I don’t normally watch terestial TV, but whilst away I flicked it on to be greeted by an advert about incontinence pants. There wasn’t much of this advert I agreed with, it was normalising incontinence, specifically after having a baby.
Incontinence affects 1 in 3 women at some time. Childbirth, menopause, impact sports and getting older all affect our pelvic floor but that doesn’t mean we have to put up with it or pretend incontinence pads are glamorous. Let’s face it, it should not be normal to wee in your pants unless you are unwell or in a nursing home! Yet so often on social media it is made to seem normal.
At points in life your pelvic floor will be weaker. Hormones play a large role as does the affect of carrying a baby and pushing it out. If you had an assisted delivery using forceps that will also cause further damage. As you get older muscle mass can decline so it becomes even more important to keep those muscles working properly. We can of course adapt by drinking less, going for a wee before you leave a safe environment (the “just in case” wee), avoiding certain moves like star jumps and wearing pants/a pad. However that is pretty restrictive and isn’t living as full a life as you could.
Urinary Stress Incontinence = poor function of the pelvic floor muscles. These are the muscles that need to relax for us to toilet, so they also need to contract to stop leaks. They can be too weak, too tight, poorly co-ordinated and working more one side than the other. So it isn’t as simple as a squeeze and release.
Now think about it, if other muscles are not doing their job what do we do? You may see a physiotherapist, take time to work on working the muscles correctly, resting them when needed, having some sports massage and work with the muscles around the injured area. It is no different with the pelvic floor! We need to focus on a whole pile of muscles around that area, plus the contraction and relaxation. You may need to downtrain the pelvic floor and you may need to change some of your day to day habits to help.
One of the most complicated things in Pilates can be the breathing. It is not uncommon for people to say that it feels back to front. They want to inhale when the teacher is cueing them to exhale. I remember being the same, the breathing just takes time to grasp.
So why do we exhale at a certain part of the movement and why is important?
Pilates is all about working with the body in a functional way, to strengthen it and keep it moving in the way it was designed to work. In the same way we work with the body in terms of the breath.
When you inhale your lungs full with air, your diaphragm descends, your tummy goes soft and your pelvic floor relaxes. This is the point where you have less strength and less of your core functioning. So it makes sense at this point that you aren’t placing lots of load and pressure on. The exhale part of the breath is when you empty the lungs of air, your diaphragm rises, your tummy comes in and the pelvic floor rises. It’s when your core fires. So therefore at this stage it’s when you load the body.
Think about lifting. You exhale as you lift a heavy weight. You exhale when it’s hard work. Yes?
Therefore we EXHALE on EXERTION in pilates. Thats when you stretch a leg away, when you curl up, when you press up from the mat, when you come into a teaser. Now of course there are aways exceptions to the rule and in some exercises the whole thing feels like hard work (for example the hundred) so you hold some core tension throughout.
Many of your know my obsession with the pelvic floor . By exhaling on exertion you are also helping to protect your pelvic floor, rather than sending pressure down on it. So next time you lift something or even get out of a chair – breath out and think of me!
It’s what you do daily that counts. This is true in so much of life.
Posture is important. There are things that you have to do on a day-to-day basis that will affect your posture. For example carrying a child, carrying a bag, how you sit, driving a car, the shoes you wear and the chair you sit in. Studies show that sitting at a desk for long periods can lead to a forward head/neck posture which then can result in back pain.
The key is it’s what you do on a daily basis even hourly basis that makes a difference. So if you can make small adjustments to your day over a long term period this will add up. You cannot think about your posture all the time but you can adjust how you move, lift and sit to make small improvements.
It’s the same with eating. As a dietician and I know that deep changing small things in your diet will add up over the long term. So adding in one extra portion of fruit a day will make a long-term difference to your health.
So the challenge is to find those things that are causing you to have pain or tension in your body. A good way to do this is to go and see someone who specialises in looking at bodies. For example a Pilates teacher or a sports massage therapist such as myself. A postural assessment and a chat about your daily life can highlight some of the things that are going on that are causing the problems. It isn’t always obvious, so the position of your foot can impact your hip for example and what is happening at your hip can affect your shoulders.
Whilst you may not be able to change all of your daily activities that are leading to push your balances. But you can do is be aware of this and use some daily exercises to help release the tension and reverse the impact on your body.
For me carrying a heavy toddler is not great for my body. I know that I have tightness in my hips and my glutes and in my thoracic spine pain in my thoracica spine from this. I can’t not carry my child but I can use regular exercises to help mobilise, stretch and release those areas as well as keeping strong.
So the challenge is to realise which areas of your body need strengthening, which need mobilising and to have a daily self care programme to help. It may only need 15 minutes of your day to keep your body in tip top form. If you don’t have a plan like this then find someone to work with you and to help you create one. Then regular massage, and exercise sessions will help you stay motivated and moving pain free!
Get in touch to book a session: email@example.com
Pregnancy is a time of real excitement but also anxiety and change in your body. Things that aren’t usually a problem can suddenly become one. One way to ensure you keep your body strong and functional is to include regular exercise with a specially trained teacher advising you. Why? As the body changes your normal exercise routine will almost definitely need to be adapted. It is also a good idea to add in movements that will build movement patterns for motherhood. The ideal time to prepare for postural changes, lifting, feeding and moving about with a baby is in pregnancy. It may not feel like it, but you have more time and head space when pregnant than after baby comes!
Top areas to focus on:
Your core. This includes your pelvic floor, lower back, lower abdominals, waist muscles. Now you don’t need to be doing hard-core ab workouts (stay away from those) but you do want to strengthen these muscles in a kinder way. They need to be strong enough to support the growing bump, your posture changes and to support your pelvis. They also need to be able to relax for labour.
Shoulders are the number 1 complaint I see in classes. Whether it is from desk working or carrying another child, now is the time to tackle it. Get some release work or massage in to complement the strengthening work. Start to work out where normal should be for your shoulders so you can listen to your body. Move within it’s range to prevent further issues. The moves we use in pilates are all about working within your normal range but also strengthening and improving it.
Supporting your pelvis. Yes working on your core will help with this, but there is more to it. Your gluts and inner thighs are also key. So make sure you have some exercises to target these areas.
Getting up and down to the floor. This is something you will need to do a lot with a baby so it is time to get practicing. Bending over is going to hurt your back. So instead lunging, hinging and squatting are your friends.
Breathing. It destresses you, it helps your pelvic floor heal, it strengthens you. There are so many benefits, getting someone to watch you breath and correct you, could be the best thing you do!
Here are some simple core strengthening and shoulder focused moves you can do on a stability ball, chair or stood.
Diastasis Recti is also known as abdominal separation. Sounds pretty scary but it is actually very common and some research suggests it happens in all pregnancies, but for some ladies it may heal up before it is noticed.
Why does it happen?
The rectus abdominals are the tummy muscles that run down the front of the tummy, from ribs to pelvis. I like to think of these are being like a zip. There are 2 bands of muscles that run down with connective tissue called the linea alba in between. When you are pregnant this area has to expand to accomodate the growing baby. This means the tissues and muscles are stretched, hence this separation can occur. For some it may occur sooner in pregnancy than others which can be due to a whole host of factors. Your pre-pregnancy muscle tone, your collagen type, if you are hypermobile or not, your nutrition and your current exercise routine can all be factors.
What can I do to help in pregnancy?
During pregnancy itself there are things you can do to minimise this seperation.
Keep your core strong. Pilates is an obvious option! Do make sure that any exercise classes you attend or DVD’s that you do at home are suitable for pregnancy and taught by someone who knows what they are doing. A weekend pre/postnatal course is not enough and yet that is often the level of qualification fitness instructors have. So it is worth having a chat to check their knowledge base out and question any moves you are not sure about.
Breathing is a great way to activate your core and practice the skills you will need postpartum to help with the healing. Breathing into your ribcage, your back, your tummy and pelvis. Letting the breath expand you and your muscles relax. Then exhale from the pelvic floor upwards and your core should engage.
Don’t overload yourself. Loaded moves like lifting or anything that makes you strain should be reduced. This can lead to pressure on that abdominal area. Always exhale on exertion.
Log roll like a pro. When you get up from lying always log roll onto your side rather than sitting up. In fact any sit ups, planks, or intense core work should be stopped.
What can I do to help after baby?
Initially you need your rest, so don’t feel the pressure of bouncing that body back or jumping into exercise. Exercise is the last thing on the list for healing, read here for why. Instead here are 3 things to do:
Deep breathing. Use that core breathing to help your core fire and relax (the video below has breathing tips), your pelvic floor engage and relax and to chill our your nervous system, read more on that here.
Nutrition. Eating a diet with plenty of fibre to help your bowels work without strain, fluid to keep things moving nicely, protein for the connective tissue and muscle healing and fruit and veggies for those micronutrients and antioxidants. It all makes a difference.
Posture. Keep on top of where your ribs, pelvis, shoulders and neck are. It is key. When breastfeeding, nappy changing and sleep deprived your body will start to round forward. Yet these rounded shoulders and slumped postures mean those tissues are saggy and it is harder for them to heal up. So take time in your day to correct your posture. Ribs over pelvis, shoulders down, neck tall, pelvis in neutral.
Abdominal massage can be helpful. It is good to know how your abdominals feel and to give them some love! Check out my video on this here:
If you need some help then I offer a postnatal package of massage, assessment, breath work and nutrition tips, possibly movement if it is appropriate. You can contact me: firstname.lastname@example.org or book a slot in my diary here.
A session may include:
Some yummy massage to release those tight areas in maybe your neck and shoulders.
Some abdominal massage too to allow those muscles to let go and heal.