When to Use a Sports Chiropractor with Dr. Karlie Causey

You're listening to the PT Proffitt podcast, episode number 45. Today I'm sitting down with a sports chiropractor, Dr. Carly Causey, and we're talking all about when to use a sports chiropractor and specifically for the pre postnatal community. Are you ready? Stay tuned. Hi, I'm Beverly Simpson, former fitness manager turned online personal training business owner. And this podcast is where smart fitness professionals, including trainers and clinicians, discover how to increase client performance in movement, package and position their products and services, and get out of their own way so that they can increase their revenue to live a life that they love without sleazy sales. Welcome to the PT Profit Podcast. What's up, coach? And welcome back to the PT Profit Podcast.

I'm.

I'm your host, Beverly Simpson, and I'm really excited to share this episode with you. Today I sat down with Dr. Carly Causey, who's been a sports chiropractor for 10 years. So besides her doctorate of chiropractic, she's also has a master's in human biology. She's a certified strength and conditioning specialist, a level two CrossFit coach, a certified barefoot training specialist, and pregnancy and postpartum athleticism coach. She's the owner of Fuel Spine and Sports Therapy in Seattle, Washington, and is the co owner of Seattle Sports Chiropractic and Rehab. Now, she has narrowed her focus, which she does share inside of this episode, to work specifically with active perinatal population. And she was recently featured as a speaker on the postpartum rehabilitation for the American Chiropractic Association Sports Council's national annual symposium. Dr. Carley Also, I'm laughing here because she says, you know, I spend my free time here and I'm looking at this and after talking to her, which you'll hear in this episode, what free time specifically? I really can't wait for you to get into this episode because we talked a lot about about when to use a chiropractor, how chiropractors can work inside of your business, and also as a patient. And we also talked about the pre postnatal community. But a lot of what we talked about is just for active in general, but we did start to specifically speak about the pre postnatal community. So hopefully you're just as excited as I am to get into it. So without further ado, let's roll that interview. Hi, Carly. Thanks so much for joining me today. How are you doing?

I'm great. How are you?

I'm doing great. Hanging in. Things are good over here. No complaints.

Great.

So without further ado, let's just go ahead and dive right in. Can you do me a favor and share with us a little bit about who you are, who you serve and how you got there?

Yeah, totally. So I'm a sports chiropractor. I co own a practice in Seattle. I guess we've had that practice open now for about four and a half years or so. But I've been a chiropractor for. This is my 10th year. So I went to undergrad, I went to University of Idaho, studied kinesiology and then went basically straight into chiropractic school in Oregon. Went there for three years. So it's a four year program, but you can do it in three if you just kind of go straight through and don't take any time off. And did a master's and a doctorate there and then started working. So I started working as an associate for another doc just to kind of learn the ropes. And I had no idea as far as business stuff what I was doing. So that was super helpful. And then I opened my own practice about six and a half years ago or so, maybe seven years ago, something like that. Did that on my own for a couple years. Just kind of running that out of a CrossFit gym, which was super fun, but then kind of wanted something a little bit, a little bit bigger. You know, it's great to have deadlift bars dropping outside of your door every day, but it's also nice to not have that every day. So. So now we have kind of a little bit bigger, more professional space. We still have a great big rehab space in our office, but you know, not a gym per se, so. So yeah, that's kind of what I've got going there. I've really taken a turn the past couple years and really started focusing on perinatal population. So active pregnant women, postpartum and just really focusing in on that population. And I just really love it. It's so fun and rewarding. So that's kind of what I've been been focusing more on the past few years.

Okay, I love that. So, just a couple of questions. So why chiropractory? What's the word?

I'm looking forward.

To chiropractic. Is that right?

Yeah.

What, why, what led you to that?

Yeah, I, you know, I saw a chiropractor growing up basically since I was a little tiny baby. My mom had a pretty significant scoliosis or has a significant scoliosis. And so she got my brother and I and really young and we just found a lot of benefit from that, just growing up playing sports. The chiropractor I saw was much more traditional. So just basically go in, get adjusted, get out where I'll, you know, I'll explain a little more of what I do later is a little bit different. But, you know, playing sports through high school, I also played sports in college, and I just found a lot of benefit from it. So when I was in undergrad, kind of trying to decide what I wanted to do, you know, I was really looking at strength and conditioning because I just love that I have a. I'm a CSCS also. So I was looking into going into that field. I was looking at physical therapy and then kind of orthopedics. And I actually went home and saw my chiropractor I'd grown up with, and he was like, you know, there's kind of this emerging sports chiropractic field. And I was like, it's like one of the only light bulb moments I've ever had. Really like that. And meeting my husband was like. Like, yeah, that's what I'm supposed to do, you know, And I told him, I was like, okay, yeah, I'm gonna do that. And he was like, oh, yeah, you're gonna look into it? And I was like, no, I'm gonna go. I'm going. So. So that's kind of how I got into that. And then I just researched a little bit which school to go to. Kind of started looking into what sports, you know, what a sports chiropractor was and how it was different than just kind of traditional chiropractic. And. Yeah. And away I went. Okay, great. That's an awesome.

Because I do want to talk about that. Can you tell me about, you know, what is. Because I feel like chiro chiropractors get a bad rep. So what specifically do you do, essentially? And what does a sports chiropractor do that's different than a regular Here, a chiropractor.

Yeah. So I think really, we want to look at kind of it's a more functional approach to the patient, I think. So sports chiropractor isn't looking at kind of the traditional bone out of place model. Your T5 is posterior. We got to push it anterior. We're looking more at the function of the whole spine of the shoulders, the knees, the ankles, the hips, how everything works together. And in general, sports chiropractors are going to spend a little bit longer with their patients. So I spend an hour with new patients, and then follow ups are anywhere from 30 to 45 minutes. I describe it to patients, like, what we do is a little bit more of a mix kind of between chiropractic, physical therapy, manual or massage therapy, personal training, and athletic training kind of all wrapped into one. So we're not just looking at the spine. We're kind of looking at the joints, the ligaments, the tendons. We're watching the person walk, squat, lunge, twist, pull, all this stuff. Right. So. And then I think it's really, you know, working on the rehab component as well. So we're making sure that, yeah, we're treating the patient in the office. We're working on, let's say, their shoulder. We're seeing how their neck and their thoracic spine are moving, related to the shoulder. But then we're also sending them home with some functional rehabilitative exercises so that they can work on those themselves and feel like they have ownership of their improvement, you know, and kind of give them. Give them a plan. Basically, you know, here's what we're going to do in the office. Maybe one time a week for three or four weeks. We'll start to spread that out a little bit, and then hopefully you'll be on your way. I kind of tell my patients, like, I want to get them out of my office as soon as possible and get them better so that, you know, then they can tell all their friends, like, I only had to go four times. It's not that I was coming back in over and over and over, you know, three times a week for the rest of your life. I just. That's not a. I don't think that's a good model of chiropractic.

So I love that. Now, you said earlier, you know, that when you were a kid, you would get adjusted, so. Adjusted? What does that mean?

Yeah, so the adjustment is kind of, you know, the. The basis of traditional chiropractic. And we do adjustments. It's a little movement of the joint. So it's feeling the spine, let's say the cervical spine, for example, feeling how each vertebrae is rotating and laterally flexing. And then it's basically just a little gapping of the joint. It's like popping a knuckle. A little gas is released, so you get a little pop. There's many different ways to do that. Some chiropractors use a little tool. Some. Some chiropractors use, like, very, very light touch to do that. Some, you know, most use their hands to do those little adjustments. And really what's most important about that piece is that as chiropractors, all chiropractors, we're trained to know when not to adjust someone, right? When there's red flags when they need to be referred out. And you know, you can teach anyone to adjust, basically. But it's, you know, that's why we're doctors, is because we have all this background that, you know, the patient doesn't have to think or think about or see of. Okay. Actually, we can't adjust you or shouldn't adjust you for this reason, you know.

Yes, I do. And I really love that you bring that up because I feel like for me as a kid, I used to think, you know, I would walk around, people would tell me, don't adjust, don't adjust your back or don't pop your back because you're just going to make it worse and you're just going to create more or the need to pop more. And now as we're talking about this, I'm wondering, is that really true?

Yeah. So, I mean, partially so. A couple different things about that is usually when we're kind of like self adjusting, you know, like we like crank our head and kind of turn it, usually what's happening is the same segment is getting moved over and over and over. So you're creating some instability, let's say at C4, you know, so you're just like, crack, crack, crack. And you do get a little endorphin release. It does feel better. So people kind of keep doing it. But what usually needs to happen if you're constantly feeling that is often above or below that segment is actually restricted. And so you're feeling this need to move something but you can't do it yourself. I can't even adjust my own neck myself. And that's my job because you're just going to keep hitting that hyper mobile spot. So what I usually suggest to patients is if they're really, you know, kind of chronic self adjusters, I say every other time that you feel like doing it, don't do it. So let yourself kind of keep doing it, you know, and like wean yourself off, basically. That being said, like your thoracic spine is supposed to move a lot. You know, you can roll over a foam roller and get like crack, crack, crack, pop, pop, all that stuff. And I usually, I'm under the, you know, the idea that that's fine, you know, your ribs are there, your lungs are in there, everything is supposed to be moving a lot. So the thoracic spine is a really mobile area. Really not terrible to get some movement in there. But the neck and the low back are really supposed to be more stable. And so we want to avoid self adjusting or kind of cracking those as much as we can.

I love that. I see now why is it that people have such a. And not all people, but why is it that people have this idea that chiropractor is almost, you know, not beneficial or not real or fake? Where does that come from? Why do people say that?

Yeah, I don't know. I definitely think it's changing quite a lot. You know, these chiropractic students that I see coming out of school now are, man, they are on it. They know their anatomy, they know their physiology, their biology. You know, the first two years of chiropractic school is the basic sciences. And so I hope this is right because I did hear this from someone in Australia, but I've heard that in Australia all those basic sciences are taken together the first two years and then they kind of spread off into like medical, doctor, osteopathic, chiropractic, you know, kind of physical therapy, whichever way they're going to go. I love that idea because it's just like we are getting a lot of that same information and knowledge and we actually take way more anatomy classes than medical doctors, spend way more hours in the lab with a cadaver. So I don't know, but I definitely think it's changing, you know, and, and especially when you start to look at a more kind of functional approach like we're talking about, like it seems that it's, you know, the way of the five minute chiropractic appointment I hope is kind of dying off because for me it's hard to call that medicine. You know, it's hard to call that like, it's just not the best care that I think you could be getting. You know, it's hard to evaluate and assess someone in under five minutes. So hopefully that's changing.

Yeah, I feel like when I was a kid, that's what it was like. You just went after for five minutes and then you were done and you're like, wait, I love that. And honestly I didn't realize, you know, as a personal trainer, I don't really know or understand the amount of study and education that it takes to be a chiropractor.

Yeah, yeah, it's a four year program, like I said. And then there is some schools offer also a master's program as well as the doctorate. You have to come in with a certain amount of undergrad. You know, most people have their bachelor's also or you get it while you're there. So yeah, it's a lot. But yeah, I mean, there's definitely a time and a place for just like that quick adjustment. You know, like anyone who's seen a chiropractor over the years, or even anyone who just knows their body really well, they know if it's like, oh man, sometimes I get a migraine and if right here kind of I feel like it's a little pokey, and then if I get it adjusted, it's better. You know, like there's a time and a place that like something quick like that is really can be all you need. But I think it's really rare because I also think that there's additional things that can be done. You know, the suboccipitals could be worked on. We could help the patient, you know, in engaging the deep neck flexors so maybe they don't end up so far out in front like this and cause those to tighten up. So, you know, I think it's just offering as much as we can to the, to the patient.

I love that. So I love that. Now, as a sports chiropractor, do you work primarily with athletes or is it a combination of athletes and active people? Like you said you worked in a CrossFit gym, so I'm assuming you had a lot of crossfitters hanging out.

Yeah, we see a ton of crossfitters in my office and you know, a couple high level ones, but mostly just kind of your average active person. I'm one of the team chiropractors for our professional rugby team here also. So we see those guys, you know, and they're super fun to work with. You know, I work with the professional volleyball, the AVP when they come to Seattle, but on the daily basis it's just, you know, active people that want to be able to play with their kids on the floor, go for a run, you know, that kind of stuff. So what are some of the signs that people come to you with?

Like if you're a personal trainer and you're noticing some things that clients are saying to you, like how do you determine? Like how, how would a personal trainer determine?

Maybe I should refer out to a chiropractor and not a physical therapist? Yeah, yeah, good question. I mean, I think there's great physical therapists and great chiropractors and, you know, there's also obviously horrible ones just like every profession. So usually what I'll recommend people start with is there's a couple of websites or a couple of Groups, the American Chiropractic Association, Sports Council. So that's the ACASC and then the American. I always mess up all the letters. You know, the ACBSP is the American Chiropractic Board of Sports Physicians, and I belong to both of those. But they both have websites with kind of where all their docs are. And so I always kind of recommend that people look to those kind of doctors first. And really, like, if you're personal training someone, you know, so many personal trainers are so great at taking care of some of this stuff. So let's say you have a patient with shoulder pain. You know, I would say a time to refer them is when you've tried all your tricks. You know, they've tried their foam rolling, they've tried some banded work, they've tried some of the rehab stuff that, you know, maybe, okay, well, maybe their lats not firing. Let me see if I can get that to work. You know, once you've tried all those kind of tricks and the patient is. Or client is having to really modify and they're having pain that they can't do the things they want to do, that's the time to refer. I think maybe you're watching someone squat and you just really are trying to get them to keep their weight centered evenly and they're just really shifted to the left. Could be that, you know, their si joints are rotated a little bit and they just need some little bit of muscle work, maybe a small adjustment and then some small rehab exercises. Um, but I would, I would always recommend looking for a sports doc because ideally they're going to want to keep the client and patient moving. And so they're not going to tell them to stop seeing you. Right. Like, they want them to keep working out and they want you to like, keep doing all the stuff you're doing with them and they just kind of want to be a part of the team, you know, So I actually, that's one of the things I struggle with is finding personal trainers who are good and who have the availability for me to refer to because I do a lot of rehab with them. But then they need some kind of transition into like, okay, well, maybe you're not ready to jump straight back into CrossFit or your functional fitness or whatever it is. You need some personal training sessions to like ramp you back up. So that would be, I mean, that would be, that would be great if I, if there were more personal trainers like that out there that you, you know, we could like, work together to, to for the better you know, for the best care for the patient and client.

Yeah, I love that. I mean, and we talk a lot here on this podcast about, you know, building out your networks. And I hadn't even thought about it or considered for a second that, you know, oftentimes personal trainers can be too hesitant or nervous because they feel like they're overstepping or worried that the chiropractor or PT is going to say no, not recognizing that they need the network just as much as Totally Trainer does. I love that. I also love that insight about looking for specific, like sports, specific doctors, because it's exactly right. We know that building strength is going to be part of the rehab.

Totally. And it's so fun. Like, I love. I have a couple personal trainers, you know, everything is so virtual now, but that I'll just shoot a quick email, of course, you know, with the patient's approval and just say like, hey, you know, maybe start out some of their warmups. Let's get some glute bridges, you know, some single leg deadlifts, and then just give them kind of. These are a couple things along these lines that would be really good for them. And then we kind of get to like work together. And the few personal trainers that I do that with, it's. It's kind of. I feel like it's kind of fun for us, you know, because we're kind of like, we feel like this team of like, you know, and, and that the client and patient, like, I think they feel like, you know, they're getting really good bang for their buck with both of us because we're like, you know, it's like we're on their side.

So I, I've been someone who has worked with the chiropractor and a person and a physical therapist at the same time. And I'm curious, you know, and I didn't know at the time, but the manual that you guys do are completely different.

Yeah.

So what are some of the ways that you guys like PTs and chiropractors work together? And what is, you know, what is it that you do that are different?

Yeah, it's so different in every state. So like in Washington state, for example, so randomly chiropractors can't use ultrasound or like interferential current. Like you can buy like a TENS unit on the Internet and put it on yourself, but like I can't legally put it on you, but PTS can. Right. So that's a more passive modality that they can do the adjustments. You know, in some states, PTs can do manual adjustments. You know, where we're actually moving the joint a little bit. And in some states they can't. So it really is like state dependent and what the different boards, you know, kind of push for or push against. You know, I have a couple of pts near me that I refer, you know, we refer back and forth to each other and. And it works out really great for me personally. Like, I am not great at post surgical rehabs except for shoulders. Like, I love shoulders, but if it's a knee or a hip, I'm like, oh, gosh, this is tough. So I usually send them to PT and we'll work together. You know, I'll do some of the, like, more manual work to the muscles, ligaments, tendons, do the adjustments, and then I'll let them focus on kind of the rehab piece. And likewise, you know, if they have a patient that they're working on something with, but they're just like, you know, their neck is really restricted and they feel like they need a manual adjustment, then they'll send to me. And so we just kind of, we refer back and forth pretty nicely. That doesn't always happen, but I think there is a growing kind of understanding of what we do and what. And it's just different for each person, you know, like, there are some chiropractors who love post surgical knee rehab. And I'm like, great. You know, like, you can do it, you can do that, but I don't want to do it, you know, so it just really depends on what the person specializes in. I think.

I had never even thought about a chiropractor for a knee before. I always think of back. Right?

Yeah, that's. I think that's another thing about the sports is like, it's a lot more like shoulders, knees, hips, not just, you know, the spine is. Of course we're working on the spine, but I also think a great chiropractors and PTs work together really well in postpartum stuff because postpartum pelvic floor pts are like, I always, I have, you know, one in Seattle that I just like, adore. She's so great. And we can work, you know, we work together on, you know, she works on pelvic floor stuff and then I kind of work on a little more like transverse abdominis core, you know, make sure their actual SI joints are moving, that kind of stuff. So it can be nice, a really nice little marriage when it, when you find the right ones.

But I love that. No, I love. This is a perfect segue because I did want to Talk about this, because you mentioned that you've now shifted. You started to, you know, shift and pivot towards prenatal, you know, postpartum. So I'm curious what caused that change? And are you working with sports moms or are you working just with moms?

Yeah, mostly active moms. So, yeah, not a lot of high level, you know, fitness professionals that are getting pregnant that are in my office, but just like super active. A lot of runners, a lot of crossfitters. You know, a lot of. Of course people are working out at home, so just doing like, you know, their boot camps and that sort of thing. So, yeah, I think I started when we started talking about having a family. I have a 14 month old now. And so kind of that year before was like, maybe two years before I just started really enjoying working with pregnant women. It was just patients I kind of already had off and on over the years that would get pregnant and come in. And so I started doing more research, doing more education. I took Webster Technique, which is a chiropractic technique that is really pretty well known amongst, like, doulas, midwives, even obs. It's just a technique that basically creates the most room in the pelvis for the baby to kind of move into a good position to be born. So I took that course. I did a pre and postnatal athleticism certification and just started, like, geeking out, you know, and it's so rewarding because these women, their bodies are just daily, I mean, you know, changing and every day is new for them. And it's so rewarding to be able to help them just like, even if it's, you know, just for the next few days, like, not be in pain and give them some techniques of how to keep working out and how to be able to be active through the whole pregnancy and, you know, which modifications are important and what things we can debunk that, like, totally aren't, you know, legit. So that's really rewarding for me. So I think once I just started having a couple of those patients geeking out, it was like, all right, now I'm all in. And then I had my son, and now I'm like, these are. These patients are the best.

I love that. Congratulations, by the way. I wasn't sure, you know, I didn't want to ask, but congratulations.

Yeah, yeah.

Now I'm curious for. On a personal note, because honestly, I. Pre postnatal was my background, and for me specifically, it was because I had had such a problematic pregnancy, and I also had problematic births and Fourth trimesters. And I had just really realized that there is a huge gap of information and support for moms. And I was a trainer, so I had years of training and I had zero idea about what was about to happen to me. I'm for it now. I'm grateful for it because it led me here. But at the time, I'm not going to lie, I was not so grateful. So I'm curious for. This is a complete selfish question. For the rest, I'm okay stating that I had failure to descend in both my births. Like, my pelvis is. Is just really small and it's really narrow. So I'm curious, if I had worked with someone like you before, if I had known about that that was going to potentially be a thing, could that have been something I could have potentially worked on?

I think, you know, with failure to descend and with, you know, you have to look at the anatomy. You know, I'd love to say, like, yes, if you would have seen me, it would have been all great. But realistically, we have to look at the anatomy and it might be that, like, you know, bone structure. Yeah. Like, the bones are what they are, and we. We get so much movement with the relaxin, but there's only so much movement. So mostly what I see is when. And it's crazy because when these patients come in and their hips are just so rotated because everything just moves so much easier, you know. But mostly what I see is that we want things to just be even. So where I find it to be the most beneficial is, let's say if the baby isn't turning. Not that we're turning the baby, obviously, but if, let's say the right hip is really far shifted forward and the left one shifted back, it's going to make it so that the baby has a hard time maybe getting into the optimal position. So we just want to make sure that there's nice movement between both hips to give optimal movement in the pelvis. So that's when I see it, like, more beneficial. Not necessarily like on a super small pelvis, but yeah. Or if they have, like, you know, if they're having really bad round ligament pain on one side, it could be that, you know, one side is pulling a lot more and you can a kind of loosen up. The round ligament actually has muscle to, you know, muscle fibers in it. So we can kind of move some of the fascia around that and try to release it a little bit and then also do small adjustments on the hips because they're super easy to move. On pregnant women and then give some, you know, stabilization exercises to like, re. Stabilize in a better position. That makes sense.

It does, it does for me because I know what, what she means that oftentimes when we're working with patients or when we're working with clients who are pregnant, they just. Can they become hyper mold? Yeah. And so you'll all of a sudden they're squatting in a. And they couldn't before, right? Yeah, I think they're like, oh my gosh. And so as a trainer, if you're looking at that and you're thinking, okay, great, now they've got some more. More mobility, it might actually not be the case. They might need actually some more strength around there. What about sciatica? Can you. Do you help relieve some sciatica pain too, for pregnant women?

Yeah, I mean, as you know, sciatica is like a super common occurrence in pregnancy, so. But I have had pretty good luck relieving that for quite a few patients. You know, with some work around the piriformis, you know, the glutes just kind of releasing around the sciatic nerve, sometimes down into hamstring, and sometimes it is just again that the pelvis is rotated because of that hypermobility, you know. So, yeah, I've had pretty good luck with that. And I think a lot of chiropractors that work with that population would say that they generally have pretty good luck with that just to at least give some relief. You know, that's the thing is it's sort of like putting a band aid on things because every day it's like a new thing. But we're trying to at least keep. Keep the patient out of pain and keep them moving and able to work out and, you know, function in their daily lives. They have other stuff going on too, so.

Yeah. Yeah. When do you typically recommend a pregnant client or pregnant person come in to see you? Only when the pain starts. Or do you think that there's. There's a reason for preventative?

Yeah, I see a reason for preventative, especially if you can find someone that specializes in that population. I usually say, you know, usually the first trimester women are pretty good. They don't have to modify too much as far as workouts. They're not usually in a ton of pain. You know, physically maybe like. Well, maybe they're like sick or, you know, fatigued and all that stuff. But so usually I say after the first trimester and I think preventative is great because what I get, what I see people benefit from a lot is Being able to give them, okay, these are, you know, these are the modifications that we're going to have you make and these are why, you know, like discuss with them diastasis, discuss, you know, make sure that they're not scared of that and you know, they know what's going on and how to help not make it worse basically and you know, take away some of the fear mongering that happens on the Internet these days. So I really like seeing them even before they're maybe in pain, just like to give them kind of these, you know, here's some guidelines, here's what you can do. You know, pregnant women always have questions about can they do this, can they do that? Like, so I like to give them all that information and then that just kind of sets up a relationship. And then, you know, we say, okay, every like I see them every like maybe two to four weeks at the very beginning and then towards the end we start making those closer and closer. Especially if they're having issues with, you know, with their pelvis alignment and you know, that kind of stuff. So.

Yeah too. And also, you know, the body completely changes. I mean, massive transformation. Right. So we talk a lot about alignment. Right. And having alignment and talk about breast support. You know, how's that, how, how does that change for you? You know, as a chiropractor dealing with, you know, completely like the alignment is going to look different.

Totally. Yeah, yeah. I mean it's just basically reevaluating how they're moving every appointment, you know, and knowing again, we're looking at the function because we have to see, you know, we're not looking at an X ray of their spine every time, you know, I don't order X rays unless there's a problem, you know, so, so I'm feeling what is going on with the spine and then I'm watching them move. We're looking at, you know, what muscles are firing, all that kind of stuff. So it just needs to be reevaluated every appointment basically. Because it's changed every appointment when, especially when you're talking about during pregnancy. Right.

And for, you know, your center of gravity is also changed. That neck, that, the neck, you know, impact on the neck that you were talking about earlier. Moms have that and you don't anticipate that. They just think it's going to be back PA and then all of a sudden they're like, what's happening? Well, your body's trying to counterbalance your center of gravity.

Yeah. And then you add in breastfeeding.

Right.

For some women. And then a lot of women don't realize how much havoc is going to be wreaked on their upper back and neck also just from that kind of hunched forward position. So also I see a lot of wrist pain in new moms. So there's just all these things that people anticipate. So I find that if we can like, talk about that earlier, you know, earlier in the pregnancy, even before the baby comes and people are like, so tired and like, can't remember what day it is. Like, let's talk about it early on and like give you some, you know, some a plan basically then that seems to be effective.

Especially that breastfeeding time too, is that you are. You're anticipating if you're anything like me.

Right.

I struggled so hard. So for me, it was kind of at any cost, amount of hours that I was spending hunched over in the hope that it would finally take.

Right.

You think as a professional, you're going to be like, oh, I'll be in the perfect posture at all times.

Yeah, right in the corner. Yeah.

Exactly. Exactly. And you're like, it's okay, we're going to get it.

Mind over matter.

Exactly. Right. That comes out for moms.

Right.

I feel like, especially your active moms. I mean, we are all about like, at any cost.

Yes.

For better, for worse.

Yeah, exactly.

You know, and I love that you're also talking that you talk about the pelvic floor because as a mom, I didn't even know that was a thing.

Yeah. And I think that's, you know, that's one of the, for all of social media's like, downfalls, you know, I think that's one thing that is really good about it is there's so much more talk about it. There's so much more information out there about, you know, pelvic floor and not just for moms, you know, that like, you shouldn't be peeing yourself when you're doing double unders or sneezing or coughing. You know, it means that there's something going on with the pelvic floor and it's super common, but it's not normal, you know. And so I think that's one of the things I do like about social media is that some of this stuff, you know, same thing with like breastfeeding issues, postpartum depression, like all these things. Right. At least they're like coming to the light a little more. And so people can try to reach out and find help for these issues because there's help out there, you know, Other countries, like, people see pelvic floor pts right after they have their baby, you know, so.

And Gwen's only five.

I mean, right?

This is recent, right? I mean, it's, it's been amazing because for me, this was completely mind blowing, which led me to that pre postnatal life chapter because I had worked. You also have that moment where you're like, oh, how many moms have I messed up?

I know, it's like, oh, if I knew now what I knew 10 years ago. But that's. I guess that's every. Every profession, right?

Exactly. That's how we grow. That's how we grow. It's so true. But I do laugh about it now. And also to your point, when you're speaking about pelvic floor physical therapists, you know, or pelvic, you know, you want to work with people that are sports minded.

Totally.

There are also people out there that are like, don't walk, don't pick up your baby. And you're like, sure, gotta get on that. I live in San Francisco and there's hills everywhere. So I'll just, you know, we'll take a trolley. I don't live in New York, but, you know, that's kind. You know, I used to live in San Francisco, so I know that life. Like, there's no way I'm not walking uphill. Are you kidding?

Yeah. And to that, you know, there's also, I mean, I've had patients who have sent to pelvic floor physical therapy and, you know, we're working together and, you know, if I would have just told them, like, do some Kegels do this? Like, actually what their problem was was that their pelvic floor is too tight. Like, they need to learn to relax it. Yeah. Super common with like, especially like people who are, you know, competitive into fitness. They're just like, all the time, you know, and so if, if they took this advice of just, you know, random Joe Schmo to do heels all the time, they would be doing more damage then good. So it's super important, I think, that you just have someone knowledgeable, you know, at least for an appointment. Like, some of my patients are like, I don't want to drive there. She's kind of far away. I'm like, just go to her once. If you don't, maybe you don't need to go. You know, maybe like, things are. She'll like, tell you that everything's all good. But if you do need to go, you need to have a resource, you know, so.

Yeah, so I'm curious, too. Now you're talking about. We've been talking a lot about in person experience. Now we're in the time of the pandemic. We're in the time of COVID How has your, you know, how has your business been impacted and what are the ways that you have shifted now that we're in this time?

Yeah, I mean, we are considered essential. So even kind of at the height of things, you know, if you throw out your back, quote unquote, you know, at that time, you'd either go to the emergency room or you'd see someone like me. So they were trying to keep people out of the emergency rooms, of course, you know, But I did take some time out of the office just having a baby, you know, at that time, he was only, what, five or six months old when this all started. So I took about five weeks out. And then slowly we introduced masks back in, like, way early on with us and our patients. And so we just slowly started ramping back up and take more time to clean, more time between patients. Like I said, we don't have a super busy turnover practice, so there's only ever a few people waiting at a time. But personally, I think the biggest thing, the biggest shift or pivot for me is that I finally developed this postpartum plan that I've been working on. I wrote the actual program after I had my Sunblaze, because I bought one online, and it was good, but I kept finding myself just adding in my own stuff that I would give to patients. And I was like, all right, I just need to make my own. And so I made it all up in an Excel sheet, and I was using it with people and sending it to my friends, but it wasn't anything fancy, you know. And finally, one of my girlfriends, who's in, you know, kind of in the fitness marketing world, was like, you got to get this out to people. Like, when are you gonna do it? And so then the pandemic hits, right? And I was like, I guess now. Now's when we'll do it. So I filmed all these videos. I ended up filming 52 videos and editing and voiceovering. I know I was only gonna do, like, the hard ones, you know, like, and then my girlfriend was like, if you want everyone to. You want this to be for everyone, which I did. I wanted it to be for, like, not just the super high level athlete. She was like, you have to record them all, so you have to show someone how to foam roll their upper back, you know? And I Was like, wish I wouldn't have made this plan so extensive now. So I developed that and we made it all pretty and packaged it up and so now that's available online. And I've started doing some consultation calls because like I said, early on in pregnancy especially a lot of what women need is not need to like adjust them. They need some understanding about what they can do, what they can't do. Very specific questions like, I like to do this, this and this. Can I do those things? This is starting to hurt. What should I do? You know? So I've started doing some online consultation, 30 minute phone calls, which has been great because it gives, you know, it gives me the ability to help women in other places, not just here.

Yeah, I love that. That's been a blessing that has come about in this time for sure. And so that's great. So it kind of leads to. What I was asking is that there are some things that you can do without going in.

Totally.

Yeah.

Yeah, totally. A lot of, like you mentioned earlier, a lot of stability stuff, you know, is like so important because like you said, sometimes most times women find this like newfound mobility and it's like, yeah, man, but now you got to keep your hips stable. Like those muscles are the only things that are keeping your hips from like going crazy. So, yeah, there's a lot of stability work people can do at home and you know, both while they're pregnant, postpartum and just in general, you know, like, I think we're gonna, I know we're gonna see more and more of that, you know, just as times are a changing. So. But I think it's. That's, that's one of the benefits, I guess. So. Right.

Have people felt nervous to come in to the office?

Not, not really. I think maybe initially a little bit, you know, but now I think they see like all the cleaning, all the, all the things, so not so much. And I think, you know, we don't, like I mentioned, we don't see a lot of patients, so there's not a lot of people in our waiting room. And people are only coming in once, maybe at the most twice a week. So it's not that big of a commitment, you know, to like be out of that, you know, be out in the world for a long time either. So.

Yeah. So how long is your program?

So it's eight weeks. Yeah, it's. I designed it. So it's four days a week for eight weeks. A lot of women that I'm having do it, you know, don't do all four days, they get in two or three, they spread two weeks into three weeks. And it's kind of designed like that, you know, to kind of go through at your own pace, but you have to have some kind of timeframe, you know, so eight weeks. I started a similar program the week after I had Blaze, but it was like, it's very like breathing exercises or, you know, and some like kneel to squats, like very simple. And then it gets progressively a little more difficult. Right, of course. But I designed it to be like really minimal equipment and able to do at your own house 15 to 20 minutes. And like I said, doable for everyone. Because I think one thing that a lot of women don't realize is that like pretty much every person who has a baby could use this kind of rehab, should use this kind of rehab. It's not just for the super high level athlete, you know, it's for you to be able to functionally heal the diastasis, to not have back pain or pelvic floor issues down the road, you know, to be able to pick up your kids without worrying about it. So I just felt like there was a little bit of a missing, a missing link to some of the other plans that I found out there. Either they were like a little bit too hard or a little bit too, too easy. And so I kind of tried to like meet in the middle somewhere.

Mm. And now do you find that your. That you have to create buy in from your athletes? Like, I'm putting personal trainers and advanced physical therapists in that athlete category because I feel like there's this, this feeling amongst us of like, no, we'll figure, I'll figure it out. I'll just strength train my way through this.

Yeah, I think the best way that I like kind of get buy in is, you know, I bought a plan from someone else. You know, I've been programming for people for years. In fact, I could program everything for myself, but I don't do it. You know, I have a coach who programs my regular fitness in my regular life and I program other people's fitness, you know, so it's, you know, every coach needs a coach kind of situation, you know, So I think that's like the biggest deal for me is, you know, just because I can. Just because I can make this plan doesn't mean I should do it for myself, you know, like, you want someone else to be in charge of your, I don't know, just to have that, to have that like accountability too.

I think that's so powerful. Me too. And I'll tell you that the coaches that I look up to and have learned from, they all get their programming from someone else too.

Yeah, I mean, you have to, because like, otherwise, you know, you're going to, you know, in the middle of a workout, tell yourself, oh, I made this too hard, let me cut down a couple rounds, you know, or, oh, I, you know, that kind of you're going to always talk yourself out of it. And it's the same with rehab stuff. You know, I love programming rehab stuff for people because I like to make it, you know, two to three to four exercises. Here's how you can do it, you know, in a little kind of program, you know, and, and this is the goal. This is like what we're trying to achieve with this. So, yeah, I think it's. I just think it's so important. I. Every once in a while I'm like, I'm not gonna. My coach's name Adam. I'm like, I'm not gonna have Adam program for me. I'm gonna save a little money and I never do it because I'm like, no, that's the reason you pay him so that you do the things you're supposed to do, you know?

Yeah, absolutely. Yeah. I definitely want to be mindful of your time, so I'll make the last question.

Yeah.

I'm curious, you know, how long does it take? Because we were mentioning that your body complete, like a mom's body, completely transforms. So how long does it typically take the muscles and the bones to kind of. I know it's going to be like the new normal, but move into the new postpartum body.

Yeah. I mean, you know, one interesting thing is that we have that six week kind of clearance. Right. Generally. And from my experience, both personally and as a practitioner working with a lot of pregnant women, I just. There's not a lot that goes into that, like, you know, whether it's midwife or ob. I wish that, you know, there would be a little more questioning, a little more like functional movement. But that's where I think, like, you know, PTs, chiropractors, personal trainers, like, we can all help. There's a just such a need for that kind of functional assessment. What I see with patients is, you know, around the three to four month mark is women start to really feel a little more like themselves. You know, as long as they're breastfeeding, they're still the relaxant and there's still all these hormones in the system. Right. So until they're done breastfeeding we really can't expect, like, full stabilization of the joints and all that stuff. And remembering that that's like, it's all the joints, you know, it's not just the spine, it's not just the pelvis that moves. It's their shoulders, it's their feet, it's their neck, it's all that stuff is going to be super mobile until they're done breastfeeding or more, more mobile than normal until they're done breastfeeding. But yeah, I see usually around three to four months, women start to feel a little more like themselves around. Kind of, for me personally, around the six month mark, I was like, okay, I can do basically everything I could do before I was pregnant, just maybe to a lesser degree. Right. Like, I can't squat as much, I can't deadlift as much, but I could do pretty much everything slower, a little lighter. And that felt really good to me. But it was also shocking. I don't know about you, but it was so shocking to me in those first couple weeks after giving birth, like, how out of touch with my body I felt. And just like, I was like, seriously, like, I can't even, like, sit up, you know, And I. And I work with these women all the time. And so I knew, but I just. You don't really know until you experience it, you know? And so I think I designed, in my plan, I designed it to be like, okay, we have to start with this breath work. We got to get you feeling, like, the excursion of your ribs again and, you know, using your diaphragm to breathe instead of, like, being so crunched up here because everything's taken up with a baby down in the belly. So, yeah, I don't know. That was like a really roundabout, weird way of answering your question.

But I was like, oh, Beverly, you said this was gonna be last, I promise.

You know, I'm good.

It's like, you know, for me too, I had a cesarean, so I definitely had that moment of like, am I ever gonna sit up again? It's just we, we. We take for granted what comes most natural to us. Yeah. And so, you know, including breathing. I mean, having. Teaching someone how to breathe is actually very hard.

And it's like, I always. I'm like, it's so boring. I'm so sorry. I even have like a disclaimer, like, this is slow. This is boring. I'm sorry. Do it anyway, you know, like, because you have to, like, you have to start there because otherwise you just skip this whole big, important Step of. That's how we really kind of can feel like we're in our own body again.

Yeah, I did. I did feel like that. To your question, I did feel completely disconnected. And I also felt too, for me, and also because I shared that I had a hard fourth trimester, too, because we were struggling to breastfeed. So my body just felt completely alien to me from the moment I gave, like, got pregnant to, like, it took a really long time. I felt like I was not in this body that I could. Would have ever dreamed of. Like, it was so, like, it felt.

Like an alien for a long time. Right. I think it's way more common than we think, you know, and so, like, talking about it and, like, being able to, like, give some advice or some guidance or point people in the right direction to different, you know, even people. Different people online to follow to, like, get some of this information, I think is just. Yeah, it's super helpful just to make you, you know, like, anything. Make you feel like you're not alone in something.

Yeah. And also, too, for my coaches out there who are, you know, working with. With active moms. Right. Is that I feel like there's this push. At least it was for me, and this was just five years ago, but. Or three, because my second is three now, is that there's this push to almost act as if you're not pregnant. Like, oh, no, you can just keep doing the same thing. Keep doing the same thing. And that's a good thing in the sense of, like, you're not broken. You're not a. Nothing's going to break. You're still resilient as a mom, but there are going to be some changes. And it's not about those changes not being there and acting as if they're not. It's about building resilience even through this time.

And I think one other important thing for coaches to remember is that. Because I didn't really used to think this way. But, you know, even if you don't work with pregnant women specifically, like, any woman who's had a child is postpartum. So that's super important to remember because if they're, you know, and to ask. Ask your clients the questions that maybe feel a little uncomfortable, but I was doing a class for a while before we went into Covid. I hope to get up online, but it was basically a class on modifications for pregnant women. But it was for coaches and personal trainers to just like. And especially for guys, because it was like, listen, here's basic anatomy. Here's how the progression is going to go. Here's what the trimesters look like, here's what and why you need to modify things. And I would always make sure I expressed to those guys, you know, you're their trusted person. So you need to feel comfortable asking them like if they're having, if they're peeing a little when they're doing anything that you're asking them to do in the gym. Like you need to know about that, you know, and it might not be, you know, like we said, it's not maybe even a postpartum client. Maybe it's just a woman or man with pelvic floor issues, you know, prior to having a child at all. So anyways, I just think so many coaches are in such a trusted place and they have so much buy in from their clients that I would love to have that, be able to have that conversation a little bit easier and then be able to kind of point them in the right direction of someone that can help while keeping them still moving.

And especially too, a lot of, you know, you want to know what these questions are to ask because you've got these moms that just, just don't tell you because they're like, oh, that's not important.

Totally. So things are like, you want to ask if they're having any leaking of urine. Of course you also, you know, and there's different ways to ask it for different people, but you want to know if they're having any heaviness in their pelvic floor. Some women say like some feels like something's falling out or like they're sitting on like a ball or something. So you want to just know if there's any of that kind of feeling, you know, you want to know if they're having pain early on. You want to know if they're having bleeding, you know, because if that increases, that means that you're probably pushing, they're probably pushing a little bit hard. So those are some of the main questions to start with, you know, just to, to get a better idea for you. But also, you know, you're showing your client how much you care about them and their overall health. So.

Yeah, so good.

Okay.

So I promised that I wanted, I was going to be mindful of your time. So those of you who want to learn more about you, where can I send them?

So I'm on Instagram, of course, drkarli just D R K A R L I E and then my website with my postpartum plan is just Carlycause.com and that plan is there. You know, people can, you know, sign up for consultation, phone calls and that stuff there too. Those are probably the best ways. You can always DM me on Instagram or my email is drcarlyazi carlykazi.com awesome.

And Dr. Carly, you have a very awesome gift for us. Right? So you've put together a gift for us.

Yeah. So if anyone's interested in the postpartum plan, it's normally 127. So if you use the code B Simpson Fitness, then you'll get 20% off. So I think that brings it down to like 103 or something. And. Excuse me, the way I designed it is you can use it really any way you want. You know, there's a PDF, there's like a Google whatever calendar. So you can like just do it, pull it up in a Google Doc if you want. There is like a weekly tracker and then of course there's all those videos. So yeah, so you'll get 20% off if you use that code.

Okay, cool. And we're definitely going to link all this up for you so you can check this out in the show notes.

Awesome. Thank you.

Thank you so much for hanging out with us today. I really appreciate it.

Yeah, it was so fun. Thank you for having me on. I appreciate it so much.

Thank you for listening to the PT Profit podcast. If you like this episode, chances are your friends will too. So it would be a huge service to to us if you would please leave us a review and share with your friends on your social media channels. When you leave us a review, be sure to take a screenshot of it and email that screenshot to my team@info simpsonfitness.com and we'll send you a very special Instagram podcast that will show you how to create compelling content so that your ideal client clients come to you. And you go from wanting clients to a wait list of clients ready for your services. Thank you so much for listening and we'll see you on the next episode.