I’m a Professional Runner and a Mom, and Having Support Is a Big Part of My Success

I had two pregnancies very close together; my sons are 15 months apart. It wasn’t my plan or my path, but life happens when you’re busy making other plans. After giving birth to my first son, Riley, I was a mess. I had a very aggressive delivery and a grade 4 tear with an episiotomy. I struggled quite a bit the first couple of months navigating sleep deprivation, changes to my body, recovering from the birth, and all the new emotions that come with being a new mom. And then it was back to work (that is, until I found out I was pregnant with my second son, Hudson, a few months later).

I’m a professional runner, so going back to work after both of my pregnancies meant something different than it might mean for other mothers: it meant that I was on the roads, training my body back into competitive shape. It wasn’t easy—during my first run after having Riley, at seven weeks postpartum, it felt like my uterus was about to fall out of me during that three-minute jog. The next run, I shit my pants. Yes, I laughed and I shit my pants. This is shit (ha ha!) you can’t make up and you can’t talk about in most settings, but it’s a shame because it’s real life. It’s not gross and shouldn’t be kept in the constraints of hospital walls and ob/gyn appointments. There should be more discussion from women, with women, and even with men about this.

Photo credit: Ryan Sterner

Truthfully, I didn’t really know what I was doing coming back from giving birth that first time. There were many times when I had to research and teach myself things to help me return to training because there wasn’t much information out there from women or athletes that had gone through it and shared their experience. For example, I discovered I had a condition called diastasis recti, which is when your ab muscles separate because of pregnancy. Even though it’s a common issue, I still felt like I knew little about it since there weren’t many athletes talking about it. I had to work hard to figure out how to treat it (thankfully, I found Celeste Goodson of ReCORE, who has helped me immensely), and I made it my mission to be public about the changes to my body following each pregnancy in order to help other mothers going through the same thing.

Through it all, I don’t know what I would’ve done without help from the people in my life. I’m lucky that I had tremendous support from my husband Ben, my coach, my training group, my agent, and my sponsor, Hoka One One, all of whom supported me 100 percent. When I got pregnant accidentally the second time, my agent had to have the hard conversations to tell my sponsor that I wouldn’t be returning to competition like we thought because I was having another baby. Hoka didn’t even think twice—they congratulated me and told me to take my time to get back and they would be supporting me all the way through it. I’m very grateful to have had that kind of encouragement and support when I needed it most. I was able to take about three years off from racing competitively, which helped me focus on time with my boys and gain my strength back.

Now, at three-plus years post-partum, I feel like the strongest version of myself as a woman and a runner. Of course, I grapple with feelings of mom guilt, especially when I have to leave my kids to go race or put them in childcare so I can train and do my job, but I’m grateful to have a team behind me to help me do what I love while being a mom. I also continue to work on my diastasis recti and will do so for the remainder of my life. My aim not just physically but emotionally has been to encourage and inspire women to not feel ashamed of their post-partum bodies and bellies. I now thank my body for how much it has improved and how much strength I’ve gained over the years. It may not look like it did before I had babies, but it is achieving more on the track and roads than it ever has. In fact, last month, I won my second national title at the US Half Marathon Championships in Pittsburgh, where I also nabbed a personal best time of 1:10:44. And after crossing that finish line, elated and exhausted, you can bet I thanked everyone who helped get me there.

Photo credit: Ryan Sterner

Stephanie Rothstein Bruce is a professional distance runner for HOKA NAZ Elite and a mom of two toddler boys. She lives and trains in Flagstaff, AZ alongside her husband Ben, where they run a coaching Business called Running with the Bruces. Stephanie has been running professionally for the past decade and recently won her second national title at the 2019 US Half Marathon Championships in Pittsburgh, PA.


A little formula in first days of life may not impact breastfeeding at 6 months

A study has lodged a new kink in the breastfeeding dilemma that adds to the angst of exhausted new parents: While most newborns lose weight in the first days of life, do you or don’t you offer a little formula after breastfeeding if the weight loss is more than usual?

For years, the answer has been “no,” as infant formula was seen as a deterrent to breastfeeding. The American Academy of Pediatrics recommends exclusive breastfeeding until 6 months of age, and continuing breastfeeding until 12 months while transitioning to solids. But according to the Centers of Disease Control and Prevention, just over one-third of infants in the United States are breastfeeding at 12 months.

The answer is no longer clear-cut, say researchers of the UCSF Benioff Children’s Hospitals — led study, publishing in JAMA Pediatrics on June 3, 2019. It depends on breastfeeding duration goals and attitudes, and needs to be balanced against the risks that newborns face in the first days of life when their weight is dropping.

In the study, the researchers tracked the long-term feeding habits of 164 babies born at UCSF Benioff Children’s Hospitals and Penn State Children’s Hospital. The infants had been breastfed between 1-to-3 days old, and their weight loss had been in the 75th percentile or above for age. Half of the mothers added syringe-fed formula after each breastfeeding, which stopped when the mother’s milk came in at two-to-five days after delivery. The other half had continued to breastfeed exclusively.

Marital Status, Breastfeeding Goals Are Factors in Weaning

The researchers found that at 6 months of age, the infants in the supplemented group were as likely to breastfeed as those who had exclusively breastfed. But by 12 months of age, that had changed. In the supplemented group, 21 of the 12-month-olds (30 percent) were still breastfeeding, versus 37 of the infants (48 percent) in the non-supplemented group. The disparity between the two groups was less marked when the researchers accounted for married status and longer breastfeeding duration goals, both of which are associated with longer-term breastfeeding.

“The results suggest that using early, limited formula may not have a negative impact on infants, but it may alter maternal attitudes toward breastfeeding,” said first author Valerie Flaherman, MD, a pediatrician at UCSF Benioff Children’s Hospitals and associate professor in the UCSF departments of pediatrics, and epidemiology and biostatistics.

While limited formula in the first days of life did not seem to change feeding habits among newborns that were exclusively breastfed, “it’s possible that supplementation reduced commitment, by the mother or other family members, to avoid it later in infancy,” she said.

An earlier study of the same 164 infants, also led by Flaherman, found that the supplemented newborns may have been at lower risk for hyperbilirubinemia, a condition that leads to jaundice and may be caused by inadequate nutrition. Of the five infants readmitted to the hospital by 1 month of age, four were in the non-supplemented group.

“Our study’s results show that early, limited formula may have significant benefits as well as risks for subsequent breastfeeding duration,” said Flaherman.

“Counseling that implies all formula is harmful would be inaccurate and may be detrimental to long-term breastfeeding success,” she said. However, if formula is used in the first few days after birth to prevent hyperbilirubinemia or dehydration, “it should be discontinued as soon as possible, since ongoing use at 1 week of age indicates a mother is at high risk of early breastfeeding cessation.”

Senior author Ian M. Paul, MD, of Penn State College of Medicine, emphasized that a “rigid, one-size-fits-all approach” was inappropriate. “Guidelines for care and standards set by hospital accreditation agencies should consider these data and how best to support babies and their mothers,” he said.

21 Awesome Gifts for the Active Dad

As hard as it may seem to believe, Father’s Day is almost here, which means it’s time to figure out as many ways as possible to spoil dad on his special day. It can sometimes be a challenge to figure out what to buy for the man who has practically everything, but for the active dad, a great pair of training sneakers or a handy foam roller can go a long way. If your dad’s weekend activities are anything like mine, you’ll likely catch him taking a long bike ride near the beach or attempting to hit an ace on the tennis court (when I let him win) now that warm weather has finally arrived.

Although we may push and plead, sometimes it can be tough to get dads out of the routines they’ve created for themselves over the years—which probably includes using products that are in need of a serious upgrade. (I’m pretty sure my dad has been riding the same bike on the weekends since I was born.) If your dad practically lives at the gym and you’re stumped about what to get him this holiday, check out a few great gift ideas that will inspire him to go extra hard during his next workout. He might be convinced to finally upgrade his cell phone, too.

All non-sponsored products featured on SELF are independently selected by our editors. If you buy something through our retail links, we may earn an affiliate commission.

Brush your teeth — postpone Alzheimer’s

You don’t only avoid holes in your teeth by keeping good oral hygiene, researchers at the University of Bergen have discovered a clear connection between gum disease and Alzheimer´s disease.

The researchers have determined that gum disease (gingivitis) plays a decisive role in whether a person developes Alzheimer´s or not.

“We discovered DNA-based proof that the bacteria causing gingivitis can move from the mouth to the brain,” says researcher Piotr Mydel at Broegelmanns Research Laboratory, Department of Clinical Science, University of Bergen (UiB).

The bacteria produces a protein that destroys nerve cells in the brain, which in turn leads to loss of memory and ultimately, Alzheimer´s.

Brush your teeth for better memory

Mydel points out that the bacteria is not causing Alzheimer´s alone, but the presence of these bacteria raise the risk for developing the disease substantially and are also implicated in a more rapid progression of the disease. However, the good news is that this study shows that there are some things you can do yourself to slow down Alzheimer´s.

“Brush your teeth and use floss.” Mydel adds that it is important, if you have established gingivitis and have Alzheimer´s in your family, to go to your dentist regularly and clean your teeth properly.

New medicine being developed

Researchers have previously discovered that the bacteria causing gingivitis can move from the mouth to the brain where theharmful enzymes they excrete can destroy the nerve cells in the brain. Now, for the first time, Mydel has DNA-evidence for this process from human brains. Mydel and his colleagues examined 53 persons with Alzheimer´s and discovered the enzyme in 96 per cent of the cases.According to Mydel, this knowledge gives researchers a possible new approach for attacking Alzheimer´s disease.

“We have managed to develop a drug that blocks the harmful enzymes from the bacteria, postponing the development of Alzheimer´s. We are planning to test this drug later this year, says Piotr Mydel.

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Materials provided by The University of Bergen. Note: Content may be edited for style and length.

Coffee not as bad for heart and circulatory system as previously thought

Drinking coffee might keep us up at night, but new research has given us a reason to sleep easy knowing that the popular drink isn’t as bad for our arteries as some previous studies would suggest.

The research from Queen Mary University of London has shown that drinking coffee, including in people who drink up to 25 cups a day, is not associated with having stiffer arteries.

The research, led by Professor Steffen Petersen, was presented today at the British Cardiovascular Society (BCS) Conference in Manchester and part-funded by the British Heart Foundation (BHF).

Arteries carry blood containing oxygen and nutrients from your heart to the rest of your body. If they become stiff, it can increase the workload on the heart and increase a person’s chance of having a heart attack or stroke.

The study of over 8,000 people in the UK debunks previous studies that claimed drinking coffee increases arterial stiffness. Previous suggestions that drinking coffee leads to stiffer arteries are inconsistent and could be limited by lower participant numbers, according to the team behind this new research.

Coffee consumption was categorised into three groups for the study. Those who drink less than one cup a day, those who drink between one and three cups a day and those who drink more than three. People who consumed more than 25 cups of coffee a day were excluded, but no increased stiffening of arteries was associated with those who drank up to this high limit when compared with those who drank less than one cup a day.

The associations between drinking coffee and artery stiffness measures were corrected for contributing factors like age, gender, ethnicity, smoking status, height, weight, how much alcohol someone drank, what they ate and high blood pressure.

Of the 8,412 participants who underwent MRI heart scans and infrared pulse wave tests, the research showed that moderate and heavy coffee drinkers were most likely to be male, smoke, and consume alcohol regularly.

Dr Kenneth Fung, who led the data analysis for the research at Queen Mary University of London, said:

“Despite the huge popularity of coffee worldwide, different reports could put people off from enjoying it. Whilst we can’t prove a causal link in this study, our research indicates coffee isn’t as bad for the arteries as previous studies would suggest.

“Although our study included individuals who drink up to 25 cups a day, the average intake amongst the highest coffee consumption group was 5 cups a day. We would like to study these people more closely in our future work so that we can help to advise safe limits.”

Professor Metin Avkiran, Associate Medical Director at the British Heart Foundation, said:

“Understanding the impact that coffee has on our heart and circulatory system is something that researchers and the media have had brewing for some time.

“There are several conflicting studies saying different things about coffee, and it can be difficult to filter what we should believe and what we shouldn’t. This research will hopefully put some of the media reports in perspective, as it rules out one of the potential detrimental effects of coffee on our arteries.”

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Materials provided by British Heart Foundation. Original written by Jennifer Mitchell. Note: Content may be edited for style and length.

Despite safety standard, laundry packet exposures increase in older children, adults

A new study conducted by researchers at the Center for Injury Research and Policy of the Abigail Wexner Research Institute at Nationwide Children’s Hospital and the Central Ohio Poison Center investigated trends in calls to poison control centers across the country for exposure to liquid laundry detergent packets. It found a modest decrease in calls for children younger than 6 years of age following adoption of a 2015 product safety standard but an increase in calls for older children and adults.

The study, published online today in Pediatrics, found that from January 2012 through December 2017, U.S. poison control centers received 72,947 calls related to liquid laundry detergent packet exposures — during 2017, there was an average of one call about every 42 minutes. Most exposures involved children younger than 6 years (91.7%), a single substance (97.5%), or occurred at a residence (98.5%). Approximately 6.4% of single-substance exposures resulted in serious medical outcomes. During the study period, there were eight deaths associated with the ingestion of laundry detergent packets as single-substance exposures. Two of these involved children 7 and 16 months old. The other six deaths were among adults age 43 years and older with a history of dementia, Alzheimer’s disease, or developmental disability.

In an effort to reduce unintentional exposures to the contents of liquid laundry detergent packets, ASTM published a voluntary Standard Safety Specification for Liquid Laundry Packets in 2015, but some experts feel it did not go far enough. The leading U.S. manufacturer of laundry detergent packets began implementing a series of changes to the product and its packaging to reduce child exposures in 2013. The American Academy of Pediatrics (AAP), Prevent Child Injury, and other organizations have conducted public awareness campaigns about the hazards of laundry detergent packets for young children. This study investigated the effect of these safety interventions and found that the number and rate of exposures among children younger than 6 years declined by only 18% following adoption of the ASTM safety standard in 2015.

“The voluntary standard, public awareness campaigns, and product and packaging changes to-date are good first steps, but the numbers are still unacceptably high,” said Gary Smith, MD, DrPH, senior author of the study and director of the Center for Injury Research and Policy at Nationwide Children’s Hospital. “We can do better.” One reason for the less-than-expected decline in exposures among young children is likely because the voluntary safety standard permits manufacturers to meet the requirement for child resistant containers in six different ways rather than requiring them to conform to the Poison Prevention Packaging Act (PPPA) of 1970, which has been shown to be highly effective in preventing child access to poisons. “Requiring that all liquid laundry detergent packet packaging be PPPA-compliant would be an important next step in reducing child access to these products,” said Dr. Smith. “In addition, each laundry packet should be individually wrapped with child-resistant packaging, which would provide important layers of protection for this highly toxic product.”

Liquid laundry detergent packets are more toxic than traditional liquid and powder laundry detergent. The reasons for this increased toxicity are not completely understood, and further research is needed to determine how to make packet contents less toxic. Such reformulation would reduce the severity of exposures to liquid laundry detergent packets.

Pediatricians and other healthcare providers should continue to counsel patients and their families about the hazards of laundry detergent packet exposures and the importance of safe storage practices. Experts recommend that caregivers to children younger than 6 years old and adults with a history of dementia, Alzheimer’s disease, or developmental disability use traditional laundry detergent instead of packets.

“Many families don’t realize how toxic these highly concentrated laundry detergent packets are,” said Henry Spiller, MS, D.ABAT, co-author of the study and director of the Central Ohio Poison Center. “Use traditional laundry detergent when you have young children or vulnerable adults in your home. It isn’t worth the risk when there is a safer and effective alternative available.”

Data for this study were obtained from the National Poison Data System, which is maintained by the American Association of Poison Control Centers (AAPCC). The AAPCC receives data on calls to regional poison control centers that serve the US and its territories. Poison control centers receive phone calls through the Poison Help Line and document information about the product involved, route of exposure, individual exposed, medical outcome, and other data.

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Materials provided by Nationwide Children’s Hospital. Note: Content may be edited for style and length.

How to Know When You Should See a Physical Therapist

If you’re an active person, chances are you may want to see a physical therapist at some point. Many factors go into how likely that might be, but even minor aches and pains can sneak up on the best of us. Thankfully, pain often comes and goes, but if it doesn’t, a physical therapist is there to help. I know, because I am one.

Considering how complicated and confusing our medical system is in the U.S., there’s no doubt that sometimes it’s easier to just endure a little pain or discomfort than book an appointment to figure out what is really going on. And, depending on your insurance status, your financial means, and your location, it may not be feasible for you to drop in for an appointment at the first sign of discomfort. But for those who are curious about physical therapy or for those who are experiencing some kind of pain or movement issue and aren’t sure where to turn, I want to set the record straight about what physical therapists actually and how they might be able to help you.

Physical therapists (also referred to as P.T.s) are experts in human movement, with a particular focus on the musculoskeletal system and potentially other body systems depending on a person’s area of expertise. Our job is to prevent and treat impairments that affect the body’s ability to move efficiently. Most P.T.s have completed a four-year bachelor’s degree and a three-plus-year doctorate degree complete with clinical rotations in different settings (outpatient clinics, rehab facilities, schools, fitness centers, and more). A doctorate wasn’t always required to enter the profession—it’s only been since 2015 that new grads seeking a P.T. license have been required to hold a doctorate degree—so every licensed P.T. you come across may not necessarily be a D.P.T.

There is a time and a place for physical therapy, but physical therapy is usually most appropriate when you’re dealing with a musculoskeletal (muscles, ligaments, tendons, bones) issue. Certain signs and symptoms indicate when you aren’t ready for physical therapy just yet, like if you have sharp, sudden pain that gets worse with movement, swelling, obvious deformity, or inability to move the body part in question. And if you’re experiencing other health symptoms or complications beyond a musculoskeletal issue, it’s often worth checking in with your primary care provider first. Here, I’ll be explaining some of the most common things that P.T.s can help with, and how to know if you can make an appointment right away or if you should talk to another provider first.

Here’s how to know if seeing a physical therapist might be right for you.

Common reasons to see a physical therapist

The most common reason people see a physical therapist for care is to address pain or a potential injury that’s inhibiting their ability to move and exercise normally. Rena Eleázar, P.T., D.P.T., S.C.S., C.S.C.S., co-founder of Match Fit Performance, tells SELF that a physical therapist will help you set goals to overcome your injury/discomfort and come up with a plan to achieve them. They will use different exercises, activities, hands-on therapies (like massage), and other tools to help you get there.

For example, when you first see a physical therapist for pain, they will do a full assessment to identify postural deficits and observe your movement patterns, as well as test muscle strength and joint range of motion in the painful area and in the surrounding muscles and joints. All of this is to help them identify any limitations you have that may be contributing to your pain. From there, they can create a unique treatment plan that focuses on improving strength and mobility where you need it, and reducing any pressure and pain that may occur at certain joints.

As you move through your program, your physical therapist will also teach you what to pay attention to and how to be mindful and listen to your body. This educational component, which is so critical to physical therapy, can help promote the best environment to heal while teaching you ways to avoid injury and pain in the future. They’ll also let you know when they think you should be evaluated by a doctor and potentially go in for imaging (MRI, X-ray) to make sure a more serious injury isn’t at play.

Another common reason people head to physical therapy is for rehabilitation after a surgery, usually with a prescription from a doctor. Whether you have had a microdiscectomy (for a herniated disc), ACL reconstruction, arthroscopic rotator cuff repair, or any other type of orthopedic surgery, you will be strongly encouraged (if not required) to participate in guided rehabilitation with a physical therapist. The post-op rehabilitation process can begin as early as the same day of surgery and last as long as six to 12 months depending on your surgery and goals. Your P.T. will work with you to support your recovery so that you are given medical clearance to return to doing the things you love.

While many people end up in physical therapy because they are hurt and experiencing chronic or acute pain, P.T.s don’t only deal with rehabilitating injuries. “Contrary to popular belief, you don’t have to be injured or have surgery to see a physical therapist,” Eleázar says. For example, physical therapists are also great resources for new exercisers or those starting to work out again after taking a hiatus, Eleázar says. A P.T. can assess your current fitness level and mobility and then create a personalized program, focusing on your mobility constraints and imbalances, to help you learn and get comfortable with basic movement patterns so that you have a base upon which to progress your exercise routine safely. Throughout it all, they will work to target and improve any strength and mobility deficits you have and address any pain or discomfort as it arises.

For some people, seeing a P.T. every once in a while could function like a quick tune-up. Peter Hwang, P.T., D.P.T., owner of RESET Physical Therapy, tells SELF that you could check with in a P.T. for a number of reasons, like when you’re having pain with activities that you normally would not (i.e. walking, running, weightlifting, etc.); chronic, recurring, or episodic pain; or if you’re looking to get active again after pregnancy or surgery. But he, like many other physical therapists, also believes a person can benefit from seeing a P.T. twice a year for a movement assessment, just like you would see a dentist for your regular cleaning. This gives them a chance to help improve your movement patterns and ultimately prevent injuries. (You can read more here about physical therapy as preventive care and how to know if it’s right for you.)

When to see a primary care provider first

If you have an acute injury, are in extreme pain, or cannot function properly (you can’t walk or lift your arm or or otherwise so inhibited you can’t move throughout daily life), definitely see an M.D. They can refer you to a specialist, request imaging, or determine if you need surgical or non-surgical medical interventions. For example, when a ligament or muscle is torn, an MRI may be critical in determining the plan of care. You should be assessed by the appropriate doctor who can then refer you for imaging and go over the results and their implications with you. After that, they will likely suggest physical therapy, or you can ask if it would be appropriate as part of your treatment.

Jennifer Solomon, M.D., a physiatrist and sports medicine doctor at The Hospital for Special Surgery (HSS) in NYC, refers patients to physical therapy frequently. Both P.T.s and M.D.s agree that working together is the most effective. Dr. Solomon and Megan Crawley, M.S., A.T.C., work closely together at HSS, often sending patients to physical therapists and other exercise specialists to help them safely and effectively improve strength, mobility, and body mechanics. Crawley and Dr. Solomon explain: “Physical therapy can be extremely helpful, and in many cases, paramount, in treatment plans.”

Crawley notes that when they refer patients to physical therapy, it is critical that the P.T. and M.D. share the same treatment philosophy and that the P.T. knows and is compliant with the M.D.’s therapy prescription. “Communication with the treatment team is of utmost importance,” she says.

Making an appointment

With our health care system being what it is (a bit of a mess) and multiple barriers in the way of accessing it, getting the care you need can feel like a long, tedious process. Most people assume that you need to schedule an appointment with your primary care doctor first, then they can either refer you for imaging or to a specialist such as an orthopedist or sports medicine doctor. Once there, you may get a referral to begin physical therapy. But by then it’s been over a week (or multiple weeks), you’ve had to rearrange your work schedule to make every appointment, and your pain has either gotten worse or stayed the same because treatment hasn’t even begun.

While seeing an M.D. may be critical in some cases, know that there is another option that allows you to skip the co-payments and multiple appointments with different practitioners. In many states, depending on the direct access laws of that state, you may not need to see an M.D. or get a prescription to schedule your first physical therapy appointment.

In New York, for example, patients can go directly to a Doctor of Physical Therapy (no referral or Rx required) for the first 10 visits or 30 days, whichever comes first. This means you don’t have to wait for anyone to tell you when to go, but you should know when it’s appropriate to skip the visit to your M.D. If you’re unsure, then don’t—it’s always best to err on the side of caution. But if you’re feeling pretty good overall and just want to take care of a minor pain or ask some questions, you can go directly to a P.T. (Also, a good P.T. will tell you after their initial assessment if they think you should go see a doctor first.)

We physical therapists hope that people will begin to see physical therapy as a necessary and tremendously helpful part of maintaining a healthy lifestyle. Eventually, we hope people will come to physical therapy for an annual check up, so that we can spot dysfunction before it becomes painful and problematic.

For now, just know that physical therapy can not only help reduce many types of aches and pains and fix your imbalances, but it can also help you better understand your body and prevent future pain and injuries, helping you to stay active and enjoy the activities you love.