post-natal fitness Archives - Vanessa Barker Fitness

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fitness, postnatal exercise, Uncategorized

Is Swimming Bad For Diastasis Recti?

I get asked about swimming quite a bit, mainly whether it’s safe when you have diastasis recti, but I’m going to cover pregnancy as well as postnatal here, so I’ll start with that.

Swimming During Pregnancy

Swimming can provide relief from aches and pains often experienced during pregnancy, relieving the pressure of your bump by supporting it, and taking the strain off your back.

It’s also great for improving your circulation which is sometimes affected during pregnancy, because of all of the hormones running around your system. The pressure of the water on your veins and arteries actually stimulates blood flow and can reduce swelling you may be experiencing, say in the feet or ankles.

A workout and relaxation all in one!

A trip to the pool also gives your muscles a great workout! Water offers 12 times the resistance of air, and your deep abdominal muscles get in on the act too, as they help stabilise the pelvis in water.

The rhythmic action of the stroke can also be quite relaxing, as can the feeling of weightlessness. For baby, the soft muffled sounds created by the water induce a feeling of calm and tranquility for him/her too.

Which stroke is best?

If you are experiencing any pelvic pain during pregnancy, I’d suggest that you avoid breast stroke leg action. Even if you don’t suffer with SPD now, I’d be mindful of how you feel, and avoid kicking too hard/ agressively. Keep the kick narrow, and avoid a wide ‘froggy’ breast stroke kick.

I personally found freestyle/crawl a lot more comfrotable when pregnant, but I know not everyone is confident with this, and it can be quite tiring.

As a guide, on a scale of 1-10, you shouldn’t exert yourself above a 7 when pregnant. This means out of breath, but not uncomfortable: you should still be able to talk and hold a converstation (albeit a panting one)!

I’d also recommend buying a pair of goggles so you can swim with your head down, because this puts less pressure on your back. Swimming with your head out of the water causes the pelvis to drop and accentuates the increased curve in the lumbar spine.

Swimming With Diastasis Recti

Ok, postnatal now. The question isn’t so much “is it safe”, as unless you have pelvic pain or a back problem, the risk of injury is low. It’s more can it worsen your diastasis, or prevent it from healing?

Firstly, people worry that being horizontal could put a downwards pressure on the abdominal wall. However water creates a hydrostatic pressure, and when you’re horizontal in the water the pressure from the water below (which helps give you buoyancy) will apply some compression to the abdomen.

There’s more to consider though, and your alignment in the water (or your technique) is really important too. If you have your head out of the water the whole time, then you’re arching your back (which may be sore) and stretching your abs. It flares out the ribs, which I see a lot in postnatal mums and you’re better off avoiding.

Let’s look at the 2 most popular strokes.

Breast Stroke

So if you’re going to swim breast stroke, head down (as in looking at the swimming pool floor) and in the water with each stroke! I can’t really go into technique much here, but if you watch Michael Phelps here, he actually keeps his back fairly neutral. Most of us don’t manage quite such a neat stroke though!

Also- if you still have any pelvic pain, the points above apply and I’d avoid breast stroke.

Front Crawl

I still find there can still be a flaring of the ribs, as when I swim in busy lanes I have to look up to see if anyone is in front of me. This arches my back a little and flares my ribs. I have to be VERY mindful of my technique to avoid it- again keep your gaze on the pool floor. Let’s look at Phelps again (may as well learn from the best!) and see how flat his body and spine is.

Keeping your hips up and kicking from the hips, using the butt muscles (instead of kicking from the knees) helps too, with both speed and glute strength (important for a healthy pelvic floor).

I also have to focus to keep my shoulders relaxed, and not up around my ears! Tight neck/ shoulders is common with my clients, so you don’t want to make that worse.

Core Strength and Shoulder Mobility

You also need to consider your flexibility. Lie down and reach your arms in the air.

Then let them fall behind you.

Does your back arch and ribs flare out (as I nicely demonstrate and highlight with my snazzy editing skills)? If so then there’s a good chance that when you swim and reach in front, you’re doing this too.

If you engage your core can you lift your arms without arching your back (again demonstrated by me below- my ribs have dropped down and my back has a gentle curve,rather than a larger arch)?

You need to engage your core to do this. Be honest with yourself, can you do this while you’re swimming? You might be better off working on increasing your core control before you get back in the pool.

The other thing that might be in issue is shoulder mobility. If your arms won’t fully reach up or flop to the side, you may need to increase your flexibility in that area first too.

postnatal swimming watford personal trainer

Breathing

No breath holding (this applies to pregnancy too). When your head is under water exhale, then inhale when out. Holding your breath places pressure on the core and floor.

Core Connection

If you’ve done some postnatal core training and can engage your deep core and breathe diaphragmatically, then that really will help. Personally I would work on that postnatally before getting in the pool. This way you’re controlling your core, controlling your spine and rib position, and minimising any pressure on your diastasis.

Swimming is a very repetitive movement, and you don’t want to be doing it in a way that repeatedly puts pressure on a tummy that needs to heal.

The Take Home

Swimming isn’t necessarily bad for diastasis, but it depends on your technique!

Ultimately, if you feel swimming makes you feel a bit human again, gives you some time out, and you feel better for it, then GO FOR IT!

BUT, if you have a large diastasis, or one that isn’t healing, maybe consider this could be a factor. Think about your technique, and it might be that you need to take a break for a bit whilst you work on restoring it.

September 27, 2017/4 Comments/by Vanessa

fitness, postnatal exercise

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

July 10, 2017/0 Comments/by Vanessa

postnatal exercise, Uncategorized

New mum with an aching back? Try this quick fix!

Have you got an aching upper back?

I seem to be seeing this quite a bit with clients at the moment, and a common cause is slouching, which granted most of us are guilty of, but feeding a baby seems to make it so much worse! I’m wondering if ‘baby-feeding back’ can become a thing, like ‘tennis-elbow’?

So a massage will help, right?

Yes and no. Yes in that absolutely, when you have a collection of knots between your shoulder blades that could earn you a Scouts badge, a good massage feels glorious.

But this can be short term, because it hasn’t addressed the cause of your soreness.

What is the cause?

I’ve already mentioned poor posture when feeding, slouching or hunched over baby. And there’s a chance it’s not just when feeding. Next time you’re in a queue or waiting for the kettle to boil, pay attention to how you’re standing: have you let your shoulders slump forwards?

Do you find yourself standing like the figure on the left or the right?

If you spend too much time sitting or standing with rounded shoulders, your chest is in a shortened, tight position, and your back is stretched. This stretch on the back muscles mean they become tense, fighting this pull and developing sore knots.

Massaging these tights spots will help make you feel and move better in the short term, so keep doing that, but your chest needs releasing and lengthening to stop that strain on your back. Even better, strengthening your back will really help you to maintain better alignment and prevent the ache from returning. Here’s how.

1. Hand to Wall Chest Stretch

This is a lovely chest release, and targets down the arm and wrist too, which can get tight from all the lifting mums do! Do one arm, then before the second do some arms circles to compare how your arms feel. Does the side you’ve released feel a lot looser?

You may want to release your shoulders too, as I find a lot of cients have tension here. A stretch or some self-massage are fine, just keep the stretch gentle and hold it long enough that you feel the muscle has released (you can compare the stretched side to the other like above, to make sure it’s worked). No need to use your hand even, just tilt your head to one side.

2. Wall Angel.

A simple exercise you can do anywhere, the wall angel is great for strengthening your upper back.

Stand with your feet 3-4 inches from the wall, and there should be a gentle curve in your low back. When you raise your arms to the wall maintain that cureve- if you feel your back arch then gently engage your tummy muscles to maintain your posture.

Once your arms are up, try to relax your shoulders, rather than allowing them to hunch. For the vast majority of people just holding this position is enough, not need to slide your arms up yet. Start with 30 seconds.

While there try to keep your breathing sow and controlled, with your ribs opening up to the sides.

Doing the hand to wall stretch before the wall angel helps to make the wall angel easier. Both together only takes a couple of minutes so you can do them 2-3 times a day.

3. Remove the Cause!

Finally,you need to remove what’s causing your back to ache, in this case poor feeding habits! Try supporting your back and baby with cushions when feeding so you can sit more upright, and if you’re bottle feeding try changing which side you feed from too.

Of course there can be other reasons for an aching, including how you hold baby, previous injuries or conditions. Core strength can also play a big part, and I’d always recommend a restorative postnatal exercise programme. And remember, if you have any severe pain, especially in the spine itself (I’m just talking about musclular aches in this blog) then see a therapist.

If you have any questions about anything in this blog you can find me, along with other pregnancy and postnatal professionals, in this Facebook support group. We’ll be happy to answer any questions.

March 22, 2017/0 Comments/by Vanessa

fitness, postnatal exercise, Uncategorized

The 4 Move Total Body Workout!

I’m often short on time. My clients are often short on time. So being able to create a workout that makes the most of the little time we have is a basic requirement for me!

So I’m going to share with you the basic template I use to create most of my programmes. It’s simple, has the potential for loads of variety, and gives you ‘bang for your buck’ in terms of what you get out of each exercise. Basically, you’re maximising the little time you do have.

How?

Because the 4 moves cover your whole body. They use big movements, which means more muscles involved, more work done in a shorter space of time, and more calories burned.

It’s suitable for any goal.

The variety I said you can get from this means that you can tweak it to suit fat loss, improving strength, work up a sweat doing some cardio: all you need is some imagination! You can use it at the gym, or at home with no equipment.

And even when I’m creating a longer workout, these 4 exercises usually make the base of that workout, and I build from there, adding some extra moves in.

So what are the 4 moves?

Lower Body Push
Lower Body Pull
Upper Body Push
Upper Body Pull

What exactly does that mean?!

An exercise using either a pulling or a pushing action. (I’m hoping the upper/ lower body part makes sense!)

So an example that is suitable for postnatal clients (click the exercise name to see a video demo):

Squat (lower body push, pretty much always a squat variation, of which there are LOADS!)
Bridge (lower body pull- generally speaking if it makes your butt burn then it’s a lower body pull.)
Wall Press Up (upper body push- works your chest)
Wall Angel (upper body pull- works your back)

As you can see, the pushes and pulls work opposite sides of your body.

Do 10-12 reps (or 30-60 seconds for the wall angel) and complete it as a circuit, 3-4 times. That’s about 15 minutes, and for really time-pressed clients, they can do 1 circuit every time they get a spare 5 minutes (this one’s low intensity, so I don’t worry about a warm up like I would on harder workouts).

“I want to get a bit sweaty and feel like I’ve had a workout.”

Let’s take the same postnatal template, and tweak it.

Squats.
Kneel-Ups.
Incline Press Up on the back of a park bench (or against a tree if this is too hard)
Wall Angel (against a building or if there isn’t one then a tree).
Hill/speed walk interval (if you’d like to include a run instead, check out my advice on returning to run after baby).

All you do is head to the park, complete the circuit then add a power/ hill walk before the next circuit. If you have a baby in a buggy, trust me, this is hard.

Single Leg Deadlift (lower body pull)
Goblet Squat (lower body push)
Resistance Band Push (upper body push)
Resistance Band Pull (upper body pull)

This is suitable for when you’re postnatal or pregnant (even with diastasis recti, although then it would be unloaded and you’d need to be assessed to check you’re controlling the exercise ok) , but because these exercises are slightly harder technique-wise it’s not one I usually start clients on. Because you’re adding resistance here it can be challenging for any level- just add or remove some weight! If you want some more postnatal core exercises you can read this blog though.

“I’m not postnatal and want to push myself even harder.”

Great. So many options for you! I’m going to throw some equipment in, but basic stuff you can buy to use at home.

1a- Kettlebell Swings (lower body pull)
1b- Side Lunges (lower body push)
2a- Leg Assisted Chin Ups (upper body pull. Note- video uses a bar, I use Olympic Rings with clients as you can set them up nearly anywhere)
2b-1 Arm Shoulder Press (upper body push)

The caveat here is that you do need to be taught to perform the swing. This is an ADVANCED option that I use, but I’ve included to show you just how hard this workout can get, especially if you have a little equipment (and all of these moves can be made harder still)!

For this one I quite like to break it down into a superset. I use these a lot with clients and on the Restore My Core programme. A superset is 2 exercises, and you go back and forth between them. So exercise 1a and 1b you go back and forth 3 times, then the same for 2a and 2b.

Obviously with the more intense workouts you need to throw in a suitable warm up and cool down before and after, but I really hope this gives you an idea of how easily you can create a workout, and how you don’t have to spend hours in the gym to improve your fitness.

November 9, 2016/0 Comments/by Vanessa

Blog Entries, Frontpage Article, postnatal exercise, Uncategorized

What You Don’t Get Told About Your C-Section Scar

I’ve written before about returning to exercise post C-section, but I didn’t touch on one important area of C-section recovery: the scar. Because I think this deserves a blog of its own.

I meet a lot of C-section mamas, and issues such as poor sensation/numbness, ongoing pain and a feeling of tightness in the area are common. Which is hardly surprising: even from a small cut I’ve felt tightness in the area as it’s healed.

But this rarely gets talked about- why not?! There’s been trauma to muscles, nerves, blood vessels, right in the hugely important area of the abdomen no less. Your core muscles (we want those functioning well, right?) and a number of organs are potentially affected by this. And massage can make a huge difference to the healing process.

So why aren’t all C-section mamas told to massage their scars as part of their recovery?

Advice is all about the appearance of the scar, such as looking for signs of infection, yet the effects of your C-section can go beyond what you feel in the scar itself.

This may sound severe, but remember the scar is far deeper than what we can see: if you think about how deep the incisions are, and how scar tissue is formed, this isn’t surprising.

After surgery scar tissue forms as part of the healing process, but the fibres go in all different directions, can feel tighter, and it can adhere to other tissues, such as skin, muscles and even organs. This is when problems can occur.

You can view a video here of what these adhesions look like.

So what issues can arise?

Low Back and Pelvic Pain

Adhesions in this area can affect the sacrum, which is where your spine meets your pelvis, so anything that interferes with its movement or function can have a knock on affect to your low back too.

Frequent urination

I think this one is self-explanatory! You should be urinating every 2-5 hours, but many women find themselves having to dash to the toilet far more often. Again adhesions in the area can affect the bladder’s expansion and sensitivity, interfering with normal function.

Pain with intercourse

This comes back to adhesions around the organs again: if it limits their movement, then they can’t get out of the way during intercourse, which can be very painful.

Obviously not every woman who’s had a C-section will experience these symptoms. But it’s worth knowing about because sometimes it can be years before any issues occur, as adhesions continue to form. And while massage won’t prevent all of this, it can definitely reduce the risk and severity of symptoms should they occur. So you’ve got nothing to lose from trying it!

So how do I massage my scar?

When to start:

Ideally as soon as it’s fully healed to prevent the formation of deeper adhesions. But it’s never too late to start, even years later!

How often:

More regularly to start, when the tissues might not be moving very freely, but once they are it’s still a good idea to revisit it once every so often, in case it’s getting tight again.

If you have difficulties doing this or notice your tissues don’t seem to be responding to your efforts, then you should see a Women’s Health Physiotherapist for treatment.

How?

This is the best video I’ve seen of how to massage your scar, by Lynne Schulte at Intuitive Hands PT.

However there are also therapists who specialises in scar tissue massage. Emma Holly from ScarWork at Restore Therapy told me about a recent client and how scar massage helped her:

After a long labour she ended up with an emergency c-section. After a few months she started to try some exercise videos and found she had bladder weakness and sought out an amazing women’s health physiotherapist and has started a course of exercise to strengthen her pelvic floor.

Her c-section scar had left her with little feeling and a disconnect with the pelvic area. She came to me for treatment where I worked along the scar tissue, using ScarWork therapy to stimulate further healing. Deep stretches loosened some adhesions caused by surgery and using massage to release the pelvis and hips post pregnancy.

After one 45 minute session she walked out of the appointment and said “oh, my hips feel different” in the days that followed she noticed her feeling of the pelvic floor improved so she could be more aware when drawing up the muscles and is now finding her exercises from the physiotherapist and in restorative pilates much easier.”

In addition, if you are having any issues with pelvic pain, or that might be associated with adhesions to your organs (including bowel problems) many Women’s Health Physios are trained in visceral manipulation, so can assess you and work deeper than you might be comfortable doing yourself.

WH Physio Becky Aston explains how this can affect breathing patterns (read this blog for more on the breath and core strength) and result in pain elsewhere:

An amazing fact about the diapraghm (muscle below the lungs) is it moves up and down 20,000 times a day. We think of the ovaries, kidneys, liver, pancreas etc just existing in our pelvic and abdominal cavity but they move in a synchronised fashion with the diaphragm.

Now imagine that you have something restricting this movement i.e. adhesions from a scar. However small, they will limit this movement and other structures will have to accommodate. This can cause pain or dysfunction anywhere else in the body.

Releasing abdominal adhesions can relieve IBS symptoms, menstrual pain, back pain, help the pelvic floor muscle and deep core work more effectively and many more things.

Visceral release work is a gentle therapy with mobilises visceral and myofascial structures which can release those adhesions and allow the body to be synchronised again.

And finally…

A note on numbness and loss of sensation in scars, as this is what I most commonly get asked about.

Nerve damage can be permanent, but nerves do regenerate. The speed of this is slow though, about a mm a day (it depends a bit on the size of the nerve in question) so it can take months and even years to regain feeling. The same goes for feeling such as tingling or itchiness.

I find that the impact of a scar can reach far beyond its immediate area. Tight quad muscles (on the front of the thighs) for example can pull on the scar, so massage and release work here can be beneficial to the C-section mama. And any scar can have a huge impact on muscle function too.

If you’re interested in booking a postnatal massage with me to help with your recovery, and with your scar massage, you can find out more about what it involves here.

And if you’re one of the many women who finds the thought of touching your scar makes you feel ill, you’re not alone. The comments I received after first writing this blog prompted me to write a second about scar aversion. You can read it here.

October 7, 2016/12 Comments/by Vanessa

fitness, postnatal exercise

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.

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.

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?

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.

September 10, 2016/0 Comments/by Vanessa

Blog Entries, postnatal exercise

Exercise After a C-Section

With c-section rates in the UK at around 26%, as you can imagine I meet a lot of mums who have had one! So I thought a blog covering some of the common questions and misconceptions I come across would be useful…

What is a c-section?

So, what is a c-section? Well, it’s an incision usually made horizontally, just above your pubic hair line, first through the skin, then the fat is moved out of the way, then a fibrous layer of fascia is cut, again horizontally. The rectus abdominis muscles are not cut as as they can be pulled apart along the cling film type structure (called the linea alba) in between the 6-pack muscles. Then the uterus can be opened, usually cut horizontally.

Skin, nerves, blood vessels and connective tissue is all cut, and clambs are used to hold them open so the uterus can be safely accessed.

The uterus and the outside incision are both sutured back together, but the muscles are not. This means abdominal seperation, or diastasis recti is very common after a c-section, and can take longer to heal than it can after a vaginal delivery.

I know I’m having a c-section, so I don’t need to do pelvic floor exercises, right?

If you elect to have a section, there’s a misconception that your pelvic floor will be fine. You might think that because your body won’t be going through the stages of labour, your pelvic floor won’t be affected. This is where you’re WRONG!

Pregnancy itself puts tremendous pressure on your pelvic floor, as the weight of your developing baby gets bigger and bigger, and therefore weakens these muscles. In addition, the nerves that innervate those muscles have been cut, so there is sometimes a loss of ‘connection’. It’s still very important that you strengthen your pelvic floor during and after pregnancy, even if you elected to have a section.

And if you’ve gone through the stages of labour, attempted to deliver naturally, and then had a C-section, think about what muscles have been stressed throughout this ordeal? That’s right – the abdominals and the pelvic floor! You may have been at it for hours, pushing and pushing and putting a immense amount of pressure on these areas.

Image found at https://www.flickr.com/photos/tammra/283538056

What is recovery like after a c-section?

After a c-section, your recovery time is longer than a natural birth. You may have a loss of sensation, a numbness, in your abdominals especially around the scar area, and the scar tissue itself may reduce your ability to do certain movements completely pain-free. The nerves that have been cut do regrow, but it can take well over a year for full sensation to return, and sometimes it never does.

Your pelvic floor may take a little while to activate consciously too, but keep sending the signal from your brain to these muscles, and eventually, it will switch back on, I promise.

When can you return to exercise following a c-section?

You will need to have had your Doctor’s check up before your return to exercise after a c-section, which, depending on your Doctor could be 8 weeks, 10 weeks or even 12 weeks, so give them a call to see what their guidelines are.

I ask mums wait a minimum of 10 weeks before they see me, however gentle deep core connection work and pelvic floor exercises can be done much sooner.

Just remember this is major surgery, and your body will need time to heal. Everyone’s recovery is different, so listen to how you feel.

What exercise is safe after a c-section?

Release work is hugely important- I find areas where the muscles are linked to the abdominal wall, such as the front of the thighs, can be very tight after c-section. So one of the first steps I’d recommend is getting a postnatal massage! I build in hands on release work to exercise sessions too though, and make sure clients have techniques they can use at home.

In addition scar massage is hugely beneficial- so much so I’ve written a whole blog on it here! (If the thought of touching your scar makes you feel ill, you’re not alone: read about scar aversion and the reasons behind it here.)

And postnatal-specific core exercise is probably THE best form of exercise for any new mum to be doing, regardless of the type delivery.

When I train a client who’s had a section, I start by asking them what sensation they have in the abdominals, bearing in mind that they may have next to no sensation, and still feel very sore and numb.

Next I ask how different areas of their pelvic floor feel. After this, I check for abdominal separation, and basic re-activation and re-education exercises to either the pelvic floor or abdominals to help the muscles return to their original strength and fire properly.

Unfortunately, there is no quick-fix cure for strengthening the abdominals following a section. It can take months of training, careful instruction and lots of homework. If your abdominals aren’t assessed and addressed early following the correct procedures and using the correct techniques, then they may stay in a weakened state, which can lead to poor posture, pelvic discomfort and lower back pain. The good news though, with the right assessment, instruction and homework, it is fixable.

I hope this helps- if you have any questions leave them in the comments below and for more advice you can download my 10 Tips for getting back in shape after having a baby.

July 23, 2016/0 Comments/by Vanessa

Blog Entries, postnatal exercise

Physiotherapy For Where?!

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!

June 10, 2016/2 Comments/by Vanessa

Blog Entries, fitness, Uncategorized

Improve Your Strut For A Better Butt!

I’ll cut to the chase: most of us suck at walking.

In her book Move Your DNA Katy Bowman describes walking as “controlled falling”, in that most of us simply fall from one foot to the next, rather than focusing on using our butt muscles to drive us forwards.

I’ve written about the benefits of walking, and more importantly how much we should be aiming to do, but now it’s time to make sure you get maximum ‘bang for your buck’ from your walks.

Here are some simple stretches, exercises and changes you can make to your walking technique to ensure you’re actually using your glutes when you’re out and about!

Release Tight Hips

Too much time sitting means tight hips. When we sit our legs are lifted in front of us, and these muscles at the front of the hips can get tight. This means when we walk and we want our legs pushing off behind us, the tightness at the front can restrict that.

Here’s a simple test to see if you have enough mobility for your bum to effectively pull your leg back.

Lie face down on the floor. When your pelvis is neutral (which is where it should be) then your pubic bone and the two most prominent, forward boney points on the side of each pelvis should all be level. So when you lie down you should feel an equal pressure on all 3 points.

You should feel your pubic bone pressing into the floor, and if you look down from where it’s labelled ‘iliac crest’ to where it ends, you should feel the 2 bony points on either side there too.

Keep your head down, and lift one leg off the floor, using your glute muscles. How high can you lift your leg? Does the pressure on these 3 boney points remain the same or does your pubic bone lift up? Do you have to work your stomach muscles to keep it down?

Ideally you want to be able to lift your leg behind your body without having to work to keep your pelvis level. If you do, then when you walk you’re likely to compensate for this tightness by arching the lower back instead.

Stretch your hip as in the video below. Make sure you keep a neutral pelvis- squeeze your glute to almost tuck your bum under, and make sure you stay upright, rather than leaning forward. Raising your arm to bend slightly takes the stretch a little deeper. Hold for 30 seconds, or until the stretch eases off.

Strengthen Your Glutes

Follow this with some exercises to strengthen your glutes. This blog includes some simple exercises to help build strength for running, and they are equally useful for walking.

Go Minimal!

Your choice of footwear has a huge impact on how you walk. As this picture shows even a small heel can alter your whole body’s alignment. This means joints getting more wear and tear and muscles not working at their best.

So a flat shoe is advisable, with a flexible sole because reduced foot movement will also affect how your muscles are loaded. However if you’re used to wearing more supportive shoes please transition slowly, to give your muscles time to adapt; the book Whole Body Barefoot is all about transitioning to minimalist footwear. And if you wear orthotics or have any joint problems please consult your physio/ osteopath/ chiropractor for advice.

Vary Your Terrain

So much of our walking is on flat artificial surfaces. Including a variety of gradients in your walk challenges your muscles in different ways. For example walking uphill requires more flexibility in your calf muscles, and works your glutes more, and the variety means less repetitive strain on your body.

Uneven terrain is good too, especially if you’re in minimal shoes. Walking over lumps and bumps is good for the feet and more challenging to the body than a flat surface, meaning a better workout!

Uneven terrain and barefoot- mega workout for her legs here!

Get off the treadmill

When you’re on a treadmill the belt carries your foot back for you, reducing the work for your butt muscles and increasing the work for the muscles at the front of your hip, which have to pull your leg forwards. This is the opposite of what we want, especially if you’ve spent too much time sitting at a desk or in a car!

If you do have to use a treadmill, make sure it is on an incline of at least 1%, to force you to push off a little and challenge the glutes.

And regardless of where you are, try to walk through the whole foot with a smooth rolling movement. Keep your head over your shoulders, rather than projecting it forwards (or looking down at a phone), and your arms should have a smooth swing, pushing back more than forwards.

For more specific exercises to help improve your flexibility, strength and posture, find out more about personal training.

April 28, 2016/0 Comments/by Vanessa