On Pregnancy, Postpartum Recovery, and NCAA Ski Coaching: Eliška Albrigtsen (Part 2)

Part 1 of this story details Eliška’s experience coaching through pregnancy and the birth of her son. Keep reading to learn about the challenges she, like many women, experienced during the postpartum recovery process, and what it took to navigate year one of life on the road with baby Viggo.

Expectation versus reality. 

When preparing to interview Eliška Albrigtsen about her experience pairing NCAA coaching with new motherhood, I expected the challenges she faced during her transition to primarily be focused on the balancing act of managing a demanding job with frequent travel and a new baby. Maybe a few relatable stories of airport meltdowns, sleepless nights in hotels while on the road with the team, and inopportune timing of diaper blowouts. Or any number of other ways societal systems in the US seem to be structured in opposition to new moms in the workplace.  

But Eliška’s passion for her job and dedication to her athletes were abundantly clear throughout the conversation; coaching is where she thrived. Her grit and energy allowed her to problem solve bringing baby Viggo on the road with the team – perhaps paired with the added fortune of a husband whose skill set includes waxing and ski testing and a well placed mother-in-law eager to help care for her grandson. And the team embraced its new member without hesitation.

In reality, the biggest challenges Eliška faced in returning to coaching postpartum were connected to the physiological impacts pregnancy and delivery had on her body. In short, it was a discussion on the shortcomings of our healthcare system and the myriad of ways the current standard of postpartum care falls short of what many women require to restore their body to full function.

Her story highlights a few key takeaways for programs looking to support women coaches surrounding pregnancy; in particular, there’s much more to the return to coaching than navigating who will care for your child while you’re out training with athletes and traveling to races. Respecting the timeline of a slow return, and perhaps offsetting the costs of postpartum physical therapy, may be an essential component of an improved and holistic support system.  

Postpartum Recovery

A theme of Eliška’s narrative of her perinatal experience was the ways in which her “athlete mindset” served and hindered her ability to roll with the punches. 

While women like Kikkan Randall, Marit Bjørgen, Aino-Kaisa Saarinen paved the way for women looking to begin their family before retiring from professional skiing in many ways, Eliška said that the ease with which they outwardly seemed to rebound beyond their previous levels of fitness was, in some ways, a disservice to women like herself who did not experience as smooth a return. In her mind, she had expected a comparable experience given her athleticism and good health, but quickly learned that women might be better served using caution when extrapolating from outliers. 

“You see these professional skiers having babies and then coming back and winning gold medals at [the] Olympics,” she said. “And you’re like, ‘Oh, yeah, that’s gonna be me.’ But no one really sees the giant support team they have behind them.

“They have professional doctors, physical therapists, and strength and conditioning [specialists] to go through their pregnancy with them, monitoring everything, having them at the birth, and then jumping right into the recovery. As a coach, you don’t get that. You probably have the same amount of on-ski hours as professional skiers – not the same quality of course, but you can’t do your job without being there. So I think that’s how most of our ski community sees pregnancy – so easy and you are an even better athlete afterwards, because all these women did it…

“For me, it was the opposite. It was hell. I can’t wear the clothes that I wore when I was pregnant because I have extreme PTSD from that… it was such a, not just physically but painfully, impacting experience.” 

Though expectation and reality could not have been more different, her drive to recover from the injuries sustained from pregnancy and birth, and the creativity required to adapt during the recovery process, mirrored her general approach as an athlete more broadly. 

“I think the athlete mindset in me was, ‘Okay, I had this baby. Now I put myself through physical therapy, and I’m gonna recover’… Just like after having a shoulder dislocation or having a torn iliopsoas, all those pretty crazy injuries – I knew that eventually you get better, and you get back to yourself.”

What Eliška identified as the biggest physical challenge she faced after the birth of her son was the repair of a condition called diastasis recti (DR), which is a separation and consequential loss of function and strength of the rectus abdominis muscles. 

During pregnancy, as a woman’s belly expands to accommodate the growing baby, the muscles of the abdomen are forced to stretch. The deeper muscle layers, known as the transverse abdominis, are structured like a corset wrapping around the belly, giving them a greater capacity to expand. However, the rectus abdominis muscles, better known as the “six pack” muscles, run vertically while connected by fascia, and have significantly less ability to adapt to the expansion. 

Instead, the outward pressure and growth of the belly causes the rectus abdominis muscles to separate, thinning and weakening the fascia as it stretches, or in extreme cases, tearing it.

“When I was the most pregnant, my six pack was under my armpits.” 

This connective tissue cannot simply snap back to its original state after delivery. As fascia lacks the blood flow of muscle tissue, it is slow to heal, leaving many women with a gap between muscles known as a diastasis. All women experience some amount of ab separation during pregnancy, but if the gap of two or more finger widths between the muscles persists postpartum, she is diagnosed with DR. 

Because of the combination of her stature, a short torso, and the size of her baby, Eliška found herself with an extreme separation. 

“Basically, you could stick your whole fist into my stomach. That was the biggest problem for me because I basically lost my core. And my core was a big part of me as an athlete – not just as a skier, but as an athlete. So that was really hard.” 

As she hopes for a second child down the road, any surgical repair options were contraindicated, and instead, Eliška dedicated herself to a physical therapy regimen. She felt lucky to have access to a Fairbanks-based Osteopathic medicine expert, Dr. Todd Capistrant, who specializes in the Fascial Distortion Model and was therefore primed to help Eliška improve her diastasis. 

“I saw him basically on a weekly basis.”

She also met regularly with a pelvic floor physical therapist, both to work on the diastasis, and to restore appropriate function to the muscles of her pelvic floor. Her PT identified that her pelvic floor was hypertonic, meaning the muscles carried tension chronically, rather than contracting and relaxing in functional patterns. Like holding a flexed arm hang and then being asked to knock out a set of chin-ups, this chronic low-level tension leads to fatigue in the pelvic floor muscles, preventing them from outputting the strength and tension required to support the organs sitting inside the pelvic girdle and interact appropriately with surrounding musculature when recruited during activity.

With the guidance of the PT and a set of progressive exercises to relax and engage her muscles appropriately, Eliška saw progress, but it took time for her muscles to function in coordination subconsciously.

“It took me probably around eight months to incorporate the mental [and neuromuscular] connections back. I was able to [engage the muscles] when I wanted to, but all the muscles of the pelvic floor, everything that’s sitting in the pelvis, they were not working with the rest of my body.”

She expressed feeling lucky to have access to high level care in Fairbanks, including her therapist who could incorporate a variety of techniques to help her recover, including deep tissue massage, cupping, electrical muscle stimulation, and biofeedback.

“I think biofeedback for athletes just works the best. Because we’re such strong willed people. Like, if we see it happening, we can really focus on making it happen more.” 

An unexpected benefit of time and resources being placed into learning how to strengthen and reintegrate her deeper core musculature trickled down to her athletes. She recognized that several of her athletes, who had complained of back pain surrounding core workouts, were not sufficiently engaging their transverse abdominis muscles, instead relying too heavily on the outer rectus abdominis or other smaller core muscles. Teaching the techniques she learned through PT helped improve the form of her athletes, relieving the back pain they had experienced previously. 

“It definitely deepened my understanding of how the core should work, and how we use it when we ski.”

As she navigated her own challenges, she became aware through talking with friends of how common these experiences are amongst mothers. Describing herself as “someone who says everything”, she felt it was important to both be open regarding the challenges she’s faced, and the resources and options available for women to make progress toward recovery, rather than accept the conditions as permanent. 

Most women only receive one postpartum checkup, approximately six weeks after delivery. As my own pelvic floor PT described it, these visits typically only check to see that the tissues have healed and that there are no visible pelvic organ prolapses, but most midwives and OB/GYN practitioners do not have the depth of knowledge to assess muscle function, hence the need for an evaluation from a pelvic floor PT. However, quality pelvic floor physical therapy is not universally available, and as it is not always covered by insurance, making it cost-prohibitive for many women to continue care long enough to make sufficient progress.  

“I think the most tragic experience post-pregnancy that I had was the realization that women are left being damaged from bringing life to the world.”

As she discussed her own experience with the women in her community, in turn, many of them shared that they continued to suffer from the impacts of ab separation or pelvic floor dysfunction from pregnancies, including friends who were more than ten years postpartum. Some of these women had given up activities they had enjoyed previously, like running, because they felt as though they were “spilling their guts” out of their bellies due to a lack of core function. 

“How is this okay for women to live this way? That was just mind blowing to me.”

Imparting the knowledge she gained in the process, and advocating for women to find their own ways to make it work, she offered up suggestions.

“I was just like, ‘Hey, if you can’t go to physical therapy, this is how you tape your belly, so at least you can start hiking fast.”

At roughly 13 months postpartum at the time of the call, Eliška recognized the improvements she’s made, while still acknowledging she has not fully recovered. 

“It’s [been] more than a year, and I feel functional. I still have pains and I would not go and enter a race, because my brain can push much harder than my body can, so I know I would hurt myself. But I’m so much better than most of my friends that, you know, [had to] just give it up…”

As she worked with athletes through the fall and winter, Eliška found ways to adapt her ski technique to avoid putting unnecessary strain on the musculature she was working to rehab, and work instead with the muscles that already had the necessary strength. In particular, she needed to change her doublepole technique.

By returning to the older style of doublepoling, which involved less of a crunch through the abdomen than modern technique, instead increasing the bend at the waist and relying more heavily on the arm and shoulder muscles. 

“I don’t have the strength there anymore [to crunch]. My muscles are two three packs, they’re not connected. So I go into doublepole and I tighten my  lower belly, but then I pull my butt up kind of like into downward dog instead, and work with my arms again.”

Another lingering problem she has experienced is a result of the endocrinological changes experienced surrounding pregnancy. To allow the body to grow during pregnancy and a widening of the hips for delivery, the body releases an aptly-named hormone called relaxin, which acts on cartilage and other soft tissues to allow expansion and increased joint mobility to occur. The production of relaxin typically declines after delivery, but remains higher than normal for the duration of breastfeeding.

While beneficial for pregnancy, it also puts perinatal women at a higher risk of joint instability and consequently injury. 

Eliška shared that she seems to produce an above average amount of relaxin, which has continued to affect her postpartum as a nursing mom. She experienced joint pain, particularly in her pubic symphysis joint at the front of the pelvis, with unexpected movements – like slipping on ice or mud. “And it’s always slippery here. Like 10 months out of the year.”

“On skis, I don’t have a problem. Because everything’s gliding and I already have the natural anticipation of gliding. But walking and slipping – I try to catch myself and my muscles, my joints, my tendons are just too loose.” 

Reflecting on her journey through the first year postpartum, the lack of care available to most women remained at the forefront of her mind. The impact of these types of conditions, which linger if left untreated, affects more than just the level of activity a woman can enjoy. As those who have experienced it (waves hand) can attest, the emotional toll affects quality of life more broadly. 

“I would absolutely fight for every woman to be able to have a year of free PT [after pregnancy]. You just need your life back.”

Life on the Road

There’s a commonly used phrase when it comes to raising children: “It takes a village.” This resonated as Eliška shared insights into what support was necessary to allow baby Viggo to travel with the team through the competition season.

While children under two-years-old are typically able to fly for free on their parents’ laps, the travel of the person who would care for Viggo while Eliška was working is not. Fortunately, her husband Tobias was already incorporated as a volunteer assistant coach, and had both the skillset and the NCAA certifications to play a variety of roles during travel, which also got him on the payroll to offset travel costs.

“I’m lucky that my husband’s quite good tester and waxer as well. And traveling with a full team this year, six [women] and six [men], I knew that we will need more than two coaches to wax.”

And, conveniently, Tobias’ mother is based in Boulder, CO. “She was able to actually drive to all the races and babysit when we were ski waxing and racing.”

For US Nationals, UAF collaborated with other Alaskan clubs to wax, but it was still useful to have an extra driver to bring athletes back and forth to the venue. Consequently, they paid out of pocket for the flight, but Tobias was able to get a per-diem salary as a driver. “So we got at least the food covered,” she laughed.

For other RMISA and SuperTour races where UAF was only waxing for their own athletes, Tobias could have his travel expenses fully covered in exchange for his work. It’s perhaps a model that’s hard to replicate for other mom-coaches, but still demonstrates that with some creativity and determination, bringing the family along for the ride is possible. 

“We call it the primary. He’s the primary on the baby when we have training days, where me and my assistant go with athletes and train. And then when we were testing and race waxing, grandma was the primary. And oh my God, bless her heart — she paid for all of her gas and her accommodation and food. She would just come to the house where we were staying when we had to leave and just babysat for us… So that’s the way that we made it work, but it’s a very, I think, exceptional situation.”

Was traveling back and forth from Fairbanks to Colorado and Utah challenging with a toddler? Yes. But Eliška knew it was something they would need to navigate as a family regardless of her career. 

“I know living in Alaska, he’s gonna fly anywhere he goes. That’s just what it is. So that was just like one thing that we were like, ‘Yeah, there’s no way around it.’ We did have to travel with more things. Because you have to have the car seat, we have to have the crib, we had to have a bunch of diapers with us.”

The system worked for the first year, but it will need to be modified for next season. The full RMISA calendar has not yet been set, however, the regional championships will be held in Anchorage, which will make at least one competition easier to travel to. 

From there, it will be running the calculus on what makes sense financially. She laughed that Viggo is already a squirmy baby to keep on their laps on the plane and will need his own seat next year, but she is also not sure whether he will still be nursing, which may make it easier for her to leave him behind with Tobias.

In terms of the impact to the team, better worded as the lack thereof, Eliška felt Viggo’s presence on the road improved the atmosphere. Rather than lamenting their littlest teammate, they found humor and joy in his presence. 

“When you’re stressed before the race, and you’re having breakfast and you’re barely putting the oatmeal into your mouth [because of nerves], and the baby in front of you is just like throwing the food and laughing… I think that it helped with the team atmosphere, for sure.”

In addition to helping distribute the weight of ski, wax, and baby gear when navigating through the airport, the athletes also served as an extra set of eyes in the team house. 

“The team, in general, was super helpful as well. When we would be waxing in the garage, they were playing with Viggo, and he believes they’re all his brothers and sisters, I’m pretty sure.”

Reflections on the Experience Thus Far

Praising the community in Fairbanks, Eliška was grateful for the help and support she received through her perinatal journey, which allowed her to not only continue as head coach, but help the team to new heights this season. Rather than holding her back, becoming a mother enhanced her ability to lead the Nanooks program. 

“I also feel like my season was so much more successful this year because I really wanted to go home to my baby. So I was really trying to work smarter and more efficiently, and I think the athletes probably had that push too.”

While some might fault a woman who shares that her priorities have shifted since having a child, Eliška explained the number of ways this desire to optimize practice time served her team. 

“I was always driven for success – I love being successful. But now it’s more like, ‘Yes, I will be successful so then I can spend more time with my child.’”  

As to whether there was anything she would have done differently, Eliška’s answer was more focused on reducing barriers to mom-coaches as a group surrounding pregnancy. 

“I think the side that no one ever talks about is: how fit coaches should actually be able to do their job well.”

Because her insurance cycle was aligned with the school calendar, her deductible reset in July. Having maximized her out of pocket expenses with prenatal care and delivery, this meant the physical therapy treatments she needed were essentially free for the first four months. However, after the plan turned over for the new year, each pelvic floor PT visit cost $60–70, and she was looking to go twice per week to continue to make steady progress. This adds up quickly, particularly for a family relying on one salary, which happens to be a ski coaching salary. 

While nationwide free postpartum PT for all women would be the ideal, Eliška proposed that these costs should, at minimum, be offset by the school or program.

“That is something I would definitely fight for women coaches. Talk to your boss, or whoever, and tell them, ‘If you want me to come back to the same level of coaching, you need to pay for occupational therapy for me to recover.”