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Speedy Postnatal and Pregnancy Circuits

While the sun was shining I got in the garden and filmed a couple of workouts to share on my Facebook page.

2 speedy circuits, postnatal and pregnancy friendly (bar one exercise when you’re final trimester, and provided no SPD), one for the lower body and one for the upper.

They’re time-lapse ones, to keep it quick for the sake of social media, BUT I’ve written up the circuits in this blog, with real time video demos of the exercises linked, so you can try them at home. All you need is a resistance band, but they are inexpensive and so versatile it’s worth getting one.

Here’s the type I use (I haven’t actually got this one as I buy long rolls and cut them out as I get through so many, but with most brands medium is an appropriate strength, and 1.2 metres is long enough.)

 

Postnatal and Pregnancy Lower Body Workout

Banded Side Steps x 20 Use a mini band as in link here or you can use a long resistance band as I did in the time-lapse video. Stick your bum out in a mini squat position and take 20 steps, 10 in each direction. Works the butt and outer thighs.

Banded Squats with Pulse x 10 Inhale as you lower, exhale as you pulse and rise. The band adds extra resistance, the pulse is HARD, but if newly postnatal or very pregnant a squat without the band and pulse is better, as in the video here.

Deadlift with Band x 10 Keep ribs over pelvis throughout, inhale and push your bum back, exhale and rise, driving the action with your glutes.

Reverse Lunges x 20 Alternating. Inhale and step back, dropping down so your knees are at 90 degrees. Exhale and return to start.

Banded Leg Extensions x 10 each side Hands under shoulders, knees under hips. Wrap the band more glutes! No need for the band if you’re pregnant or newly postnatal (and is too much strain for a larger diastasis), and final trimester this will start to get too hard even without the band, so you can do it sliding your leg back whilst keeping your toe on the floor, then skip it completely.

Repeat circuit as needed!

 

Postnatal and Pregnancy Upper Body Workout

Pulldowns x 10 Sorry no video for this one, but detailed instructions: hold resistance band overhead. Exhale and bring your arms down to the side of your body with a 90 degree bend at the elbows, with the band behind your back. Inhale and return. Engage core to keep ribs down (rather than let them flare out). Good for the back and shoulder and chest mobility.

Chest Press x 10 Exhale as you straighten the arms, inhale as you bend them. Aim to bend the elbows to 90 degrees, forearms parallel. Works chest, triceps and shoulders.

Open the Door x 10 Exhale as you open your arms up, inhale as you return. Works deep shoulder muscles and opens shoulders, good for posture.

Pull Aparts x 10 Keep ribs down as you exhale and pull the band apart. Keep shoulders relaxed, slide shoulder blades together. Great for the back, shoulders and posture.

Bent Over Row 10 Keep a neutral spine‐ this means not letting your back bend forwards. Bicep Curls 10 No video but very simple! Stand on the band with arms straight and exhale as you bend your arms.

Overhead Tricep Extension x 10 each side Keep your ribs over pelvis‐ there’s a temptation to let your back arch here! Exhale as you straighten your arm.
Repeat circuit as needed!

 

These are pregnancy and postnatal Safe, BUT Stop anything that causes pain, and book into see a Women’s Health Physio‐ many do packages with a pregnancy and postnatal appointment. All exercise carries a risk of injury, so consult your doctor before starting anything new

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Top 5 Postnatal Core Exercises

“What’s the best exercise for toning my tummy?”

I probably get asked this question more than any other. Which is understandable- I remember how weak I felt in the months after giving birth, and looking down at a tummy that didn’t look like mine anymore!

Your postnatal core isn’t the same as your pre-pregnancy core. For a start it’s about 10x more amazing because it’s just grown a baby. So let’s give it the love it deserves!

Which means not rushing things for a start. The pressure to ‘bounce’ back can be immense, and I don’t just mean physically. Emotionally it takes time too, to adapt to your new role as mummy, yet new mums are up and about so quickly.

And this can affect how well you core recovers. Nutrition, rest, stress, all of this helps early healing. Check out how new mums get treated in some cultures!

But when you are ready to start exercising it can feel like there’s a huge list of what not to do, and not much guidance on what you can do! The go-to exercises for ab toning, like crunches, are no good, and running shouldn’t be rushed.

There are SO many fantastic exercises you CAN do though! Here are 5 here to get you started.

 

Just remember that these are for progressively strengthening your core. I always work on breathing technique with postnatal clients before any exercises- it’s vital you get this right to get the most from them, especially if you have diastasis recti.

And when it comes to that postnatal bulge, it could be a case of weakened muscles that need gradually strengthening, but if there’s a layer of fat on top then you’ll need to look at your nutrition, and I always recommend walking for postnatal clients too (it’s massively underrated).

1. Heel Slides

These are great for the early postnatal period when you’re just returning to exercise. It’s about finding and connecting to your deep core muscles, (not your abs) as you stabilise your pelvis while applying a very gentle load to your core. Building this base is the first step towards a more toned tummy.

There are a few variations on this exercise, and for some clients, including those with a larger diastasis, I give a slightly different version to this where you keep your heel on the floor and exhale through the entire exercise, however for most of my postnatal clients this is the one we start with.

2. Bridge

Love this one! For many ‘core’ means ‘abs’ or six pack, but the core, as well as including muscles much deeper than the abs, is about all the muscles around it too, and how well they function as a team.

So here we’re hitting the low back AND the butt, which work together. Plus, if you nail the breathing you’ve got the deep core involved too.

Again there are variations, but here I’ve added a ‘squeeze’ with a pilates ball to give the pelvic floor some extra work.

3. Straight Arm Pulldown

Love this one too! Since we spend the vast majority of our days upright, it makes sense to do some exercises that way! This is another one that I use in the early postnatal period for connecting to the deep core muscles and perfect for moving from the mat to standing work. It applies a gentle load to the core, which means enough to stimulate tissue regeneration and help heal diastasis without overdoing it and making it worse.

Really try to focus on the exhale, and getting a good 360 expansion (read this blog if that doesn’t make sense) on the inhale. Alignment is really important too- ribs over pelvis, no arching the back or thrusting your hips forwards here!

4. Half-Kneeling Push

So this is a fantastic exercise when it comes to getting ‘bang for your buck’. When you’re short on time (as most mums are!) this works the core and the chest, triceps and the split stance engages your legs and butt as they stabilise your pelvis.

With your shoulders relaxed, and wrist, elbow and shoulder level, your push forwards and exhale. The pressure of the band pulling you backwards engages your core, and you can add a twist which mimics how we tend to actually use our core: pushing a door open, playing tennis or boxing for example, we twist.

I wouldn’t start with the twist, but build to it. However this can be adapted to suit nearly any level, by adjusting the resistance from the band. You can keep it incredibly light so as not to create too much pressure (which we don’t want when you first return to exercise after baby) and focus on the deep core connection, then build to a much stronger band to really tighten the muscles around your waist.

5. Birddog

This is such an amazing core exercise (when done properly). It works your entire torso and pelvis as you use your butt when you straighten your legs AND your upper back and shoulders to stabilise your arm and shoulder blade!

PLUS the ability to co-ordinate your opposite arm and leg (like when you walk or run) is a really important movement pattern. There’s a reason we learn to crawl before we walk- it develops the necessary co-ordination, stability and strength. So this is becoming quite a trendy exercise- check out this Washington Post article about how crawling is the new plank!

Unfortunately I see this done badly a LOT. Remember to keep it SLOW and straighten your leg from your hip using your butt muscles, NOT arching your lower back (although yeah I’m sure it does look more sexy in an Insta post). Also try to avoid shifting your weight side to side too much. This gets easier with practise as it requires using your core more, but the pole on my back in the video is to demonstrate alignment and gives me feedback so I can feel any weight shift or postural changes.

This really is deceptively hard though and NOT one I use on clients with a very large or soft diastasis- the pulldowns, bridges and heel slides are a better place to start, then progress to this.

For more advice download my 10 Tips for getting back in shape after having a baby.

Disclaimer: consult with a medical professional before making any changes to your exercise routine, especially if you haven’t done any restorative postnatal work- be sensible about what you attempt! See full disclaimer here. If you’re unsure whether any of these are suitable then please see a postnatal qualified instructor or a Women’s Health Physio, or comment below and I’ll do my best to help.

 

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Learn This Simple Step to a Stronger Core

I think every client who comes to me wants a stronger core, and this is where we start. It really is a simple step. Or at least it sounds simple. In reality, it can be pretty hard to master, at least when you’ve just grown a baby!

I’m talking about breathing correctly.

Correct breathing technique is one of the tips in my guide to kick-starting your postnatal fitness, and it’s one of the first things I look at with postnatal clients, before starting any exercises even.

It might seem silly, and you’re thinking “but I feel so weak- I need to get working, feel my muscles again!”

And I get that. But if you don’t get the breath right, you won’t be getting the most out of your exercises.

Let’s start with the core itself.

I’ve explained it in this video, and if you look at the image below, you can see how the muscles of the abdominal wall and the back form a cylinder, with the diaphragm (that’s the main muscle used for breathing) at the top, and the pelvic floor at the bottom.

postnatal fitness

These four elements work together, and when one isn’t functioning properly, it affects the rest of the team.

Before you read any further, try something for me: place one hand on your ribs, thumb to the back and fingers to the front, and the other hand on your tummy. Take a few breaths- what can you feel moving, what’s happening?

Here’s how they should be working together.

postnatal core fitness

As you inhale, the diaphragm moves down, the pelvic floor lengthens, and the abdominal wall (and trunk in general, the low back opens up as well, which isn’t shown here) expands. The rib cage opens up in a 360 degree action too.

Here are the ribs in action:

You should hopefully feel a softening of the tummy and pelvic floor as this happens.

As you exhale the diaphragm rises, and the pelvic floor and abdominal wall naturally tension. You may even feel your low back joining in on a more forceful long exhalation.

How is this relevant to getting a flatter/ stronger tummy?

 

Because so many people have poor breathing technique. Especially new mums. Having your tummy muscles stretched and a baby’s butt pushing into your diaphragm for months will do that. Here are a few of the problems that I come across.

Mistake Number 1- Belly Breathing and Diastasis.

 

Diastasis Recti is when your abdominal muscles stretch apart during pregnancy. Once the baby is gone and the pressure stretching them removed, they should move back together again over the next few months.

But sometimes the pressure isn’t removed. If you’re a belly breather (think BIG expansion of your tummy every time you inhale) then that’s pushing on your diastasis every time you take a breath. Which is about 20,000 times a day. Not good.

Mistake Number 2- Sucking It In.

Holding in the abs. How many of us are guilty of that? In a world where we’re continually informed that a flat tummy and six pack= sexy, it’s tempting to do!

But if your tummy’s sucked in, where’s that pressure going? Down on your pelvic floor, or up on your diaphragm. The whole mechanics of your core is altered.

Strong abs do NOT = functional. You need them to be able to move with the breath. Permanent tension is not practical, and can result in back ache as your low back muscles over work too.

So let it go!

Had to be done!

Mistake Number 3- Shallow Or Chest Breathing.

 

Booby breaths as I like to call them. Think heaving bosoms in corsets. This often goes hand in hand with the sucking in, but many take heavy chest breaths, where the ribs go up as you breath, rather than out. It’s usually a tense and shallow breath, which means the core will not be effectively loading and unloading, so not making the most of your exercises. And think how relaxing a good deep breath is- you’re not getting that release if you’re stuck shallow breathing! If you’re shoulders rise when you breathe in- you’re doing it wrong! Remember- 360 expansion.

Now let’s try connecting to your deep core as you breathe.

 

With one hand on your tummy, one on your ribs, inhale, and try and feel a 360 degree softening in your belly and your ribs open up to the sides. Feel your pelvic floor soften and lengthen.

Now exhale for an 8 count, like blowing bubbles (I get the Restore My Core mums to actually do this!)- can you feel a tensioning in your tummy and hopefully pelvic floor?

personal training core

You might only feel your chest at first. After giving birth, regardless of the type of delivery, nerves can be affected, so this, plus the load carrying a baby placed on you, means this connection to the breath can be lost.

Bring your attention to your tummy and pelvic floor, and take your time.

Here’s a live facebook video I did on this, exaplining how you can practise correct breathing technique (it’s live so forgve me for forgetting to mention- as you inhale try to feel your pelvic floor lengthen, and rise as you exhale):

It takes practise, and there are also certain releases (such as massage, or some self applied techniques that I teach on Restore My Core) that I find very effective in helping to release and open up the rib cage and low back.

Hopefully you can see that even if you do the best exercises in the world to heal a diastasis, if your breath is putting pressure on your abdominal wall all day long, they won’t be effective.

To get a strong core you HAVE to start with the deep muscles. Once they are well co-ordinated, THEN you can start working on your abs.

But only when the inner unit is stabilised! Which means the diaphragm, pelvic floor and deep core working together on every breath.

Once you’ve got the hang of this head to this blog for some postnatal core exercises to get started on, and you can also download my 10 Tips for getting back in shape after having a baby.

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Physiotherapy For Where?!

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I sometimes describe pregnancy exercise to clients as training for their Olympic event. Because that’s kind of what it is- a life changing event where huge physiological changes occur in a woman’s body.

So we prepare for it. My clients stay as mobile, fit and strong as they can. We work on opening the pelvis for labour, on keeping the pelvic floor strong but not tight- we need it to relax and stretch for baby, and on making sure mum is in the best position she can be to recover afterwards.

 

But as with any sporting event, injuries occur.

 

And who do you see when you get an injury? Back pain, tennis elbow, knee pain? A physio, right? Or at least I hope you do- masking the symptoms with painkillers won’t do much good long term!

And the particular physio you need in this case is called a Women’s Health Physio. Some women will  see one in hospital, for example after a bad perineal tear. But most of us don’t. We should, but we don’t.

Giving birth is probably the only physical trauma that we don’t get help for!

 

It can be major surgery to abdominal wall that interferes with the core and whole body function, a cut or tear to perineum; it’s pushing a baby through your vagina!

How many times have you heard women complain “I’ve had pain around my pelvis/ incontinence since giving birth…” YEARS later?

Because there are ‘injuries’ from giving birth that we simply don’t recognise as such. Incontinence for example. Common but NOT normal, we treat the symptoms with pads, instead of the cause.

And the best way to determine the cause is to see a WH Physio, because it isn’t necessarily a weak pelvic floor.

The pelvic floor could be too tight, not used in the correct way or have other muscles compensating for it.

Emma Tailby, Women’s Health Physio at Ashlyns Physiotherapy in Berkhamsted says “We use an holistic approach in treating pelvic floor disorders.

“From treating incontinence to prolapse, pelvic pain or constipation, there is growing evidence that WH physiotherapy can alleviate, and in many cases cure these symptoms. Most women don’t know that help is available and it can be an embarrassing topic.

By doing correct pelvic floor muscle exercises 7 in 10 women avoid surgical intervention. You need this strong core foundation to start to rebuild your postnatal body.”

So what exactly does pelvic floor physio involve?

 

The initial assessment will include plenty of questions about your delivery, how your muscles feel, have you had any incontinence, your bladder and bowel health, diet, posture. You’ll be checked for abdominal separation and how well your deep core muscles are functioning, and there’s a thorough internal assessment.

This internal examination is explained and consented to. “Every woman’s body and post birth recovery is different so it is key to examine you to ensure the strength and function of your pelvic floor as an individual,” Emma explains.

However for anyone uncomfortable with this an external assessment can be done too.

“Can’t I just do my kegels?”

You can, and I work through kegel progressions with clients and on Restore My Core, with the aim of integrating the pelvic floor in to whole body movements, working it as part of a global system rather than in isolation.

BUT- you need to start in isolation. And you need to get it right. And I can’t know for sure if you are or not. As one client told me, “it wasn’t until the physio had her fingers up there that I really got the full lift through my pelvic floor!”

Becky Aston from Becky Aston Physiotherapy in Chesham says “Only 50% of women will do their pelvic floor exercises correctly when taught without an examination (or with verbal instruction). Some will have pelvic floor muscles that need help to contract and a WH Physio will be able to help with that. Some women have restrictions from scars even ones that are years old and without these released activating the pelvic floor muscles is difficult.”

You’ll be asked to perform a variety of contractions as your pelvic floor is thoroughly assessed. Full contraction, part contraction, a long squeeze, a series of shorter ones. Squeeze and hold then try and squeeze more. That kind of thing.

And you’ll get given exercises specific to you.

 

Let’s face it, you’re out of hospital as quickly as they can manage, and the 6 week postnatal check leaves a bit to be desired. If you’re lucky you’re told to do your pelvic floor exercises and pretend you’re stopping the flow of urine.

However Erica Lewis from Hertfordshire Women’s Health tells me this is far from ideal:

“Every woman has different needs and desires regarding what they want to achieve from their treatment and this, along with findings from the examination, determines what is appropriate and what should be avoided.

“Variations in pelvic floor exercises include the number of repetitions, effort of contraction, length of hold and exercise position, and for some women we have to focus on releasing and relaxing the pelvic floor before we even begin exercising it.”

I wish every client would see a Women’s Health Physio before coming to me.

 

This way I KNOW you’ve connected to your pelvic floor. I know, from the physio, EXACTLY where you are strength-wise. I know how well you’re connecting with your deep core muscles. I coach through this, but a personal trainer will not be able to do this as effectively as a WH Physio if you’re having problems here.

And then I can focus on what I’m there for: exercise programming.

(Although I like to be clear- exercises are the last piece of the puzzle when it comes to restoring your core after baby! Correct breathing technique, alignment, releasing tight spots and nutrition are all essential to the postnatal journey. Without getting all this right the best exercises in the world won’t make a difference.)

“But I feel fine!”

That’s great! I still think it’s worth having a postnatal check-up though. I want to KNOW everything’s ok, and even if you don’t have signs of incontinence, bulging at your stomach or pelvic floor/ low back pain/ pelvic pain, sometimes the problems don’t happen straight away.

Pelvic floor exercises and correct abdominal recruitment is not easy, and Becky Aston says “many women come and see me saying that they have been doing kegels for years and yet they still have a problem. On examination they are holding their breath or bearing down or recruiting every other muscle other than their pelvic floor muscles- how great would it be to get it working correctly before problems arise?”

When we start the menopause, the hormonal changes mean that connective tissue begins to lose elasticity. So if there is a weakness somewhere in your core or pelvic floor, this is when it will show itself. And it’s thought over 50% of women suffer a prolapse at some point.

Pelvic Organ Prolapse (POP) is when one or more of the pelvic organs (bladder, uterus, rectum) prolapses into the vagina.

 

There are varying degrees of this, and it can be managed, but in some cases it will require surgery. And in every case it is upsetting for the woman experiencing it.

You can get false teeth if you don’t care for them properly, but you can’t replace your pelvic floor, and that’s what’s holding your pelvic organs in place. It really is one of those things you don’t appreciate until something goes wrong.

And whilst the menopause is a high risk time for POP, it happens to plenty of young women too. Some exercises put more pressure on your pelvic floor than others, so if you’re thinking of going to bootcamp then you 100% need to see a WH Physio and find out if your pelvic floor can cope with it.

Even if you’re years postnatal, it’s never too late- book an appointment with your local WH Physio.

 

And if you know a new mum and are wondering what you can get her, instead of baby gifts how about a Mummy MOT? Along with cleaning, cooking, and help looking after siblings, I think that should be up there on the list of best things you can do for a new mum.

For more advice download my 10 Tips for getting back in shape after having a baby, and head to this closed pregnancy and postnatal support group, where I can be found to answer any pregnancy and postnatal related exercise questions, along with a whole team of experts, invluding 3 Women’s Health Physios!

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Are You Getting Enough?

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Probably not. Most of us don’t. Cars, the convenience of online shopping, the weather, it all means we don’t get as much time walking as we should.

Yes, walking. What did you think I was talking about? Ok I’m sorry, but it’s not easy making a blog on walking sound exciting.

walking benefits for the pelvic floor and postnatal

Because most people don’t think of walking as exciting.

It’s not a sexy form of exercise. You don’t see people boasting about their walking personal best like a runner does, or the killer spin/ Insanity/ whatever class is on trend and torturing you right now. (Sorry, I shouldn’t say that, I used to teach indoor cycling and don’t really consider it torture. Not once you’ve got used to the seats at least.)

But walking is the most underrated form of exercise.

And we really don’t get enough. One study found 80% of adults didn’t even manage to take moderate exercise 3 times a week, and just 25 minutes of brisk walking a day can add up to seven years to your life.  (ok, this is getting a bit boring now; no more health stats).

Walking is a fundamental movement of the human body.

As well as not doing enough of it, a lot of what we do is poor quality walking (I’ll talk more about this in my next blog), and it has so many benefits. I cannot emphasise enough how awesome walking is.

Walking works your pelvic floor

The pelvic floor loves movement; a sedentary lifestyle is one of the worst things for it. Watch this to see how regular walking engages your pelvic floor:

It gets those glutes working!

Too much sitting results in weak, ineffective butt muscles. Walking is a great way to strengthen them. Walk, and walk often, making sure they’re engaging properly. Make sure you’re pushing back with them, not just flopping forward from one leg to another. Have a feel- place your hands on your buttocks and see if you can feel them tense up as you land on each leg (don’t worry, this won’t look weird at all), then try and drive your eg back and use them to push yourself forwards.

Walk your way to more vitamin D

Not all walking is created equal, and walking on a treadmill is NOT the same as getting outdoors (more on this in the next blog). And when you’re outside, you get your daily dose of vitamin D. A LOT of adults are deficient in this, and interestingly it’s been linked to pelvic floor dysfunction, so yet another benefit to your pelvic floor!

Walking is fantastic postnatal exercise

It has none of the risks that some exercises (such as running) carry for vulnerable joints and pelvic floor muscles, when done properly uses a huge number of muscles, and it is one of the few exercises that is easily done with baby. In fact it’s great for babies to get outside, and increased sunlight has been linked to better night time sleep for them!

Add to that reduced stress, especially in natural settings, the chance to think (or not think if you need a bit of mindfulness), the benefits to the glutes and pelvic floor- this is why daily walking is part of the homework for mums on Restore My Core.

It’s easy to fit in

It’s so easy to spend your day rushing around and busy, but never really moving. A lot of people struggle to find the time to go to the gym or follow a more structured exercise routine, but it’s so easy to fit in some walks. Because walking serves a purpose: getting from A to B. Even if it’s just parking a bit further from your destination, start to build a bit more ambulation into your day.

How much do you need?

This depends on a bit on how much you’re getting now (I feel like I should be able to slip some puns in here). As with any exercise, build up slowly. But looking at how much our ancestors walked is a good guide to what we should be capable of.

In her book Move Your DNA, Katy Bowman says anthropolgists estimate hunter-gatherers walked about 1,000 miles a year. That’s 2.75 miles a day. BUT, this mileage wouldn’t have been broken down that neatly. There would be short walks spread throughout the day, along with days of very little walking and days with much longer walks.

The odd longer (10 mile) walk means you develop the strength and endurance in your muscles. The regular short walks mean you benefit from regular boosted circulation (‘feeding’ your cells and removing waste products) and regular breaks from too much sitting and all the negative adaptations that can bring.

10 miles might seem intimidating.

But how about signing up to an event like our local Starlight Walk? It’s 13 miles, but you’re raising money for a good cause, and there’s plenty of motivation and entertainment on the night. Something fun to aim for is the perfect excue to get started!

Next time I’m going to tell you how to pimp your walk (yep, still trying to make it sexy) and get the most from your daily amble. Because a lot of people are doing it wrong.

Not all walking is created equal, but with a few tweaks to your route, and the right stretches and exercises, you can make sure you maximise the benefits next time you head out for a stroll. Sign up for updates here to make sure you don’t miss it (and grab a couple of freebies while you’re at it).

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What Your Doctor Doesn’t Tell You At Your 6 Week Check.

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The 6 week postnatal check- that’s when you get the all clear and it’s back to business as usual, right?

That’s how I remember feeling anyway, and from my experience training new mums, I know I’m not alone.

I remember sitting there and asking, “So I’m ok to go back to exercise now?”

And I got lucky, because my GP said yes, but advised that giving birth means my body had been through some big changes, and 3 months would be better, to really have time to recover.

That, plus having a baby who didn’t sleep well, plus geting mastitis at 3 months postpartum, meant that I didn’t get back to training as quickly as I had planned. Which probably saved me from doing myself some harm.

Because although I’d been a personal trainer for 7 years, I didn’t have any postnatal qualifications at that point, and the general message I’d absorbed from the media is that if you’re in good shape you should ‘bounce back’.

And I was fit, so I should be fine. In fact, because I worked in the fitness industry I felt I should be seen to recover and get my fitness back quickly, and I was very fortunate to have a doctor who gave me some good advice (and to be too exhausted to argue with it)!

Because The 6 Week Postnatal Check Does Not Mean You’re Ready To Exercise!

However, this hinges upon what your definition of ‘exercise’ is. Because I could also say you don’t need to wait 6 weeks before you exercise.

The problem I come across is that many doctors aren’t specific about what they mean by exercise. So while they’re thinking a few walks and pelvic floor exercises would be good, I know a lot of women will be thinking ‘back to my old workout routine.”

What Happens If You Do Too Much Too Soon.

Even though you might feel ok at your 6 week check, it takes so much longer than we realise to recover from childbirth. Then there’s the pregnancy hormones, lack of sleep and breastfeeding to consider. I’ve written here about postnatal recovery already, and the potential consequences of too much exercise too soon, and this blog is a must-read example of what happened to one mum when she returned to exercise too quickly.

Your Pelvic Floor

The pelvic floor is the area that often pays the price if you overdo it, and unfortunately this is one of the things your doctor probably doesn’t tell you.

Pelvic Organ Prolapse is when 1 or more of your pelvic organs (bladder, rectum, uterus, intestines even) move out of place, and prolapse down into the wall of the vagina. I had 2 children, did my ante and post natal exercise qualification, and still hadn’t heard of this. (I’ve since studied both pregnancy and postnatal exercise to a higher level to rectify the gaps in the fitness industry’s basic training!)

And I really wish GPs, or even the hospital/ homebirth team, would give new mums some information on this AS STANDARD! Because prolapse can have such a huge impact on your life, I’m sure a little information would lead to a lot of mums making far more sensible decisions.

Diastasis Recti

This is something else that I really wish GPs would check, but generally they don’t. I can count on 1 hand the number of mums I’ve met (out of 100s) who have had their diastasis checked at their 6 week appointment. For more information about what exactly diastasis recti is, read this blog, but it’s another biggie in that if it isn’t healed, you’re at a higher risk of injury or pelvic floor problems if you do too much too soon.

doctor 2In fact, I don’t know about you, but my 6 week checks have been a quick blood pressure check and then asking what contraception I was using. In case the 6 week baby wasn’t enough!

In many cases the check up is more about the baby than the mum, and even though one of mine was a seperate appointment than the baby check, it still didn’t go anywhere near as deep as it should. The only way to know for sure what’s happening with your pelvic floor is too see a Women’s Health Physio (if you’re local to me I recommend some here).

So What Can I Do?

I said before that you don’t have to wait for 6 weeks until you exercise, and you don’t. But I’m talking about exercise so gentle you may not even think of it as exercise.

You’re advised to start your pelvic floor exercises (kegels) as soon as you’ve had baby, and you can start doing some gentle deep core connection work after a few days. Even with a c-section, you can do these from around 7-14 days. I do this with clients and mums doing Restore My Core, as there can be a loss of responsiveness in those muscles, which needs to be restored.

Following on from this, progressing to glute exercises to promote pelvis and hip stability is also beneficial. This, plus some gentle walking when you feel up to it (and I’d advise a few weeks rather than a few days for that) can help in a number of ways:

Faster Recovery Post Birth

The pelvic floor exercises will increase circulation to the area, helping to heal any tears, and both the core and floor work will help your nervous system to re-connect to these muscles.

Healing Diastasis and Preventing Incontinence

The right exercises, especially those that involve the deep transversus abdominis and pelvic floor, will help to heal diastasis recti. And pelvic floor exercises will help you regain control if you’re suffering from any leaking post-birth.

Reduced Pain

Having a stronger core will help take the pressure off your back muscles, which have to pick up the slack when the rest of the core isn’t functioning properly. Some gentle stretching and release work can help with this too.

The best course of action is to follow a specific post natal restorative programme, such as Restore My Core, but to learn more now you can download my 10 Tips for getting into shape after baby. And remember- the most important thing in the early postnatal period is rest, and when you do start exercising it should make you feel better, not worse. If you feel fatigued after you may have over done it. Listen to your body, and take it slowly.

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Think You’re Ready To Run? Read This First!

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So, you’re ready to get started. You’ve read my last blog about how long you should wait before running after baby, and it’s time to run.

Running is a great form of exercise- it’s free, and anyone can do it, anywhere. But it’s an advanced exercise. Your feet will hit the floor about 1500 times per mile: that’s your body weight plus the extra g-force, and if you’re carrying any extra pounds then that’s pretty intense.

I can’t remember where I heard this (I definitely stole it from somewhere!), but it’s so true:

training running

So Let’s Make Sure You’re Ready!

I don’t just mean make sure you’ve recovered from giving birth. I mean let’s get your body ready to cope with the stress, and get better results when you do run. Here are 5 tips to get you ready.

1. Incline Walks.

I know, I know. You want to work. Really feel like you’ve built up a sweat, get that kick that only running gives. And you will. Seriously. Hiking up a steep hill is hard work, and it’s perfect for preparing to run.

More so than walking on a flat surface, a good hill will get you using your arms and rotating your body, just like you do when you run. This will help your running technique. It requires loading and control on one leg, like running, but without the impact. And all this means you’re integrating your core and building the strength needed to run.

So if you haven’t yet, spend some time doing hill hikes before you start the running regime.

2. Build Your Butt!

The bum, or glute, muscles, are important for a number of reasons: they help maintain posture, play an important role in reducing the risk of injury (underactive or weak glutes mean more strain on the back, hips and knees), and they help to balance the pelvic floor by keeping the pelvis in alignment.

Those hill walks will do a great job of getting your butt working, and here are a few exercises you can start doing right now to work on your glute strength. Click here to find out where to buy the minibands.

Kickbacks.

I love these because you’re standing up and on 1 leg, so it engages your core too. This exercise really focuses on making sure you get a good extension behind your body. So many runners just fall forwards from one leg to the other, rather than using their glutes to propel themselves forwards.

Side Steps.

These work the butt muscles at the side of the pelvis, so help to keep it stable when you’re on 1 leg. Having strong muscles on the outside of your hip helps to keep your knees in line and prevent injury.

1 Leg Miniband Squats.

A lot of people struggle to keep their knee in line when they stand on 1 leg and it moves inwards instead of staying in line with their toes. This is a corrective exercise where you use the band to pull on the working knee: the muscles on the outside of your hip have to work harder to fight this pull and keep your knee from moving in, thereby getting  better at doing this, even when the band isn’t there.

3. Breathing

How you breathe has a huge impact on your core and pelvic floor. I explain how in more detail here, but essentially your diaphragm (your main breathing muscle) and your pelvic floor work together, along with your core. If this system isn’t functioning properly you increase your risk of incontinence when you run.

A really important point here is to make sure you’re not tensing or pulling your tummy in while you run. It’s not always easy to do- when you’re working hard it’s difficult to stay relaxed. I see a lot of runners with tense shoulders, jaws or fists, and tummies can tense up too. This interferes with the natural movement of the core as you breathe and puts more pressure on your pelvic floor.

4. Alignment

This links to your breath- you need to keep your ribs over your pelvis so that your diaphragm and pelvic floor are in their strongest positions. ribs over pelvis

You also need to keep your pelvis in what’s called a neutral position. This means your bum shouldn’t be tucked under and your back flat (more about this here), but untucked so there’s a slight curve in your low back. If your bum is tucked under then your pelvic floor is left in a weak position and you’re at risk of- you’ve guessed it!- leaks. The butt exercises above will help with this too.

5. Reduce The Impact.

As with anything, build up slowly. Start with slow, short jogs or intervals, where you jog then walk, jog then walk. This gives your body time to adapt and get stronger, so you’re less likely to suffer the result of your pelvic floor giving way as a result of too much, too soon.

Other key things to bear in mind when planning your run:

Running surface.

Grass, gravel and sand will all reduce the impact on your joints and pelvic floor. Try to avoid alwasy running on the pavement.

Reduce your stride length.

A long stride will lead to a heavier landing on your heel, and more impact. Take smaller strides and land with your foot under your body, rather than out in front.

Avoid downhill running.

Downhill running tends to result in a heavier landing and more impact, so try to stick to flat surfaces, or walk down hills.

Vary your workouts.

Include other forms of exercise in your routine to give your body a break. Cycling and swimming are great pelvic floor safe cardiovascular workouts, and a good resistance programme will complement your running, as will yoga or pilates.

If you still feel you need help getting fit to run then personal training can help, giving you a programme to build up to running again, or to complement your existing running routine. If you’d just like a chat about where to go next with your training, or what help you might need, then get in touch here.

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Running Postpartum – How Long Should You Wait?

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Running after baby pelvic floor postnatal

I get asked this question a lot, so I think it deserves a blog!

Unfortunately there is no simple answer, because EVERYBODY’S DIFFERENT! So you need to start listening to those motivational memes on Facebook telling you not to compare yourself to others- it doesn’t matter that your friend was back running 3 months after giving birth. Someone who was fit before and during her pregnancy, and had a quick labour with no tearing will recover a lot faster than someone who isn’t a regular exerciser and/or had a difficult labour. This is about what’s right for you.

It Takes Longer to Heal Than We Realise

postnatal recovery

I have seen it advised that it takes at least a year for the pelvic floor to return to full strength , and if you look at the graphic above, you can see why that is! Connective tissues, such as tendons and ligaments, have a slower healing rate than muscle, and there’s a lot of this within the pelvic basin.

This doesn’t necessarily mean you can’t run for a year though!

Here are some guidelines to help you decide whether to start running yet, and signs that you need to slow down.

We’ll start with a hormone called relaxin which is released into your system in the early stages of your pregnancy. Its job is to relax your ligaments to help prepare your pelvis for childbirth, but relaxin doesn’t just affect your pelvis, it affects every joint in your body. And it stays in your system for up to 6 months after birth, or until you stop breastfeeding.

As a result your joints aren’t as stable as they once were. When you run, your entire body weight lands on 1 leg with a G-force of 2-3. So there’s a lot of impact going through those unstable joints. Plus, for those of you who no longer have relaxin circulating: I’ve assessed a lot of clients over the years, and most people have poor alignment in a 1 leg stance. If you wobble when standing on 1 leg, how well will you cope with impact?

Next up is your pelvic floor.

If hasn’t recovered yet, chances are, you’ll wee yourself the first time you go out for a run, and could do yourself some everlasting damage. Even if you don’t suffer any incontinence, if you feel a heaviness down there: stop.

Unfortunately incontinence is accepted as normal by many women. Common, yes, but not normal, even if you just leak a “little bit” when you sneeze or jump. In the majority of cases it can be resolved, so if you have any doubts about your pelvic floor see a Women’s Health Physio and follow an appropriate exercise routine. And no running! If you place pressure on a dysfunctional pelvic floor it’s never going to heal.

Do you still have diastasis recti?

Your abdominal wall forms a sort of pressure system with your pelvic floor, low back muscles and diaphragm. And if you have diastasis, there is a weakness in that system, which means your back is going to be less supported while you run, and potentially there’s going to be more pressure on your pelvic floor too. So focus on restorative core exercises before starting anything high impact.

I know the idea of no running can be hard.

For many it’s not just the physical side (although it does feel good to go for a good run and feel like you’ve worked) but the mental side, as it relieves stress and gives you time to yourself. But remember: this is a phase of your life. It will pass, and it is so small compared to the bigger picture. At some point you will be able to run and jump again, just as long as you don’t rush things now.

Jenny Burrell of Burrell Education explains this brilliantly: You brush your teeth every day, even though you could get dentures implants if all your teeth fell out, but there is no replacement for your pelvic floor!

So, you can start running again, if:

  1.  Your pelvic floor is in check.
  2. Your diastasis recti is healed.
  3.  You’ve done a couple of months’ worth of work on restorative core exercises, and some whole body strengthening.
  4. You’re at least 4, if not 6, months post partum. This is a minimum- some will need longer.
  5. You’ve invested in a good sports bra (always a must with impact exercise, but especially when breastfeeding!)

What if you’re not yet ready to run?

I have a few blogs to get you started- this one has training tips to get you fit to run, and this blog has my top 5 postnatal core exercises. You can also download my top 10 tips for getting in shape after having a baby here.

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No Housework And Regular Massage: Postnatal Traditions From Around The World.

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postnatal traditions recovery fitness

I have some vivid and precious memories from the first few months after my sons were born, despite being in a bit of a daze at the time. It’s such a special time, and one of enormous transition: physically there’s a lot of healing needs to take place, there are hormonal changes, bonding, learning to breastfeed, and relationships adjust.

And I can’t help but feel we don’t honour this time as we should. We’re pretty good about pregnancy, but once baby arrives, the mum doesn’t always get so much attention anymore. And with paediatrician appointments,  endless nappies to change, baby clothes to wash and visitors to see baby, self-care can take a back seat.

 postnatal recovery traditions

But is this good for our recovery?

In a word: no. Which made me wonder- do other cultures take better care of new mums than we do?

Confinement.

Many countries have confinement practices where the new mum stays at home, with no visitors except close family until the confinement period is over. For Malaysian women this usually lasts for 42 to 44 days, for an Indian mum, it’s about 40.

Wouldn’t it be wonderful if we could follow a similar practise in the UK, treating the postpartum period as a time to cherish and give mum extra care? Unfortunately it is just not practical for most of us: how many have family members who can tend to us for that long? There is the option of hiring a doula though, who often provide support beyond the birth itself and can advise on self-care and even help with household chores, or postnatal support from someone like Karen at Parents & Co, who can provide overnight care too.

No washing your hair!

This is a Chinese one, and linked to an overall practise of staying warm, because loss of blood and energy is thought to make mum ‘cold’: in Vietnam they practise nam lua (‘mother-roasting) where a fire keeps the mother warm for a month.

Other warming practises include bathing in warm, herb infused water- I don’t think any of us want cold baths or showers, so this one is pretty easy to follow!

postnatal traditions

Is this a valid concern though? Apparently so! One study found people who dipped their feet in icy water for 20 minutes were more likely to develop a cold than those who didn’t.

Given that new mums often experience increased sweating (getting rid of the extra water retained during pregnancy) these warming traditions do seem like a good idea!

No TV or reading!

Ok, I would have struggled with this one. I get the reasoning- strain on the eyes and potentially tiring- but I’m not sure I could stay in the house for that long without books. Unless I ran up a MAHOOSIVE bill at audible.com. Is it acceptable to ask for itunes vouchers instead of baby clothes as a gift?

Other activities considered to be stressful and avoided include shouting, crying, and too much conversation. I may have struggled with the crying (hormones!), however talking to fewer people may have helped…

No housework

Awesome. Also, no bending at the waist to prevent back injuries. In India new mums are sometimes helped by a dia (or even a maid) who will help with cooking, laundry, and bathing the baby.

In some cases, where the birth has been particularly difficult and there may be problems such as a prolapse, this is great advice. In others, it may feel impractical: bending over baby to play, for example.

Also, whilst I’m all for rest, some exercise, such as gentle walking, can be really beneficial in encouraging the core to repair. It will increase circulation which will increase the nutrients being delivered to mums muscles, aiding her at a cellular level.

However, there’s something else that aids circulation…

Massage.

postpartum traditions healing massage

Also awesome. In India the dia will do this too (maybe even daily), or in Malaysia a bidan massages the abdomen. Pregnancy and the strains of a new baby can leave mum with tight areas, and  a tight spot pulling you out of alignment can affect posture, and therefore abdominal healing (diastasis recti).

Release work doesn’t have to be done with massage, I give clients techniques they can use at home for this, but massage would be my method of choice!

Abdominal binding.

Many cultures practise some form of belly wrapping to aid with healing the core. In Malaysia they use a special postnatal corset (bengkung), and India a long cloth to bind it. They can give extra support to weakened abdominal muscles, reduce postnatal swelling, and encourage them to close back together.

In the UK Physiotherapists can recommend abdominal support for women who are having trouble healing. But whereas across the pond in France new mums see a Women’s Health Physio as standard, subsidised by the government, here you have to be referred by your GP if, or search for a private one. The difference this would make to recovery, and incidences of pelvic floor disorders such as incontinence and prolapse, is immense.

Diet: warming ginger, good; windy onion, bad.

The keeping warm theme continues here, as in many countries (including China, India and Malaysia) some foods, such as ginger, are believed to promote better blood circulation and strengthen the joints, while other cooling foods are avoided. Cucumber, cabbage, young coconut and pineapple fall into this catagory, the ‘cooling’ elements thought to cause rheumatism, arthritis and weak joints in a mother.

I’m not at all convinced by this, and would have recommended pineapple myself, as the enzyme bromelain in it is thought to aid digestion! However other advise I came across, such avoiding ‘windy’ foods like as onions and jackfruit, seems pretty wise! And bone broth/ soup is a staple of the postpartum diet in many cultures, which is great for recovery.

nutrition postpartum tradition soup

Not all these practises are followed rigidly; even for the confinement, some mums will end early if they feel they need to. I don’t think I would: the prospect of a month of massage and having my meals cooked is almost enough to make me want another baby!

If you’re struggling with your diastasis recti find out about my postnatal personal training packages here.

References

http://www.hyphenmagazine.com/magazine/issue-23-bittersweet/motherhood-rooted

http://www.babycenter.com.my/a1021145/confinement-practices-an-overview
http://www.babycenter.com.my/a1042118/indian-confinement-practices#ixzz3ZlkB5GUy

http://www.babycenter.com/0_postpartum-sweating_11720.bc

 

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What Do Ab Curls REALLY Do To Your Postnatal Tummy?

Should postnatal mums do ab curls?

I’ve talked a lot on social media about crunches and sit-ups being a no-no when you’re postnatal, but a video I shared on my Facebook page recently seemed to really hit the mark. Aside from the comments and shares, I had quite a few mums tell me how clear it made things for them.

So I thought it was about time I wrote a blog on this. Unfortunately there’s a lot of bad advice out there when it comes to postnatal exercise, and many new mums do crunches to try and flatten their tummies, so we need to keep spreading the word that IT DOESN’T WORK!

Before I carry on, here’s the video:

 

Sit-ups, or any variation of this movement that works the six pack muscle, can cause more harm than good.

So, if you’ve recently had a baby and you’re doing sit-ups, STOP them immediately!

During pregnancy the first thing your six-pack muscle (Rectus Abdominis) does is lengthen, vertically. Then, as your pregnancy develops, and your baby grows and your bump gets bigger, this muscle starts to separate around your belly button.  This is referred to as Diastasis Recti. The abdominals can take time to re-align after your baby has been born, so for several weeks and indeed months (or for some, years) after birth, your six-pack muscle remains in a lengthened, separated state.

The first thing we need to do regarding this area is actually focus on connecting to your pelvic floor which is a bit like a sling of muscles supporting you from underneath, and the deep abdominal muscles which lie under your six-pack muscle.  This deep muscle is known as the Transversus Abdominis (TVA).

Strengthening the abdominals after birth, and specifically the TVA and pelvic floor, is a bit like building a house.

If your house has a solid framework and foundations, it will always be strong.  If you work on strengthening the deepest muscles first, then focus on the next layer, then the next layer after that, then your abdominals will re-align to their original structure.

What do crunches do?  They strengthen and work the six-pack muscle.  During pregnancy, we know that this muscle has lengthened and separated.  If you don’t have a solid foundation underneath this six-pack muscle before you work it (I’m talking about your core and pelvic floor here), then by doing crunches, you’re actually going to make your separation worse.  In other words, any separation you had after birth, will now be wider, because you’re forcing the muscle to strengthen, when it’s still in a weakened, separated state.  The amount of abdominal pressure placed on the six-pack muscle when performing a sit-up, forces it to separate further apart. As shown in my video.

And here’s what the pressure can do to your pelvic floor:

 

I follow a system with postnatal clients which involves locating the TVA first.  We connect to and strengthen that, along with lots of focus on the pelvic floor.  Once function in these muscle groups has been gained, then strength work can be done.

So, I hear you ask: “Why do people do sit-ups?”.  Well, in most cases, people do sit-ups in the hope that they will get themselves a toned, flat stomach and a noticeable six-pack.  I’m here to tell you that doing sit-ups AREN’T going to help you (as a postnatal woman), or anyone you know, male or female, get a six-pack.  Your body needs to be extremely lean to do this, which has nothing to do with sit-ups! (See this blog for my thoughts on having visible abs as a fitness goal.)

As a final point: I don’t even use sit-ups for clients who don’t have diastasis recti. As explained on athletic coach Eric Cressey’s website here:

“World-renowned low-back researcher Dr. Stuart McGill says that we have a finite number of flexion/extension cycles in our back until injury is caused. That number is different for every person, but the bottom line is that by performing exercises like crunches and sit-ups, you’re increasing your risk for injury with every rep!”

Plus, they’re promoting a rounded posture, which is the very one I’m usually trying to get clients out of, after too much time sat at a desk!

I do sometimes use crunches, but never in the early postnatal phase, and doing a crunch where you are engaging your transverse abdominis is very different to an uncontrolled crunch. So I recommend having a professional (physio, trainer) teach you how to do one properly, and also assess whether you need to do them.

Please share this blog and forward it to anyone you think might find it useful, as unfortunately I still see a lot of ab dominant work recommended for postnatal women- this myth needs busting!

For help with your postnatal fitness click here to find out more about my next Restore My Core course, or get my 10 Tips for getting back in shape here. You can also read what core exercises ARE safe and effective when you’re postnatal here.

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