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Archive for the ‘Pelvic Floor’ Category

Baby – Check!  Support bra – Check!   Trainers – Check!  Running … hang on a minute!!!

It’s my experience that regular runners  (both before and during pregnancy) want to get back to running as soon as possible after baby is born.  However, do so with great caution…

Going back to (or even starting) a running programme isn’t recommended for at least six months after baby has been born, and possibly longer if you are breast feeding or have had post-pregnancy problems.

Running is categorised as a ‘high impact’ activity (where both feet are off the floor at the same time), much like jumping, hopping and even hopscotch!   It is a form of cardiovascular (CV) exercise which means it has a host of benefits – but there are some considerations…

The desire to get back to ‘your old self’ and the longing to lose the baby weight, plus the ease and accessibility of running make it a popular exercise choice.  However, even an experienced runner needs to tread cautiously when returning to fitness.  If you are not a natural running and have not run before – now is not the time to start!  Leave it till you feel absolutely back to your old self!  However, walking is excellent for everyone!

Benefits of CV exercise

If your CV workout is at the right frequency, intensity, type and for the right time (FITT), it is valuable in helping with post natal recovery:

  • increase circulation promotes blood flow through varicose veins and aids reabsorbtion of excess fluid as a result of pregancy,
  • the improved efficiency of the hear and lungs to transport and utilise oxygen
  • the increased endurance of the leg muscles will make everyday tasks easer
  • may be helpful for reducing weight gained during pregnancy
  • therapeutic to help deal with stress and anxiety by assisting dispersal of the hormone adrenalin.

Joins and relaxin

The hormone relaxin  continues to affect the body post natally and as such makes exercise choices somewhat limited during the early months of being a new mum.  If you are breast feeding, these effects last longer.  Low impact exercises choices are available (where one foot remains on the ground – walking!).  Excessive movement around the pelvis, especially during weight bearing exercises may stress your SJ joints or your pubis symphsis (your pubic bone) which can aggrevate existing conditions or cause a new problem to develop.

The Q-anlge (the angle between your knee cap (patella) and the front of your hips (ASIS)) is greater in new mums, which means the pelvis is a little wider and can predispose a new mum to anterior knee pain and other syndromes. Knees are particularly vulnerable to injury and misalignment with the repetitive action of stepping and cycling; the length of time exercising has to be balanced with the amount of physical activity you expend during the day – just by being a new mum!  Ankle stability is also at risk due to the quick lateral movements and directional changes that can occur in many ‘aerobic’ activities.  Correct posture and technique are important throughout every exercise session.

High impact exercises are extremely stressful to the pelvic floor and are associated with pelvic floor dysfunction.  Decreased support form the ligaments that support the pelvic organs and muscle imbalances increase the risk of prolapse!

Abdominals

The abdominals  have been stretched and weakened and will reduce the stability of the torso and spine.  The muscles inside need to be working (contracting) first before limb movement (which is exactly what Pilates can help with!).  Moving limbs whilst the abdominal and back muscles or not contracted can lead to long-term problems.

Breasts

High impact activites are unsuitable for breast-feeding mums; the breasts are heavy and may leak with excessive movements.  Any movements what bring the arms closer to your chest will need modification (think of the arms swinging during the running action!).  Breast milk is not affected with moderate-intensity CV work –read here for more details.

Weight loss

Easy one in principle – use more calories than you take in!  However, if it was that easy, then we would all be slim!  Exercise is often used to help with weight loss, but food intake also needs to be considered.  However, if you are breast feeding you need extra calories! Perhaps a sensible choice would be to wait after breast feeding to begin a weight loss programme?

Putting exercise into your’s and babies routine…

Daily walks with baby in the pram are most suitable as an introduction to exercise.  If it will form a regular part of your routine, then 10 minutes at a time is a good starting point.  If you can’t manage daily walks, then increase the duration when you do go out (to get the same benefits of daily exercise). Every new mum should follow these suggestions as the risks far outweigh the benefits.

Try to walk at a pace that means you are able to reach 4-6 on the rate of perceived exertion scale (see here for more details)

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Well, we could write a whole thesis on it, but below is an outline of what it is, what it does and where it is!

The pelvic floor consists of layers of muscles which stretch like a supportive hammock from the pubic bone at the front to the back of coccyx.

During pregnancy you may find that your leak urine when you cough or strain. This is know as stress incontinence of urine and it can continue after pregnancy.

By performing pelvic floor exercises you strengthen the pelvic floor muscles and this helps reduce or avoid this problem after pregnancy.  it si also important to do then even if you are young and not suffering from stress incontinence now.

You will also need to pracrise tightening up the pelvic floor before and during coughing and sneezing.

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One piece of advice that is regularly given by nearly all health care professionals is to “do your pelvic floor exercises”.

Pelvic floor exercises help to strengthen the muscles of the pelvic floor which are placed under great strain during pregnancy and childbirth.  However due to the effects of the hormone relaxin combined with the weight of baby means these muscles need as much help as possible to maintain support and continence. It is essential to exercise them regularly.

These exercises can be done any time, any place, anywhere but always with the spine in an upright position – not slumped, like on the sofa! Nobody should be able to tell if you are doing them except maybe a lifting of the eyebrows!

Here are two to help your practice:

Slow exercise
This exercise strengthens the pelvic floor muscles.

Draw the two sides of the pelvic floor in towards the centre and wrap around the front passage as if to stop yourself having a wee. Lift up inside and hold for a few seconds, continuing to breathe, then release with control.
If you find there is nothing left to release and the contraction has been lost you’ve probably held it for too long. Start with just a couple of seconds and only progress when you can lower confidently without letting it drop. This is just the same as doing a biceps curl with a weight in your hand – you need to control both phases of the movement – the pelvic floor is no different!
 Gradually build up to a longer hold. Remember to keep breathing throughout and adopt an upright position.

 

Quick Exercise
This exercise will help prevent any embarrassing leaks when you cough, sneeze, laugh or lift something heavy.
Stand or sit in an upright position as before. Tighten and lift the pelvic floor in one quick contraction and release immediately Snatch the snatch! Pause before repeating four times.

NB: Aim to make your fourth repetition as strong and quick as the first. You may find this difficult to do initially but stick with it and monitor your own progress. It’s never to late to start but once you do it should be an exercise for life!

And yet another way!

Close up your back passage as if trying to prevent a bowel movement.  At the same time, draw in your vagina as if you were gripping a tampon, and your urethra as if to stop the flow of wee.  Do these both quickly – tightening and releases the muscles straight away, and slowly – holding the contractions for as long as you can before you relax.  Try to count to 10.

Try to do three sets of eight squeezes every day.  To help you remember, you could do them once at each meal time.

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