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You are here: Home / Archives for exercise

exercise

Pelvic Floor Exercises

July 28, 2018 By Louise Brennan

pelvic floor exercises, Pilates, postnatal

This blog is written by Grace Lillywhite from Your Pilates and discusses pelvic floor exercises. Your Pilates is a St Albans based company who offers exciting and innovative pregnancy and postnatal Pilates classes designed to support women throughout their motherhood journey.

‘I have been working with this wonderful population for the last 9 years and can’t imagine doing anything more enjoyable or rewarding. I have been teaching Pilates for nearly 10 years, I am a Faculty member of The Center for Women’s Fitness and a member of the Guild of Pregnancy and Postnatal Exercise. I am also a mum of two gorgeous girls and I am constantly challenging myself with new training to bring the best possible classes to my clients’.


Your Core Matters – why should you consider your pelvic floor when choosing postnatal exercise?

 

There is a lot of misinformation out there about what is safe for women to do in terms of postnatal exercise. A client recently told me that at her 6 week check her doctor told her it was now safe for her to start running. THIS MORTIFIES ME!! One of the reasons it can be confusing is because it really is different for everyone. Your experience of pregnancy, your birth experience, your body type, your collagen type, your posture, how many babies you have had, your exercise history and your diet will all impact on how you should be exercising and how well your pelvic floor will cope with your choices. However, even if your pelvic floor seems to be in tip top shape (and unless you have seen a Women’s Health Physio you won’t know for sure if it is or not!), there are long term implications in doing too much too soon that many women (and GPs!) aren’t aware of.

 

The pelvic floor experiences huge forces during labour and will undergo a huge stretch, possibly tear or even cut (episiotomy) during a vaginal delivery. When a woman has a caesarean section the impact on the connective tissue also means that postnatally the pelvic floor will be recovering and needs to learn to function again. In addition, it is coping with the normal load of supporting the organs and sphincter functions. All this after having carried a growing baby for around 40 weeks! It is not really surprising that around 25% of women have a level of pelvic floor dysfunction and this number rises with age – just because things seem to be OK immediately after your birth it doesn’t mean you don’t need to be mindful of what your pelvic floor has been through!

 

The general guideline in the UK is that for a vaginal birth a women can return to exercise after 6 weeks and for Caesarean birth 8-12 weeks. But what kind of exercise is safe and appropriate?

 

Exercise should be approached gently – Royal College Of Obstetricians (RCOG) makes the following recommendations ‘If you have had an uncomplicated pregnancy and delivery, then you should be able to do mild recreational exercise such as walking and stretching immediately after birth. You should be advised to do pelvic floor exercises after the birth, as this reduces the risk of urinary and faecal incontinence.’

However, I would add the following:

Immediately after birth what women should ideally be doing is RESTING!! No matter what your birth experience your body has been through a lot and the best way to heal is to sleep (as much as baby and other children will allow) and eat good, nutritious food that will support your body in its recovery. While walking is certainly a great way to get moving again, I would say that at least the first couple of weeks should be spent relaxing as much as possible rather than feeling the need to “exercise”. If you feel like going for a walk then great but if you feel like resting (and are afforded that luxury!) then please do it!

Another important point is that pelvic floor issues can come from tightness/tension in the pelvic floor as well as weakness so the typical pelvic floor exercises (lift and squeeeeeze) that are often given out to postnatal women do not work for everyone. It is really useful to have an awareness of how the pelvic floor connects to the breath so that you can work with its natural rhythms and allow a fluidity of movement as well as strength within the muscle. It is often difficult to find the pelvic floor muscles as neighboring, more global, stronger muscles like the buttocks may be faster at responding. This is especially true for postnatal women who may have lost sensation due to weakness or birth trauma.

 

How do I find my pelvic floor?

There is a vital relationship between our breathing and our pelvic floor. The pelvic diaphragm works in synergy with the thoracic diaphragm so we need to look at the overall postural alignment when restoring the functioning of this interplay. When we inhale, both diaphragms contract and pull downwards, the ribcage expands and the abdominal wall expands and then we exhale both diaphragms recover their position to resting. Try lying on your back and just noticing the moment of the breath as you inhale and exhale. See if you can visualise the downward pull and release of the pelvic floor as you breathe in, then the gentle lift and contraction as you exhale. You may just be imagining this at first but if you start to think about it more it should start to make a bit more sense!

To get an effective contraction that works with the breath, it is helpful to imagine the elasticity of this system; rather than ‘working hard’ during the exhalation, exhale first, make time to allow for the natural recoil and recovery process before deepening the connection through a pelvic floor contraction. This helps the pelvic floor to work without tension and, hopefully, will mean that the contraction becomes more effective. On the inhale, the focus should be on release and letting go of the pelvic floor.

 

Different visualisations that work for some people are as follows:

  • Drawing the sit bones, pubic bone and tailbone into the centre of your pubic triangle
  • Pulling your front and back passage towards each other like you are trying to stop yourself from passing wind
  • Imagine that your vagina and anus are an elephant’s trunk and think of trying to pick something up with them
  • Imagine you are trying to suck up a piece of spaghetti into your bottom

 

If you can choose one of these visualisations then start to coordinate it with the breath as outlined above, making sure that the release is just as important as the contraction, hopefully you will be doing an effective pelvic floor strengthener. Ideally, if you have pelvic floor issues, you should be doing this 3 times a day, every day.

 

Is this all I need to do to keep my pelvic floor strong? In a word, NO! The basic contraction is just the tip of the iceberg and needs to be added to movement to make it truly effective and functional for your everyday life. The pelvic floor muscles contribute to both postural and respiratory functions so it has to be viewed as part of a full body movement system rather than a muscle that can be strengthened with an isolating exercise as described above. When you have learned to co-ordinate with your breath, movements like squats, lifts and lunges can be deeply strengthening for the pelvic floor and are useful for new mums too as they are functional and applicable to their daily movement patterns.

 

RCOG also says:    ‘You should return to the exercise routine you maintained before pregnancy only when you feel ready to do so. You should not try any high impact activity (where both feet leave the ground at the same time such as jumping or jogging) too soon.’

 

Many women aren’t really sure what ‘too soon’ means. One major thing you need to be aware of is that leaking is not OK! It may be considered ‘normal’ because many women experience it but that doesn’t mean it is something that you need to live with. Do not assume that this is part and parcel of postnatal exercise – if you are leaking, you are overloading your pelvic floor and you need to up your pelvic floor exercise (this doesn’t just mean lift and squeeze) and adjust your running expectations.

 

The pounding motion of high impact exercise like running has a high impact on the pelvic floor and the action of the heel hitting the ground with each stride can stretch the pelvic floor and connective tissues that have already been weakened by pregnancy and birth. When the stride is repeated again and again, the impact forces the pelvic floor downwards and if the pelvic floor is already weak you are setting yourself up for pelvic floor problems at some point, even if your body isn’t showing you the warning signs now.

 

My advice would be to go and see a Women’s Health Physio to get your pelvic floor function checked before you think about returning to high impact exercise again. Begin your postnatal exercise with low impact work such as Pilates, swimming and walking. Move on to more difficult low impact movement (cycling, standing squats, lifting) when you are ready and don’t be in a hurry to ‘get your body back’. If and when you do start more high impact exercise again, begin with shorter sessions and take your time. The faster and longer you exercise for the more pressure you are going to exert onto your pelvic floor so build up to it so your body has time to adjust.

 

To find out more about Grace‘s classes, please see your-pilates.co.uk


To find out more about the postnatal support I offer, please click here.

Filed Under: Advice, exercise, midwife, pelvic floor, pelvic floor exercises, Pilates, postnatal, Pregnancy Tagged With: advice, baby, exercise, louantenatal, midwife, pelvic floor, pelvic floor exercises, Pilates, postnatal, pregnancy

Baby Steps Back into Exercise

December 22, 2017 By Louise Brennan

exercise, postnatal, fitness
This is my first guest blog and it comes from Bump2Baby Fitness on exercise after having a baby.
Beginning in 2013, Bump2Baby Fitness has grown from strength to strength instructing thousands of women on their pre and post-natal exercise journeys. In 2017, we launched our first active wear collection, taking inspiration from the most popular trends and fit-mums across the globe.

Baby Steps Back into Exercise

There are so many photos of celebrity mums on social media who have their tight toned tummies 5 minutes after giving birth, and that’s awesome, but that wasn’t me and even if we do look amazing, there could still be a lot going on inside.

Take the time to gradually and safely get back into exercise with our 6 top tips!

1. Your 6 week check.

Normally this is the first thing we as post-natal trainers ask – ‘have you had your 6 week check?’ Quickly followed by ‘What did they do/say?’ and it’s not uncommon for us to find out that they missed a lot. Only about 60% of my fitbuggies women has their split diastasis (abdominal separation) checked at their 6 week check. You need to know, what is your separation at? How many fingers? Is that all the way down or is it different for the top/bottom abdominals? Is it really deep? If you had stitches, did they check them? Are they healing ok? Do you have any residual epidural pain? (I did for quite a while).

Your midwife may not check this as they are only with you for the first few weeks but you can ask your doctor at your 6 week check.  They are there to look after you as well as your baby. Also this will help us to ensure that the exercises you are doing are suitable for you.

2. Not so fast!

No pre and post-natal trainer will recommend running 10k’s and going to HIIT classes straight after giving birth. You gotta take it easy! Your body has been through a lot and there should be no pressure to lose your baby weight quickly. Start by walking with your baby in your pram for 20 minutes a day and build it up slowly. This will be a great foundation for when you move onto a planned workout. When you do progress your workouts remember that your body is still healing and recovering from pregnancy. I’m all for a getting hot and sweat in a workout and walking away from the gym all pumped, but make sure you do this safely. If you attend yoga and Pilates classes, remember that you may still have the hormone ‘relaxin’ in your body which can cause the muscles to lengthen longer than usual and can lead to injuries, so stay in your normal range of motion.

If you attend step, HIIT or an aerobic classes, make sure you take the lower impact options so that you don’t put any extra pressure on your pelvic floor until you are ready. Trust me on this…..which leads to my next tip of……

3. Don’t pee yourself!!

I didn’t do any pelvic floor exercises after my oldest was born and boy did I regret it. You can begin these straight away and they need no fancy fitness equipment. A great tip to ensure you practice them often is to set a reminder on your phone or even practice them randomly whilst watching X Factor. If you are struggling with incontinence, speak to a women’s health physio on how to ensure you are performing the exercises correctly.

4. Core blimey!

Abdominal separation (split-diastasis) is very common post-pregnancy as your abdominals separate during pregnancy to allow your baby to grow. As a general rule, you should avoid any exercise that works your abdominals like planks, sit ups and crunches. As well as core exercises, you should avoid any exercise that makes your stomach ‘dome’ (creates a rise down the middle line of the stomach). There are lots of modifications that can be made to every exercise so take it down a notch until you can perform the exercise safely.

5. Find a local post-natal class.

There are so many benefits of joining a post-natal fitness class. Not only can you workout under the guidance of a post-natal fitness expert, you can also meet and socialise with other like-minded mums. As well as being a cheaper alternative to one-to-one personal training sessions, you can also save on childcare costs by bringing your baby with you.

6. Speak to someone.

I always say that it takes 9 months to create a baby, so it can take 9 months to recover, but if you are concerned that your post-natal recovery is not progressing as you would hope, speak to someone. We are not offered extra post-natal services as standard on the NHS so if you feel something is not right or is uncomfortable, speak to your medical professional and push for more. Post-natal trainers are qualified in training post-natal women however it is not uncommon us refer an individual to a medical professional such as a doctor or women’s health physic.

 

Check out our website for FREE pre and post-natal exercise guides, tips and advice.
www.bump2babyfitness.co.uk
0330 55 55 828


You can contact Louise for any postnatal midwifery advice.

Filed Under: Advice, baby, exercise, midwife, postnatal Tagged With: advice, baby, exercise, fitness, postnatal, pregnancy

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