By Jude Coe
At this year’s GSSPP Symposium, Ros Cooke delivered a talk that resonated deeply with coaches, students, clinicians, and researchers alike. Titled “Medals & Motherhood: Managing Performance in the Perinatal Athlete,” her session tackled one of the most under-discussed yet vital topics in sport and physiotherapy: how to support elite athletes through pregnancy and postpartum recovery. It was encouraging to see a balanced mix of men and women in the audience; all equally engaged in hearing Ros speak
Ros’s central message was simple but powerful: “Don’t panic.” A growing body of research is now empowering healthcare professionals with the knowledge and tools to confidently support athletes through this exciting and transformative stage of their lives. In a world where performance is often measured in milliseconds and medals, her words were a refreshing reminder that athletic identity and motherhood are not mutually exclusive. Instead, with the right support, planning and mindset, they can coexist and even enhance one another.
Reframing the Journey: The 6 Rs Framework
Ros’s talk was grounded in the 6 Rs framework, recently published in the British Journal of Sports Medicine. This model offers a phased, biopsychosocial approach to returning to sport postpartum, moving beyond traditional injury-based models to consider the whole athlete; body, mind, and context.
The 6 Rs stand for:
- Recover – Prioritising tissue healing and rest.
- Restore – Rebuilding foundational strength and function.
- Recondition – Gradually reintroducing sport-specific demands.
- Refine – Fine-tuning performance and technique.
- Return – Resuming full training and competition.
- Retain – Sustaining performance while managing ongoing perinatal needs.
This framework encourages clinicians to individualise care, avoid rigid timelines, and embrace a proactive, team-based approach. It also highlights the importance of including pelvic health specialists and mental health professionals in the athlete’s support network.
A New Era of Athlete Care
Ros’s insights challenged the audience to rethink what it means to be “ready” to return to sport. She emphasised that progress isn’t linear, and that setbacks, adjustments, and pauses are not signs of failure, they’re part of the process.
For listeners at the GSSPP symposium, it reminded us that physiotherapy is not just about rehab protocols and performance metrics; it’s about people. And when we support the whole person, we empower athletes to thrive not just in sport, but in life.
J.Coe@bham.ac.uk