Millions of women are living with pain, discomfort, and silence, told that it is just a part of life. It doesn't have to be. This is Healing at Your Core, where pelvic floor physical therapist Brie Allred brings more than 20 years of clinical expertise to the conversations women deserve to have. Real answers, real healing, no shame. And now, your host, Brie Allred. Welcome to Healing at Your Core. I'm so excited for our guest today. we've got Dr. Steph Denniston with the Active Family Chiropractic with us, and we're really going to talk the ins and outs of pregnancy a little bit. It's a big transformation in a woman's life, and several women will go through this multiple times, these big transitions, not to mention the postpartum, but we're going to focus on the first part of it today. So Steph, tell us a little bit about you. What got you into chiropractic care in general, and then why you chose to have one of your specialties be pregnancy. Awesome. Well, I'm excited to be here. And I have been in chiropractic for 20 years now. And I chose the pregnancy side of it because I myself went through pregnancy when I was in chiropractic school. And it was hard. And I realized that it didn't have to be hard because I was adjusted through my pregnancy, which made my second pregnancy a little bit different, but that pregnancy was also really hard because I had a breech baby. So that was what really kicked me into the pregnancy side of things because I was wanting to help moms deal with that different pregnancy. That's really neat. So then tell me chiropractic in general, what led you down that pathway? I honestly, I just, I was experiencing my own issues with my body and being in pain. And I went to a chiropractor, not even cool story, but I loved watching people get better while I waited to get adjusted myself. And that was it. I just feel like I'm in on this. I'm in. Yeah. I loved it. So, so cool. That was what took me down the chiropractic route. Okay. Yeah. I love it. So we're going to talk about a common myth. When you're pregnant, most women think that it's like, oh my goodness, I'm going to be in pain. Like it's just part of pregnancy. So tell me what your thoughts are about that. Like, oh, this is just normal. And when one of my taglines a little bit is that common isn't normal or doesn't have to be normal. But we can challenge that nomenclature that it's like, yeah, pregnancy presents some challenges in your body. And it doesn't have to equate pain. through pain. Yeah. It's interesting because pregnancy, I have so many that come in on their subsequent pregnancies after they've been in pain for their first and seen me through their first and was like, I'm not going to do that again because they learned that actually pregnancy doesn't be that way. And the fact that we have been societally told that, oh yeah, you just have pain in pregnancy. It's a bummer, but it is absolutely avoidable. And we as chiropractors, pregnancy chiropractors can balance out those, the pelvis and the hips to make your body work better for you during whatever pregnancy you're on. Yeah. Whether it's your first, whether it's your third, whether it's your 10th, but pain is not something you have to endure during pregnancy whatsoever does it happen but enduring it is not you don't get a badge you're making it through with the most painful pregnancy definitely don't and i don't recommend it yeah yeah it doesn't have to happen yeah pregnancy is beautiful and it can stay beautiful like without pain i mean you really think about it it's like your body grows a human it does from the small i'm out we'll say it i'm like i'm gonna totally like our male counterparts contribute a seed and we get to do all of the work of of actually growing the human like it's a pretty incredible thing that our bodies do yes i say that to women all the time i'm like girl baby like we our bodies are amazing so really are let let's believe in it and know that we can make these changes for body. Absolutely. We just have to get the right tools. Yeah. Yeah. Yeah. So what would you say are the most common complaints? Like you've got somebody walking into your office. What are the most common complaints during pregnancy that you're going to be hearing about or treating? The most common is probably sciatica. They get that pain down, like starting at the back of their hip, so to speak, and it shoots down into their bum or even lower into their legs that's probably the very most common and then pubic symphysis pain front some people call it lightning crotch yep um and that's real as well and then um just low back pain as well like their their low back hurts they starts to make them waddle and probably the pregnancy stance and movement, right? Yes. Yes. Which ones would you say from your experience, what things are normal in a pregnancy? What are normal adaptations that our body are going to compensate with or change? And what would you say are things that you're looking at and being like, oh, we've got to correct this from maybe even really specifically from like an alignment perspective? What is stuff that you're like, oh yeah, we see these changes in pregnancy. Some of these are going to stay and are actually normal compensations or adjustments? And which ones are you looking at and being like, yes, we're going to try to realign them? So the pelvis is obviously the home for the uterus and the baby to grow in. So we want that as stabilized and balanced as we possibly can get. So if they come in and things are twisted, we try to get that to be very normal. and then there's that lovely sacrum that sits in between your big like that nice triangle shape but yeah bone at the bottom of your spine yes yeah um that can be shifted one way or another against how your pelvis is sitting so that the big pelvic bones how they sit and we don't want them to be contradicting each other so those are the big things that we try to get to work together so that the baby can be housed in there as suspended as equally as we possibly can get it. Yeah. So those are the major ones that you'd be wanting to correct. Yes, those are the major ones. And then I always check the ligaments up front because they attach it to the pubic bone, which the lightning crotch happens, I think, a lot of times because of that imbalance up there. Yeah. So getting all those working together and the house is a lot better. And then it usually will make it so that the rest of the spine will sit better and pregnancy can be a lot more comfortable. Yeah. Because it does go all the way up their mid back as everything else changes and their ribs get wider. We can't forget about that. Yes. Because it's a real thing. Yes, for sure. So let's talk. I think we'll just kind of bounce ideas a little bit of like, what are the normal changes that it's like, okay, these are things that we commonly see that are normal changes that we're, neither of us are really going to be like, yeah, we're not going to correct that. So like one example being our pelvis is going to widen just a little bit. And as long as that's happening pretty symmetrically, like it naturally has to happen to house a growing baby in your body. Yeah. And it's a normal compensation that's there. And I'm like, yeah, we're going to support that with some strength from my end. Right. And you may support it just making sure that structurally things are doing well. Yeah. But we're not really going to look to change that during pregnancy. No. I mean, it's the body changes it so much for us that we can the best thing we can do, I feel like, is support it. So, yeah, just making sure that the muscles stay balanced between either of the things that we do. And the ribs also change, like I was just saying. So between those two places, because that is where the baby grows and grows, the ribs are also going to get wider in most places. So a lot of women will see, especially during pregnancy, and sometimes we'll have some lasting changes afterwards. like your bra size will often change for most people it's going to increase and be a little bit wider so you're going to have to go to a little bit bigger maybe like your cup size might increase a little bit too but more from like the band right that it's like your rib cage is going to widen and expand as well um and i feel like if we can support that top and bottom the bottom just tends to stay balanced Because the other thing that sacrum that we were talking about that triangle bone it will start to dip in a little bit as it starts to move away from the like open up so that that pelvis can get wider. That's another change that we see that we just have to support and hopefully it doesn't happen too early. Yeah. Because we want it to move so baby can make its way out. But when it's happening at 20 weeks and their low back hurts and they're getting sciatic pain, we try to get things to balance out so they're not so tight or immobile yeah that's the other thing that will happen with moms is like you actually have the immobility and it won't have it won't work with the big pelvis bones to actually move yeah i agree and then i think from my perspective too i would say that there's going to be a little bit of curvature in the spine because you can't grow the front of your belly without some compensation from what's happening in the back yes um and I do see that curvature towards kind of more curving towards the front think about mimicking what your belly does right yeah follows that a little bit and then our posture I did we see it compensate to where it's like you have to lean back so you don't tip forward so it's like you have to adjust your center of balance a little bit to where it's like oh if I'm constantly like my belly's growing and things are getting bigger in the front I have to shift my my top half back just a little bit to counterbalance that so that's something where i'm like again we want to find kind of our happy mediums but that's something that i commonly see during pregnancy yeah pregnancy and we as moms i think just naturally want to protect that as well so we kind of get even a little bit more hunched around the belly so reminding and being mindful of posture all the time as pregnant mom is is is what makes things more comfortable it gives baby more space it gives you more space gives your organs more space so I feel like if we can again support that stuff by just reminding them like oh yeah we're working on posture it's so helpful for moms I guess I mean even when we're not pregnant we get into our our slump so to speak but then you add the weight in front of us and posture weight and then how it stretches muscles we get breast changes tend to get a little bit bigger and pull things more into that slouch posture absolutely as well yeah it's it's a journey it is yeah it really is and it's fun to be able to help them realize how to support it better yeah okay what would you say i look at these as kind of like little pet peeves that it's like what do women suffer with too long before they seek help oh i think low back pain is a huge one they suffer with i would even say sciatic pain because we do the oh it will just go away yeah and i mean whether we're pregnant or not again like it just does that so anytime that we can get the body to go no like we don't have to we have help yeah then we don't have to suffer with low back pain for long but unfortunately we as providers are not known enough to be like oh hey we have support to go do that stuff but yeah they back pain and like in sciatic pain that you suffer with and then by the time they get to us we have to do some pretty good catch-up a lot of times okay so with this platform and educating yeah when should you seek help if you're a pregnant woman do you know when should you seek help when is the time to maybe start that to seek if didn't start seeing you maybe and i can kind of respond to that a little bit from a pelvic floor standpoint as well. Ideally, if we could have mom's pelvis in a really healthy space before they get pregnant. Prevention. An ounce of prevention is worth it, right? I can't even remember the saying, but an ounce of prevention is worth like dollars, thousands of dollars of treatment. Absolutely. When they get to kind of an emergency zone, so to speak, when they're not walking very well, when they can't do everyday activities, definitely get help they don't endure um but yeah ideally it would be in the very beginning because then we can get the pelvis in a good place and then baby can grow a little bit we can check pelvis and then baby a little bit more and we make sure that that environment is so happy for everybody to um give that baby space and mom the ability to let that belly expand with balance. It's really fantastic to watch when they can start early. So I really think the answer to that for both of us is the sooner the better. If you're trying to conceive, that might be a great time to establish some care. Or even if you're just thinking about having a baby, maybe getting an initial chiropractic assessment, an initial pelvic floor physical therapy assessment so that we're seeing um i really feel that pregnancy has a tendency to unmask dysfunction that's already there like we're compensating just below the surface and pregnancy all of a sudden is like hello i'm here and now i'm going to give you major problems so oftentimes we can find those little things that your body is just managing very well that pregnancy seems to not give you the capabilities to manage any longer. Yes. The increased demands kind of just really bring these to the surface. Absolutely. I couldn't agree more. Going forward, somebody has decided to seek chiropractic care with you. What does that look like? Our initial visit, they come in, we sit down and we do a history of where they've been and previous injuries potentially or previous, you know, discomforts that they've already been feeling this way and then we go through and figure out where there might be a discrepancy in their pelvis for sure in there between their sacrum and pelvis low back see where there's tightness see where things aren't moving the best that they can and we do that through an examination of between movement and muscle palpation or You guys kind of like pushing or touching things. Yes. And then we do, I always check the rest of the spine because it all goes together. So that's the main part of when they're laying face down. We have special pillows and tables that can drop away so belly has enough room so that you're not actually laying on belly because that would be weird. And most moms can do it anyway. um and then when when they turn over onto their back we check ligaments in the front diaphragm as well just to make sure they possibly are getting breath work like they're breathing okay also that heartburn can be a huge part of that so that all gets checked um we do go through you know just body systems on how all that's working and um making even sure they're not having headaches because headaches are a problem aren't fun during pregnancy as well so yeah um that's kind of just like the simple part of it I always check that moms are comfortable with us moving around and trying to communicate if things are uncomfortable even having like being touched so yeah it's pretty simple you like it works well okay and then I would say take us through like optimal goals right you're finding some discrepancies in people when do people know that they're done with treatment with you yeah um done is usually after the baby comes that is that's and that isn't that's like a a changing chapter point but we don't in my office i don't necessarily go with a done. We try to get to a point of maintenance. So if that can happen during pregnancy, I find that most moms, if it works in their lives, they will come for probably at least the last month, once a week, if not longer, just because we can keep that pelvis in a really good place. Some moms are rocking, you know, life and they actually keep their adjustments really well. so we we roll with how how the body is is actually holding on how it's responding what your symptoms are like yes i just feel like maybe some of the myths are that's like oh once you go to a chiropractor you always go to a chiropractor yeah well and the the way that i explain this is that we always are going to have a spine luckily and it's it's kind of like our teeth we maintain it after and I know this isn exactly like this is a whole nother discussion but when baby is out it so nice to be put back together and get that pelvis realigned so that it will actually feel comfortable and move comfortably as there is no baby in there anymore so we talk about that once baby comes and then we go from there I have and I'm sure you have the same but postpartum is a huge thing that we miss the boat on and want to put that body back together yeah especially if you're gonna have subsequent babies fairly soon but also just for your own comfortability yeah because lots of moms want to get back into running or their sports or fitness or life. Or chasing after this baby as it grows up. Yes. And so if they can do that better. So it isn't, I don't look at it as a life thing. It's just maintenance. You know, we don't necessarily stop walking and going to the gym and, or, you know, whatever your way is of like moving and stretching, that's something that we maintain forever. As chiropractors, we help that mobility the rest of your life. Where it's like, yeah, it's like taking care of your car. You get oil changes every so often. You're doing swap outs of your wiper blades and burning your fluids. It's that same idea. And I love to give them the tools to maintain it at home. Yeah. Because that's important. You know, we see them for such a short period of time in the office that the maintenance outside the office is almost bigger. so we do give that education as well I love it so good um tell me a little bit about um if mom is carrying a breech baby can you help with that yes we see a lot of breech babies in our in the chiropractic world and breech babies I don't know if you are aware of this but the midwife that I speak with the most, it's just a variant of normal, which is not how our society has been taught to know that. And there are bigger, you know, risks. There are some risks associated with delivering a breech baby. Absolutely. We want the head out first because then there's a breath. And the shoulders don't normally get stuck, you know, or at least the heads out if they do. The head's a little bigger stretch than a baby's feet and pelvis. Yes. So it helps prep for the shoulders a little better than coming the other direction. Yeah, absolutely. So when they're not in the head down position, what we can do as chiropractors, again, is get the body or the pelvis ready for that structural balance. So that hopefully that baby will be suspended in the middle of that pelvis the best that it possibly can so that it can. So it's not stuck on one side or being pushed into different places where it's like it doesn't have the capabilities to move. Right. And if we can get the ligaments in that balanced position, a lot of times babies will find their positioning better. Moms will feel big, huge movements and babies can turn into the position they want. If that's not happening because muscles and structures are way more stuck, you know, that's when they look at that external version. But that is not what we do in our office. You're not moving baby. You're moving mom's body to help encourage baby to have places to move. Like that clarification. Yes. So let's talk a little bit about like why would they see a chiropractor versus why would they see a pelvic floor physical therapist? Where do we overlap and maybe where do we have our own independent kind of realms that we focus on? Because that's the interesting thing sometimes in these, I would call them body working, body worker spaces, right? Massage therapy, acupuncture, chiropractic, physical therapy. Like we have some overlap within all of our professions and we have our own individual focuses. So I'll let you speak to it first and then I'll kind of give my perspective on it as well. So when I feel like they come to the chiropractic side is when we want some big structural changes with the adjustments. Like that's a really big part that chiropractically we do. The muscle tone, especially within the pelvis, you are the pro at. I would so much rather send people to you. You're like, that's not where I'm going. Brie has this like her crew she's got this like please go see her and get the the specialty you need to like get your pelvic floor ready to go and the structures around it um I think also with like the um incontinence I will definitely send people your way because they they need that that extra help that you're the professional on that. You're the pro and I am not the pro. I think we overlap in just keeping that pelvic floor in general in a better space, just a way more stable space. And both of the things that we can give them to do or we do for them in our office can absolutely stabilize the pelvis. And sometimes they, like the patient needs one versus another, you know? So I would agree with that. And once again, I'm going to try to make this kind of a generality, which we hate generalities, but the idea of like, I really think that your specialty area, and correct me if I'm wrong, I love these open discussions, is like, you're really looking at the bones and the ligaments attached to those bones and how they're pulling or asymmetrical or imbalanced and kind of restoring that balance. Right. And I would say from a physical therapy standpoint, my focus is a little bit more on the muscles and how do we support and how are the muscles pulling on those bony palaces, right? Those bones and those joints and things that way. And then I think our overlap comes from when you adjust something, you get it lined up, the muscle function improves. Absolutely. And I do think the overlap from my side a little bit is that it's like we do some things called muscle energy techniques. We do things within that practice that I'm like, I'm going to start here. If you need more than this, I'm going to send you to the chiropractor who is really the expert in adjustment. Right. If we're seeing some bony symmetries and things that aren't moving great, I'm like, OK, that's more your expertise. And I do feel the overlap comes a lot from when the muscles are functioning well, we see the adjustments stay in place. and vice versa right when things are aligned well I see the muscle strength doing what it's supposed to be doing yes so I fully agree and then I feel like you have the pelvic floor part of it as well that I don't you're like that's not your specialty it is not my specialty yeah that is definitely I can give them some tips and just like modifications for how they're moving around like not doing lunges you know towards the end of pregnancy like i recommend i'd recommend that they stop doing that or even whenever they hit it because it's like shearing and your pelvic floor isn't its favorite thing it's got a lot of demand and now doing that movement creates more demand right yeah so but beyond that like i think you can like you can help them with that that pelvic floor very differently. Yeah. So I agree with that structure way more balanced. But I think we work so well together in that because it's like the muscles don't function if the bones aren't doing well and the bones don't stay if the muscles aren't doing well. Yeah. And I have told so many people I'm like a good chiropractor usually will give you exercises and a good physical therapist may do a little bit of joint mobility and mobilization, but it's more of like, where do I spend most of my time? Right. You're spending most of your time adjusting. I'm spending most of my time doing exercise. And we have a little bit of gray area in the middle where we each kind of dabble. Yeah. Is that a good explanation for me? Totally. I'm like, this is how I explain it to some of my patients. I'm like, I dabble just a tiny bit in some adjustment and joint mobility stuff. And you dabble just a little bit in getting exercises to support people so that your adjustments can be as effective and stay and hold. but we're also saying actually our best specialty is when we're combining or our best treatments and our best outcomes come when we can combine both to where it's like we've got your beautiful specialty and joint mobility and alignment and posture yeah and we've got my specialty and the muscle support to help keep it there they're so cohesive yeah and I wish that it was just the way the the pregnancy team went was like you see your OB you know you see your midwife you see your chiropractor you see your pelvic floor specialty you see your lactation I just wish it was like a very cohesive team that every pregnant person got I agree Yeah. Because you can't be good at everything. No. No one person can be good at everything. Like you need a team. Yeah. And it takes a village. It really does. Yeah. It really does. Both to take care of mom. Yeah. And for Mottas as we're raising our babies. Absolutely. But we got to get those babies here and happy. And when moms are happy during pregnancy, I think it just makes the rest of it. It changes things a lot. Yeah. It really does. Because their happiness and their even just like stress during pregnancy can make such a difference as baby comes out. Yes. Yes. For sure. I agree with that. Let's just very briefly touch. We kind of touched just a tiny bit on postpartum. Yeah. I like to call it the fourth trimester. Yeah. Um, so ideally let's even focus on maybe like right after baby comes for six weeks, but then also talk about if we're taking a trimester is generally three months. Let's talk about the first three months postpartum. um so like i was saying previously getting that body to come back together after it's been expanded to get baby out and things have been stretched out for a while and as they start to shrink back into their normal so to speak sometimes they don't go back into that right place and we still have things off in the pelvis so if we can start within those first six weeks or just around like the six, eight weeks to get that pelvic floor or the pelvis back to that place so the pelvic floor can be in a good place. That is a beautiful start to getting your body back. Yeah. So when would you recommend that somebody come see you postpartum? My recommendation for moms is when they're comfortable. That's generally my recommendation too. That is the next day if it is the day they have the baby if it's six to eight weeks you know like as soon as you feel ready to add something else to your plate that's usually what I tell them that is perfect yeah I just said when you're comfortable and I have had moms stop on the way home from the hospital they're like I need your help just adjust I was in weird position yes so um but then for the next three months it's so like a lot of change is happening too because it isn't in the first six weeks for most you know there are those beautiful women that get to like get their bodies back really quickly but for most it does take three to ten to twelve months to even get your body back and it doesn't even show up potentially until the fourth or fifth or sixth month that you're like I've had the baby, my body hurts now because it's been compensating or trying to figure out how to put itself back together. Well, and the demands change afterwards, right? Now all of a sudden you're carrying a baby around all the time, which is in your arms. You're not used to having weight here all the time. You're carrying a car seat, strollers, diaper bags, like the demands on our bodies change. And we may be on our feet. If we have a fussier baby, we may be on our feet a lot more than maybe we were used to, especially during pregnancy. Or sleeping in weird positions. Yep. So that you've got a baby that you're holding or you're falling asleep in the rocking chair or. Or you're on your side. Yep. Yeah. One leg's all crazy and your pelvis is like in a twist. Yeah. So yeah. But I agree with you that I was like, somehow society is just like, oh, six weeks, like you're bounced back. You're all better. Right. And it's like, that's not how this happens. there's a general rule of thumb in the physical therapy world that it's like as long as it takes you to get there it's going to take you twice as long to get out of there so I'm like nine months to get there 18 months to get out of there and again I say that's a general rule of thumb yes like your strength and your health going into the pregnancy is definitely going to affect things your activity level what you're trying to get back to like yeah all of these play these things play a role but I'm like just give your body some time it really is I'm like just you're not better at six weeks. Just because the uterus is closed and wounds are healed does not mean that you're better at six weeks. And I would say that most moms would agree with. Yeah. Yeah. We feel it. Yeah. We do. It's like, you mean I'm better now? Yeah. Really? News to me, right? Yeah. And that's where it's so lovely that we can be part of their support after baby goes because we can remind them they don't. it's it's okay that they their body heals here's actually what's the time yeah and if they nurse it's definitely it's like that 18 months for sure it's like that's a it's a long time that your body is just rearranging and hormonally is rearranging or staying at a different level and it affects things yeah so so yeah you're not better at six weeks trust your instincts you know So where that number came from is also very interesting. Yeah. There's not actually much behind that. I mean, there's tissue healing. And that's what I would argue. My tissues are healed back together. Like if there's been a tear, if there's, and like even from a muscular standpoint, like six to eight weeks typically for a muscle to heal that's been strained or torn. I think there's, so there's some physiologic data, I think, that comes behind it. But that isn't back to optimal function. Would you, that's kind of my, like from a tissue healing perspective. I would say, yes, we're healed. Like, tissues that got torn are now back together and have adequate scar tissue to help resist there. And uterus is now closed. Bleeding has stopped. Like, risk of infection is down. So you're like, yeah, for all intents and purposes, you're fine. Right? It's like, well, your wounds have healed. But that doesn't mean that everything's rehabbed afterwards. Agreed. I would totally agree. Okay. This has been so much fun to visit with you today. I absolutely love it. I am just going to do some rapid fire questions. Okay. Things that are just fun for people to get to know you a little bit. Okay. So what's your favorite pregnancy tip? Oh, let me think for just one second. My favorite pregnancy tip is probably posture. That is where I, every time they come in, I will remind them, you know, like to do their posture, open up their chest, lift their chest up. Posture. I love it. What is one thing that every pregnant woman should avoid? Talking from generalities that we hate, right? Yeah. Every pregnant woman should avoid. That's a really good question. Honestly, being completely sedentary. That is one of the hardest things to sit and do. But when you feel comfy, it's really hard to not yes yeah what's your favorite guilty pleasure it just in general oh man or maybe we even say guilty pleasure and food and then just guilty pleasure for time or how you spend your time my guilty pleasure is being outside riding my bike or skiing depending on the season and I would say food are probably any particular sure um chocolate chocolate chip cookies okay you want a way to stuff heart chocolate cookies are you thinking yeah um and then let's close with just what would you say is your the biggest misconception about chiropractic care? That it's not going to help. Yeah. That's probably the biggest conception is that it's not going to help. You're almost like I challenge you to try it and see what you think. Yeah. Right. Yes. I would love to help you see a different side of that. Yeah. Yeah. You're like, I can convince you otherwise. That's so good. Yeah. Okay. Well, thanks so much for joining me today. I'm so excited. How can people find you if they're like, Hey, I want to go see Dr. Steph. How would they find you? Um, so we are located in Providence, Utah on the South end of, of Logan. Uh, and then if they want it on social media, we're on Facebook as active family chiropractic and also on Instagram as active fam Cairo. Okay. We can find us there. So good. Yeah. Okay. Thanks, Steph. Appreciate that. Have a good one. Thank you. Thanks, guys, for tuning into Healing at Your Core. Be sure to subscribe and just keep looking forward to educating you on everything core related. Millions of women are still waiting for someone to take their symptoms seriously. You found this show. Share it. 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