I came across a great post on Instagram by a fellow alignment nerd yesterday which I had to share in my client Facebook Group.
The photo showed a pregnant person in poor, lifted chest, “bump out in front of her” posture on the left, and then her again in perfect alignment on the right.
It’s fascinating to see how lifting your chest and standing with your pelvic weight forwards can apply pressure and more load than necessary to your lower back, so do go and check out the link below because sometimes a picture speaks a thousand words, huh?
Click here to see the image: https://www.instagram.com/p/BkyEmsLHZg1/
Having a chat to a few of my pregnant clients over the past fortnight, it’s apparent that some of you are suffering with pelvic pain, sneeze wee and sciatica.
So, I thought I share my thoughts on what to do when you feel either of these symptoms setting in.
Although common, it’s not normal to wet yourself when you sneeze.
This essentially means when your bladder has urine in it, your pelvic floor is not strong enough to withstand the downward forces produced by said sneeze.
You may be happy to tolerate it for now, thinking you only have a few months left of your pregnancy, so what’s the point doing much about it now?
Well, it tells me there is a problem, because, well – read paragraph one again, ok?
The “problem” won’t go away by itself and I take a full body approach to pelvic floor rehab if you hadn’t noticed, so doing a tonne of “squeeze and release” exercises to your vag may not make a lick of difference.
See my Your Pelvic Matters or pregnancy Pilates or Beginners Pilates classes for more info, or come and see me for postnatal personal training, where I can put an individualised program of exercises together specifically for you.
Pelvic Girdle Pain or PGP as it’s sometimes termed can include pain at the front, back or sides of the pelvis.
So, discomfort at the pubic bone, groin area, outer thighs, hip bones and/or lower back/gluteal pain all falls under the umbrella of “PGP”.
If PGP becomes really bad, you may be offered Physio by your local hospital, with the worst case scenario being, they’ll offer you a support belt an crutches if your symptoms get worse, rather than get better.
I’ve worked with a tonne of pregnant women with PGP one-on-one and in a group setting, and I can always find movements for them to do.
Mindset is huge with this one here, so if someone says a support belt is your best option, you’re going to think it is.
It may provide you a teeny bit of relief, but there’s more at stake here, because using a set of crutches and/or wearing a support belt are sort of “plastering” things.
What you need is pelvic stability back in your life, and I can certainly help you attain that.
I’ve had this and it’s pretty grim.
Although it was well over 10 years ago, I can still remember the torment of that shooting/tingling pain that starts in the butt, runs down the back of the leg, all the way underneath the foot to the big toe.
For me, sitting down aggravated it, so it’s important for you to work out what it is that’s causing more discomfort and do less of that for starters.
I generally advise against stretching out the gluteals if sciatica is present, because it can sometimes make symptoms worse.
WHAT SHOULD I DO IF I HAVE SNEEZE WEE, PELVIC PAIN AND/OR SCIATICA?
Well, I’m glad you asked!
In a nutshell, you need to:
- Sit better (if you must sit, or vary the way you sit eg floor sitting)
- Stand better (I teach you how to do this in every class setting on my timetable, so no excuses)
- Walk and move more (but you need to learn how to stand better for you to be able to move and walk better, so you can sort of see how these things are indeed connected)
- Strengthen your glutes (a huge role in relieving pelvic pain, sciatica and sneeze wee is building yourself a strong butt, which incidentally is linked to walking better – you see – I can find a tenuous link to everything!)
- Release your hamstrings (particularly if sneeze wee is something you suffer with – it tells me your pelvic floor is possibly too tight)
- Teach your core to switch on reflexively (which means you don’t “draw it in” all the time, or at all – you let it anticipate and adapt to the load you’re asking it to bear), and finally
- Learn to breathe better (because you can’t get a reflexive core, if you’re not breathing into your ribs, and breathing better can also help pelvic floor/core synergy too)
And, there you have it!
That’s quite an extensive list as you can see, but you’ll know that if you’ve ever asked me a question that goes along the lines of:
“What exercises are good for….?”
I rarely if ever answer it by listing my “go to” exercises.
This is because I look at the body as a whole unit.
And, just sending you away with 4 movements to do, in isolation, isn’t going to relieve your symptoms.
YOU have got to take some responsibility for your pain and actions going forwards too, you see?
If you’re concerned that any symptom you’re suffering with is not going away, it’s probably time to get in touch with me, don’t you think?
I run a host of classes where you can learn about how to stand, sit and move better.
Mummies and Buggies indoor postnatal buggy class is Wednesday at 11am.
My pelvic floor exercise class is 7:30pm on Wednesdays (but check the link for info on how to enrol).
Beginners Pilates is Tuesday at 8:30pm in West Bridgford.
And, if you want a fun, fat-burning, full-body workout that offers postnatal options, it’s my Little Black Dress Workout on a Monday at 8:30pm you’ll want to book on.
05 06 2018
I take a full-body approach to improving pelvic floor function and when assessing someone, I always start with the foot, and work my way upwards from there.
I haven’t prescribed a Kegel in my classes (those “squeeze and release” and “draw up and hold” exercises) for around 4 years now for a few reasons:
- often my first time pregnant clients don’t know what the heck they’re supposed to be doing, and
- traditional pelvic floor exercises don’t work for every man/woman with pelvic floor weakness (and I have the research to back that statement up)
Here are my top 3 non-traditional pelvic floor exercises you can do at home to help improve pelvic floor health:
So, if you’ve been wearing heeled footwear, you may just find that the calf muscle has shortened, passively over time due to always having a raise underneath the heel of your foot.
NB – most sports trainers and some ballet flats have a hidden heel or a super high heel within the factory made insole, by the way so check them out if you don’t believe me.
If your calves are tight, you will lack range of movement/mobility in your ankle which has a knock-on effect to your gait, and how your pelvis and pelvic floor functions as you go about your day.
So my message is clear: get out of heeled shoes, walk around in bare feet at home to increase foot mobility, and stretch out your calf muscles.
Your hamstrings at the backs of your legs are often chronically tight through excessive sitting and the very sedentary nature of our lives nowadays.
If these muscles are tight, they’ll pull the back of your pelvis down towards your heels, and attribute to a tight pelvic floor.
A tight pelvic floor generally also attributes to a weak/dysfunctional pelvic floor, and the number one best way to gain strength and length into your pelvic floor is to release your hamstrings.
So, as the bare minimum, try stretching out your hamstrings as often as you can.
If you read a recent newsletter from me about “poking your bum out” when bending forwards/down to pick something up, I need you to do this consistently, every time, so that it becomes normal practise.
So my message here is clear: The more that you tip forwards at the hips, the more you open up your pelvic floor at the back, and indeed lengthen the backs of your legs.
(and, can I point out, the more you move in this manner in your day-to-day life, bending down to pick something up off the floor, the more you decrease the load on your lumbar spine. So, if you’re getting lower back pain a lot when bending forwards, re-read that paragraph above, ok?)
When standing upright at the change table, kitchen counter, bathroom sink etc, you’ll want to stand with your feet hip distance apart, toes pointed forwards and bodyweight backed up over your ankles.
Most people, when they have a contraption in front of them like a desk, table or counter will start to lean/pitch their pelvic weight towards that object.
The more you do this, the more load you’re putting on the spine, and it can really throw off what’s happening the pelvis too.
If you’re prone to tucking your tailbone under in standing, this “tuck” will be increased the more you wear your pelvis out in front of you.
So my message here is clear: Stand and walk around with your pelvic weight backed up over your ankle bones, and the only way you’re going to be able to do that is by:
a) getting out of heeled shoes, and
b) lengthening your hamstrings
Can you see the connection now?
It’s really interesting to note that once you start to learn how to hold yourself, you start observing others around you randomly on the street etc and it starts to make your eyes bleed a little.
If you have pelvic floor issues yourself, or are concerned that during your pregnancy, you’re not doing enough exercise to increase your chances of giving birth naturally, you have a few options:
Book on my Mummies and Buggies classes where you not only get a great workout that’s safe for your pelvic floor, but you also get to bring baby with you.
Feel as though you need specialist attention for your pelvic floor?
Did you know I have a pelvic floor exercise class on my timetable?
Check out Your Pelvic Matters here where you’ll learn the exact exercises you should be doing on a regular basis to help rehab your pelvic floor.
Email me back if you have any questions.
Have a great week.
There are a number of muscles that feed in and out of the pelvis.
Let me make a little list for you:
- Hip flexors,
- Quadriceps (front of your thighs),
- Glutes (your bum),
- Outer thighs,
- Inner thighs,
- Hamstrings (backs of your thighs).
Each and every one of these muscles needs a good bit of attention particularly if:
a) you’re pregnant and preparing for childbirth,
b) you’re postnatal and getting frequent pelvic/back pain,
c) you’re suffering with pelvic floor weakness, and/or
d) you’ve sat down a good part of your life.
When you exercise with me, at the end of your workout, or sometimes interspersed between exercises in my Bump to Babe, pregnancy Pilates or Mummies and Buggies classes, I add some release work in for you.
It’s not all about strength, strength, strength all the time.
And, this is sort of why traditional pelvic floor exercises don’t work.
I’m talking about those “squeeze and release” type exercises where you imagine you’re stopping the flow of urine, and repeat 15 times or whatever.
You need to be able to release your pelvic floor, before start adding load or strength work to it.
That general rule applies to most of the muscles in the human body if I’m honest if there’s dysfunction present.
If you released all of these areas of your body on a regular basis, I’d hazard a guess that you’d:
- get less back pain,
- suffer with fewer aches in your hips and pelvis,
- increase your pelvic floor strength and function,
- increase your chances of delivering your baby naturally,
- decrease the chances of you tearing during childbirth,
- decrease the severity of menstrual cramps,
- increase your chances of fertility,
- suffer less with leg cramps, restless legs and other circulatory conditions,
- improve your gait pattern, and
- therefore improve your pelvic floor function
There’s this misconception that pregnant and postnatal women can’t stretch.
Or, perhaps that they can stretch, but for only short periods of time.
Google’s a great tool granted – but if you have a question relating to exercise that isn’t located on my blog, can I get you to ask me directly instead?
Because internet searching can also call up a tonne of misinformation and really old hat advice!
I update my skills on a regular basis, and there are exercises I would not have done 12+ years ago when I first qualified…
…only to now include them because we now realise in the pre/postnatal fitness industry, that’s it’s a little foolish to blacklist certain movements altogether when you’re likely to need to be able to do them after birth, caring for your newborn.
With a few tweaks in the way you use your body throughout the day, you’ll be rewarded with less back, pelvic and knee pain and fewer symptoms of pelvic floor weakness.
Hip tightness and back tension often refers into the pelvic floor, so if you have a pelvic floor issue – for full-body function, you need to sort out your pelvic mechanics, and get more mobility in your spine.
If you have pelvic floor dysfunction, take onboard all of these tips because the key to pelvic floor rehab and labour prep is actually getting your whole body working better for you.
If you’re pregnant or postnatal reading this right now and concerned you’re not doing enough exercise that is specifically designed to strengthen and release the right muscles to prepare you for childbirth, then, you’ll want to book on my pregnancy fitness classes in Lady Bay which are an education in itself.
My Bump to Babe pregnancy fitness classes on Mondays in Lady Bay provide cardio, toning, Pilates, stretching and tonnes of education about what happens to your body during pregnancy.
And, if you’ve recently had your baby, my indoor postnatal buggy classes known as Mummies and Buggies are held 11am Wednesdays in Lady Bay and provide you with cardio and toning that leaves very few muscles unturned!
Today, I thought I’d share answers to the 5 top frequently asked questions I’m often asked about the pelvic floor, so here goes:
1. SHOULD I PERFORM “SQUEEZE AND RELEASE” EXERCISES TO MY PELVIC FLOOR?
Yes and no.
It depends if you’re pregnant, postnatal and/or have issues in your pelvic floor muscles right now.
I’m not a big advocate for “squeezing and releasing” and/or “drawing up and holding” pelvic floor type movements, hence the reason I don’t teach them in my classes.
That’s not to say there’s not a place for them for some people, and certainly if you have zero signal or control over your bladder/bowel, then it’s at this point you’d be well advised to perform them (under the guidance of a Women’s Health Physiotherapist or similar).
In a lot of instances of where clients come to see me with sneeze wee, or that feeling of urgency to use the toilet at time throughout the day, it’s often a case of the pelvic floor being too tight.
In a word, no.
According to various studies, roughly a third of postnatal women suffer with some form of pelvic floor problem post-birth, but in my experience, I believe this figure to be much higher.
Put it this way, there are a lot of women suffering in silence with “sensitive bladder” issues as it’s now commonly termed (annoyingly coined, shall I add, as though it’s a perfectly normal issue for women to suffer with).
Don’t get me started on those “whoops moments” adverts – they drive me nuts and the actor portrayed is actually quite young.
Wetting (or indeed pooing) yourself whilst going about your day-to-day activities is NOT normal, alrighty?
Why do I have you perform this exercise so frequently with you?
Well, it’s for the health of your pelvic floor.
You probably weren’t expecting that to be my answer, were you?!
Apologies if you’re eating right now… Maybe pop that food down, ok?
I don’t actually prescribe Kegels very often to my pre/postnatal clients, and haven’t done for 3+ years.
Your feet have 26 bones, 33 joints and hundreds of muscles.
They’re your platform and serve you well most of the time (if you treat them fairly back, obviously).
The vast majority of people are born with the ability to stand and walk with their feet pointing straight ahead.
Your baby/children’s feet will also be parallel.
What’s up with your feet?
What do YOUR feet look like?
I once met a client who came to my postnatal Pilates classes who had all 3 of these things:
I’ve rehabilitated and lessened the symptoms all of these 3 issues in a lot of women (and men) over the past few years.
They’re all linked.
Let me explain a little further:
TOO MUCH PRESSURE
The human body has 3 cavities:
1) thoracic (chest and ribcage area)
If you have too much pressure building up in one of those cavities, there are 3 ways of that pressure is going places once it’s reached the pressure cooker stage:
When it comes to training the pelvic floor muscles during pregnancy and after birth, I’m here to tell you, as a trained Ante/Postnatal Fitness Expert who keeps her education and skills fresh and up-to-date, things in recent years have most definitely changed.
Strengthening your pelvic floor muscles for postnatal women should be of paramount importance.
No news there.
Keeping your pelvic floor muscles in check during pregnancy is vital too.
Again, no surprises.
Stress incontinence (that’s where you when you laugh, cough, sneeze or do exercise and a bit of wee or poo comes out too), is quite common with 30% of new mums suffering with the condition for up to 3 months after birth.
I personally believe this figure is more like 50-60% though and because it’s such a taboo subject, there are a lot of women out there suffering in silence.
When it comes to alignment during pregnancy, you may not realise, but the way that you stand, sit and even walk, all have a direct influence on your body and your baby.
Having a pelvis that’s in its optimal position will make childbirth a lot easier. No surprise there.
A toddler doesn’t just learn to walk all of a sudden – it observes how YOU move and mimics your movements.
So, how you hold yourself and go about your day, will affect your toddlers’ gait too.
A baby’s ability to move from a breech position into the head down position, ready for labour, will be determined by a number of factors, but the main one is whether your deep hip flexor muscles are flexible enough for him/her to make manoeuvre. Interesting, huh?
I’ll go into the first point in more detail for you now, and cover the other two topics in a future blog post, ok?
If I’ve whet your appetite about how your posture, pelvic floor and your ability to give birth are all linked to posture, then keep reading:
SPACE IN AND THE SHAPE OF YOUR PELVIS
Without going into too much detail, put simply, if you sit down a lot, and have done for the majority of your day for the past how ever many years, your pelvic floor muscles might end up in a ‘tightened’ state. This is not really good news when you’re trying to push a baby out through your privates, now is it?
When we sit down in a relaxed state it’s often done so with a tucked under tailbone. Check out your posture now if you’re reading this in seated. Are you sitting on the edge of the chair with your tailbone out and your legs uncrossed, or are you sat with your back against the backrest, molding yourself to the chair, Homer Simpson, style?
If it’s the latter and you’ve done a lot of it before becoming pregnant, chances are the space between your pubic bone and your tailbone has actually got shorter. Why does that matter? Well, it kind of does, if you’re about to push a baby out through it, doesn’t it?
The pelvic floor shouldn’t be tight – it should be flexible, and when it comes to pregnancy in particular, it’s your pelvic floor that needs to have enough ‘give’ in it, to facilitate childbirth to physically get baby out through the birth canal.
If you visualise your pelvis looking downwards, the shape of the bowl or outlet of the pelvis should be somewhat circular. If your pelvic floor muscles are tight, it means you’ve changed the shape of your pelvis, and I know I’d much rather push a baby out through a circular outlet, than try and do so from a flat oval shaped one.
Getting some flexibility back into your pelvic floor muscles isn’t unachievable. It’ll just require a lot of squats, exercises to help strengthen the glutes to pull your tailbone back from out of the pelvis and a lot less sitting.
When you do sit, here’s how you should be positioned:
- bum towards the edge of the chair,
- feet flat,
- knees hip distance or a little wider to accommodate bump,
- hip bones forwards (meaning you might need to stick you butt out a bit to get the hip bones on top of the pubic bone),
- rib cage down, and
- chin in.
For some simple, effective exercises you can do which will get you thinking about your posture at work, rest and play, click here for a downloadable worksheet of movements you can do to help re-align your body and prepare you better for labour.