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When is it safe to return to running?

9/12/2018

How soon can I start running again after giving birth?

This is the million dollar question and there is no straight answer here. Every woman is unique, and her readiness will be determined by many factors.

Most women are advised to wait between 4-6 months post birth before thinking about adding any high impact to your workout. For others though even this is far too early.

When assessing your readiness to return to or start running after birth the following 7 factors need to each be considered:

1. Type of birth – A more traumatic or invasive birth will need a longer recovery e.g it is advised to await approximately 10-12 weeks before returning to any structured exercise other than light activity (walking etc). So obviously you wouldn't begin with jogging you would very slowly build up to it.

2. Joint stability – Hormones (Relaxin) stay in the body for up to 6 months post birth or longer if breastfeeding making your joints less stable, putting you more at risk of injury (especially if your core doesn't activate as it should to stabilise the spine and pelvis.) You should also avoid running with any Pelvic Girdle Pain (PGP) and give the body adequate time to recover following any PGP.

3. Diastasis Recti – Abdominal separation which commonly occurs during pregnancy will affect your core stability and often contributes to lower back pain, pelvic floor dysfunction & poor core activation. Fix this first prior to vigorous exercise or you could be making things a whole lot worse.

4. Pelvic Floor health – This is a biggy! Pelvic floor muscles have been stretched during pregnancy & following a vaginal birth (especially if an assisted birth). These muscles need time and re-training to restore strength & endurance to cope with the forces created by jogging. If ligaments are lax for at least 6 months due to lingering hormones then guess what? Your pelvic floor ligaments will be too! Check with a physio following 2nd or 3rd degree tears before returning to running and if you ever feel like your insides are literally "dropping out of you" STOP and seek advice!

You should avoid jogging if you experience any form of incontinence (leaking of urine or faeces) or any dragging or heavy sensation from your nether regions (seek some advice for this one!) Although stress incontinence (leaking of urine when coughing, sneezing etc) is common after childbirth it is not normal if it continues and help is out there!

Please note: Even if you are symptom free your pelvic floor has been through some degree of trauma during childbirth and need adequate time to recover.

5. Are you a runner? - Those who ran prior to and during pregnancy may be able to return to running sooner than those new to running. Experienced runners with a good technique can also minimise impact with the ground which helps to protect joints. However, all of the factors mentioned here need to be considered in addition.

6. Energy levels – Being a new mum is a tough job in itself and may leave you with little energy for vigorous exercise and may put you at a greater risk of injury. In the early weeks/months lighter exercise, fresh air and a good nutritious diet may be more beneficial at this time. Weight loss goals should be relaxed and a focus on your physical & emotional health should take priority.

7. Why do you want to run? - Ask your self this question!! There are many other activities to increase your heart rate to help you with any weight loss goals. Get creative and try a different low impact mode of exercise (cycling, aqua running, pram power/hill walking). Your local Buggy Fitness classes should be advising you on low impact options and screening you for suitability. If not, find someone who does!

What does a low-impact class look like? Try this next time your in the park once warmed up:

- 2 minute power walk
- 45 seconds squats
- 30 second hill push (fast walking)
- 45 seconds Press up on fence
- 45 seconds step ups (low wall or steps)
- Row on fence (resistance band)
- and so on...

Following any type of delivery, your exercise regime should begin with at least a couple of months worth of core stability or postnatal specific Pilates to strengthen from within first. You cannot build a house on jelly – I love this saying!! Instead for those who need to, think of this time as your pre-running training...your body will love you for it and you may just save yourself a whole load of problems in the long run! (excuse the pun!!!) :-)

Did you enjoy this article? If you would like to receive more fitness & well being tips during pregnancy and beyond why not subscribe to our fortnightly newsletter and receive a FREE GIFT in return. Subscribe & find our latest class timetable here: http://misfitmamas.weebly.com/

Why not check out our class reviews/pics here: https://www.facebook.com/misfitmamas1/

Debbie x

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Recipe Ideas for Busy Mums

8/11/2018

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FAT-BURNING, CLEAN-EATING RECIPE IDEAS

Avoid the sugar rollercoaster ride by reducing or even better eliminating processed foods from your diet (check the labels as almost all will have sugar added sometimes called dextrose, sucrose or glucose), and aim to:

reduce white carbs such as white potatoes, white rice & white pasta
pack in more fresh veggies and therefore nutrient dense foods.
Ensure you eat good quality lean protien at each meal needed to repair tissue post birth and to keep you fuller for longer.

Enjoy feeling less bloated and shed fat!

Carbohydrates are converted into glucose, with any excess stored as fat in the body if not used. However, they are not all equal. The white or refined carbs release sugars much quicker which causes blood sugars to spike and drop leading to cravings, plus they contain less fibre that their wholemeal or brown counterparts. Traditionally carbs tend to dominate the plate. So instead aim to fill your plate with veggies with some lean protein at each meal and carbs contributing to about a third of your meal.

Theses are the best carb choices for a lower sugar option:

Sweet potato
Quinoa
Small amount of brown rice
courgette or squash spagetti (e.g. courgetti which can be bought spiraled for you)

Or if like me you struggle to give up bread completely then aim for wholemeal/seeded loaves and go easy!

Lean protein ideas may include:
- 2 boiled eggs or 2 egg omelette
- Chicken breast/lean ham/tinned tuna/fish/turkey/sardines/mackerel
- Pulses or beans (lentils, quinoa, soyabeans, kidney beans, chickpeas etc)
- Other foods high in protein include almond butter, pistachio & cashew nuts, low fat greek yoghurt, cottage cheese.
- Protein powders (good quality) if you can stand the taste!

TIME SAVING HACKS FOR BUSY MUMS:

Buy good quality cooked chicken slices or cooked turkey slices (to save time cooking). I low raw salmon slices that are ready to go when needed.
Prepare a lovely salad with lots of your favourite salad veg & herbs but omit the tomato as it goes soggy! E.g. try spring onion, spinach leaves, sweetcorm, beetroot, cucumber, olives, parsely, feta cheese.
You can also pre mix a tub of tuna mayo with chopped tomato, onion & sweetcorn and keep refridgerated for a healthy sandwich or baked potato filler.
Batch cook what you can when you have some help e.g at the weekend perhaps and either refrigerate or freeze such as:
- cook chicken breasts to keep in the fridge in a tub ready to add to meals
- soups for fridge or freezer
- ratatouille is an easy base to use for sauces (fry peppers, onions, courgette plus anything else you enjoy, add tinned tomatoes, garlic herbs and simmer). Any excess can be frozen until needed.
- Roasted veggies such as squash, sweet potatoes, courgettes, aubergine etc. (pop in the oven at 180 degrees covered with foil with a little oil for 20 mins and uncover for another 5-10 mins). Keep covered in the fridge.

- Turkey meatballs (turkey mincemeat, finely chopped onions, garlic & herbs mixed with an egg and make into balls). Can be frozen or popped in the fridge.
You can buy pre chopped frozen fruit/veg in bags in Aldi for juices/smoothies, handy if you have a blender/juicer and just add to Almond milk or a little fresh juice.
Lastly, I didn't used to understand why you would pay more to buy pre-chopped veg...NOW I GET IT!!

Here we go.. some ideas for both lighter meals and main meals to tickle your taste buds. Feel free to add or omit things to please your pallet.

Light Meal/Lunch Ideas:

Omlette, packed with veg/Salmon and a side salad
Chicken & avocado & bacon salad
Wholemeal pitta bread with tuna & salad (or other protein filling)
Soups with added protein e.g chicken, bacon or lentils/pulses etc.
Super salad (packed with lots of veg) with a choice of protein e.g salmon
Leftover dinner from night before
Don't forget the breakfast ideas are also ideal lunches too!

ASPARAGUS, PEA AND LEEK SOUP (<15mins prep)

INGREDIENTS
8 asparagus spears (roughly chopped)
1 leek (finely sliced)
200g frozen peas
Olive oil
Salt and pepper to taste
Place a tablespoon or olive oil in a saucepan. Fry the asparagus and leeks in the oil until soft. Add the frozen peas and then cover the mixture with water. Season with salt and pepper. Simmer for 10-15 minutes. Remove from heat and blend mixture with a hand blender/food processor.

ADDED EXTRAS
1) Fry up some crispy bacon, bacon lardons and use as a garnish
2) Add green beans, broccoli or any other vegetable you have available if you don’t have asparagus or leeks

SWEET POTATO SOUP (my absolute favourite due it's sweetness!)
Ingredients:
2-3 sweet potatoes
1 onion
teaspoon of cinnamon
salt & pepper to garnish

So simple:
Just fry the onions until soft, add cinamon, then add the chopped potatoes with water. Bring to the boil and simmer for 30 mins. Add garnish & blend. Sometimes I add a little dolop of reduced fat greek yoghurt too. Delicious! I would eat this alongside a small chicken wholemeal roll.

Main Meal Ideas

CHINESE STIR FRY CHICKEN & BROWN RICE (<30mins)
Stir fry spring onions, sliced carrots, sweetcorn, cabbage and chicken thighs or alternative meat until cooked. Boil brown rice until cooked (about 15 mins) and add sauce to chicken & veg (sauce: combine dark soy sauce with honey to taste for a delicious sweet sauce) and serve.

SLOW-COOKED MOROCAN STEW (<15 mins prep)
Chop lots of your favourite veg (root veg works well and adds starchy carbs such as squash parsnip) and put into the slow cooker or large pan. Add either a meat option such as lamb or chicken or lentils, add almond flakes, dried apricots and a little chilli, cinamon, paprika. Simply add enough stock to cover the contents and cook for several hours. You can always add more flavour as it's cooking if needed or cornflour to thicken to desired consistency.
I tend to wing slow cooked meals but if you need more guidance try this: https://www.bbcgoodfood.com/recipes/moroccan-chicken-stew

Tip: If you haven’t already got one, I’d suggest getting a slow-cooker, because, if you’re busy out and about during the day time, the easiest way to make healthy, nutritious food for the evening is to bung a load of ingredients in the slow-cooker in the morning, then when you come home, your house smells amazing

‘SUPER SALAD’ and choice of protein..SALADS DON'T HAVE TO BE BORING!
Ingredients: Spinach Leaves, watercress, rocket leaves, beetroot, grated carrots, fresh herbs, tomatoes, cucumber, sweetcorn, red pepper, spring onions, rocket, artichoke, avocado, olives, handful of mixed nuts or seeds, 2 tablespoons of flaxseed,

ROAST VEGGIES, CAULIFLOWER COCONUT MASH & choice of protein
Cauliflower: Steam or boil 1-2 heads of cauliflower.
When tender, place in a big bowl and add 1/4 teacup of coconut milk, sea salt and freshly ground black pepper and apply masher until you get a consistency that looks like mashed potato.

'SUPER SOUP’ with choice of protein added – bit like a dahl depending on your preferred consistency and really yummy!

Ingredients: Add onions, carrots, green leaves (like kale, spinach, cabbage) garlic, chicken or vegetable stock, ½ teacup of coconut milk, quinoa, freshly ground black pepper. Chop veggies, place all ingredients in a saucepan with sufficient water and simmer until everything is cooked.

MAcKERAL, SPINACH & VEG (WITH DRESSING)
Dressing Ingredients: Add 1 tablespoon extra virgin olive oil, 1 tablespoon of apple cider vinegar or juice of half a lemon, Himalayan or sea salt and freshly ground pepper , 1 clove of garlic crushed and a few chilli flakes. Use to dress your salad or over steamed veggies for a healthy, clean and tasty dressing.
Smoked makeral (already bought cooked). Simply fry up baby tomatoes, mushrooms and add a handful of spinach at the end of cooked for 1 minute. Serve with roasted veg or brown rice.

How about some well known favourites with a few tweeks?

COURGETTI BOLOGNAISE – home made turkey meat balls with spiraled courgette or butter nut squash or try half n half with brown pasta if needed. (<30 mins prep)
Fry onions & choice of veg, then add the sauce (or premade ratatouille) and add the meatballs to the sauce. Add stock for extra flavour, cover and simmer for 30 mins turning meatballs ocassionally very carefully. Meanwhile steam the courgetti/squash or boil the rice.

HOME MADE PIZZA using flat bread for a thin and crispy base (without the natsy transfats added to normal pizza bases!) (<15 mins prep)
Add tomato puree,lots of cooked veggies and a little cheese/mozzarrella. Pop directly onto the oven shelf at 180 degrees for 8 minutes. Serve with salad (kids love helping with this one!)

BAKES SWEET POTATO WITH CHILLI FILLING (or half n half veggie mince & minced meat) and salad. (<20 mins prep)
Rub some olive oil over a medium sized sweet potatoe and place directly on the oven shelf and bake for 40mins/180 degrees or until cooked. Simply reheat pre made veggie mince and serve with salad.
Veggie Chilli: Fry onions, garlic & courgette until soft then add diced carrots, frozen peas and I bag of veggie mince and cook for 3 minutes. Add 1 carton of passata sauce and ½ a stock cube & italian herbs and simmer for 15 mins.

BAKED FISH & SWEET POTATO CHIPS (& choice of steamed veg >15 mins prep)
Cut sweet potatoes into large wedges (skins on), drizzle with oil and bake at 220 degrees for 30-40 mins. Brush fish with olive oil and bake in oven at 200 degrees for 7 minutes or until cooked. Serve with steamed kale and a low fat mayo dressing with a squeeze of lemon for a zingy dipping sauce.

...and there you have it...Bon Appetite :-)

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Top 3 Pregnancy Back Releases

6/17/2018

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Hip Release - We love this one for helping to keep the pelvis well aligned and reduce lower back pain. Try this with a cushion under the back knee. Simply drop the tailbone a little first and transfer the weight towards the front leg (no further than the foot). Add the arm lift for added benefit and reclaim some rib space!

Child's Pose - This is a lovely release not only for the back and posterior pelvis but also for the pelvic floor muscles. You need to adjust your position as your pregnancy progresses for comfort e.g. this can be done on the elbows and with the tail bone higher and further from the heels. You will also need to take the knees further apart as your bump grows.

Chest Opener - Simply love this one for releasing the muscles of the chest, front of shoulders and the spine. Begin lying on the side, head on a cushion with one hand stretched out on top of the other. Sweep the top arm towards the ceiling and behind the body towards the floor, keeping it straight. Stop when you feel the stretch and return, repeat for however long it feels good. Repeat on the opposite side.

Give these releases a try several times per week and feel the benefits that regular stretching of your muscles can bring to your ever changing body during pregnancy.

Enjoy,

Debbie x

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Is your Pelvic Floor waving a huge red flag at you?

6/3/2018

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Ok so post birth your nether regions do feel a little different this is true and that may be completely normal, afterall things have been stretched way beyond anything else you've experienced down there right?

However, there are some warning signs which we consider as not normal which need to be checked out. These are known as red flags (waving at you to urge you to take action!)

Remember, you are NOT wasting anyone's time. It is far easier to deal with issues as soon as you suspect something may be wrong than months or years later when your symptoms have worsened and could of been prevented.

Your pelvic floor is precious and should be well cared for like any other part of your body.

Red Flags can include any or all of the following. If you experience any of the following seek help from your local Woman's health Physio. You can either visit your GP and ask for a referral or get in touch with a local private Women's Health Physio (visit my links page if you are local to me).

- Pelvic Pain/Buttock pain
- Difficulty with toileting or finishing/not feeling quite empy
- Heaviness or dragging down below (can occur after exercise or heavy lifting)
- Discomfort/pain with intercourse
- Being unable to contract your pelvic floor muscles
- Any form of incontinence if it doesn't improve in the weeks post birth (when sneezing, laughing, running, coughing) get it checked out!

Occasionally there can be no symptoms at all with some pelvic floor dysfunctions. The Mummy MOT service offered by specialist physio's can give you the reassurance you need to know you are fit for purpose!

Hope that has been insightful,

Debbie x

#pelvicfloor #mummymot #incontinence

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What happens to your abdominal muscles during pregnancy?

3/17/2018

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Here we are talking about exactly what happens to your abdominal muscles during pregnancy and some helpful tips for good abdominal care. It will also help to explain why there's such a fuss over doing the correct form of abdominal exercises post birth when you understand just what your mid region has perhaps undergone.

Here we go...

The six-pack muscle (Rectus Abdominis) runs from your breast bone to your pubic bone and is joined together down the middle with a strong fibrous sheath called the Linea Alba. In some pregnancies, the Linea Alba becomes a little darker in colour and is visible on your stomach - (see pic). This is called Linea Negra which simply means “dark line”.

You may have heard people talk about your abdominal muscles “splitting”. Your muscles don’t usually “split”, because they’re already in a separated state, as they’re held together by the Linea Alba which I mentioned above.

What happens to the abdominal muscles during pregnancy, is completely painless, you aren’t aware of it, and I like to refer to it simply as abdominal “separation”. It's correct name is a Diastasis Recti.

The Rectus Abdominis stretches vertically (up and down your stomach) to accommodate baby bump at your front, and when it can’t stretch any further up and down, then the linea alba begins to thin out and stretch and the two sides of the abdominals move further apart (horizontally - see pic). This most often occurs in the third trimester but can also begin in the second trimester.

I guess it’s a little bit like the Linea Alba is heavy duty cling film stretching apart. The muscles are nowadays thought to separate in almost all pregnancies so is very common and nothing to worry about. However there are steps we can take to try to limit the degree of separation even if we cannot avoid it (see below).

This change to our core muscles is one of the focuses at our Pregnancy Pilates class. Some people are more likely to get a separation than others and it depends on a number of factors. E.g. multiple births or carrying a larger baby to name but a few. The separation can take place above the belly button, below the belly button, or both.

The result can lead to poorer core strength/support for the lower back, pelvic floor weakness and a change in posture. But there's lots we can do to help...and most of it relates to keeping pressure off the abdominal wall (it's under quite enough as it is!)

Abdominal care tips during pregnancy & early postnatal:

- Perform the log roll in and out of bed (come onto your side to enter into and out of bed).

- Avoid hard abdominal exercises e.g planking and crunches from your second trimester

- Avoid slouching/tucking under pelvis when sitting, instead use cushions in the small of your back.

- Bring your weight slightly towards your heels when standing (ensuring you feel stable)

Doing Pilates-based exercise and pelvic floor strengthening (Kegals) during pregnancy and immediately after birth is important to help these muscles maintain strength and also assists the adbominals re-align post birth. After all, the pelvic floor muscles form the base of your core unit and is fundamental in good core function.

Whilst Pilates is great for your pregnant/postnatal body it is crucial that your instructor is pre/postnatal trained as regular Pilates classes involve work on the outerlayer (six pack muscle) which is counter productive and can cause pelvic floor issues and exacerbate / prolong abdominal separation.

So there you have it - If you want to know more about keeping those muscles strong during pregnancy or to have your core restored and abdominal muscles assessed following birth please check out our timetable to find a class near you.

Best wishes,

Debbie x

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What do cherry tomatoes have to do with pelvic floor exercises?

1/10/2018

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Nutrition Considerations For Postnatal Healing

8/6/2017

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Did you eat well and look after your body whilst pregnant? Did it all go out of the window when baby turned up?

Nutrition plays a vital role in your recovery during the postpartum period (and not just if you're breastfeeding!) Nutrient -rich foods can assist your journey back to full fitness, vitality & for successful weight loss.

So here's what's in:

Good Fats e.g oils,oily fish, nuts & seeds
Superfoods/Veg e.g berries, broccoli, kale, turkey, tomatoes & cauliflower
Hydration - 2 litres of water per day
Low GI Foods/starchy carbs such as sweet potatoes, brown rice or quinoa
Protein foods e.g eggs, lean meats, fish, nuts, seeds & pulses

Supplementation (if needed)

What's out or very limited:

• Alcohol (or limit!!) - Apart from the obvious de-hydration alcohol also has 7kcals per gram
(almost twice that of carbohydrates or protein)

• Processed/packaged/refined foods – Look at the ingredients list. If you can't buy the
ingredients in the supermarket try to avoid it. Anything ending is “ose” such as dextrose is
SUGAR and sugar is not helpful to a healing body!!! Try to make your own sauces,
marinades and meals from scratch. To save time & energy make larger batches and freeze
them!

• Sugar - Watch out for added sugar in “low fat” foods!! The fat is quite often replaced by sugar for flavour! Instead consider eating smaller amounts of the foods you enjoy. SUGAR WILL NOT GIVE YOU ENERGY! Sugar will leave you feeling depleted and wanting more!!

• Excess caffeine (1 coffee per day max!) Caffeine can irritate the pelvic floor and is not
helpful for pelvic floor recovery.

To add to the list of what to avoid - Stress/overdoing it (especially early postnatal
months). Take a little time out when possible, get support and say “yes” to help offered.
Cortisol is a stress hormone known for it's ability to prevent weight loss!!

Hope you have gained a little insight from today's blog. Of course being a new mums does make eating healthy more tricky so planning is key and of course you can still enjoy those on the "what's out" list occasionally. Perhaps the way forward is to question everything that you put in your body by asking yourself "is this food going to nourish and heal my body?" then enjoy the benefits!

Bon appetite!

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Breastfeeding & Exercise

7/10/2017

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There is no reason to avoid moderate intensity level exercise whilst still breastfeeding. But there are some considerations to be aware of to make it easier.

Myth - My baby will be reluctant to feed due to exercise changing the taste of my milk

You would have to exercise at a very high intensity for lactic acid, the by-product of exercise to accumulate enough to affect the taste of your milk.

Should I wear a sports bra if i'm breastfeeding?
Absolutely, especially if you're doing any high impact such as running or jumping activites. Breast tissue are mostly made of mammory glands, fatty tissue and connective tissue. Vigorous /high impact exercise puts breast tissue at risk of internal bleeding (due to rich blood supply), pain, sagging and stretch marks.

Unlike muscle tissue breasts cannot be “toned”, therefore, it is important to protect delicate breast tissue from any long term damage caused by exessive motion e.g. high impact exercise.

So if you are thinking about stepping up your workouts and are still breastfeeding check out the following links for nursing sports bras....they do exist! Here are a few I have found but there's probably plenty of others too. Prolonged compression of the breasts when breastfeding is not encouraged due to the risk of plugged ducts, so this may be a consideration for those prone to blockages especially.

Here are a few Maternity & Feeding sports bras links:

http://www.boobiemilk.co.uk/

http://www.amazon.co.uk/La-Leche-League-Intimates-pllover/dp/B004NDTUCO

https://www.amazon.co.uk/Leche-League-Sports-Nursing-Bra/dp/B06XTXD857/ref=sr_1_14?s=clothing&ie=UTF8&qid=1499679316&sr=1-14&nodeID=83450031&psd=1&keywords=nursing+sport+bra

http://www.rookiemoms.com/sports-bras-for-nursing-moms/

http://www.brooksrunning.com/en_us/juno-sports-bra/350025.html?utm_campaign=mc_move#pr-header-350025

My 7 Top Tips to exercising whilst breastfeeding

Wear a well fitted supportive bra or consider wearing a sports bra over your nursing bra especially for high impact exercise to reduce the risk of tissue damage
Feed just before you exercise for comfort and to avoid leaking. Baby is also then hopefully settled
Express if possible to create some “me time” away from baby or attend a baby friendly class
Avoid lying face down (prone) to exercise if uncomfortable
Perform pelvic floor exercises whilst feeding to help fit them in during the day
Take on extra fluids to replace those lost during exercise & eat a healthy diet

Reality check - You may not fully spring back to your pre-pregnancy weight whilst breastfeeding. Yes you can burn around an extra 500kcals per day if feeding exclusively but other factors such as increased hunger and hormones will ensure you maintain some body fat as reserves for baby. Now is not the time to drastically restrict your diet or worse still go on a FAD DIET. This is a time to nourish your baby and yourself as you are also repairing and needing energy. Besides, improving muscle tone and posture can do wonders for how you feel and look in your clothes!

10 benefits of postnatal exercise:

Reduces the chance of postnatal depression
Improves emotional well-being & mood (releases endorphins)
Aids recovery of core muscles including pelvic floor function - reduce stress incontinence
Increased energy....and we all need more of that right?
Gives you a bit of well earned “me time” and relieves stress
Improves sleep patterns (of mummy not baby unfortunately!)
Stretches tight muscles & strengthen weak muscles which occur during pregnancy and can be made worse postpartum (improves posture = appear slimmer)
Reduces fat stores (if combined with a healthy diet...NOT A DIET!)
Builds a sense of connectedness with other women in similar situations
Begin to feel a little like you again!

RETURNING TO EXERCISE SHOULDN'T BE RUSHED BUT IF YOU FEEL READY TO RE-JOIN THE HUMAN RACE WHAT ARE YOU WAITING FOR?

Come & join us and find a class near you today:
http://misfitmamas.weebly.com and book here: https://bookwhen.com/misfitmamas

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Your Pelvic Floor

7/5/2017

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Introducing Your Pelvic Floor by MisFit Mamas

Find Your Pelvic Floor Muscles - This complex and important set of muscles offer support for the pelvic organs, keep you continent and are an integral part of your core system giving your lumbar back and pelvis stability.

The muscles of the Pelvic Floor (PF) run from the pubic bone at the front to the lower spine (coccyx) at the back. They are also attached at the sides of your pelvis, to the bones that you sit on. They support the bladder, vagina & bowel.

They support the contents of the pelvis and are put under great strain during pregnancy and labour which isn't helped by hormones released during pregnancy to relax the soft tissues in preparation for labour. Think of a trampoline that can stretch under weight and recoil back again, only during prolonged stretching as in pregnancy they can become weakened/stretched increasing the risk of incontinence (being unable to make it to the toilet in time) or stress incontinence (leaking urine when laughing, coughing, sneezing or jogging - very common) or worse still a prolapse!

Working the pelvic floor muscles (PFM's) during pregnancy and balancing this with focused "letting go" or "relaxation" of the PFM's especially later in pregnancy is ideal).

In the early weeks following birth isolated pelvic floor exercises not only strengthens them but can help aid healing following tears during labour by increasing blood flow to that area and is the first step towards improving your core function.

The Pelvic Floor exercise is just one element of the overall picture for pelvic floor health. Posture, daily movement, good nutrition/hydration and a balance of muscle strength & flexibility are also necessary.

PAIN RED FLAG! Any pain in the pelvis or pelvic floor area is a red flag. Don't ignore it! Some women struggle with an over active pelvic floor that is in a permanent contracted state and unable to relax. Some of the symptoms can include pain (or pain during intercourse) and incontinence. A tight pelvic floor is also a weak/dysfunctional pelvic floor after all.

If suffering from incontinence speak to your midwife/G.P

To improve the symptoms of stress incontinence try to perform some pelvic floor exercises but if there's no improvement seek a referral from your G.P.

For a weak/lengthened pelvic floor commit to daily pelvic floor exercises and avoid anything that causes you to leak or increases pressure:

high impact exercise e.g. jogging (jogging too soon post birth can lead to further damage!)
lifting heavy objects, sitting straight up from a lying position or being constipated (creating abdominal pressure which puts strain on the weak abdominals and pelvic floor)
Slouching or sitting with the pelvis tilted backwards (this can shorten the pelvic floor which can add to pelvic floor dysfunction!)

How to do Isolated pelvic floor exercise (can be performed within 24hrs of birth):

Slow contractions – On a slow exhalation through pursed lips (think blowing out a candle), "zip up" the back passage (as if to stop passing wind) to the front passage (as if to stop the flow of urine – do not practice this on the toilet! Or imagine moving the coccyx towards the public bone). Pull the pelvic floor muscles upwards as far as you can (to your imaginary 10th floor) over the count of 5 seconds. Hold for up to 5 seconds (whilst breathing) and release slowly. Rest for several seconds and repeat up to 10 times in total, 3 times per day.

Fast contractions – Draw up as above but fast on exhale (in one second) and release quickly on inhale (in one second). Perform 10 in total, 3 times per day.

When & how to do them:

Whenever you can e.g watching TV/adverts, feeding baby, washing the dishes-form habits!!
Easier – lying down then progress to sitting or standing (this adds gravity to pull up against)
Easier still - try performing in a child's pose position (kneeling and sitting back on heels.)

Not feeling anything happen down there? Don't panic....they will get stronger the more you practise. If you don't feel them working after several weeks there could be some nerve damage and it's probably worth visiting the GP.

YES THEY ARE BORING & TEDIOUS BUT A GOOD STARTING POINT FOR PELVIC RECOVERY AND BETTER THAN A LIFETIME OF SPARE KNICKERS IN YOUR HANDBAG!!! JUST KIDDING!!

URINARY STRESS INCONTINENCE IS NOT SOMETHING YOU SHOULD BE LIVING WITH - IF IT DOESN'T IMPROVE SEEK HELP! YOUR GP CAN REFER YOU TO A WOMEN'S HEALTH PHYSIOTHERAPIST (check out the Mummy M.O.T service on this page!)

Pelvic floor muscles however don't work in isolation so integrating pelvic floor exercises into an exercise routine is also beneficial to which is something we do in class.

LEARN HOW TO SUPPORT YOUR PELVIC FLOOR FUNCTION FOR LIFE & HOW TO INTEGRATE THE PELVIC FLOOR INTO DYNAMIC MOVEMENT BASED EXERCISES IN MY MUMMY & BABY PILATES CLASS or PREGNANCY PILATES.

Debbie x
Prenatal & Postnatal Exercise Specialist

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The Dirty Dozen – 12 Hard Facts of Childbirth and 3 reasons why all women should have post-natal rehab by Kate Walsh, guest blogger

6/29/2017

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I'm very excited to have our very first guest blogger today, our very own local specialist pelvic health physiotherapist Kate highlighting some not so pretty hard hitting postnatal facts. Brace yourself...but seriously we all know prevention is better than cure don't we and that KNOWLEDGE IS POWER right?

My name is Kate Walsh, I have worked as a specialist physiotherapist in the field of pelvic health on Wirral and Merseyside for 15 years. We are now delivering a service called the Mummy MOT which links post-natal recovery with return to functional fitness, including the holistic core restore exercise programme.

The Dirty Dozen – 12 Hard Facts of Childbirth and 3 reasons why all women should have post-natal rehab.

There’s a reason I do what I do – and they are the statistics below. I am not trying to scaremonger, simply stating facts, in the hope that women will take notice. It enrages me that the post-natal rehabilitation of women, their bladders, pelvic floor and other abdominal organs & functions are not more prevalent in this country.

We cannot let another generation of childbearing women suffer these terrible consequences when so many of the symptoms are controllable, improvable and even surmountable given the right treatment, exercises and advice.

Here are the Dirty Dozen top 12 shocking stats you need to know about life after childbirth…

50% of women experience pelvic organ prolapse with symptoms of bladder and bowel dysfunction. (Hagen et al 2004)

50% of women who have had children have some degree of symptomatic or asymptomatic pelvic organ prolapse. (Hagen & Stark 2011)

In women with vaginal prolapse, 63% will experience urinary stress incontinence. (Bai et al 2002)

Urinary incontinence during pregnancy nearly doubles the likelihood of urinary incontinence at three months post baby (regardless of delivery method, so Caesarean section or vaginal). (Eason et al 2004)

Women who are incontinent before pregnancy are 5 times more likely to leak after birth than women who are continent before pregnancy. (Sampselle et al 1998)

52% of women with lower back pain during pregnancy were found to have pelvic floor dysfunction (Study by Pool-Goudzwaard et al 2005)

a study of 1004 women with pelvic organ prolapse showed that straining on the loo is associated with anterior vaginal wall and perineal descent. (Kahn MA 2005)

52% of women with a pelvic floor dysfunction (stress urinary incontinence or pelvic organ prolapse) have a Diastasis Rectus Abdominis. (Spitznagle et al 2007)

66% of women with a diastasis recti abdominis have a pelvic floor support dysfunction (stress urinary incontinence or pelvic organ prolapse) (Spitznagle et al 2007)

45% have urinary incontinence 7 years post natally. (Wilson et al 2002)

36% have rectus diastasis abdominis 8 weeks after delivery. (Boissonnault 1988)

Prevalence of stress or urge incontinence and intravaginal prolapse was 42% in women with one or more vaginal deliveries as opposed to 35% in women who had a C-section delivery. (Sakala 2006)

And my top three stats on why we should have post-natal rehab for every mum…

Training post birth after experiencing pelvic girdle pain in pregnancy using a specific stabilisation exercise programme, results showed significant reduction in pain and 50% reduction in disability. This tells us that specific stability exercises are useful for reducing pelvic girdle pain after pregnancy. (Stuge et al 2004)

Retraining muscle after injury is essential as inhibited muscle does not automatically reactivate and retrain. (Stener & Petersen 1962)

A survey of 115 postnatal women found that after 8 weeks the gap between the rectus muscle - the inter recti distance or recti diastasis - will not change without intervention. (Coldron 2008)

Kate Walsh
Specialist Physiotherapist Pelvic Health.
www.continencephysio.com

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The Dirty Dozen – 12 Hard Facts of Childbirth and 3 reasons why all women should have post-natal rehab by Kate Walsh, guest blogger

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