspect that personal trainers, athletes, and other exceptionally strong women are MORE susceptible to pelvic floor dysfunctions like stress incontinence BECAUSE their abs are so strong – and no one ever taught us to train our pelvic floor to be equally as strong. Once it’s stretched, it can’t withstand our hyper-strong abs when they contract (like when you lift, sneeze, or laugh).

I was diagnosed with a stage one prolapse after overdoing it on training

When my first baby was around 18 months, I was training a group of women to hike the Inca Trail in Peru. There was one woman that hadn’t come to much of the training, and I was worried about her fitness, so I started training to carry her pack as well as mine. I was doing hill repeats with my 18 month old in a back pack, and an additional 30kg in the pack. On the way down the hill, I could tell something wasn’t ‘right’, but it wasn’t like any of the prolapse symptoms I had read about or taught my clients.

I went to the physio anyway and was diagnosed with a stage one, which is so common that the Women’s Health Industry considers it ‘normal’.

I had mastitis for four months after my second child, and was hospitalised when I became septic

I was on intravenous antibiotics twice a day for three weeks, and I was not allowed to exercise, work, or do housework. When Maia was 10 months, I felt ready to head back to exercise, and joined someone else’s gym to train with an exercise physiologist. In my very first session she made me deadlift my body weight… three times…. for 10 reps…. and coached depth. My theory is that she saw the words “personal trainer” as my occupation, and all thoughts of me as a recovering mum flew out the window. I was debilitated with back pain for 2 weeks, I couldn’t walk, lift my kids, or function normally. Needless to say I never went back. This was a shock for me as I was bulletproof before having babies.

Clare Hozack look to the positives and everything she can still do with her children
Clare Hozack look to the positives and everything she can still do with her children

I got back into running 12 months after my last baby

I tried a run group, thinking that 12 months was a good time. I had been consistently performing my pelvic floor exercises and my abdominal separation was closed. One day I was walking the dogs when I felt something akin to a tampon half in and half out… I immediately knew it was a prolapse in some shape or form, and seriously freaked out. I cried for three days, which was as long as it took to get the first available appointment with any women’s health physio in my area. By the time I got there I was an emotional mess, and the prolapse was gone (well, still stage one anyway). This experience was a turning point for me, and I never took my pelvic floor for granted ever again. I wear a pessary, more for peace of mind than for necessity, and I train my pelvic floor with movement, syncing my breath with my exertion with my lift, on a daily basis.

After all my hard work and diligence, my linea alba still does not withstand the intra-abdominal pressure of a chin up

I recently filmed myself doing chin ups as a demonstration for another purpose, and was shocked to see that I am still “doming”. I think back to all the training I did hanging from bars for Tough Mudders, and mentally tick another box – another lesson learned through my own mistakes.

I am a little disappointed that I cannot do everything I want to do, however there is a mother-load of stuff I CAN still do!

I can still deadlift and do chin ups if I pay attention to my breath and pelvic floor lift. I can still go windsurfing and ride my bike with my kids. I look to the positives. I also think it’s important to overcome my own pride, admit my mistakes and use them to help other women.

"I believe that it is because we are strong that we put ourselves at a greater risk of dysfunction and pelvic injury."
“I believe that it is because we are strong that we put ourselves at a greater risk of dysfunction and pelvic injury.”

I share my stories, and others from other clients openly

We do not shy away from the word “vagina” in my studio, treating it like any other injury. We do not talk a lot about body image, focusing instead on what their bodies can do, the improvement they have had already, and where the journey will take them. We have a stylist that helps them look amazing with what they’ve got, I have taken mums hiking in Nepal, mountain biking in NZ, and cycling in Samoa; using their stories to provide inspiration for the others just starting on the rehab journey.

We work hard at educating ourselves in my gym so that we can provide pelvic floor safe exercise without compromising intensity

I feel like trainers today have the mentality that it has to be one or the other; either pelvic floor safe OR high intensity. I believe you can do both because the loading on the pelvic floor has a lot to do with the movement being performed. If you can get high intensity performing a low-pelvic floor loaded movement, then you get both outcomes without ignoring a vital component of a woman’s body.

I have some unsolicited advice for personal trainers

Don’t be complacent just because you’re fit and strong. In fact, I believe that it is because we are strong that we put ourselves at a greater risk of dysfunction and pelvic injury. Every woman needs to see a women’s health physio after having a baby, especially if they’re fit and strong.

Written by Ilona Marchetta

Ilona Marchetta is a freelance writer and publicist who founded A Wholefood Lover’s Guide to Sydney in 2014.

Ilona’s wholefoods journey began in 2010 when she sought help from a macrobiotic counselor for lifelong digestive issues. Finding herself in better health than she had ever been, Ilona began a quest to learn more about the connection between diet and health, and the idea of food as medicine. It led her to the wonderful world of wholefoods.

When she’s not eating her way around Sydney, Ilona teaches women entrepreneurs how to write media releases and do their own PR.

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