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Could You Have An Overactive Pelvic Floor?

After many years of experiencing pelvic pain, discomfort during sex, the inability to wear a tampon and the overly painful experience of pap smears I thought it was about time that I should see a Physiotherapist who specialised in the Pelvic Floor. After all I was advising Mums about pelvic floor health and the importance of maintaining a strong healthy pelvic floor!

I took a trip to see the wonderful Physios at Fitwise where an examination revealed I had an overactive pelvic floor!..

What is an Overactive Pelvic Floor?

An overactive pelvic floor does not relax properly when they should.

Tight shortened pelvic floor muscles can cause painful tension and spasms in the pelvis. The same way a tense muscle can cause you pain in your calf.  You may be unwittingly holding tension in your core, doing pelvic floor exercises wrong, or involuntary tensing your muscles, like when you have menstrual cramps or other pain. An overactive pelvic floor can also be related to childbirth, surgery or an accident like falling on your hip or tailbone. Having a C Section or Hysterectomy can leave behind adhesion’s and scars that can make the problem worse.

In my case my pelvic floor muscles were clenched into tight knots and in spasm as a result of a fall I had a few years back where I landed on my tailbone.

I was so so happy to finally have an answer to why I was finding sex so difficult and painful, and simple things that women should be able to do like wear a tampon and be able to have a pap smear without being in tears! It really was such a relief.

An overactive pelvic floor is rarely something that will vanish quickly and will need intermittent follow-up treatment. In my case to start I was prescribed with a relaxation CD to teach me how to relax my pelvic floor muscles, other treatment can include internal and external massage.

My exam and treatment with Fitwise was very professional and I am so grateful to have found someone that has helped me find a cause to my years of discomfort.

Anatomically speaking the pelvic floor is the centre of your physical power and balance. Determining whether you have an overactive pelvic floor or underactive pelvic floor is crucial. Exercising an overactive pelvic floor can lead to pain and nerve irritation whereas exercising a weak pelvic floor will lead to vast improvement in core strength, lower back and hip function… wow! it really is a double edged sword!! It is so important that if you experience any discomfort in the pelvic area or have any concerns at all  you seek advice from a specialised Physio.

Author: Ali Broomfield

What is the Core and when Can I do a Sit Up?

The core is the muscles which surround the trunk of your body! These include muscles of the abdomen (Inner and Outer) Back, Pelvic Floor and even our breathing muscles (the diaphragm).

Ideally these muscles should work as a team, but quite often during pregnancy and childbirth the integrity of these muscle can be affected. Due to a combination of hormone changes, weight changes and a growing baby these muscles are stretched over the months during gestation. As a consequence of these changes during pregnancy and subsequently birth these muscles may become too weak to support the trunk and this could be the reason some of you experience re-occurring back pain, pelvic pain or even pelvic floor problems.

In regards to your abdominal muscles there are two sets to be aware of:

The Inner Abdominal Muscles – (Transverse Abdominis):

This is the deepest innermost layer of your abdominal muscles and should contract the same time as your pelvic floor. These muscles are like a corset covering the abdomen and spine and providing support to the joints and pelvis.

These muscles are designed to be gently active for long periods of time.

Then there are the Outer Abdominal Core Muscles – (Rectus Abdominis & External Oblique’s) :

Also known as the ‘6 pack’! ‘ It sits above the deeper core muscles. Intense exercises that work these, such as the sit up, contract this muscle strongly and this increases downward pressure on the pelvic floor, if your pelvic floor is weak and unable to counteract this pressure, pelvic floor problems can occur.

A sit up, or as some people know it, a ‘crunch’ is a very popular exercise performed in many gyms and exercises classes over the world. The fact that during the movement of the sit up, the pelvic floor is forced downwards is important to bear in mind.

The safety of a sit up/crunch for your pelvic floor/core depends on:

  • Your current Pelvic Floor Strength
  • History of Pelvic Floor Issues
  • Prolapse Surgery
  • Pelvic Floor Dysfunction (Prolapse, Incontinence)
  • Rectus Diastasis (Abdominal Separation)

At Shape Up mums we recommend that it is not advisable to do sit ups, in the first 12 months of giving birth, you should also consider the above factors.

The overall aim should be to safely maintain, restore and strengthen the Core muscles without compromising your pelvic floor.

If you are wondering…’is it possible to train the abdominals and protect the pelvic floor?’ The answer is yes! We include a Core section at the end of our classes, which are completely pelvic floor safe and help you to activate those core abdominal muscles.

Eventually when your trainer feels you have the core integrity to safely start sit ups. We can guide you into safely, slowly and affectively engaging your core and pelvic floor to do this type of exercise in a VERY controlled manner!

If you have any questions or feel you are ready to do a sit up, please speak to you trainer who will be able to ensure you are doing them with correct technique and start you off slowly.

Ali Broomfield – Personal Trainer

 

 

“I’m Pregnant! Can I still come to Shape Up Mums?”

so you’ve just found out your pregnant, you must stop exercising immediately right? WRONG!

We at Shape Up Mums encourage pregnant women to participate in our exercise classes, wether you were fit before or not.
One thing we do recommend is that your main goal is to maintain a good fitness level and healthy lifestyle and not make reaching your PEAK fitness your goal.

“So why should I continue exercising?” You ask.
Well benefits of exercising during pregnancy include:
– improve physical and mental well being
– maintain a healthy weight
– helps you to rerun to your pre-baby weight quicker
– reduces the risk of gestational diabetes

At Shape Up Mums we understand as pregnancy progresses the body goes through huge changes and our lovely trainers will modify programmes accordingly…and don’t forget our exercises are Pelvic Floor safe!

So keep you and your bump, active, happy and healthy and come along to Shape Up Mums today!

Simply book in here..

Pregnancy Pelvic floor app

Pregnancy Pelvic Floor app

The Continence Foundation and Pelvic Floor First have been conducting a project recently, which has led to the development of an app for mums-t0-be. This is a for more information on the app, see the below information from www.continence.org.au

Pregnancy Pelvic Floor Plan app imagesWith the increasing use of smartphones and apps to access health information, especially by pregnant women, a review of current apps available for women during pregnancy highlighted a gap in information about bladder and bowel health and pelvic floor muscle exercises.

The Pregnancy Pelvic Floor Plan smart phone app was developed in conjunction with The Pregnancy Centre and with input from women who are currently pregnant or have recently had a baby.

The free Pregnancy Pelvic Floor Plan app includes:

  • Tips on looking after your pelvic floor, bladder and bowel during pregnancy
  • Learn how to do pelvic floor exercises and receive reminders
  • Information about safe exercise during and after pregnancy
  • Health and wellbeing tips on looking after yourself
  • Find local services for pelvic floor problems

The information in the app is divided into key pregnancy milestones and users can enter their details to view information and receive reminders personalised for their due date.

The free app is available for iPhones from the App Store and from Google Play for Androids.

Source: http://www.continence.org.au/pages/pregnancy-pelvic-floor-plan-app-.html

Pelvic floor in the early days….

In the days following the arrival of your new baby your body is trying to adapt to its new situation. It no longer has a baby inside, many women are trying to breast feed for the first time and you are being woken all hours of the day by this beautiful little baby!

It is important to remember to do your pelvic floor exercises in the early days, as the early you start working on it – the quicker it will regain is strength.

Whilst you are pregnant the front part of your pelvic floor is supporting ~10-15kg of additional weight in the form of your baby and the fluid protruding from your abdomen! Following the birth of your baby (both a vaginal birth and a C-section) your pelvic floor (particularly the front part) is significantly weakened and traumatised. Therefore it is really important that as your recommence your pelvic floor exercises, your focus is on strengthening this area. Many women will do their pelvic floor exercises and feel a good lift and squeeze, however most of this can be coming from the back region of the pelvic floor (that supporting your anus and rectum).

It is important to be focus on both areas of your pelvic floor, but separately. To recruit the front muscles you can think about stopping the flow of urine, and lifting and squeezing these muscles up inside your vagina. To recruit the back muscles, you can imagine trying to stop yourself from passing wind (sorry!) and lift and squeeze into your back passage.

Once you have concurred this simply exercise, you can repeat these as often as your can remember! Aiming for a minimum of 3 times/day!! I often suggest to mums doing them when you are breastfeeding (once you have breastfeeding worked out! I know, too many things to think about initially!!)

Initially doing your pelvic floor exercises lying down can be the easiest and most straight forward. But it is really important that you do progress to doing this sitting (driving the car), standing (washing dishes, making a cup of tea etc), and then walking and lifting your baby.

womenspelvis

For more information about your pelvic floor checkout http://www.shapeupmums.com.au/pelvic-floor/

Sally Muir – Personal Trainer

Exercises tips for mums at home

From our recent client feedback survey, the most popular topic that you want covered in the newsletter is ‘Exercise ideas for home!’ So here it is….

Exercise with baby

No excuses for not having any equipment, all of you can use your baby!! Making sure if you are using your baby as a weight, that the weight of the baby is evenly distributed. Therefore its important not to have them on your hip, either on your front or back is ok. You can even make it easier for yourself and put them in a baby carrier (for some of the exercises)! Some great exercises to do with your baby include:

  • Baby kiss push –ups, just like your usual push up (remember your 3 SUM options we give you) as your chest is at the bottom of the push up kiss your baby and push back up.
  • Baby squats, again remember you pelvic floor squatting principles. Make sure your baby is sitting evenly on your front (even weight distribution). Ensure that your pelvic floor is being activated as you rise out of the squat
  • Baby walking/static lunges, same as above.
  • Sitting baby shoulder press, sitting on the edge of a seat, holding your baby at the armpits (for babies old enough to have good head control!!). Hold your baby at chest height, and then extend your arms above your head. Ensure pelvic floor is activated whilst pressing upwards
  • Sitting baby clock, sitting on the edge of your seat, holding your baby at the armpits (for babies old enough to have good head control!!). With semi-straight arms move baby around in front of you like a clock, then change direction.
  • Baby hip bridges, sitting your baby on your hips (lying on your back, with knees bent, feet flat on the ground). Bridge up and down, with your baby resting on your hips.

Incidental exercise

For those keen to optimise their workout within the home, you can definitely make the most of your incidental exercise.

  • Baby wake up lunges – when you hear you baby wake, do 10 lunges playing peek-a-boo as you bob down and look through their cot (make sure you are lunging correctly, and not just bending over!!)
  • Reach with calf raise – place something you use daily up high just out of reach (your coffee cup!), each time you want a coffee reach by doing 10 calf raises
  • Kettle push ups – whilst waiting for the kettle to boil, do bench push ups for the time the kettle takes to boil!
  • Wash squats – spread your washing out over your laundry floor, pick up one piece of clothing at a time by doing squats (remember to activate your pelvic floor as your pick up the clothing, and rise out of your squat!)
  • TV dips – whilst watching TV on a chair, simply place your hands at the edge of the chair (fingers facing forwards) and do a series of 10 dips!

Apps for home exercise

Pocket Yoga: I’ve enjoyed doing some yoga at home with the ‘Pocket Yoga’ app, its a great way to do some exercise whilst your baby sleeps!

Pelvic floor first, a continence foundation initiative has just realised an app!Pelvic floor app

App features include:

  • Instructional videos and audio for all workouts
  • Detailed pictures and instructions for each exercise
  • Pelvic floor muscle exercise guide
  • Ability to save favourite exercises for personalised workouts
  • Links to useful websites to learn more about your pelvic floor

The free app is based on the Continence Foundation of Australia’s Pelvic Floor First website pelvicfloorfirst.org.au. It is now available to download for smart phones and tablets through iTunes. The app will be available from Google Play in the coming days – please keep an eye on our social media pages for details.

Abdominal seperation (DRAM)

Abdominal separation or diastasis recti (DRAM) is a common condition of pregnancy and postpartum, when the right and left halves of your abdominal muscles spread apart at the body’s mid line. During your pregnancy your abdominal muscles are stretched, due to the growth of your uterus and baby. During this time, your abdominals become compromised due to hormonal changes, and often separate to allow room for your baby. Following the delivery of your baby your abdominals will not automatically re-join, and resume their pre-pregnancy strength (unfortunately).

Abdominal seperation DRAMOnce you have delivered your baby your doctor or physio will often assess the level of separation between your abdominals. A mid line of more than 2-2.5 fingers widths or more than 2.5-3cm can be considered problematic. Should you feel that you have a separation that is greater than 2.5-3cm, it is important that you visit your local women’s health physio to discuss appropriate exercise prescription to optimise the closure of this. A small amount of widening occurs in all pregnancies, and is very normal. Disastasis recti is thought to occur in approximately 30% of all pregnancies, and unfortunately separation in a previous pregnancy significantly increases the probability of the condition in subsequent pregnancies.

Unfortunately for some women the separation can result in them requiring surgery to close the gap between their abdominals. However this is in situations where the gap is large and all attempts at rehabilitation under women’s health physio have been unsuccessful.

What does DRAM mean to me?

A separation is a safety mechanism of the body to avoid the muscles tearing during pregnancy. However it can become a problem postpartum should the muscles stay separated. Stretched and separated muscles do not provide full support for your back and may increase incidence of back pain, back injury, pelvic instability and other injuries due to compromised core control.

What can I do to fix reduce my separation??

A variety of things can be done to reduce the separation following the birth of your baby. The sooner you act on this issue, the better the results will be. Some of the following can have a significant impact on reducing the separation:

  • Exercises to strengthen the deep abdominal muscles.
  • Wearing an abdominal support belt, such as Tubigrip™, or firm compressive underwear following the birth of your baby
  • Avoiding sit-ups or abdominal crunches until the separation resolves.
  • Rolling when getting into or out of bed.
  • Minimising lifting anything heavier than your baby or anything that causes your tummy to bulge with strain.

Deep abdominal muscle strengthening exercise – postpartum

  1. Begin your exercise in one of the following positions; side lying, lying on your back, sitting, standing or 4 point kneeling.
  2. Draw your lower tummy in towards your spine.
  3. Hold for 5–10 seconds while breathing normally.
  4. Rest and repeat 8–12 times. Repeat this set of exercises 4 times each day.
  5. To make your exercises harder, over the next 6 weeks do them in a sitting or standing position and increase your effort as you are able.

Monitoring the recovery of your abdominal muscle separation

  1. Lying on your back with your knees bent place your fingertips across your belly at the level of your belly button.
  2. Lift your head away from the floor (a mini curl-up) and feel for the sides of your abdominal muscles coming together.
  3. If you can feel a gap wider than one finger then you may still have a separation.

Exercise to avoid

  • Any exercise that causes your abdominal wall to bulge out upon exertion
  • Lifting and carrying very heavy objects
  • Intense coughing without abdominal support
  • Movements where the upper body twists and the arm on that side extends away from the body, such as “triangle pose” or lifting a toddler into a car seat
  • Exercises that require lying backward over a large exercise ball
  • Yoga postures that stretch the abs, such as “cow pose,” “up-dog,” all backbends, and “belly breathing”
  • Abdominal exercises that flex the upper spine off the floor or against the force of gravity such as: as crunches, oblique curls, “bicycles,” roll ups/roll downs, etc
  • Pilates mat and reformer exercises that utilize the “head float” position, upper body flexion, or double leg extension

 

Sources: http://www.thewomens.org.au/AbdominalMuscleSeparationorDiastasis, Hold It Mama – The Pelvic Floor & Core Handobook, Mary O’Dwyer

 

Post-natal exercise for new mums

Following the birth of your baby your initially thoughts are about recovering from you recent birth, ensuring your new bundle of joy is nourished, dry and sleeping. As a new mum you are also trying to get some nutrition and sleep for you!new mums exercise

As the days roll into week, and the weeks come around to that 6-8 week point many mums start to thinking about reintroducing some exercise back into their routines. Before this point in time of the post-natal recovery period it is important that new mums limit their exercise in duration and intensity to ensure that their body is able to recovery from the recent birth.

It is important to discuss your return to exercise with your GP or obstetrician at your 6 week appointment. Your doctor will assess you recovery, and usually discuss any concerns regarding your pelvic floor and your return to exercise.

As a new mum your exercise needs to be introduced gradually. New mums must realise that they can’t just resume their pre-pregnancy exercise routine, their body and pelvic floor will take time to become strong again.

Initially start with gentle exercise of walking, swimming or post-natal pilates. Once you have developed a solid foundation of exercise, you can start to introduce a greater variety of exercise.

It is paramount that during the 12 month post-natal period you continue regularly do your pelvic floor exercises to ensure that your pelvic floor regains the strength and muscle integrity that is required to increase exercise intensity. Should you have any concerns that your pelvic floor is not recovering from your recent birth, it is paramount that you see a women’s health physio to ensure your recovery is optimised.

post natal exerciseIf you choose to attend exercise classes at a gym or bootcamp environment it is extremely important that the instructors understand the post-natal recovery period and the impact on a new mums body. The increased levels of hormones (relaxin), the energy demands of breastfeeding, the recovery of the pelvic floor are just some of the changes a new mother’s body is experiencing. Many fitness professional do not understand the changes, and the modifications to regular exercises that can be made to ensure that post-natal woman can exercise safely without damaging their recovering bodies.

Sally Muir – Personal trainer

When should I see a physio?

Knowing when to seek help is something that can take a little time to realise. and following the birth of your little one, your focus shifts to your baby, But it is so important to take care of YOU. Wether it could be a small ache here and there or a large embarrassing problem that is getting you down. Here are some key signs of when you need to see a women’s health specialised physio.

Why see a Women’s Health Physiotherapist?

The reason we recommend seeing a Women’s Health Physiotherapist, instead of a general physios or a sports physio is that women’s health physios see these type of concerns all day every day! Women’s health physios assist women during and after pregnancy, as well as continence issues for both women and men later in life. These physios have further qualifications in this area, usually a Post Grad Certificate in Continence and Pelvic Floor. This knowledge combined with their daily practice in this area ensure that they manage your health in the most appropriate and safe way.

Shape Up Mums highly recommends seeing the physios at Fitwsie Physiotherapy in East Melbourne or Women’s and Men’s Health Physiotherapy in Malvern.

What reasons should I see a physio for?

The following are some signs that you should look out for during your pregnancy:

  • Lower back pain
  • Pubic bone pain
  • Accidentally leak urine when you exercise, play sport, laugh, sneeze or cough
  • Need to get to the toilet in a hurry or not get there in time
  • Find it difficult to empty your bladder or bowel
  • Accidentally lose control of your bowel – or accidentally pass wind
  • Have a prolapse? A bulge or feeling of heaviness, discomfort, pulling, dragging, or dropping in the vagina?
  • Suffer from pelvic pain or experience pain during or after intercourse?

The following are some signs that you should look out for following the delivery of your baby, and during your first 12 months.

  • Accidentally leak urine when you exercise, play sport, laugh, sneeze or cough
  • Need to get to the toilet in a hurry or not get there in time
  • Constantly need to go to the toilet
  • Find it difficult to empty your bladder or bowel
  • Accidentally lose control of your bowel – or accidentally pass wind
  • Have a prolapse? A bulge or feeling of heaviness, discomfort, pulling, dragging, or dropping in the vagina?
  • Suffer from pelvic pain or experience pain during or after intercourse?

Even if you are unsure of how to do a correct pelvic floor muscle contraction, popping along to a women’s health physio for an assessment and general advice could be all you need.

Pelvic Instability (Pelvic Girdle Pain)

About a month ago, I visited our physio friends at Fitwise so that I could do some pilates sessions during the final 12 weeks of my pregnancy. As I discussed with my physio (lovely Claire) any concerns etc, I explained I’d experienced some mild lower back pain – particularly on days that I had carried Abi upstairs or across soft sand! She did some further investigating/assessments, and then explained to me that I had the start of pelvic instability (something I hadn’t considered! I thought I was just a little tight!!) Hence I thought I’d put some facts/information together on what it is, what the signs are and what you can do to manage it.

What is Pelvic instability or Pelvic Girdle Pain?

Previously referred to as Pelvic Instability, however now known as Pelvic Girdle Pain (they mean the same thing!) is a condition that causes pain around the joints of the pelvis (pelvic girdle) during and after pregnancy. The pelvis has 3 main joints, pubic symphysis joint (at the front) and 2 sacro-iliac joints (located at the base of the spine between the pelvic bones and sacrum).

In normal pregnancy a hormone called Relaxin softens the ligaments around the joints of the pelvis. This is a natural process which assists childbirth and does not usually cause lasting discomfort. For some women this natural process seems to go wrong, causing the joints of the pelvis to loosen too much. This can result in the pelvis becoming unstable or out of alignment. Pregnancy can also put strain on muscles of the back, stomach, pelvic floor, hips and pelvic girdle which may lead to the pelvic joints becoming less stable.

What are the signs of Pelvic Instability?

Unfortunately Pelvic Instability is sometimes misdiagnosed as ‘aches & pains of pregnancy’ and women can miss out on the help they need. If you think that you may have PGP, and the symptoms don’t improve after a few days of rest, you should see your doctor or a women’s health physio.  We highly recommend Fitwise Physiostherpay in East Melbourne and Women’s & Men’s Health physiotherapy in Malvern

Managing Pelvic Instability?

During Pregnancy

If you have any concerns, and think you may have Pelvic instability it is important you seek the advice and assistance of a trained physio. Physiotherapists who have experience treating this condition are usually able to assess whether you are experiencing Pelvic Instability. Some general do’s and don’t if you do have pelvic instability include the following:

Do

Don’t

  • Rest
  • Keep your legs together!! Particularly when   rolling over in bed.
  • Stand with your weight distributed on both   feet
  • Stand up (from sitting on a chair/floor) in a   squat position, not with one foot forward
  • Sleep with a pillow between your legs
  • Switch on your core (particularly your tummy   and pelvic floor muscles).
  • Ice your painful joints for 20minutes at a   time (repeat every 2 hours, until pain manageable).
  • Stretch – frequently stretch your gluts by   sitting on a chair, with one ankle resting on the opposite knee. Tilt from   the hips, until you feel a stretch through your gluts.
  • Stand on one leg
  • Don’t do exercises where you have weight distributed unevenly (lunges, one leg squats/calf raises, yoga poses such that require a lunge or uneven distribution of weight between feet.
  • Carry children on your hip (if you have to carry them, carry on your back/front). Try to avoid carrying them as much as possible
  • Step over things
  • Climb stairs
  • Push a shopping trolley
  • Walk/run as an exercise
  • Sit with your legs crossed!

In regards to exercise options if you have pelvic instability, it is important to avoid/limit walking. Two great options are swimming and stationary cycle classes, both of these allow you to enjoy cardio exercise – without causing any further inflammation.

Post-natally

Once your baby is born, you need to be careful during the first 3-6 weeks. The pelvic girdle needs this time to improve its control and stability mechanisms to support your pelvic. Pelvic instability usually resolves itself 3 months after giving birth (unfortunately for some women it can exceed the 3 month period).

Following the birth of your child it is important to still follow the Do’s and Don’ts above, until you can successful walk etc without pain. It is highly recommended that you continue to seek the assistance and advice of a qualified physio, to ensure your recovery and return to exercise is not hindered. For some women that have required a pelvic belt to assist with the management of pelvic instability, it is important that the pelvic girdle is able to rebuild its stability and strength to support the pelvis.

Source: Fitwise client information leaflet – ‘Pelvic Girdle Pain’,  PIA Australia – www.piaaustralia.com

Sally Muir – Personal Trainer

10 ways to remember to do your pelvic floor exercises!

In the perfect world, we would all remember to do our pelvic floor exercises 3 times a day, every day of the year! Speaking from experience (and talking with lots of Mums) this isn’t the case, as good as our intentions are during pregnancy and following the birth of a child it’s very easy to forget to do these simple exercises! So I’ve made a list of different ways to remember. If one of these ideas helps you remember then we have success!! You can do your pelvic floor exercise lying down, sitting or standing (for more information on how to do your exercises correctly click on the link). It is always easiest to do them lying down, so if you have recently given birth – start with this option.

  1. Every time you stop at a set of traffic lights, try and do 2-3 x 6 second holds.
  2. After you have emptied your bladder. One way to learn how to recruit our pelvic floor is by stopping urine flow mid-stream. This is not an exercise; it is simply a way to know you are using the correct muscles. However you can do your exercises initially after you have emptied your bladder. Once you feel the pelvic floor has improved its strength you can trial doing the exercises with a full bladder, this requires more strength and recruitment of those tricky muscles!
  3. Every time you change a nappy. When you are standing at the change table, trial engaging the pelvic floor. You can do 6-10 seconds hold (remember to breath) or you could do some short/strong engages (~10).
  4. Each time you put the kettle on. Instead of doing multiple things at a time, simply stand and wait while the kettle boils, doing your pelvic floor exercises.
  5. When you answer the phone! No one can see you, so if you need to lie down to do your exercises initially this is a great way to remember your exercises.
  6. Each time you get an email. Try to sit down for this one, and sit and read your emails whilst you are doing your exercises.
  7. While you brush your teeth.  If you remember to do them every time you brush your teeth, you are at least doing them twice a day, every day!!
  8. When you are giving a baby a bottle or breastfeed. This is an easy option in the early days. It is one chance you have to sit down for 10-60minutes! So this is a perfect opportunity to do those exercises.
  9. Once you are competent at your pelvic floor exercise, trial doing them whilst you are walking with the pram. This requires greater control and specific recruitment to ensure that you are not using your abdominals, but in fact engaging your pelvic floor.
  10. 10.   An app!! I recently discovered a couple of apps that sound an alarm each time you need to do your exercises. There is a couple available, they provide different exercise options and tell you when you need to engage your pelvic floor and relax. For the modern Mum, this might be the perfect way to remember to do your daily exercises!!!

What types of exercise should I avoid if I have concerns with my Pelvic floor?

Following the arrival of a baby a female must be careful how she recommences exercising. It is recommended that prior to the 6-week check-up only very light exercise is done, such as light walking and incidental movement around the house. Once you have seen your GP or obstetrician for your 6-week appointment and they have confirmed that you can commence exercise it is still important to very gradually increase exercise intensity, duration and type.

Almost every form of exercise that you do affects your pelvic floor. This includes sitting, standing, changing your baby etc. Some forms of physical exercise can actually harm the muscles, leading to bladder and bowel control problems. Bladder and bowel weakness is a common problem, affecting nearly 4 million Australians. Interestingly one in three Mothers will report some degree of urinary incontinence! So let’s not make it worse by doing the wrong exercises!!!

Some forms of exercise place more stress on the pelvic floor than others, especially for people at risk of pelvic floor problems (pregnant ladies and ladies who have given birth fall into the category of ‘people at risk’!). Throughout any exercise it is important to monitor your pelvic floor and make sure it isn’t dropping/dragging or pushing downwards. Following the 6-week check-up it is recommended that each Mum very gradually increase the frequency, intensity and duration of exercise as her pelvic floor recovers and strengthens with regular pelvic floor specific exercises.

Exercises to avoid:

  • Abdominal exercises
  • Deep lunges
  • Side lunges
  • Wide legged squats
  • Deep Squats
  • Jump squats
  • Lifting heavy weights
  • Chin ups
  • Full push ups
  • Jumping
  • Netball/ Basketball/ Vollyball
  • Star Jump
  • Skipping
  • High impact exercise

Until the pelvic floor has recovered from child birth and regained its integrity it is suggested that running and boxing be limited. These activities require the pelvic floor to be engaged to support the body. Many Mums are keen to return to their pre-pregnancy fitness regimes such as running following the birth of their child. It is suggested that a gradual introduction of these types of activities take several months. Initially it is suggested that Mums start by walking at a comfortable stroll for 20-30 minutes. As your fitness and pelvic floor strength improves the duration and intensity of the walking can be slowly increased to longer power walks. Initially you can introduce short distances of powerwalking within your regular walks and build this distance. Exercising in the morning will ensure that your pelvic floor is well rested and has more stamina to cope with your light exercise.

Once you are comfortably powerwalking and feeling strong with your pelvic floor you can start to think about moving towards commencing some higher intensity exercises. Initially one exercise you can start to trial is engaging your pelvic floor and lightly jogging on the spot. Start with 5-10 seconds and building up over the weeks until you can run for 60 seconds on the spot with your pelvic floor engaged (not feeling any concerns in your pelvic floor).

Once you have successfully completed 60 seconds of running on spot (on a number of occasionsions), you will be able to think about introducing some walks with small amounts of running. One way of introducing running back into your fitness regimen is to go for a walk and trial running 10-15metre of running. When you trial this it is imperative that you have your pelvic floor engaged and are able to breath regularly throughout the short distance of running. You can repeat this short distance after 5-10minutes of steady walking, 2-3 times. (If you feel any dragging or pulling in your vagina it is very important that you stop running immediately).

Once you feel confident with this type of walk/run exercise you can start to extend the periods of running out to longer distances. Or you can simply go for a very short run down the street ~ 50-100m. Once you have conquered this distance you can then extend the distance to around a small block (200m) and you can keep extending the distance. Whilst you run it is important to always be very aware of how your pelvic floor is feeling. You may find that around particular times of the month (particularly during the first 1-2 days of your period) that your pelvic floor may feel weaker. It is also important to empty your bladder (and bowel when required) prior to exercise to decrease the load on your pelvic floor.

With any type of physical exercise it is important that you listen to your body. Only you can tell how your pelvic floor feels. Your trainer will guide your exercise choices, however if you ever feel uncomfortable (any dragging or pain) you must tell you trainer immediately and reduce the load on your pelvic floor.