pelvic floor | Pilates with Priya

What postnatal pilates can do for you.

9 January, 2017 Priya Tew

When you are pregnant there is a lot of focus on keeping your body healthy, looking after yourself and putting you first. There is a lot more time to focus on exercising well, cooking good meals and thinking in general. The midwife and friends/family are asking how your body feels, how is the bump, what aches and pains do you have and giving plenty of advice. Then the delicious baby arrives and is totally the centre of attention. Your life is suddenly a whirlwind of feeds, sleepless nights, surviving as best you can. There is little time and energy left for exercise. Cake and chocolate can be relied to get you through the day or are part of a treat at playgroups. No-one really asks how your body is feeling or what they can do to help YOU, it is more about the baby.

The problem is that when you are postnatal your body is pretty vulnerable. It has been stretched, carried a heavy weight around and then birthed a baby. Now if you had a major operation you would lie in bed, rest, recover, have meals brought to you and be looked after for a few weeks. This is really what you need after having given birth. Instead you have a little person dependant on you, you cannot rest as much as you need and you cannot listen to your body.

As a pre/postnatal specialist Pilates teacher this is an area I focus on and love to teach.

Postnatal Issues Pilates can help with:

POSTURE:
It is hard to maintain good posture when you are sitting up feeding, especially at night. However without good posture, those aches and pains slip in. Muscles get tight in the wrong places which can cause restrictions in your movement and cause you to compensate.

Over time poor posture can cause long term pain throughout the body, so it’s not something you want to ignore. Postnatal pilates when run by a specialised teacher will put in exercises to strengthen your upper back, talk through shoulder placement with you and use functional exercises to help with those motherhood moves that you do daily.

Sitting more will also lead to tighter hamstrings, so these need to be stretched out regularly.

The key really is to find out which part of your posture you need to focus on and which muscles need releasing. A good class and teacher will highlight this to you.

FLEXIBILITY:
There can be a lot of hormones flying around. Relaxin is a hormone that can affect the laxity of your ligaments, so this can leave you vulnerable to overstretching and potentially pulling a ligament. Learning to work within the normal range of movement for your body is the key here and not pushing yourself too hard, too soon.

PELVIC FLOOR:
Having carried a baby around your pelvic floor has taken a lot of strain. If you have then pushed baby out then that is even more damage that will have occured to the pelvic floor. Pilates will help you strengthen the whole of your core, including your pelvic floor. If you need more help in this area then check out “Pimp Your Pelvic Floor”

ABDOMINAL SEPARATION:
Many ladies suffer from Diastasis Recti, this is a condition that is common in pregnancy and nothing to be concerned about as long as it is fixed postnatally! For some, the abdominals will naturally heal up by themselves, for others it will take more work. Exercises such as curls ups, planks and sitting up from lying on your back are not suitable and can make matters worse. A specialist pilates teacher with postnatal training will be able to help you.

PELVIC GIRDLE PAIN:
If you suffered from this in pregnancy then the likelikood is that it will disappear once baby comes along. However it is always a good idea to do some strenghtening work postnatally. If your hips and pelvis were struggling in pregnancy then some TLC for them can make all the difference in the long term.

LOWER BACK PAIN:
One of the common complaints I see in mums. Those babies get heavy when you are carrying them around a lot. Having a strong core and good posture when you lift and carry is so important. Pilates will help train your body so you are stronger and more able to manage this. The release exercises will also help mobilise and decrease any pain.

If you aren’t local to me, then check out my Postnatal Pilates DVD.

Posture, Breathing and Pelvic Floor Problems

13 October, 2016 Priya Tew

Your posture plays a huge role in helping your body work effectively and functionally. Many of those aches and pains can all be related to poor posture, which can seem obvious. What can seem less obvious is the relationship between your posture and a weak pelvic floor. Posture can affect your bladder control, prolapse issues and weak pelvic floor problems. So it’s vital to work on getting it right.

Try this out…Sit in a slumped position, with your shoulders rounded and your chest compressed. A fairly typical posture for those who sit alot, and often how we relax on the sofa! Now try to breathe deeply, you should find it is difficult to fill your lungs. In this slumped posture your abdominal contents become compressed and your diaphragm can’t move downwards, so instead of using your diaphragm effectively you use your upper chest muscles to help you breathe.

Slumped forward position and breathing with the upper chest muscles increase pressure on the pelvic floor. Not good. In this position your core muscles (including deep abdominal and pelvic floor) can’t effectively counter the increased pressure.

Guess what, sort out your posture and breathing and suddenly the core muscles start to work in the right way. Our bodies are built in an amazing way.

So start focusing on your posture, with a tall spine, shoulders down in the back, ribcage soft and not pushed out, tall neck and allow there to be space for your abdominals to work.

Next focus on the breath. You want to breath using the diaphragm. That may sound obvious as it is how our bodies are built to work, but so many of us do not breath correctly. It is called Diaphragmatic breathing or thoracic breathing. Some people breath with just their tummies, some people breath with just their ribcage. You want to use BOTH.

Try out this exercise:

Place 1 hand on the bottom of your ribcage and 1 hand on the side of your ribcage. Breathe in slowly and deeply so that you feel your tummy rise and your ribcage expand out to the side. You want to focus on breathing into the tummy and ribcage whilst keeping the upper chest muscles relaxed. Think of your lungs like balloons expanding out to the side of the body.

Breathe out by letting the rib cage fall back to resting and the tummy fall back down.

It takes practise and you may find it quite forced at first. Try practicing when you are relaxing or use it as a way to relax throughout the day and it will become habit.

Exercise 2: breath with a band:

Tie a band or a scarf round your body just below the ribcage. Sit with good posture, your ribcage over your pelvis. As you breath in feel your ribcage expanding into the band. As you breath out the ribcage decreases in size. The band can be a nice way to practice your breathing.

When should I return to high intensity exercise?

9 June, 2016 Priya Tew

Exercise can be so so key when you are a mum and so many people I work with and talk to are desperate to get back to their former routine, jeans and get time for them. Having had 2 babies and about to have the 3rd I completely get it.

Why should I wait?

Your pelvic floor deserves a break. After 9 months of carrying a baby it’s had a lot of extra work to do, then there is the act of pushing out a baby. It’s understandable that it may need some R&R time. Jumping back into high impact workouts will put extra pressure on the pelvic floor muscles, preventing them from recovering properly and potentially damaging them further. A weak muscle is a muscle that is easier to damage. It is NOT right to need to wear protection in your pants when you exercise. Leaks should not be the norm.

Your body has had 9 months of carrying a baby around. It takes 9 -12 months to recover nutritionally, so why would it take any less time to recover your physical body?

You need a good, strong, solid foundation before you build. Your core is your floor. So get that strong and the rest will follow. Your lower abdominals, pelvic floor, the postural back muscles and the obliques all functions together to provide your stable base. Don’t rush into running, lifting, jumping in order to have it crumble away under you.

How long to wait:

A lot of the time this is individual and depends on your previous fitness, how many babies you have had and how your pelvic floor function and core were before. But I recommend you wait a good 4-6 months and build up slowly. Listen to your body.

Things to watch out for:

If you feel a dragging or heaviness in your pelvic floor.

Have pain in your lower back, pelvis or abdominals.

Leaks when exercising.

It generally feels uncomfortable or wrong.

THEN STOP.

Go back to working on your core, get stronger and then try again in a couple of months.

Pimp Your Pelvic Floor Was a Success!

27 September, 2015 Priya Tew

This week we ran our first Pimp Your Pelvic Floor workshop. In fact it was our first every Pilates workshop!

We had 5 ladies, 4 of whom were already mums and 1 of who was 36 weeks pregnant with twins! Plus we had the company of a beautiful 11 week old baby 🙂

I so so so enjoyed this workshop. It was amazing to share knowledge, pass on tips, get feedback from the ladies and then run a practical side to the session.

We spent time on the anatomy of the pelvic floor and then looking how it functions as a part of the whole body. This part especially I find important. The pelvic floor doesn’t work in isolation does it, it works under loads and under pressure as we walk, lift, cough, jump and move everyday. Looking at the models of the pelvis showed us all how the pelvic floor really is affected by movements we do and is connected to the body.

The feedback has been really good with participants ranking the workshops as excellent. We hope to run these regularly – so don’t worry if you haven’t been able to book on yet.

Looking forward to running the next one in October 🙂

How to help stop those leaks.

12 August, 2015 Priya Tew

Have you ever had one of those moments where you’ve bounced too much on the trampoline, coughed and sneezed too much or just bent down and leaked a little? Horrible to talk about but it happens.

One way to help with this is to practise and use core bracing. Any movement that increases the pressure inside your tummy can push pressure down on your pelvic floor. To help counter this you can brace the core. It’s like adjusting the tension on a trampoline so that when you jump you don’t touch the floor.

Ready, Steady, BRACE:
As you breath out draw in the lower tummy muscles (tranversus abdominus) and the pelvic floor muscles too. Your transversus abdominus muscle is below your belly button, to find it you can slide your fingers just inside your hip bones and cough. That muscle that you feel move is the one to engage. To engage your pelvic floor think about lifting the muscles around your vagina and anus. It can take a bit of practice to engage your core and pelvic floor at the same time, but persevere it will come.

Practise this when doing everyday movements and it should become a habit. So whenever you cough, sneeze, lift something, bend, bounce, push something, extend away, reach or twist you can brace the core.

Embrace the mummy tummy.

5 July, 2015 Priya Tew

A sensitive topic. Mummy tummies and post baby bellies are something that I deal with on a regular basis. I know how much pressure mums can feel to lose the baby weight and get back into their skinny jeans. I felt it myself after my second baby especially. Social media and the media shows us how some celebs look like they’ve never had a baby just a few weeks after giving birth. There are posts of mums doing all kinds of crazy in order to lose weight and tone up. Whereas actually if your body has just had a baby doesn’t it need to rest and isn’t it perfectly natural and normal for your body to not ping back to normal after 9 months of stretching and carrying an extra person around inside it?

I’ve had 2 babies. I’m a Pilates teacher and a dietitian. So I eat well, I exercise and I didn’t put on too much weight with either pregnancy. Yet I still took 6 months to lose the baby weight. Here I am 4 weeks after baby with a definite bump still there.

Pilates with Priya: Post Natal Tummy Week 4

Reasons to embrace the mummy tummy:

1. If you are breastfeeding then your body needs to have some reserves to make milk. Breastfeeding can help you lose weight but your body may not let you lose it all too soon. It’s a pretty sensible system really isn’t it. There is some built in protection for baby in those early months.

2. It’s taken 9 months or so to create a baby, you’ve done a stunning job of carrying baby around and feeding baby. All of that takes a toll on your body, it uses your nutritional stores. Now your body needs to recover. 9 months on, 9 months off is the commonly said phrase and I agree with it. It may feel like a long time but it really isn’t in the grand scheme of life.

3. Obviously you don’t want your weight to stay higher than normal for ever, but initially it’s a rite of passage and a sign of mummyhood. Try to savour those early days. Spending time with your baby and looking after yourself is the most important thing.

4. Getting back into high intensity exercise too soon can be damaging. Your pelvic floor needs to be strong enough and any abdominal separation fixed before you start running, jumping or high impact workouts. Stick to swimming, postnatal classes or specialist pilates.

Look out for my next post for top tips on how to lose that mummy tummy.

Pelvic Floor: It’s not all about the lift.

14 June, 2015 Priya Tew

I’m slowly turning into a pelvic floor geek. Someone save me! Seriously I have learnt so much more about the pelvic floor in the past year and know I have more to learn. It’s pretty sad that so much of the information that is given out is so out of date.

Gone are the days when strengthening your pelvic floor was just about trying to mimic the actio of stopping the flow of urine. This is such a simplistic view on a working a complex muscle.

In this brief video below I talk about the pelvic floor being like a trampoline, how we need to strengthen it all the way round thinking about all the attachments and the danger of over tightening. No-one wants an over-tight muscle. Think about having a tight calf muscle. No fun. It can lead to that muscle actually being weak, which is the whole issue you were trying to avoid. Whoops. So focusing on all the muscle attachments and strengthening PLUS relaxing it is the way to go.

(This video was recorded live on Periscope some I respond to the live viewers in parts).

Royal Bumps and normal bumps, tips on getting your body back post birth.

24 August, 2013 Priya Tew

So on Monday …… the newest addition to the Royal Family made an appearance. With Kate in labour there were people camping outside the hospital, live feeds recording the hospital and all sorts of chatter going on. Now I understand the excitement but thinking back to the birth of my first child, personally I was pleased to see they were given some privacy. The whole labour experience can be so challenging, unexpected and yet at the end there’s the amazement of meeting that gorgeous baby that you have been carrying around for 9 months. Those first few days are overwhelming, emotional, tiring and a big change to life.

The thing that I’ve found sad is the media chatter around Kate’s baby bump still being present a few days post-birth. Now in my mind that’s completely natural and normal. After 9 months of growing a baby your body is going to just spring back to it’s previous shape after a couple of days. It’s made me, as a pregnant lady and a antenatal Pilates instructor, think about the pressure on new mums. Yes, we wants new mums to look after their bodies, to eat healthily, to restart exercise when it’s safe to and to get that body confidence back…… but there can be far too much pressure. Having said that everyone’s bodies are different and if you have exercised through your pregnancy you are more likely to lose the weight quicker. Here I am 8 days post-baby number 1 back in my “comfy jeans” but certainly not back to my normal size and shape, who knows how I’ll be after baby number 2.

: Bump to Birth Pilates: 8 days post baby.

My advice:

It’s taken 9 months to grow a baby, it will take time for the baby weight to come off, be patient.
A few days after birth light exercise such as gentle walking and pelvic floor exercises should be safe.
Don’t engage in any high impact exercise until you have had your 6 week check from your GP and have built up to it. Jumping straight into high impact work can cause more damage than good. Strengthen your core and pelvic floor first.
Build your exercise back up slowly and steadily. Start with gentle walking, some light resistance work perhaps and think about a post natal Pilates class to strengthen your core and pelvic floor safely.
You may have diastasis recti (a gap in your tummy muscles) so certain abdominal exercises will not be suitable, post natal Pilates will help with this.
Try not to succomb to the cakes, biscuits and chocolates that are often around 😉 yes you need extra calories when breastfeeding but it’s better to get these from nutritious sources such as fruit, vegetables and wholegrains, lean protein, nuts and seeds. Keep the “treat foods” as treats.
Relaxin is a hormone that makes you more flexible and supple than usual, this hormone is still around post-birth so take care when stretching or in yoga moves.
If you are still bleeding post-birth be cautious not to overdo it, if the bleeding gets worse then rest.
Remember you have a new baby to look after and will be up in the night, so rest is also important.
Specialist post natal classes are fantastic – look for a cardio class such as a boot camp or aerobics class to complement a Pilates class. You can often take your baby to class with you.
Be active, take time for you and be kind to yourself!

Pelvic Girdle Pain and Pilates.

9 March, 2013 Priya Tew

Working with pregnant ladies I often end up advising and chatting about pelvic pain. I also have a few other non-pregnant ladies with this type of pain, who had this type of pain in pregnancy and it’s continued after birth.

Pelvic Girdle Pain (PGP) has been renamed Symphysis Pubis Dysfunction. Big terms for pain in the joint that make up the pelvis, the syphysis pubis joint and the front and the sacroiliac joint at the back. Pain can be felt in the lower back, groin, thighs, hips and pelvic floor. This can lead to pain walking, climbing the stairs, getting in/out of the car and bath, straddling, turning in bed and standing on one leg.

There are many reasons suggested as to why this pain can occur, in some cases the pelvic joints can be damaged or weak, there could be a biomechanical problem or it could be due to hormones. Between 14-22% of pregnant ladies get PGP and in many it is a random thing that cannot be predicted!

Pilates can really help prevent and minimise PGP. In my ante-natal classes we focus on strengthening the muscles above and below the pelvis, so helping the pelvis remain strong. We strengthen the core muscles and also muscles in the thighs, legs and bottom. For example a pelvic tilt or small roll up can strengthen the core and modified squats and oysters can strengthen the gluts and thighs muscles.

If you get pelvic pain then here are my top tips:
See a physiotherapist. In Southampton you can self-refer to the obstetric physio, which is an amazing thing. the midwifes will pass on the number to you. A physio will assess your pain, range of function and possibly realign your pelvis.
Once you have seen the physio, then Pilates exercises can help strengthen you to minimise any further pain. Try a one to one session for some specially tailored exercises to do at home or attend a class.
Remain active within the limits of your pain, keeping active is important and will help, but obviously you don’t want to be in constant pain, so you will need to judge how much you can do.
Avoid activities that make it worse, standing on one leg often does this or having the legs too wide apart. Try keeping some activites seated.
Using a pillow between your legs when sleeping can provide relief for some ladies.
Ask for help when you need it!

Priya will be releasing her own worksheets to help with this area and her own Pilates in Pregnancy DVD very soon, contact us to pre-order.

To book a one to one session click here.

Pelvic Floor, use it or lose it.

8 June, 2012 Priya Tew

This week in my classes, the pelvic floor has come up a few times. Now as a dietitian I end up talking about bowels a lot and as a Pilates instructor I now get to talk about pelvic floors – you can see how glam I am 😉 , I thought I’d add a quick blog post on it to help you out.

In Pilates we use the “CORE” muscles these include the “transversus abdominis” (TA) muscle, which is similar to a corset, wrapping round the body, I describe it as being below the belly button, and the pelvic floor.

The muscles of the pelvic floor can be thought of as being like a hammock going from your front to your back passage, holding everything in! When these muscles are weak most people know it can result in stress incontinence, but did you also know the pelvic floor muscles aid the emptying of your bowel and bladder, and they can make sex more enjoyable!

So how do you find these muscles? It sounds crude but I’d suggest when you go for a wee try stopping the slow of urine part way through and this will show you were there muscles are. Or think about going on a long car journey and being desperate for a wee but having a husband (like mine) who refuses to pull into the services 😉 It’s those muscles you have to use to hold it in!

Your pelvic floor is pretty much like the foundation of a house, if that is strong you’ll function better. After a while in Pilates you learn to get both your TA and pelvic floor muscles firing when you are doing exercises, but in the early stages you may need to remember to engage both of these seperately. What will end up happening is when you contract one the other will co-contract.

So I’d encourage you to start training your pelvic floor and keep using my reminders in class to check you’ve got your CORE engaged. Use it or Lose it 😉

Tag: pelvic floor