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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?
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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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To Plank or Not To Plank?

6/29/2017

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We all love a good plank challenge but for some of us it's perhaps not the best choice of exercise especially if you are a new mum, here's why.

Planking increase intra-abdominal pressure. This pressure creates a great force on the abdominal wall and your pelvic floor. As these are the muscles most likely weakened during pregnancy they are not going to thank you for it as they struggle to cope and you may cause yourself more harm than good particularly if you have an abdominal separation (Diastasis Recti where the two sides of the abdominal muscles move away from each other on the right and left side of the body) or a weak pelvic floor.


Your body is ready to begin planks when:

1. Your tummy separation is no longer an issue and adequate tension/strength has been achieved e.g. see point no. 2!
2. When planking your tummy IS NOT pushing outwards (towards the floor) meaning your core muscles can cope with the pressure otherwise the force put upon the abdominal wall may cause more issues for any separated abdominals!
3. Your pelvic floor is reasonably strong (no leaking when sneezing/coughing etc)
4. Planking DOES NOT cause you back pain.

If all above is fine:

1. Begin with a plank on the knees (straight line from shoulders to knees)
2. Start with short holds (e.g 10 seconds, rest & repeat and build up)
3. NEVER hold your breath but DO engage your pelvic floor and abdominal muscles!
4. Remember press ups can use a plank position too so be cautious here too!

Why do you want to plank anyhow? If it is to lose tummy weight the most effective way is to focus on your diet (by that I don't mean go on a diet), enough protein and good fats but reducing sugar/refined carbs and combine with resistance training (building muscle will not only increase metabolism but will help you do all your daily mummy tasks better too!) 

A great phase  - "You can't out train a bad diet" No matter how much exercise you do if the diet isn't right your tummy won't shift!

Debbie x

P.S Find a class near you in Liverpool or Wirral here:https://bookwhen.com/misfitmamas or find us here: https://www.facebook.com/misfitmamas1/

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When is it considered safe to run post birth?

6/29/2017

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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.

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 then guess what? Your pelvic floor ligaments may 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!

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/postnatal-classes.html



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

Debbie x
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