Should I leak when I run?

Running is great for mental health, being outdoors provides fresh air, a new perspective and the pounding of your feet in a rhythm can help your thought processes.

However it is also known that the impact of running can elicit symptoms of stress urinary incontinence. That little bit of leaking that you get when you run, or the need to wear a pantyliner/pad is not how our bodies were designed to function and is a symptom that there is a bigger issue.

So should you run whilst you leak?

A review of 28 studies on continent and stress incontinent women showed the timing of pelvic floor activity in relation to movement was key. What does this mean? It means that co-ordinating your pelvic floor with your movement is crucial. This is something that comes with practice. Like any muscle the pelvic floor is one that needs training, but not just on it’s own via kegels. Don’t get me wrong, kegels are definitely useful and have a big role, but these need to be integrated into movement. So if your pelvic floor is not functioning properly when you run, it’s all about practicing moves to prepare for running using pelvic floor cues as well.

Does this mean you may need to stop running whilst you train your pelvic floor? Yes it may do, for a short period of time. Now whilst I completely understand that it is so hard to stop doing an exercise that you love and that is so helpful to you, there is a bigger picture to be seen. If you have the symptoms of leakage then continuing to put impact through a weak muscle can lead to it worsening. This could lead to prolapse, a condition where the pelvic organs descend… and you having to stop running for longer.

Think about it this way, if you had an injury in another muscle, such as a hamstring, then you would seek advice, possibly have some physio, work on exercises to rehabilitate and take time out from running whilst it healed. So why is the pelvic floor any different?

I’m running some brilliant courses that will help you get your pelvic floor up to speed.

Everywoman is a 12 week course with 6 weeks of in person classes and homework, then 6 weeks of online classes. Full support provided including some help with nutrition and stress regulation.

Next course starts in November

Athlete 12 is for you if your pelvic floor is already ok (no leaks) and you have already done come core work first. If you want to get stronger and fitter, it is a brilliant aid to improving your performance and having coached support without paying for a PT each week. This is a 12 week online course with workouts delivered to you and support from myself.

Want to sign up? Drop me an email priya@pilateswithpriya.co.uk

Why fixing diastasis recti is not all about movement.

So often I hear the phrase movement heals. Whilst I agree with that there is also a point where movement is not the first point of call. There are so many programs out there now and so much advice on what to do if you have a pelvic floor concern or abdominal separation. The over flow of information is confusing and can just add to the noise in peoples head. How do you know who to listen to? How do you know which advice is correct? As someone who has spent a number of years doing advanced study in this area I’d like to share my top tips. I certainly know that a new mum I did not get it right first or second time around… but third time lucky.
If you can you always want to get somebody who can put their hands on you and give you a thorough assessment. That might not mean that they do an internal assessment but you do you want somebody who can physically I do your body, what you move, and placed their hands on you whilst you breathe and use their hands to correct you and to release you. Now that might not always be possible, and I’m not knocking The online program set out there. However I do think if you can get a one-to-one hands on assessment with the women’s have physio or a very experienced fixed price that you want to do that before moving on to any other form of program.
When looking at a program always look at how rounded it is. If it just focuses on the movement then I would say it’s not a full program. There is so much work to be done before you get to the movement, for example:
I want to woman to be able to breathe properly In a full 360° breath.
I want them to be able to connect the pelvic floor, lower abdominals and feel their back expand as they breathe.
In order to correct your posture work is going to need to be done.
This is going to involve some release moves, possibly some soft tissue work.
It needs to be a daily approach. What you do in a class needs to spill out into your daily life.
It’s also really important to focus on you. Self-care cannot be underestimated. Finding ways to make yourself out of that highly stressed fight/flight state into the calm zen like parasympathetic nervous system is absolutely 100% important. This could involve meditation, mindfulness, breathing exercises, along path, or otherwise of chilling out. However you do it it’s important. If you are living in stress and tension you’re not going to be able to heal your body.
It’s only when all of this has been accomplished movement can be layered on top. That’s why I love doing what I do. I get to work with people either 1-1 or in  class and bring them back to that chilled out relaxed state.
If you want to get involved and get some help that focuses not just on the issues in your body but also on healing all of you, then get in touch.
What is best for you? Hard to say as I work on a person by person basis, we are all different.
If you have a significant diatasis recti or significant pelvic floor issues you are likely to need some 1-1 sessions.
If you have some concerns with leaking, a small separation or feel like your whole system needs a tune up then our Holistic Core Restore EVERYWOMAN 6 week course is for you.
If you want ongoing classes then our pilates classes are the best bet.

The secret sect

Since starting specialising in postnatal womens recovery I feel like I’ve discovered a secret sect. An un-talked about condition that is just normalised by ladies and it shouldn’t be. It has become something these ladies accept and life their life around. Why? Often I think life is busy, most of these ladies are mums and when you are a mum you are no longer at the top of the pecking order. The children come first, there is a lot less time for focusing on yourself and you learn to put up with those annoying niggles and problems.

Incontinence, leaking and those accidental moments should not be a normal part of life. Whether it be having to avoid the trampoline, “sneeze pee”, not being able to wait until you get in the door for the toilet or needing to wear a pad when you run, it is not how your body is built to function and it can be improved upon.

Maybe you have had some help in the past and it has not worked? Or you have squeezed your lady parts over and over with no improvements? Well it’s time to start over. Yes those kegels/pelvic floor exercises are important but if you are not doing them correctly they won’t work and there can also be other muscular imbalances in your body that are the sticking point. Our bodies are connected from head to toe, this means that your foot position and your neck position impact your pelvic floor! So if you feel you need a fresh approach then here are my tips:

  1. If you have any heaviness or dragging in your pelvic floor region go and get checked out by a womens health Physiotherapist. Yes this costs money but it is well worth knowing what is happening in your body. I recommend a Mummy MOT for ladies who want a once-over post baby.
  2. Be committed. Your pelvic floor is a group of muscles like any other in your body and it takes time to see progress. However after a few weeks you should be noticing improvements. It takes work all of your week and not just the session you work with someone. I encourage people to do daily, focused work using the exercises we do in a session and to also focus on their posture as much as they can in the day, plus some dedicated breathing time. So you need to carve some time into your day to do all of this.
  3.  It is NOT all about the work however. For some people it is all about the RELAXATION. Over-working a muscle leads to it being tight and weak. So if you live life in your stressed place the relaxation phase can be the key.
  4. Get your breathing assessed. Oh my days, so many of us do not breath properly and all kinds of funky things go on connected with this. It could be you are pushing down on your pelvic floor when you breath out and it needs a re-train.
  5. If you aren’t a fan of lying on your back doing Pilates moves then it doesn’t have to be that way. There are plenty of ways to incorporate your pelvic floor rehab work into variations of the exercises you like.
  6. Find a practitioner who you can work with, someone you like, who really knows their stuff, who has worked with lots of ladies with success and who you be open with. Facebook can be a great place to get recommendations. I work with women on a 1-1 basis and via the Holistic Core Restore courses.

Get in touch if you need to chat or to find someone who can help. Most importantly do not suffer in silence and get some support.

Prepare to Plank

Let’s talk planks.

An amazing exercise for building core strength, for working the whole of your body and there is so much you can layer and add into a plank.

Also one of the exercises that therefore needs great technique or a lot can go wrong. All too often people are encouraged to dive head on into a full plank without knowing the hows, why’s and why nots. I love a challenge, but I don’t like the planking challenges. Personally I do not see the benefit to being able to hold a static plank. I have a body that rarely stays that still and so far more useful is a moving plank with levers and motion.

Many people are just not strong enough to launch into planks. These are not beginner exercises. Done incorrectly the intra-abdominal pressure will build up and it has to go somewhere, so if you have weak abdominals these may sag and bulge or the same with your pelvic floor. I remember attending a mums and babies fitness class with mums there 6 weeks after having baby – all being told to plank for 1 minute. If your core is not ready, do not do a full plank, if you have recently had a baby and you are rebuilding your strength, do not plank, if you have a weak pelvic floor, do not plank. Now that may sound harsh and rather black and white… so here is the softer version. There is a version of a plank that everyone can do, it is just finding your level and knowing which muscles to use plus ensuring you breath.

So what about if you really want to plank or if you are in a class with planks and you need a variation? Here are some plank progressions for you, including a standing version that I use with my pregnant and postnatal ladies.

 

I’d love to hear how you find these. For more videos and tips do follow me on Instagram and Youtube.

 

 

 

Postnatal Care – is it enough?

I’m not even sure where to start with this post. So I will start with my own experience. I’ve had 3 babies in the past 7.5 years and my youngest is about to turn 2 yrs. With each baby, my own recovery, my own postnatal journey and the care offered to me, has been different. I’ve had 3 babies who have lost weight post-birth, 2 of which required a period in hospital, each baby has had a tongue tie and it’s always been a stressful start in those initial weeks. Now I’m a well-educated, opinionated, determined (or bloody stubborn) kind of girl, which has got me through. What I have been, and continue to be surprised at, is the lack of support that is out there for new Mums. I had a hyper-tonic pelvic floor before babies, after babies I was complete unprepared for the change in my pelvic floor! I also had a diastasis recti after baby 2 and 3.

Having baby 1 is overwhelming, you are learning new skills constantly and becoming a new family. Subsequent babies are also equally overwhelming, suddenly you have to balance everyone’s needs. The babe becomes the most important in all of this and Mums come way down the list. But they shouldn’t. The early postnatal period is a critical time for recovery, by offering good support at this stage and preparing Mums we could actually help prevent some problems later on. Even by helping Mums with some simple stress management and practical ideas it could help them feel looked after, nurtured and reduce their cortisol levels. I know I was highly stressed after having my 2nd baby and it really had an impact on my body. Techniques such a deep breathing, meditation, mindfulness and just having time off for Mum can make such a difference. I now recommend Mums have a 2 week chill-out after baby as much as they can and call in lots of help.

Mums are usually offered a 6-8 week check, however this is often more for baby than for mum. It’s a quick assessment and I think a lot more could be offered at this stage, however resources are thin on the ground. The Mums that I see and my experience is that pelvic floor is not really discussed, perhaps a cursory “are you doing your exercises”, abdominal separation is rarely checked but there is a screening for Mums mood and contraception.

Whilst it is great that Mums and babies are seen by the GP and continue to be monitored by the health visitors, I feel we are missing a vital opportunity. A chance to talk to women about their bodies, what is not right, where could they be signposted to get more help. I’m not suggesting these teams can provide the answers but they could link in with NHS or private services who could. For example, local women’s health physiotherapists and postnatal fitness instructors who really specialise in this type of rehabilitation.

We need a revolution in postnatal care, more chat, more information sharing, more love, more respect for how women’s bodies change and more holistic care. I’d love to know your stories and thoughts.

Why being flexible isn’t always the aim.

Some people come to us thinking that Pilates is all about the stretch and that they need to be super flexible to be any good at it. Confession, ahem…. whilst we have super flexible people who teach for us and I envy their ability to do the splits I’m not a bendy ballerina.

Whilst I totally can work on my flexibility and improve it, I’m also aware that being super bendy is not always a good thing and you can overstretch for your particular body. Yup, I’m saying it doesn’t always pay to s–t–r–e–t–c–h.

 

Let’s think about that over-stretching:

  1. If you are hypermobile or have Ehler-Danos Syndrome then pushing your body past it’s normal range of movement into the hypermobile zone is possible for you but not a good idea. Over time moving out of the normal range can increase your risk of injury, sprains, dislocation, joint pain and can lead to the joints popping out. Pilates is one of the best forms of exercise for these conditions as a good teacher will watch your range of movement and help you work out exactly what you need to strengthen. By strengthening the areas around the hypermobile joint it can help you stay strong.
  2. The effect of hormones. When you are pregnant and postnatal you definitely do not want to be overstretching. At this point of life your ligaments are laxer and you may have a greater range of movement. But moving too far and stretching too much can lead to your muscles becoming overstretched. This leads to pain/injury for you which can then be an ongoing weakness in your body. Relaxin can take up to 4 months to leave the body after you stop breastfeeding. This can also mean your body is not as strong as you expect it to be. I remember after baby 2 really struggling with some of the harder pilates moves until I stopped breastfeeding (I fed baby until he was 16 month) and then a couple of months later my body was at it’s peak once again. So don’t rush things and risk a lasting weakness.
  3. If your body is causing a muscle to be tight for a reason. Sometimes the body is protecting itself. Much like we do not work muscles in isolation, it can be detrimental to stretch a muscle in isolation too. Instead we need a whole body approach and to think through why an area is tight. Is it due to a certain posture you adapt most of the time – in which case work on the posture. If it is due to pain elsewhere in your body and you are compensating, then the area of pain needs to be dealt with too.

Anyone can overstretch their bodies. Our collagen make up is genetic and we just aren’t all born with stretchy joints, ligaments and bodies. So whilst stretching is of course good for us, listen to your body.

Hypopressives are coming to Southampton

The Hypopressive exercise, is a relatively new technique developed to help with pelvic floor rehabilitation and postnatal recovery of the abdominals. It is a form of breathing and intense posture work that involves creating a vacuum with your breath. This activate the involuntary fibres of the pelvic floor and abdominals, you don’t have to find the right muscles and squeeze them, instead you work with the bodies natural reflexes.

Where did the Hypopressive Exercise originate?

In the late 70’s, Dr. Marcel Caufriez realized that ‘traditional’ abdominal exercises were damaging women’s pelvic floors. So he looked into alternatives, moving away from high intra-adominal exercises such as creates and planks, the hypopressives were born. These exercises have been used for 30 years in Spain and are now used postnatally in hospitals in Europe with ladies with know pelvic floor and diastasis issues. However this is all brand new to the UK, we are pleased to be on the cutting edge, bringing you this technique.

Priya has trained with UK Hypopressives and has started doing hypopressives herself. With just 10 minutes a day she is feeling the effect on her core. These exercises are fabulous as they don’t take a lot of time and do not need any equipment. If you can breath, you can do them! However you do need hands on help to learn the technique.

This is a technique that can be incorporated in with other pelvic floor safe rehabilitation work, or used on it’s own for 30 days. It really depends on what level you enter this at. For example, someone with a prolapse it would be sensible to use the hypopressives only, then build on other pelvic floor work later.

 

Additional benefits can include:

1. Decreasing back pain

2. Reducing the waistline

3. Preventing disc and abdominal hernias

4. Improving sexual function

5. Treating and preventing urinary incontinence

6. Treats and prevents Pelvic Organ Prolapse

7. Improving respiratory function

8. Improving posture and balance

If you would like to learn more and experience hypopressives for yourself then please book onto our workshops. These are kept to small numbers so that you can have plenty of hands on help to learn the technique.

Dates:

Monday 29th January 10-12pm

Book Here

Thurs 22nd March 1-3pm

Booking to come

The 3 top benefits of postnatal pilates.

It strengthens your core and fixes your body. This is HUGE NEWS. Mums are lifting, bending, rotating, reaching, rocking, pushing and feeding babies. A whole lot of work and strain on the body. The core is made up of the abdominal muscles, the back muscles and the pelvic floor. This cylinder provides the support for the rest of the body to move. After carrying a baby in your womb for 9 months there has been quite a strain on the core. Your abdominals have been stretched and may have stretched apart slightly (diastasis recti). Your pelvic floor muscles have been supporting a heavy load and then may have helped push a baby out. Your lower back muscles will need supporting and strengthening as your baby grows and gets heavier. This is where Pilates has been invaluable for me and it fixes me weekly. Yes there are plenty of other fitness classes you can do postnatally, but a specialised postnatal Pilates is the one you want to do FIRST. It provides you with the foundation that you need to rehabilitate your body after pregnancy and labour. If you do not strengthen your core and get your posture sorted then later along the line you could suffer set backs and problems such as leaking and abdominal separation that doesn’t heal up. If you have this issue come see me for a 1-2-1 session.

If you have pelvic floor issues then you need to be on my pelvic floor workshop.

There are a couple of ways we work on core strength in classes.

Firstly BREATHING. It is something we all do all of the time but breathing using the diaphragm will help the core work in synergy. The Diaphragm, abdominals, back muscles and pelvic floor are all involved in breathing. Try this out:

1. Place your hands around your ribcage. Inhale feeling the breath come into your ribcage. So your ribs move out to the side, your back expands, your chest expands.

2. As you exhale, breath out with pursed lips, feel the tummy come in, the lower back tense and try to get right to the end of your breath to feel an tension in your lower abdominals and a lift in your pelvic floor.

3. Practise this for 5-10 minutes and it really can help, plus it relaxes you 🙂

All the Pilates moves are layered on top of the breathing. It can take a while to get the breathing at the right time and in the right way but suddenly it will click.

It reconnects you with your body. As a mum your primary focus is on your gorgeous baby. There is less time for you to look after your own body and this can get pushed down the list of importance. However your postnatal period is an important time of recovery for you.

A postnatal class can teach you how your body feels when you do certain movements. I know I can be busy rushing around all day and then suddenly in a class I realise my shoulder is out of alignment or my hips ache. It makes you focus on your tummy and pelvic floor, an area many mums don’t want to connect with post-birth. Let’s  face it things are changed in or bodies but it is something to embrace and work to strengthen rather than to avoid. A class also means someone else also has a look at how your body is functioning, which can give you valuable insights and reassurance.

I myself go to classes so that someone who knows my body can give me feedback and push me further. We all need someone who knows us well to watch out for us.

It is you time. Our postnatal classes are run with a creche. I love babies, but having taught with one crawling around the studio, going under and over me… I know how distracting it is to doing the moves correctly. You tense up in order to ensure baby is safe which then means you do not get the full benefit from the class and exercises. You listen to their noises and not your body.

We’ve found over the years that having a creche away from the studio works best. Then the mums are not listening out to their babies, they aren’t all in the studio freezing each time a  baby makes a noise, working out if it is theirs, if so do they need to go to baby. It takes trust on the part of the mum, but James has been running our creche for 7 years now and has seen an awful lot of babies in that time. If he can’t cope and needs a mummy, he knows when to ask.

So if you are thinking about trying a postnatal class I would highly recommend you try Pilates. Yes I am completely biased, but I am also proof that it works. Having had 3 babies, I have rehabilitated each time with Pilates. It works.

When should I stop my normal pre-pregnancy exercise routine?

We get a lot of emails from pregnant ladies who are worried about losing their fitness whilst pregnant. They have been working out and love their current exercise routine but obviously want to look after the baby too. Well the best way to look after baby and yourself is to keep exercising but modify as you progress through pregnancy.

Years ago, the advice was for pregnancy ladies to stop all exercise and to pretty much go on bed rest. Then this changed to a focus on only low impact exercise. However now we know from the recent research that exercise in pregnancy is a good thing, but that pregnant ladies tend to reduce their exercise. In the first trimester the advice is that you shouldn’t take up a NEW form of exercise, but this seems to sometime get misconstrued into “I must not exercise”. What this advice actually means is “Keep doing your normal exercise routine as much as you can/feel ok to do so”. Of course the nausea, tiredness and  pregnancy hormones may mean you find exercising harder than normal, but some ladies do find doing exercise can help them through this trimester. 

A study on over 1,000 pregnant ladies showed the rate pf physical activity was lower in pregnancy (20.1%) and that less than half received exercise advice in pregnancy (47.4%). Yes, when you are pregnant it is absolutely important to look after the baby, but part of that is looking after your own body so it is strong, fit and able to cope with not just the demands of pregnancy but of being a mum. Carrying, lifting, feeding, rocking and crawling after a small person is pretty tough on the body.

So can you continue your normal exercise routine? Yes to an extent. You will need to seek advice and modify some things. I was teaching spin until 7 months pregnant with my first baby and I taught Step Aerobics until 2 days before baby 1 and 1 week before baby 2. Through my 3rd pregnancy daily Pilates and functional work kept me strong and sane. Maybe surprisingly (or not) doing more Pilates and functional work lead to the pregnancy with the least aches and complications and a simple homebirth. So I’m not saying that you need to be running or cross-fitting your way through pregnancy, but that many forms of exercise can be adapted for you to continue whilst pregnant.

I have ladies who have run through pregnancy, who have continued to lift weights and to do modified cross fit. For all these ladies they have naturally tapered their levels of impact and exertion down as needed. Running may become a slow job with some walking, weights can be lighter and the range of movement smaller, cross fit moves can have some of the impact taken out.

All exercise needs to have a strong core as a foundation, this is even more important in pregnancy and postally. So for me, Pilates is essential as part of an exercise routine, but it doesn’t have to be the only thing you do. Having said that, it could be! Our pregnancy classes include whole body functional movements such as lunges, squats, wall press ups and wall planks that ensure our mums are working those global muscles as well as the core. It isn’t all breathing!

The 4 keys:

1. Listen to your body. When you feel hot, tired or just not right then stop.
2. Seek the advice of a trained exercise professional who knows their stuff. Someone who knows about pregnancy and if they don’t knows where to get help.
3. Expect to make modifications.
4. Keep your core strong. This is your foundation, with your abdominals being stretched and your pelvic floor taking a heavy load you need to have more focus on this. A specific Pilates class will do this for you or check out our DVD.

3 reasons your abdominals may not be healing up.

Saggy Tummy skin?

Mummy pouch?

Abdominal separation that hasn’t healed?

Here are 3 reasons you may not be seeing results.

1. Posture.

I can’t highlight this enough. Try this out. Place one hand on your tummy muscles. Stand up with poor posture, rounded shoulders, head jutting forward. Now what does it do to your tummy? Those muscles feel taut and strong, or saggy and loose? What changes when you lengthen up through the spine, bring the shoulder blades round and down in your back and straighten your neck? You should feel your tummy muscles are tighter and in a better position to heal up when you have good posture.

DiagramPosture-01-209x300

2. Nutrition.

If you are not giving your body good nutrition then you aren’t giving it the best chance to heal. Protein, zinc, iron and vitamin C are all important in wound healing and muscle repair. I know as a mum you need quick meals and often have to eat on the hoof, but you can eat still eat healthily. It is all in the preparation and mind set. Step away from the cake and focus on nutritious snacks that give you energy and fill you. Nuts, seeds, homemade granola bars, hummus, egg muffins are good examples. A bowl of fruit, Greek yoghurt (higher in protein) and a small handful of nuts is a fabulous snack. Make overnight oats with fruit and seeds the night before, ready for an instant breakfast. Bake a pile of sweet potato’s ready for lunches, then you can heat them in the microwave for lunch, top with tuna, pile some salad on the plate and it should keep you going. The diagram below is both relative for pelvic floor healing and diastasis recti.

Nutrition for pelvic floor

3. Breathing and Stress.

How much attention do you give to your breathing? Probably very little. Yet thoracic breathing can be a deal breaker. When you breath into the ribcage and not the belly you activate the intercostal muscles instead of forcing the tummy muscles out. As you breath out your pelvic floor lifts and you core activates. So breathing alone can work to strengthen your pelvic floor and lower abdominals. Stress leads to shallow breathing higher in the chest. It also affects hormones, posture in a lot of people and eating. A triple whammy. So taking time to relax, bring your cortisol levels down and calm down can be a factor. A bath, reading for 10 mins, a pilates class, it all helps.

Breathing Quote
I know how hard it can be. I’ve been there. But I also know this stuff works! I’ve closed 2 diastasis in my own body. Don’t delay, start with the tips above today.

If you want a 1-1 session for posture assessment and exercises you can use at home then get in touch I can even work over Skype.