As many of you know, I’ve been spending most of my time discussing the topic of fitness postpartum. Not only does it apply specifically to my life, but it also pertains to MOST of my clients. Even as little as two years ago, the steps to regaining our strength properly postpartum were foggy with a lot of misguided information, often muddled with societal pressures of instant fat-loss and getting your body back as fast as you can. (Don't even get me started...I've got plans to discuss this with you soon.)
As much as I wanted to think I was doing it right, looking back now, there were more than a few cringe-worthy moments during my journey through exercise after having my daughter just 16 months ago. This is why I have truly made it my mission to provide the best support and information I possibly can by first and foremost educating myself (currently pursuing a specialty certification in postnatal fitness) and then sharing it with all of you. With several experienced pelvic floor physiotherapists and postnatal fitness professionals like registered kinesiologist, Jessie Mundell taking the lead, I am confident that postnatal fitness education is finally gaining a clear and concise voice. It's my goal to join in this movement, and assist you the best way I can by helping pave the way for you to begin your journey back to exercise postpartum the right way.
Please note: This article and others like it do not in anyway take the place of the guidance of your physician or any other qualified health professional and I do not claim this article to. Before starting up any exercise routine, please seek clearance from a qualified health professional.
Last week, I let you know what I've been up to lately and we discussed the initial steps to getting back into fitness after having a baby, with REST and lots of newborn baby snuggles being first and foremost. You can catch up by starting there.
In this article, we’re going to begin reconnecting with our bodies through proper breathing that enlists your core and pelvic floor to work together during both exercise and all activities of daily life. This connection is the foundation to everything you do whether it be during exercise or simply lifting your baby up out of their bassinet. And before my mamas of babies that are already 5, 10, 20 years old start tuning out, let me remind you that we, as mothers will always be postpartum and therefore, we can all benefit from starting at the very beginning.
Most of you I’m sure know a bit about the core, yes? But what about the pelvic floor? If you’re like me when I was pregnant with my daughter, you’ve heard the words being used maybe once or twice and you know it’s somewhere “down there”, yes? But what is it? Below is a diagram of your core and pelvic floor. As you can see, they go hand in hand. And yes, if one is weak, you can bet that the other will suffer. Think of the core and pelvic floor as a canister. You've got the top starting with your diaphragm, the sides with your transverse abs and back muscles, and the bottom with your pelvic floor. Yes, both men and women have cores and pelvic floors, and both can experience dysfunction. This week, we will be focusing primarily on the core and pelvic floor after birth and next week, we will dive even further into the core.
Diagram borrowed from The Pregnancy Centre website.
In simple terms, your pelvic floor is made up of specific muscles that connect from your tailbone, sitz bones, and pubic bone that provide support to the pelvis and most specifically the pelvic organs, i.e. your vagina, bladder, uterus, and rectum. During pregnancy, if you can imagine, there’s quite a bit of excess weight and pressure being loaded onto your pelvis, which in turn puts a lot of pressure on your core and pelvic floor. What’s amazing is that our bodies were made for this! But that doesn’t negate the fact that recovery and restoration is necessary following birth. If you think about it like a marathon, your core and pelvic floor has just finished running an almost 10-month long marathon all the way through without so much as taking a water break!
Whether you had a vaginal birth or cesarean section, weakening and dysfunction of your pelvic floor is possible.
Here are a few things you might notice after birth that may indicate pelvic floor dysfunction:
1. Incontinence (urinary and fecal): You know that thing that moms like to joke about that if they laugh too hard, sneeze, or jump on a trampoline, they pee? Yea, it’s not that funny. And it is much more common than it should be. Mamas, you are not doomed to a life of wetting your pants or wearing liners. We deserve better, don’t we? Your local women's health physiotherapist can help!
2. Pelvic Organ Prolapse (POP): Scary word, right? But again, this is much more common than one might think. Some things to be aware of that may indicate a presence of prolapse are: any feeling of wearing a tampon when you’re not? Heavy feeling? Does it feel like you’re sitting on something kind of like an egg? Before stressing too much, please know that these things can be worked with and you can find a solution. There are hundreds of women leading completely normal lives who happen to have prolapse. If you feel like you might be experiencing something like this, call your doctor and get a referral to see a women’s health physiotherapist. You have options.
3. Pelvic Pain: This can occur at any time during any activity. Pain isn’t normal, so let’s talk about it shall we? Contacting your local pelvic floor specialist is a great place to start.
4. Lower Back Pain: This is something that many mothers experience early after having baby, and often times it goes ignored. Living in pain and discomfort is not necessary. Again, you have options!
Before we go on, are you noticing any trends here? Before having my daughter, I didn't even know there was such a thing as a women's health physiotherapist. But they are real and they are fantastic. I highly recommend finding one in your local community and setting up an appointment after the birth of your baby, even if you aren't necessarily experiencing the symptoms above. Knowledge is power, mamas! And of course, if you're experiencing any of the above symptoms, be sure to give your doctor a call and get yourself a referral to see a women's health physio. You don't have to live uncomfortably. It's time for us to be able to talk about these things openly and without shame. We deserve better.
Core and Pelvic Floor Connection Breathing
This is how we will begin to restore connection with our bodies. When our bodies are functioning properly, tightening and relaxing of the pelvic floor is a natural reflex during activities of exertion. However as you have learned, enduring pregnancy and birth requires a bit of retraining and restrengthening for the pelvic floor. This breathing technique will show you how to do both. And remember, even if your babies are 5, 10, or even 20 years old, a properly functioning pelvic floor and core is key to starting any new exercise program.
1. Sitting in a chair on your sitz bones (not your tailbone), make sure your ribs are aligned over your hips, with shoulders squared and head slightly lifted. Place one hand on either side of your lower ribcage. Breathe in filling your entire canister from your diaphragm down to your belly and pelvis. Breathe out. You should have felt your ribcage expand and contract. Practice this a few times.
2. Next, it’s time to get in touch with those ever so important pelvic floor muscles (PFM’s). Sit tall on your sitz bones and this time as you breathe in, fill your entire canister and focus on breathing all the way down into your pelvis. Imagine your hip bones widening and a slight swelling sensation in your pelvis as your pelvic floor relaxes. Breathe out. Repeat a few times.
3. Next, let’s engage those PFM’s. Sit tall on your sitz bones, take a deep breath filling your entire canister evenly, feel your hip bones widen, pelvis swell, and as you breathe out, imagine your hip bones coming back together while slowly lifting your core and pelvic floor muscles up and in. (Like a kegel at maybe 30-40 %). Repeat again.
4. Now let’s put that breathing into action. I want you to implement your breathing into a daily activity such as squatting down to pick something up. (You can find a helpful video here.)
Stand in neutral alignment with tailbone untucked and ribs stacked over hips. Next, start to sit back into a squat while performing your inhale, relaxing your pelvis and pelvic floor. At the bottom of your squat, just before you return to starting position, I want you to start your exhale, engage those amazing PFM’s, and exert by pressing through your heels and returning to standing position. Give it a few more tries.
This is an excellent visual for your pelvic floor while breathing!
During any exercise or daily activity that requires exertion, remember: Inhale and relax your pelvic floor. Exhale, engage your pelvic floor and core, and exert. Pretty soon, your body will become accustomed to this and you won't even have to think about it. And that's a pretty darn cool thing!
Many of you might be wondering WHEN you should start building this foundation. Honestly, it's totally up to you. Listen to your body, rest as much as you need to after having your baby and you'll know when you're ready. I'm comfortable with clients starting this breathing regimen as early as 2 weeks postpartum and practicing when you can daily. Remember, you don't want to bear down or squeeze as hard as you can during the "lifting" portion of your breath-- Inhale-relax, exhale-engage-exert. And if sitting isn't quite comfortable, you can practice performing your breaths in a side lying position.
Stay strong mamas.
Up next: The core during and after pregnancy, diastasis recti, and 3 core and pelvic floor strengthening exercises that every mama should be doing. Safe for diastasis recti too!
Expecting? Curious about possibly using a doula? Check out a recent interview with this beautiful mama of 5 and certified doula for more info!
Have questions? Let's connect! Feel free to shoot me an email.