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.

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.

What postnatal pilates can do for you.

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.

Postnatal Pilates: why all mums need it

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

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.

the-core2

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.

breathe_titled

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.

Pilates in Pregnancy, it’s a must.

I’ve been lucky enough to teach antenatal pilates for 4 years now and in that time I must have worked with over 250 ladies. I’ve also used pilates myself through 3 pregnancies and it has helped keep me strong, shown me which parts of my body needed working on and enables me to keep working and being a hands on mum throughout. The comments we get from some of our ladies are:

“If I miss a class I really notice the difference”

“My hips and pelvis ache less and I can feel the difference Pilates is making”

“Classes help to keep me strong and relaxed during pregnancy”

“I always leave feeling better than when I arrived and with exercises to use in the week”

 

Pilates with Priya: Antenatal Pilates class

 

Antenatal Pilates offers multiple benefits including, developing your natural corset to support your back and baby, helping with the changes to your posture, pelvic floor education, breathing technique, toning the muscles and, thus, helping in weight management. Practising Pilates on a regular basis can improve posture, alleviate backaches, and, ultimately, help with labour and delivery. It can even help the baby rotate in the optimal position. I tend to have a format where I use a mixture of functional exercises that help in daily living, for example moves you will need to bend, lift, rotate, get to the floor, release stretches for the areas I know get tight as pregnancy progresses, core strengthening exercises and some move to help in labour and for baby positioning.

CAT

Lets look at some of the changes that happen in pregnancy:

1. Breathlessness:

There is around 15-20% increase in oxygen consumption during pregnancy. The breathing rate will stay the same, but an expecting mum will breathe more deeply each time. The changes in the blood vessels caused by the hormonal changes together with the changed position of the ribcage and diaphragm may make a mum-to-be feel breathless at times.

The breathing we use in Pilates helps make an expecting mum’s breathing more efficient. Focusing on breathing in an antenatal class also has a relaxing and calming effect which can then be used in labour.

2. Muscle, ligament, joint and postural adaptations: 

Hormonal changes during pregnancy have an effect on muscles, ligaments and joints. There can be more movement, stretching and instability. A safe pregnancy pilates class will help you exercise within a safe range of movement and strengthen the supporting muscles. It can really help with conditions such as SPD/pelvic girdle pain.

3. Core Strength:

Pilates exercises focus on core stability, and pelvic stability. This obviously helps keep the abdominals strengthened  but it also can help keep your pelvis in good alignment and reduce pelvic girdle pain.

4.Posture:

Pregnancy affects posture as the centre of gravity shifts. Some women adopt a posterior pelvic tilt (tucked under) with a flat lower back, whilst others adopt an anterior tilt (bum stuck out) with an increased curve in the lower back. Either way it is not helpful for the body. Knowing about neutral posture will help you correct this in day to day life and pilates will provide you will a range of exercises to strengthen the right muscles.

So if you are pregnant, antenatal Pilates with a specialist teacher is a MUST. If you can’t get to a class or want something to use in between sessions check out my specialst Bump to Birth DVD.