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Maintaining a strong military ethos alongside the culture of rehabilitation can be a tough juggling act. As you can imagine, any injury, recovery or period away from general health or full fitness presents a requirement for individual needs to be
met, it is not a linear or generic process
with standardised timelines. The aim of
my role as an ERI is to return those service personnel to operational levels of fitness
as soon as possible – the ‘fitter quicker’ principle. Where this is not achievable the aim is to attain the maximal level of physical, psychological, and social health. This can be achieved by delivering group therapy, or individual exercise programmes, as part of a multi-disciplinary team.
Minimising the effect of MSKIs is a
priority at all levels and in all branches of
the Army, and there are three broad groups of stakeholders who have a role in reducing MSKI; Commanders, Individuals, and Subject Matter Experts (SMEs). Each owning their own individual roles & responsibilities but all focused towards education, reducing the risk and building foundations for
healthy behaviours and lifestyle choices. Physical Training Staff are responsible for the delivery of a comprehensive physical training programme including reconditioning fitness training, in line with AGAI Vol 1 Chapter 7, and providing SME guidance
to both the Chain of Command (CoC)
and all individuals. The individual has the responsibility to keep fit, meet physical standards for their respective employment groups, and when injured engage with recovery treatment in the most effective manner. The individual responsibility can seem quite daunting to any service person who has had a period away from structured or regular physical training but in particular following a major life event - the birth of a child. Within this article I will focus on fitness related advice and information to support service women during Pre & Post-Natal (PPN) periods.
Within a general population it is estimated that only 3-15% of women will achieve recommended physical activity guidelines during a normal pregnancy. The UKAF bi- annual diversity statistics paper suggested that as at 1 Jan 19, the total number of servicewomen in the British Army was 7150 and 6.6% (472) were on ordinary maternity leave. Of these figures, 99% of Officers
and 94% of soldiers intended to Return
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to Work (RtW) following their maternity period. Therefore, it is possible that up to 1000 women may need some advice and support in returning to fitness at any one time. Women generally show a decline in adherence to exercise throughout pregnancy and beyond and in the long term we already know that a lack of physical activity is a
key risk factor for susceptibility to MSKI. Reconditioning training is a key component in returning individuals to full fitness post injury, long illness or returning from a period of physical inactivity. Effective reconditioning physical training (PT) programmes must be provided to enable soldiers to transit from a deconditioned state to full fitness.
The introduction of Pre and Postnatal (PPN) PT Programmes has commenced
to enable female personnel to maintain appropriate levels of fitness and wellbeing, both during pregnancy and upon RtW.
This will allow servicewomen to return to operational fitness levels within a safe, prescribed time after giving birth. Pre and post-partum exercise programmes and nutritional advice is available from qualified Pre and Post Natal Instructors (PPNI), usually Royal Army Physical Training
Corps Instructors (RAPTCIs), or Tri-service equivalent, at present there a no trained All Arms Physical Training Instructors (AAPTIs).
These specially qualified instructors have been trained to deliver, advise, and support servicewomen during their PPN journey. PPN exercise programming can vary quite significantly throughout the trimesters, the PPNIs will guide Service Personnel (SP) on areas like nutrition and supporting physical holistic needs throughout both pregnancy and recovery phases. Also applying individual adaptations and considerations to a SPs current physical condition and making appropriate regressions or progression specific to them. A plan will be agreed after an initial screening to assess what the
goals are, what resources are available and ultimately guide and manage expectations.
DPHC also provides interventional care dependant on the medical status of the individual guided by the MO. Additionally, there are multiple women’s health physiotherapist located across Defence that specialise in maternal care and can
be referred to if this support is required. I would advise all PPN women to approach the PPNI SME’s so you can be offered the correct individualised advice and guidance.
We want to help; we want to ensure you receive the care you need. If you do not have regular access to a unit or regional RAPTC PNNI, you are always welcome to contact me, or your local RRU/PCRF. Collectively we can signpost you to your local appropriately trained PPNI professional. It is important you get advice on exercise and pregnancy as soon as possible as every servicewoman, fitness level, pregnancy and labour are all so individual.
The Pregnancy/Maternity and Return To Work Guide, has been created to support service personnel and the CoC during pregnancy, including pregnancy loss, maternity, breastfeeding and returning to work. The guide and similar documentation can be easily found on SharePoint by searching “Pregnancy and Maternity Guide”. The emphasis that it is for guidance only and the ultimate provision is contained in JSP 760, Chapters 24, 25 and 27.
I would like to finish this article with a special mention and thanks to Major Serena Darke RADC, who is widely contributing and enabling others to obtain the appropriate knowledge care and guidance, through
her own lived experience. Ma’am you are
a credit to the RADC, a fantastic mother, professional, role-model and leader.
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