Your pelvic floor – how to build pelvic floor rehab into your day to day

Your pelvic floor – how to build pelvic floor rehab into your day to day

I’m doing two FREE workshops next week: Your Confident Mothermorphosis for you beautiful bumps, and a pelvic floor restore workshop at Level Six Peckham next Thursday morning 6th December, babies welcome – come along if you can.
If you don’t already, you can follow me on Instagram @mothers.wellness.toolkit – I share there lots of postnatal healing and pelvic floor information, and Pelvic Floor Meditation live on Insta at 7.30pm on Mondays, which stays on my stories for 24 hours.
woman holding baby while sitting on fur bean bag
Photo by Daria Shevtsova on Pexels.com

But I’m a mum – I don’t have any time!

Remember there is never a “perfect time” to focus on your postnatal rehab. You have to build it in to the time you already have and try not to feel that it’s a “to do” pressure to feel the weight of. Doing 3 minutes here, 3 minutes there is much more valuable for your core health than trying to make time for an hour a week.
It doesn’t have to be a “full workout” to be effective. 7 minutes a day is valuable, remember. Build it up as and when you can. When pushing your buggy or baby wearing, take a moment regularly to breathe, really fully deeply breathe and soften your shoulders.

Your mum posture day to day

Check in at least once a day with how you are carrying yourself. Either stretch against the wall: stand against the wall facing perpendicularly away, place your hand onto the wall. The rotate away from the wall, straightening your arm. You should feel a stretch in your pecs. Or: lie on your back with your arms outstretched and draw snow angels in the floor.
Most importantly, think about your A, B, Cs: Alignment, Breathing, Centring, with your every day movement.
  • Alignment: release yourself into the ground at least once a day: lie down, breathe, soften, legs up the wall is ideal.
  • Align your ribcage directly over/in line with the pelvis whenever you can, to restore the natural momentum within your torso: diaphragm over the pelvic floor.

Breathing is your number one tool for healing

You carry it around with you daily. Use it, it’s free, you don’t have to do anything “extra”, plus it will calm and soothe your nervous system. Breathe. It’s SO important. Breathe well, and your pelvic floor health will benefit.
Remember – 5 deep breaths is all it takes to soften you out of fight or flight mode.
Remember when you’re picking up your baby/carseat/squatting down/getting up from the floor blow as you go: 
Breathe OUT to lift UP your pelvic floor when you pick up your baby, lift the carseat, sneeze, etc.
Lifting your baby in a carseat places more load on your pelvic floor than any sit up will.
Pelvic floor exercise will help heal any diastasis abdominal separation, it’s your deep abdominal wall that you want to strengthen, and this works together alongside the pelvic floor.
Don’t be afraid to move. But build your INNER STRENGTH adequately before you start high impact work such as running and HIIT.

Can I run while I’m leaking wee?

If you are running and also leaking, or feeling like you’re “falling out” – the simple answer is to stop running. Running while experiencing pelvic floor dysfunction is a bit like wallpapering a newly built wall before the plaster is dry. It’s temporary. Build the strength first, and then test it. Don’t test it simultaneously while you’re still building it, it’ll be like jumping into a boat which has a hole in it.
Download the Squeezy app without delay. 3 minutes, 3 times a day is all it will take to see some difference.
If you are experiencing urinary or faecal incontinence, DON’T IGNORE IT. DON’T LAUGH IT OFF. DON’T JUST REACH FOR A TENA PAD.

PELVIC FLOORS ARE FOR LIFE

Your pelvic floor will not magically get better on its own. It needs attention and care, and then it will work loyally and diligently for you in return.
THINK TENNER NOT TENA: imagine lifting a ten pound note up into your vagina. Hold it for 5 seconds, then drop it down.
Other resources to have a look at: Pilates by Georgia is a physio and Pilates teacher, and on facebook she shares free workouts which are postnatal pelvic floor friendly.
Her website is Home | Pilates By Georgia where you can do a 2-week trial for free or you can pay a subscription for her workouts, some of which are really short and really easy to squeeze in (if you’ll excuse the pun).
Advertisements
Pregnancy and Postnatal mindfulness and core strength workshops

Pregnancy and Postnatal mindfulness and core strength workshops

I’m excited to be adding two monthly workshops to the schedule in the new year. I’d love to hear your thoughts, and if you’re in south London, come along!

For mums to be

Your Confident Mothermorphosis

A workshop introducing a toolkit of tips to help you release anxiety and soothe your body as you enter the next phase of your life. This workshop uses techniques from Pilates and mindfulness-based cognitive therapy (MBCT) to connect to your body and calm your mind and spirit, enhance your feelings of self-compassion and confidence in the journey ahead. Including a guided meditation and breathing techniques which will equip you well both for your birth experience and into early motherhood.

For mums

Pelvic floor and core restore

Pilates for postnatal rehabilitation. This workshop focuses on breathing, alignment and pelvic floor awareness, releasing tension and finding your deep inner strength – suitable if you’re suffering from diastasis recti. Find out how to connect to your centre in your day to day activities rather than make time for “pelvic floor exercise”. Rebuild your foundations to feel more energised in your mothering day. We’ll finish with a short (baby-friendly) guided meditation to leave you relaxed and uplifted.
How do you feel about your pregnancy and early motherhood experience? I’d love to hear. Get in touch and tell me your story xxx
073A9336
My book Pilates for Pregnancy is available now
Twitter banner
The Supermum Myth Anya Hayes
The Supermum Myth
Diastasis recti – how to strengthen your separated abdominals post-birth

Diastasis recti – how to strengthen your separated abdominals post-birth

Around the second trimester, depending on the size of your bump, you will have experienced some degree of abdominal separation: diastasis recti. The rectus abdominis muscle is your “six-pack” muscle. It runs down your front, from your breastbone to your pubic bone: two segments running vertically parallel and intersected by a fibrous band, the linea alba.

In a brilliant design feature of the human body’s adaptability, as your bump grew, the linea alba stretches to allow your baby more space. The two bands of muscle stretch away from the centre. This is most likely to begin at the navel as that is where your baby usually requires most room.

This is a normal structural adaptation, you can’t necessarily prevent it, and neither would you want to – it is a design specially created for your baby’s comfort and growing power. Around 30% of women experience this abdominal separation in the 2ndtrimester, with a further 66% separating in the third trimester. Some research says that 100% of women have some level of diastasis of the rectus abdominis by the third trimester (Gilliard and Brown 1996, Diane Lee 2013). Look at those stats again: 100% of women have this happen at some point to some degree during pregnancy.

The extent of your abdominal separation depends on a number of factors:

  • Your abdominal tone pre-pregnancy
  • If you carried more than one baby
  • If you’ve had more than one baby
  • If you gain a lot of weight, or if carried a big baby for your height, your baby will have had less space and needed to “pop further out”
  • Age plays a part: it can be worse if you’re over 35
  • Lack of regular exercise
  • Postural load – are you stooping/lifting constantly without care for your technique and form?

IMG_2241

Mind the gap

Until quite recently we’ve talked in fearful terms about THE GAP, and the need to “close the gap” postnatally. But actually we now know that it’s not the width of the gap that is the issue: it’s whether or not there is deep tone of the supporting muscles underneath that matters. You could have a 3-finger gap, but as long as your core muscles are firing properly and you can manage your intra-abdominal pressure – the pressure in the space between your respiratory system (your diaphragm) and your reproductive system, placing load out into your belly or down into your pelvic floor – this gap is considered to be “functional”, i.e. not a problem. You may never “close the gap” completely, but as long as you have tone supporting the linea alba, this is ok. So: a problematic diastasis recti is one where there is soft squishy tissue rather than tensile active tissue underneath the linea alba “gap”, therefore not truly supporting your core in movement and leaving you vulnerable to injury and pelvic floor issues.

Diastasis used to be considered a purely cosmetic issue, merely a cause of the “mum tum” or “postnatal pooch” – and dismissed roundly by GPs as a result “ah well you’ve had a baby what do you expect?”. But this is heartbreaking for me to hear of so many women fobbed off when they inquire about DR. There is a direct correlation between a diastasis lacking tone, and the impact and load placed on your pelvic floor and your spine. In essence: if you have a serious gap, you my also experience back pain and/or symptoms of pelvic floor dysfunction.

Diastasis has an effect on the strength and action of your oblique (waist) muscles, and mayhave an impact on the ability of your abdominals to control the pelvis and spine – this in turn could possibly be a cause of back and pelvic pain, if the integrity of your core support isn’t given some scaffolding with strength and conditioning exercises (such as Pilates).

You might have noticed when you were pregnant that when you got out of bed or even up from sitting, there was a strange doming in your stomach, a bit like an alien pushing out, or a Toblerone triangle. As a rule of thumb, you don’t want to see that doming any more. We don’t want to be in a position where you’re putting your muscles under pressure and encouraging it to happen. If you see it when you lift yourself out of bed or off the floor, try rolling over onto your side and pushing yourself up with your hands, rather than using your abdominals.

Continue to avoid ‘regular’ exercises – even if you get the “all clear to exercise” from the GP at your six week check up, unless they have actually palpated your abdominals to check for a DR, please don’t rush back into traditional ab exercises, oblique strengtheners (twisting curl ups and side planks), or any loaded rotation and definitely avoid getting back into running or any other high impact exercise just yet. Erring on the side of caution is always the best policy – despite what some celebrity trainers might suggest on their glossy Instagram feeds.

Excessive abdominal training when a diastasis is present, particularly with twisting movements such as oblique curl ups, can cause a downward pressure in the abdomen through the pelvic floor, which will pull the already weakened linea alba further out to the sides.

Diastasis recti doesn’t always resolve itself on its own, the first 8 weeks are where the main natural healing takes place, and if yours is still a problem gap after this point it needs conscious training and dedicated deep core healing work.

You can hear me chatting about diastasis recti on BBC Radio here. Any questions about postnatal healing – get in touch!

My new book Pilates for Pregnancy is available now

Twitter banner

Be the mum you want to be

Be the mum you want to be

Hello, my name is Anya. Lovely to have you here.

Anya Hayes author and speaker
I help women who are experiencing challenges in their postnatal recovery to strengthen their pelvic floor, restore their core and rebuild their vitality, in body AND mind.
It breaks my heart that too many women put up with postnatal physical discomfort and dysfunction, critical inner dialogue and overwhelming anxiety… and think that it’s “just part of being a mum”, or “just the way they are”.


Body image is so intrinsic to our sense of identity and self-esteem – and inner power! If you feel your body has let you down, or you’re feeling weak and uncomfortable every day, this is going to have a dripping tap effect on your energy and happiness levels.
Tapping into your source, unlocking your power can transform your day to day, from your mood to your relationships and productivity.

NOW is the perfect time to focus on your wellbeing and strength. Don’t delay it any more.
Get in touch if you’d like to work one to one or come to a group class, or keep following this blog for more information and advice. Get in touch! I’m always here to answer your questions. 

Tell me – what is it that you plan to do with your one wild and precious life?

Have a wonderful day
xxx

Anya Hayes The Supermum Myth

Build the right foundations

Build the right foundations

I’ve just taught my Pelvic Floor Health and Wellbeing course at Market Studios in Greenwich. It’s my favourite course to teach – and today there was a teeny weeny 10-week old baby there, which is always the best part of my job, soaking up the baby cuddles.

woman holding baby while sitting on fur bean bag
Photo by Daria Shevtsova on Pexels.com

One of the mamas there was talking to me about her pelvic floor situation. Her baby is nearly a year. She’s been going to physio for 6 months, she’s downloaded the Squeezy app, she’s been doing everything right…. “but I’m still leaking when I run so I feel like my healing has flatlined”.

So, you’re still leaking when you run? Yes.

Did you stop running at any point in your recovery or have you run from pretty much since you could strap on your trainers since having your baby? I’ve run since I first had the energy to, yes.

But you’re still leaking? Yes.

And running anyway? Yes.

And feeling frustrated? Yes.

Have you considered that although you’re doing all the right exercises to build your strength, you’re also simultaneously running to challenge that fledgling strength at its most highest impact, which may be akin to re-plastering a wall in your house but then trying to wallpaper it before the plaster is dry?

Ah…no…

I really get, I SO understand, how much we want to “get back to normal” post-baby. So much of our identity is intertwined in our looks and how we FEEL inside. And if you’re a runner, running is in your legs and in your heart and it can feel totally alien to consider not running. BUT. But. You must build the appropriate strength to withstand the force of running. Otherwise any good that you’re doing will be chipped away as soon as soon as you can say Kegel.

Patience is so tricky in our world of immediate instant gratification and of the Bounce Back, and pictures of the Duchess of Cambridge looking immaculate hours after having her baby (was her hair being blow dried actually while she was still in labour, I wonder??) don’t help our feeling of not being good enough, not healing fast enough, not being enough.

But believe me when I say that slow and steady really does win this race. And better still, don’t see it as a race but a lifelong meander. Your long term pelvic floor health will appreciate the extra month or so you took to look before you leap forward. To hesitate before you HIIT. Breathe before you burpee.

Breathe. Be kind to yourself. Honour your long-term healing. Stop running if you’re weeing. You’ve knocked down a supporting wall in your house. You need to build that back up before you build on the loft extension. It will happen, but it takes time, love, patience and commitment.

And I’m here with you all the way.

How is/was your postnatal healing? I’d love to hear your stories. We need to smash the stigma of pelvic floor dysfunction. Let’s keep the conversation going.

cropped-twitter-banner.jpg

Once postnatal, always postnatal

Once postnatal, always postnatal

There’s a general misconception about the “postnatal period” – differing opinions that it lasts from around 6 weeks…some say 9 months, others a year.

IMG_2241

Well, I say, if you’ve ever been pregnant and given birth, you are postnatal forever. Pregnancy and birth have profound effects on our systems, on our emotions and bodymind. And there is no “returning to normal” after this, there is only a new normal being established.

This is not to say that you are forever weakened. Not at all – only that if you don’t allow yourself space to heal properly, to strengthen adequately and completely, if you rush it, take on too much too soon, or skip over the basics, you may carry with you effects of your pregnancy and birth forever, in weakened core and unbalanced muscles, in compromised breathing power.

IMG_2246

Particularly useful for the first days, weeks (and years!) after you’ve had your baby are exercises that allow you to switch off tension, soften and tune into your breath. We never stop needing to learn to relax and soothe your body and soul. This in turn will stimulate your circulation and therefore your healing: Legs up the wall, Pelvic floor: Deep belly breathing, releasing back over a yoga bolster or big ball.

A big Pilates ball (Swiss ball) can be a great help in these early days: not least as a way of soothing a crying baby: gently bouncing or rolling your pelvis in circles or figures of 8 on your ball while holding your newborn or with newborn in the sling is a lovely way of mimicking the movement your baby is used to in the womb, and a great way of settling. It is also a good way of establishing a gentle pelvic floor lift and naturally encouraging your stabilising postural muscles to activate. Make sure you are securely balanced with your feet fully connected down to the ground, or place the ball up against a wall if you feel at all insecure with your balance.

Your pelvic floor

Your pelvic floor has been through a lot. Nine months (maybe more) of pregnancy followed by being battered by your baby’s head pushing through the birth canal, possibly having stitches or tears. Your perineum will be feeling very bruised. Even if you had a caesarean, your pelvic floor will have been under immense pressure throughout your third trimester.

Although you might not think it’s appropriate if you’re sore and tired, pelvic floor awareness “exercises” can and should start around 24 hours after birth. If you’ve had stitches don’t worry about disturbing them by starting pelvic floor work, actually the opposite is true. Trauma to the pelvic floor can begin to heal by encouraging blood circulation to the area, which will help to reduce swelling. As your healing progresses and you become more mobile, start to “exercise” your pelvic floor in different positions: lying down, sitting, standing. Think about your pelvic floor in your regular daily activities which is when you most need them: when you’re standing up from sitting, picking your baby up, pushing your baby’s buggy, carrying shopping while putting your baby in the car seat, etc. Remember it’s never too late to begin to heal your pelvic floor! Even 20 years postnatally you can make some difference in pelvic floor health with dedicated practice. The pelvic floor responds beautifully to care and attention. It fares less well with a blasé attitude of ignoring its needs and hoping they go away.

IMG_5540

I really recommend downloading the Squeezy app, which has regular prompts and comprehensive information about pelvic floor exercise, how to locate your pelvic floor properly, how to learn to release it. Most importantly, to remember to include it into your daily repertoire of self care as a non-negotiable just like teeth brushing.

And – however many years postnatal you are, it’s always worth seeing a women’s health physio – check out Mummy MOT to find one in your area.

Your emotional health

It’s a rollercoaster time, the newborn phase…and motherhood! It’s a watershed of all of the anticipation of the past nearly year, finally holding your baby in your arms (and even more if you’ve been trying for a while). You will probably feel exhilarated and ecstatic. But you also might feel pummelled by your experience, a bit shocked and really, really tired. Be honest with those close to you, and try to be gentle with yourself. Be careful about allowing hundreds of visitors in to see the baby if you really don’t feel up to it. It is an immensely joyful and lovely time taking your baby home, but it is also unprecedentedly stressful, and if you’re trying to establish breastfeeding it can have a detrimental effect to have visitors vying for your baby’s cuddles.

Give yourself a break if you don’t feel 100% happy every moment. If you are feeling very on edge, anxious, or detached and depressed, reach out to your health visitor or GP and ask what support there is available. There should be no stigma to mental health issues postnatally, so please don’t succumb to “I’m fine” syndrome, if you’re anything but. Each phase of motherhood brings different challenges, things get easier but something else always gets harder. Your sleep deprivation might accumulate and have an effect on your resilience. So be kind to yourself. Always come back to your breathing tools, be aware of the physical symptoms of stress and anxiety.

You might feel low or even be despairing about your postnatal body. But remember this time of recovery is so crucial that you will reap the most rewards if you don’t rush it. Try to go against the societal grain and cultivate some compassion for your amazing wonderful body which has done so much miraculous work over the past year. IT TAKES TIME to recover your strength. And, like it or not, HIIT, “body shreds” and Power Pramming is not the way forward initially, which can be a bitter pill to swallow if you were a gym bunny pre-children. Be patient with yourself. Be the tortoise not the hare. It is really important to take the time to recover well and fully from childbirth, to help prevent problems with future pregnancies and in your pelvic floor for life.

Why Pilates is so perfect postnatally

Pilates focuses on releasing tension, breathing, and strengthening the deep abdominal muscles and pelvic floor, it will help you restore and bring you back to strength and functionality. With Pilates you heal your body from the inside, correcting your alignment and optimising your body functions once more. You begin to learn about your body, reconnecting can help foster a positive feeling about your body – which is particularly important if you have any sense that your body has “let you down”. Being a mum is hard work, physically hard graft, and Pilates helps to iron out the demands small people put on you, and offer you a coat of resilience.

Here’s the lowdown on what you need to know after you’ve had your baby – whenever that was!

  • Breathing is the starting point for your recovery, physical and mentalYour breathing is so important to enable you to release tension and anxiety, to allow your body space to recover from your birth experience. Breathing is intrinsically connected with the efficacy of your abdominals and pelvic floor, as the diaphragm has to learn how to communicate with your pelvic floor now that your baby has evacuated the space between them.
  • NO SIT UPS. NO CRUNCHES. NO PLANKS. These are strictly contra-indicated in the early stages of your postnatal recovery, due to weaknesses caused by diastasis recti, and due to causing an increase in intra-abdominal pressure which in turn increases the load placed on your pelvic floor.
  • Diastasis recti. The superficial layer of your abdominals (your rectus abdominis – your six pack) has become separated due to stretching of the linea alba “fascia”, the connective tissue that holds the two bands of muscles together. Trying to “strengthen” these abs to close the gap is not the solution. We need to strengthen the deeper stabilising muscles: the pelvic floor, the transversus abdominis, and, fundamentally, get the diaphragm firing properly.
  • Bum deal. Your pelvis has taken most of the burden of carrying your baby, so we need to give it some strong scaffolding. Your hormones are still flooding your system, which will keep your ligaments and joints unstable for up to 9 months (and if you are breastfeeding, potentially longer), so it is important to regain strength and functionality in your glute muscles, to stabilize your lower back and hips. They are particularly important if you want to eventually get back into high impact movement such as HIIT and running.
  • Posture matters. Everything hinges on your alignment in terms of your body systems working effectively post-birth. No amount of pelvic floor exercise will be truly effective if your alignment is poor. Plus, you will do a lot of lifting and bending when you have small children so it is important to strengthen the posterior chain of your muscles – the muscles at the back of your body so important for good posture – especially if you are breastfeeding. Your posture also has an influence on Diastasis Recti, and the relative pull on your abdominal muscles from your daily movements.

How do you feel since having children? Are you preparing for birth/pregnancy? Has this article helped? I’d love to know! DM me or comment below xxx

My next book Pilates for Pregnancy is available for preorder now.

IMG_4348

You’ve just had a baby! What now?!

You’ve just had a baby! What now?!

It’s a rollercoaster time, the newborn phase. It’s a watershed of all of the anticipation of the past nearly-year, finally holding your baby in your arms (and even more if you’ve been trying for a while). You will probably feel exhilarated and ecstatic. But you also might feel pummelled by your experience, a bit shocked and really, really tired. Be honest with those close to you, and try to be gentle with yourself. Be careful about allowing hundreds of visitors in to see the baby if you really don’t feel up to it. It is an immensely joyful and lovely time taking your baby home, but it is also unprecedentedly stressful, and if you’re trying to establish breastfeeding it can have a detrimental effect to have visitors vying for your baby’s cuddles.

IMG_2250

Give yourself a break if you don’t feel 100 per cent happy every moment. Emotions run high and ‘baby blues’ are to be expected a few days after birth, usually coinciding with your milk fully coming in (whether you breastfeed or not) and the exhaustion of 24-hour days taking its toll. If you are feeling very on edge, anxious, or detached and depressed by the time your six-week check comes around, please reach out to your health visitor or GP and ask what support there is available. There should be no stigma to mental health issues postnatally, so please don’t succumb to ‘I’m fine’ syndrome if you’re anything but.

Keep a close eye on your mental health for the first year of your baby’s life – and beyond. Each phase of motherhood brings different challenges; things get easier but something else always gets harder. Your sleep deprivation might accumulate and have an effect on your resilience. So be kind to yourself. Always come back to your breathing tools, and your awareness of the physical symptoms of stress and anxiety.

 

IMG_1116

Now is NOT the time to be thinking about ‘getting your body back’. You have your body now and it’s incredible. Look what it created!

Clients often say to me that in the postnatal period they feel like their body isn’t their own. You might have loved your baby bump, and now your belly wobbles like a deflating water balloon. It’s hard to come to terms with, and you must be patient with yourself. Internally it feels like everything’s been swapped around, as if all the furniture in your house has been surreptitiously rearranged, and maybe a supporting wall has been knocked down. I will not hear of you wanting to get a at tummy or be back in your skinny jeans. This is about connecting to your body, re- establishing your breathing, your pelvic floor, your awesome abdominals that have housed your baby for the past nearly-year.

You might feel low or even despairing about your postnatal body. But please, this time of recovery is so crucial that you will reap the most rewards if you don’t rush it. Try to go against the societal grain and cultivate some compassion for your body, which has done so much miraculous work over the past year. IT TAKES TIME to recover your strength. And, like it or not, HIIT, ‘body shreds’ and Power Pramming are not the way forward initially, which can be a bitter pill to swallow if you were a gym bunny pre-children.

img_6857

Be patient with yourself. Be the tortoise not the hare. It is really important to take the time to recover well and fully from childbirth, to help prevent problems with future pregnancies and in your pelvic floor for life.

My new book Pilates for Pregnancy is out in August – preorder it here!

Returning to “normal” post-baby

Returning to “normal” post-baby

img_3811

  • You have a baby. You take it relatively easy for the first 6 weeks, maybe doing the odd squeeze of your pelvic floor (clenching your buttocks hopefully and raising your eyebrows?) when you remember/can be bothered, but you’re itching to get back into it and “lose the baby weight”, “get your body back”. Pictures of Kardashians pinging back into their pre-baby shape make you feel like you’re lagging behind, being lazy, stuck somehow “doing nothing” under your baby when there are other more important things to do. You feel like 6 weeks is a LIFETIME before you can be “signed off as back to normal” and ready to get stuck into regular activity, sign me up for baby Zumba now please!
  • Even if you’ve been “signed off” at your 6-week check, this should be seen as the START line of the marathon of your body healing itself, not the finish line. Your 6-week check is often cursory and currently skips over some fundamentals of your healing.
  • The 6-week check usually marks the formal end of maternity care, and you may think woo hoo I’m good to go, hot baby spinning Zumba here we come! – but at six weeks your body is not yet healed. Too often the GP only has time to offer you a quick glance and doesn’t ask you in depth about pelvic floor healing or check your abdominals for separation (see below). So you shouldn’t take it as read that you’re now all clear to get into high impact exercise – particularly if you weren’t an avid exerciser before pregnancy.
  • Six weeks leaves just enough time for your organs to settle back to their original position once baby has evacuated that space, and the first stage of soft tissue healing. And potentially it takes much, much longer if you’ve had a caesarean. It can take several months for the abdominal and pelvic muscles to recover fully, and for the connective tissue to completely firm up. Your body is healing, there is so much going on under the skin that you can’t see, it needs nurturing and kindness.
  • Running and HIIT exercise appeals to mums because it requires no equipment, costs nothing, and can be crowbarred fairly easily into a suddenly-chaotic yet full-of-nothing-much day. You think getting back into it will make you feel great, lose all the weight, find your mojo. And it might. There’s no doubt about the importance of exercise for wellbeing. But going straight into high impact activities like running if “my 6-week check was fine” (did the doctor specifically say anything about exercise?) may not be the best plan for your long term healing.
  • Breathing is the most crucial starting point for your recovery, physically and mentally. Sooo boring, right? Well, your breathing enables you to release tension and anxiety, to allow your body space to recover from your birth experience, to move you from “fight or flight” into “rest and digest” mode. Breathing is intrinsically connected with the efficacy of your abdominals and pelvic floor, as the diaphragm has to learn how to communicate with your pelvic floor now that your baby is no longer hogging the space between them. Breeeeathe, wide and full into your belly, allow your diaphragm to fully descend and open and it will stimulate the conversation between the pelvic floor with its symmetrical rise and fall motion. It’s the most overlooked healing tool we have: it’s free, you’re doing it anyway might as well make it count, it doesn’t take any extra time ladies.
  • Diastasis whatsi? Diastasic recti – abdominal separation. Your rectus abdominis – your six-pack muscle, has separated during pregnancy due to stretching of the linea alba ‘fascia’, the connective tissue that holds the two bands of muscle together, sort of like unzipping at the front. Trying to flatten the mum tum with sit ups is not the solution as it will make the separation worse. We need to strengthen the deeper stabilising muscles: the pelvic floor, your corset muscle the transversus abdominis, and, fundamentally, get the diaphragm firing properly with proper breathing.
  • I’ll say it again because it’s so important: NO SIT-UPS. NO CRUNCHES. NO PLANKS. These are strictly contra-indicated in the early months of your postnatal recovery, due to weaknesses caused by abdominal separation – and if you’ve never been checked for ab separation, this rule applies for years after postnatally. If you’ve got diastasis it is going to cause problems however “new” or old a mum you are. ‘Ab exercises’ cause an increase in intra-abdominal pressure, which in turn increases the load placed on your weakened pelvic floor – sort of like building a loft extension on top of a house where you’ve knocked down a load-bearing wall. It’ll cause back pain, may exacerbate pelvic floor problems, it’ll make your foundation weaker not stronger.
  • If you do go to a buggy running-type group, or attend any fitness group in the year after your baby, your instructor MUST check your abdominals for separation and at the very least ask you in detail about your birth experience, how your pelvic floor is feeling, whether you experienced pelvic pain during your pregnancy. If the PT or instructor omits any of these essential postnatal duty-of-care issues, and particularly if they launch into AB EXERCISES, planking, sit-ups, leg lowers, flat tummy exercises etc., DO NOT DO THIS CLASS. Run, run away (slowly and with care).
  • Bum deal. Your pelvis has taken most of the burden of carrying your baby and probably also provided the exit route, so we need to give it some strong scaffolding. Hormones are still flooding your system, which keep your ligaments and joints unstable for up to nine months (and if you are breastfeeding, potentially longer), so it’s important to regain strength in your glute muscles, in order to stabilise your lower back and hips. If they aren’t firing on all cylinders you’re more likely to experience low back pain or have issues with your hips, knees and ankles. Strong bums are particularly important if you want to ultimately get back into high-impact movement such as HIIT and running…or just lifting and day to day craziness with your minis – I mean, that can be a HIIT workout in itself, right?
  • Posture matters. Everything hinges on your alignment in terms of your body systems working effectively post-birth. No amount of pelvic floor exercise will be truly effective if your alignment is poor and you’re not breathing fully. You do a lot of lifting and bending when you have small children and it’s important to soften and balance your body – especially if you are breastfeeding.
  •  I wet myself! LOL! IT’S NOT FUNNY. The main thing to remember about your pelvic floor after birth is that you should not suffer in silence, or laugh it off. There is absolutely no evidence to suggest that pelvic floor issues get better if they are ignored. If you are struggling with pain, discomfort, lack of sensation, a feeling of heaviness or ‘bearing down’, or even if things simply don’t feel ‘normal’ – not asking for help and laughing it off only means that the problem will definitely get worse over time.
  • Think about your 70-year old self and how you want her to feel. There is a real risk of pelvic organ prolapse postnatally, and it is so important to strengthen your pelvic floor to increase your chance of avoiding this, particularly if you want to have more children. If you feel any sensation of your insides ‘falling out’, do not ignore this. A prolapse is when the uterus, bowel or bladder descends into the vagina. Go to your GP and ask to be referred to a women’s health physio.
  • I had a C-section, pelvic floor exercises don’t apply to me. Sadly you don’t get let off the hook. Your pelvic floor has provided a neat pillow, punch bag and trampoline for your baby for 9 months. It needs some attention even if it didn’t serve as the exit turnstile.
  • Whatever birth you had, start your pelvic floor exercises as soon as possible. The sooner the better. BUT IT’S NEVER TOO LATE. So start now. NOW. If you had a perineal tear, whatever grade, begin these exercises without delay, as they’ll promote healing, send blood circulation to the area, reduce swelling, increase sensation and help you to regain your strength and function.
  • To do your pelvic floor exercises correctly: lift your back passage – imagine you are trying to stop breaking wind – then travel the engagement forward as if you want to stop the flow of wee, squeeze and lift forward and up.
  • Try not to hold your breath: lift up with an exhale, and then allow the entire pelvic floor to fully open, soften and relax on the inhale. Do a few repetitions, slowly and intentionally, a few times every day with this breath pattern. Then progress to doing some quickly. Squeeze and repeat 10 times, breathing normally without holding your breath, and always fully releasing and resting with an inbreath at the end.
  • Remember that when you lift your pelvic floor there should be no clenching or tension anywhere else: bum, shoulders, jaw, inner thighs. It’s an internal engagement. A strong pelvic floor is the key to healing your mum tum.
  • Look at the Squeezy app for more guidance and information about pelvic floor exercise.
  • Pilates is a perfect postnatal activity to strengthen your core and bum, to release tension – but it has to be the right kind of Pilates. Check your instructor has experience and the right credentials for working with mums.
  • Yoga is brilliant to. But as above.
  • Swimming is low impact yet surprisingly challenging, and meditative – just keep swimming just keep swimming just keep swimming….
  • And walking. Especially in green spaces. Walking is very healing and strengthening.
  • Your postnatal mojo is so linked to how your body FEELS and how you’re functioning. If you’re weeing when you exercise, or even when you cough and sneeze, that’s going to make you feel like shit, and make you scared to speak up about it or to continue to exercise, which perpetuates a negative cycle for your wellbeing.
  • Depletion in body: make no mistake, pregnancy withdraws all you got. It takes you well into your overdraft of energies, nutrients, minerals, strength. And then you don’t often choose to make deposits back into your account once baby is out (the “bounce back”!).
  • Your gut health may well be affected by your birth experience – antibiotics, caesarean birth – which will compromise your absorption of nutrients from your food. And crucially, may compromise your production of serotonin – the hormone of JOY, which is largely produced in the gut and therefore arguably could be one of the missing links in some out of the blue experiences of postnatal depression.
  • You’re not sleeping well, and probably not drinking enough water so you’re dehydrated. And you may only be eating toast, biscuits and mainlining coffee anyway, so your poor gut doesn’t have that much to work with.
  • Postnatal depletion is not depression. But it can make you feel generally a bit meh and crap. Which lends itself to becoming depression if left unchecked over time. The most basic form of selfcare is to tell yourself that you matter, to feed and water yourself adequately. How do you FEEL? Are you strong? Are you strong enough to carry a toddler in your dungarees like a sling for a mile when they refuse to go in the buggy?
  • It’s normal not to feel amazing all the time. But if it’s affecting your every day and you just feel “not right”: this is the tipping point. Check your PHYSICAL needs today: drink enough water, breathe properly and fully – this will be affecting your mind and spirit too. Our body image is so intrinsic to our happiness and identity, and postnatally this can take a real kicking.
  • It takes time to heal and regain your strength, you are only human, you’re not a Kardashian. It’s not frivolous to prioritise you and getting your body back safely and effectively. If you return to sit-ups, planks, running, HIIT too soon you can do more harm than good.
  • So ladies please: drink enough water, remember to breathe, and if you’re at all worried, ask your GP to refer you to a women’s health physiotherapist. Look after YOU!

The Pelvic Floor Patrol

The Pelvic Floor Patrol

We, the Pelvic Floor Patrol, are a team of 5 women who are all passionate about empowering women with health and wellbeing postnatally. We are starting a campaign to improve postnatal care and make sure that all women have access to the right information, and are given the option to have physiotherapy to heal fully and effectively after birth. Birth injuries can otherwise last a lifetime, if not dealt with fully. But there is so much that you can do to empower your own recovery.

Your pelvic floor is at the centre of what Joe Pilates called your “powerhouse”, or “girdle of strength” – a strong core offers you the freedom of graceful fluid movement, without tension and impingement. Your pelvic floor is the base of this “core”. Think of your core as the space from your ribcage to your pelvis. The diaphragm is the “ceiling”, the deep abdominals (the Transversus Abdominis and obliques) are at the front, the deep muscles of the spine (the multifidus) are at the back and the pelvic floor is the foundation.

The pelvic floor isn’t just one muscle, but a layer of muscles supporting the pelvic organs, spanning the pelvic cavity. Imagine it as a round mini-trampoline made of firm muscle, attaching at the tailbone at the back and the pubic bone at the front. These muscles are interlinked, overlapping and webbed together in a figure-of-eight shape around your vagina, anus and urethra to support the uterus, bowel and bladder. Men also have a pelvic floor (perhaps a little known fact, as we always associate the pelvic floor with women) but they don’t have the baby exit route to consider. The pelvic floor muscles provide you with strength, spring and support through your daily movement, plus they’re your rapid response team to make sure you don’t leak urine when you cough or sneeze. They’re also important for sexual function – the contraction of the pelvic floor contributes to sensation and arousal.

It’s so important as a woman to lay the foundations for your pelvic floor health in the long term, for a life where you are able to go for a run, or jump up and down without fear of letting some wee escape.

cropped-img_5639.jpg

What is the fuss about the pelvic floor? Why should I bother?

Your pelvic floor is a shock absorber through the daily pressure of movement – the pressure is particularly increased with pregnancy and childbirth. Remember that the pelvic floor forms the base of the core: your structural support system. Imagine what would happen if you built a loft extension on a house where a load-bearing wall had been knocked down? It would all collapse. This is why pelvic floor exercise matters.

Weakened pelvic floor muscles will mean your internal organs are not fully supported. This can lead to incontinence and pelvic organ prolapse.

Pelvic floor health declines as we age, particularly if we do nothing to maintain awareness and strength – this is one of those inevitable facts of life. Staggeringly, only 25 per cent of women aged 18–83 have ‘normal’ pelvic floor support (Swift et al. 2003). So when you add pregnancy and childbirth into this picture – there is a huge potential for pelvic floor malaise.

But we laugh about stress incontinence as mums – we normalise it (“me too! A tidal wave after 4 kids! LOL!”) and accept it as “just a part of being a mum”.

IT IS NOT NORMAL and women, we are doing ourselves a huge disservice by accepting this. There are things you can, and should, be doing to take the power back for your pelvic floor health and make sure you will be able to run after your kids without fear of weeing. Plus, your pelvic floor health and your mental health are inextricably intwined. Fear of weeing yourself in public will lead to feelings of shame, inadequacy, failure, and avoidance behaviours such as stopping exercise, which will mean you might start to feel physically weaker and more under par, which brings you down further..it’s a vicious cycle that begins with THE FLOOR.

Pelvic floor awareness

We need to be aware of the balance of the pelvic floor muscles rather than simply make them ‘strong’. Think about your arm muscles – they allow you to bend your arm in towards your shoulder, but they also straighten and extend your arm out and away from you. You’d be a bit stuck for functionality if you could only hold your arm in a slightly bent position in mid-range of movement, with neither of the two ends of the movement spectrum available to you. This flexible strength is what we need to aim for with our pelvic floor.

We need to balance strength with release.

Stand upright, in front of a mirror if you can, to check your alignment. Your feet are hip-width apart. Find your neutral pelvis by tilting the pelvis through full range and stopping at the midway point. You don’t want it sticking too far out but you don’t want it completely tucked, either. Make sure that your ribcage is stacked directly over your pelvis. Create length through the spine as if someone is drawing the crown of your head to the ceiling, keeping the chin softly tucked parallel with the ground. Soften your shoulders into your back. Take a wide breath in, imagine the ribcage opening out to all sides, like an umbrella.

  1. As you breathe out, lift your back passage, as if you’re trying to stop breaking wind. Continue this lifting energy up and forward. Engage from back to front, up and in. We want to locate the full breadth of the muscles from the back to the front, and from the sides in: imagine flower petals folding up and into a bud, evenly from all sides. Some sides might feel easier to you than others. You will feel your lower belly lifting gently as well. Maintain this lift for a few seconds, as long as you can remain relaxed and soft everywhere else.
  2. Breathe in, and let the engagement go, fully release it like dropping a marble into a glass of water. Try to do 10 of repetitions of these slow contractions.

We also need to train the pelvic floor with fast contractions, lifting up and in quickly to train the emergency rapid response element of your floor, for when you cough, sneeze, jump.

  1. On an out breath, quickly lift the pelvic floor to full engagement, keeping your surrounding muscles – the bum, inner thighs, upper abdominals, and your jaw, soft and relaxed.
  2. Then slowly relax the whole of the pelvic floor. Try to do 10 of repetitions of these fast contractions followed by a slow release. Breathe in a way that’s comfortable for you throughout these exercises, remembering not to hold your breath at any point.

Remember, when practising pelvic floor exercises:

  • Scan your body for tension and try to release it: jaw, neck, inner thighs, buttocks.
  • If you lose your connection, don’t feel frustrated. Take a breath and start again. With practice, it will become more natural.
  • Make sure that you can still breathe, and your torso isn’t rigid.
  • Please don’t practise this while sitting on the loo and stop mid-flow while actually having a pee. You might introduce the chance of a UTI.

Help! I can’t feel it!

If you really can’t find your pelvic floor at all: try sucking your thumb, pressing your hands down on your desk in front of you, or coughing. These actions all trigger your natural functional pelvic floor lift.

Persevere with gentle pelvic floor awareness exercises every day, often.

If you really struggle with lack of sensation, or pain, I’d advise going to a women’s health physiotherapist to see if a hands-on practitioner can give you some pointers.

To protect your pelvic floor health, always consider exhaling, and consciously drawing up in your centre as you lift heavy objects or your children.

The breath and your core strength are inseparable. If there is a missing link in the natural momentum: if your alignment is slightly off, for example your ribcage is tilted forward or back, or your pelvis tucked underneath you, this directs the natural momentum off course and pushes pressure to areas where it shouldn’t be. Pelvic floor exercises therefore are linked inextricably to good alignment and mindful posture.

Watch this space for updates about the PELVIC FLOOR PATROL. What are your experiences of postnatal care? Please share by commenting, or sharing this post with your friends. We need to build awareness and get the message out there that it is not ok to put up long-term with effects of birth which could otherwise be prevented and improved.

cropped-073a93231.jpg

Pilates for Pregnancy

Pilates for Pregnancy

Yesterday I had the pleasure of talking to the Pilates PT Hollie Grant about all things passion-led career, pelvic floor, Pilates and pregnancy for her podcast Strong Not Skinny. And it was great to have the opportunity to talk about my upcoming book, Pilates for Pregnancy, which publishes with Bloomsbury in September.

I realised during my chat with Hollie just how lucky I am to be doing something that I really care about – sometimes I think in the day to day rush hour mayhem we can take these things for granted. I definitely have been carried along by daily motherhood swell too much recently and don’t stop to smell the roses enough when it comes to the things that I am doing every day. So, to be able to pause and talk about my upcoming project was quite a treat and got me really excited about the new book.

The Supermum Myth written with my lovely coauthor clinical psychologist Dr Rachel Andrew came out in September last year, so to have another book coming in such quick succession has definitely been a bit like finding out you’re pregnant again straight after giving birth…but it just means that I’ll have two book babies to tend at different stages of development. Combine the two together and you have a fantastic resource for maternal health in body AND mind.

cropped-073a93231.jpg

I believe so passionately in the power of Pilates for changing the way you view your body for the better: for enabling you to feel strong, supple and calm throughout your pregnancy and into motherhood. And to lay the foundations for a better recovery post birth.

Pilates for Pregnancy is a straight talking, woman-to-woman exercise guide, focusing on pelvic floor and core strength, to improve your health, mood and energy during pregnancy.

Clear, step-by-step Pilates exercises, tailored for the demands of each trimester, show you how to:

    • improve your posture as your bump grows
    • protect your back, especially when lifting older children
    • optimise the position of your baby for a better birth experience
    • help you release tension and create a positive mindset for birth
    • reconnect and restore your core postnatally, focusing on your pelvic floor muscles – and including Caesarean recovery.You’ll find helpful advice and motivating tips from mums throughout, showing how much Pilates enhanced their strength, birth experience and postnatal recovery, to help you prepare you physically and mentally for your new arrival.

Pilates for Pregnancy comes out in September – but you can preorder it now!

IMG_2241