The Hows and Why's of Pelvic Floor Exercise January 26 2015
The Pelvic Floor
All women should perform pelvic floor exercises regularly, but it’s particularly important both during pregnancy and post pregnancy. Strong pelvic floor muscles can aid in childbirth, and also prevent or minimize embarrassing leaks when laughing, coughing, sneezing or lifting (stress incontinence is a billion dollar industry!). Pelvic floor exercises are also known as kegels, so if you’ve heard that name and wondered what it meant, now you know!
Your pelvic floor is made up of a sling of 3 muscles that connect the pubic bone at the front to the ‘sitting bones’ at the side and the tailbone at the back. This serves as a support structure for the contents of the abdomen and pelvis, including the bowel, uterus, and bladder. The extra weight of your growing baby makes these muscles work even harder and keeping them strong can help prevent incontinence and prolapse, and also aid in the birthing process. For these reasons pelvic floor exercises should be started as early as possible in the pregnancy.
Learning to isolate and contract your pelvic floor muscles is easy. Imagine urinating and stopping in mid flow and it will be these muscles doing the work. Aim to do it without clenching your bum if possible as this brings in another set of muscles entirely. It is important though that you don’t actually do your pelvic floor exercises whilst urinating, as this can lead to problems like bladder infections.
The great thing about pelvic floor exercises is that they can be done anywhere at any time, as only you know
you are doing them. The difficult thing is sometimes remembering to do them. To help with this try to associate them with different activities such as ironing, cooking, driving, or even having sex. After a while you’ll find yourself doing them automatically when performing these activities. They should also be performed every day, several times if possible. At first you may find it difficult and tire easily, but strength and muscle control should increase rapidly.
Squeeze and Hold
Squeeze/contract your pelvic floor muscles and hold for a count of 5 seconds. (Aim to build this to 10 seconds over a short period of time). Relax and rest for 10 seconds. Do 10 reps, several times a day.
The pelvic floor is made up of 2 different types of muscle fibres. Some respond to quick contractions and some to slow. This exercise is for the ‘quick’ fibres. Contract and lift the pelvic floor muscles as quickly and strongly as possible and let go. Gradually increase the speed of the contraction and the number of repetitions until the muscle tires. When the muscles are fatigued wait a few seconds to recover and start again. Aim to do this 10 times and repeat several times a day.
Try and visualise your midsection as a lift, then draw your pelvic floor upwards to the first floor and hold for 3 seconds. Breathing gently but without releasing the contraction, draw upwards to the second floor and hold for a further 3 seconds, then to the third floor for 3 seconds. Release and repeat several times a day.
Learning to relax your pelvic floor is very important too, so aim to relax the muscles slowly and under control during the exercises (except the speedums). This will help you during the birthing process. Performing these exercises whilst sitting on your birth ball will result in a stronger contraction.
Written by Mark Hibbitts and Martin Beckley personal fitness coaches specializing in pregnancy & postnatal exercise. Authors of The Birthball Handbook available from www.themiraclebox.co.uk at £9.99 including access to online Pelvic Floor DVD.
Ante and Postnatal running……Is it safe? January 23 2015
Ante and Postnatal running...Is it safe?
Of all athletes and fitness lovers, runners are probably the most dedicated. The thought of taking time off from training is often not an option, so pregnancy offers a dilemma. Can they continue running or not?
Well in most cases the answer is yes. If you are fit, healthy, and used to exercising regularly then there is no reason why you shouldn’t carry on with your normal routine. Old myths that stated ‘the jarring of running could hurt baby’ or ‘running may cause miscarriage or early labour’ have proved unfounded. In fact it is now known that in the absence of contraindications, there are some very good reasons for you to continue. Current research by Dr. James Clapp (2000) states that women who performed 45 minutes of weight bearing, aerobic type exercise on 5 or more days of the week throughout their pregnancy experienced improved well being, reduced constipation, reduced leg cramps and a quicker return to their pre-pregnancy weight than their non-exercising counterparts. There was also a reduced risk of gestational diabetes and pregnancy induced hypertension. Added to this, babies of exercising mums have been shown to have less body fat at birth and be less cranky, with a reduction in the instances of colic, and greater neurodevelopment in language and motor skills by the age of 5.
This is all good news for the pregnant runner, but on a more cautious note certain guidelines should always be adhered to. Your body experiences many physiological changes during pregnancy and your goal should be to maintain your fitness level and not increase it. Whilst competition can be motivating and challenging, serious racing will be off the cards for a while, and without question you must be prepared to reduce your distances. Your desire to run will most probably decrease as you become heavier and things become more difficult. During the second trimester, it is normal for most women to cut back the length of their runs by 30-40% and by the third trimester by up to 75%.
Maintaining good posture is essential as your shifting centre of gravity will make falling or stumbling a whole lot easier than usual, and the hormone relaxin that softens your tendons and ligaments to aid the birthing process, makes your joints more susceptible to injury. Because of this it is also necessary to be very careful when stretching, so only stretch through your normal range of movement and avoid any developmental stretching. Always remember that it’s the aerobic effect of exercise that is beneficial to you in pregnancy, so avoid interval training or sprints that may take you into an anaerobic state. Dehydration has been known to cause early labour, so keep well hydrated at all times and listen to the feedback from your body. During pregnancy there is no room for a ‘no pain no gain’ mentality and if you feel yourself hurting, getting exhausted, or overheating, you must stop straight away. If running does become too uncomfortable, then do look for another means of aerobic exercise such as walking, or possibly a stationary bike or elliptical trainer. Dr. Clapps research has shown that women who stopped exercising late in their pregnancy quickly lost all the benefits they had gained up until then.
Although ‘I’m eating for two’ is a great excuse for you to eat whatever you like during pregnancy, the recommendation is only for an extra 200-300 calories a day after the first trimester. That’s something like 2 slices of toast and a banana… ……per day. Women who run need more than the recommendation as exercise burns calories, although no studies have focused on exact requirements. The best thing is to listen to your body and don’t let yourself get hungry. Try and choose from nutritionally beneficial foods such as fresh fruit and vegetables, lean meat, poultry and fish, and wholegrain bread, pasta, and brown rice. Whenever possible avoid refined, processed foods that are full of additives, and have little or no nutritional value.
Other things you’ll need to consider may be some new kit. A good sports/maternity bra will be essential for comfort as your breasts will be expanding along with your bump. Your feet are likely to grow too, so some new running shoes may be in order later in your pregnancy. And finally, when planning your route, it’s always a great idea to know where the toilets are!
Running after the birth
Back in the 1980’s, Norway’s Ingrid Kristiansen won her first race less than two months after the birth of her first child, and much more recently Paula Radcliffe made headline news when admitting to starting training less than two weeks after an arduous 27 hour labour. Elite athletes such as these will always make the news, but stories such as this can be misleading and possibly even dangerous. The relaxin hormone mentioned earlier can stay in your body for several months and possibly as long as you are breastfeeding. This will not only have an effect on your joints, but also on your pelvic floor muscles, already weak from pregnancy and birth. Pounding the pavement too early after childbirth could result in stress incontinence or even prolapse, and this may need surgery to put right. In short, your fitness level at the time of the birth will determine how early you should start running afterwards. My advice would be to spend a minimum of a month enjoying your new baby and exercising your pelvic floor and other core muscles regularly before venturing out onto the open road. It will be pleasing to know however, that many women find their race results after baby substantially better than before!
Mark Hibbitts is a personal fitness coach specialising in pre and postnatal fitness. He is also founder and director of Newborn Fitness and a full member of the UK’s guild of pregnancy and postnatal exercise teachers. It is important that you consult your doctor/midwife before starting a pregnancy or postnatal exercise program. To read the contra-indications to exercise during pregnancy, the ACOG guidelines
Visit http://www.themiraclebox.co.uk/for more information