3 Must-Do’s in the First 12 weeks Postpartum

Here are three simple steps to take in the first 12 weeks after giving birth ( your “4th Trimester”) that will drastically help your post-baby body recovery. 3 steps

1) Wrap your Belly: Women have been wrapping up their torsos after delivering babies for thousands of years. Japanese women wear a “sarashi”, Latin women bind themselves with a “faja” and Malaysian women use a “bengkung”. North Americans are evidently far behind when it comes to this practice! One of my new clients started crying after she bound her belly following her third c-section. Alarmed, I asked if she was ok. She responded saying her body felt “so much better” and was upset wishing someone had told her about binding benefits after her first two deliveries.

Wrapping the belly after delivering your baby provides support to stretched out abdominal muscles, helps your uterus contract, can reduce back pain  (especially those with C-sections and abdominal wall separation), helps rid your body of excess fluids and helps pull your hips and ribcage back into their pre-baby position.  The greatest benefit comes from binding during the first 8 weeks postpartum, when the hormone levels of relaxin are still very elevated. It’s a no brainer: binding is a win-win. Just make sure you’re not cinching too tight and putting downward pressure your on pelvic floor. You also don’t want it so tight that you have trouble breathing! It had to be said!

2) See a Pelvic Floor Physiotherapist: You just grew a human and carried it around in your womb for the better part of a year. Regardless of how you deliver your baby – vaginal or caesarean, the weight of your uterus has been pushing sustained downward pressure on your pelvic floor for many months. Your pelvic floor is like a hammock from pubic to tail bone that supports the internal organs, prevent urine leakage, supports your spine, and keeps your sex life happy, to name but a few of its functions. Pelvic Floor Physiotherapists are licensed to do internal exams and can safely determine if a) Your pelvic floor is weak or tight b) If you know how to properly do a kegel, c) If your bladder, uterus or rectum have dropped, and to what degree. d) If you have abdominal separation or diastasis recti.

These highly specialized physiotherapists are invaluable to postpartum women. In fact, in France each woman receives pelvic floor physiotherapy appointments after childbirth as part of her government covered health care. Even if you don’t have extended health insurance, these practitioners are worth every penny! Even just one visit can tell you so much. Here’s where you can search for a Pelvic Floor Physiotherapist in your area.

3) Connect with your Deep Abs: No we’re definitely not talking about crunches. It all starts with understanding how to engage your pelvic floor (refer to step 2 above!) The idea is to work your deepest layer of stabilizing muscles called your Transversus Abdominus.  This deep muscle wraps around your torso like a corset and stabilizes and compresses the abdomen for a “flat belly.” This is key after giving birth when your internal organs are contracting back down to their pre-baby size.  Learning to engage the deep abs is also crucial to “lifting” your internal organs and preventing pelvic organ prolapse, which often happens over the course of pregnancy and during pushing in delivery. (NOTE: traditional sit ups can actually make prolapsed organs drop further as the forward crunching movement creates intra-abdominal pressure, essentially pushing things “out the exit door”. So, to reiterate – NO crunches!)

The best way to engage this inner core unit is by recruiting your pelvic floor and doing a deep belly vacuum exercise through diaphragmatic breathing.  The result is a flat strong lower tummy.

The good news with all of these steps is you can start right away. The exercises in step 3 are gentle, similar to a meditative breathing (they require a great deal of concentration!) Give your body the time and proper tools it needs to recover. Connecting physiologically with your muscles will give you the strength and confidence to get back to your favourite activities, whatever they may be!

Cheers to all that!

Why Kegels may be bad for some Women

Originally published by The Belle Method in The Purple Fig and The Huffington Post 

We Pilates teachers love to talk about kegels. Like, all the time. Not just in class but at dinner parties, too (well, maybe that’s just me). It’s for good reason: engaging your kegels works your pelvic floor. The pelvic floor muscles are a group of muscles that attach to the front, back and sides of the bottom of the pelvis. They are like a hammock or a sling, and they support the bladder, uterus, prostate and rectum. They also wrap around your urethra, rectum, and vagina.

Kegel_exercises_diagram

A strong pelvic floor keeps you from leaking urine, holds your internal organs in place, supports your spine and pelvis and is needed for sexual function. Yes to strong pelvic floors, please! So many of us have been taught to dutifully “do our kegels,” especially after giving birth to make sure things stay where they belong and sex stays enjoyable. When you’re hypotonic (weak) in that area, kegels done correctly are fantastic.

But what if your pelvic floor is too tense, or “hypertonic.” Basically that means it is constantly contracted (think of your shoulders hiked up to your ears when you’re stressed…now picture that happening down there). Doing kegels in that situation would be like trying to hike those shoulders up even higher; NOT a good solution to decreasing tension and improving muscle function.

Symptoms of a hypertonic pelvic floor include:

  • Urinary frequency, urgency, hesitancy, stopping and starting of the urine stream, painful urination, or incomplete emptying
  • Constipation, straining, pain during or after bowel movements
  • Unexplained pain in your low back, pelvic region, hips, genital area, or rectum
  • Pain during or after intercourse, generalized vulvar burning, inability to orgasm, throbbing, spasm, “pressure in the vagina”

The troubling thing is that so many women suffer silently with undiagnosed hypertonic pelvic floors. Many are doing exercise that is making them worse. Kegels are so often recommended to post-partum women, but how they are performed is almost never assessed in North America. Dr. Arnold Kegel started teaching pelvic floor contraction exercises in the 1940s by using internal palpation to cue the proper muscles. Somehow we’ve stepped away from that and kegels have become something women told to do without any real instruction other than “hold your pee.”

By contrast, in France every woman is offered six pelvic floor physiotherapy appointments after giving birth to prevent pelvic floor dysfunction. This is the way it should be! Let this be a public service announcement for the benefits of Pelvic Floor Physiotherapy. Just go get yourself checked, even if you haven’t had children.

So what causes a hypertonic pelvic floor?

Chronic stress: Tension patterns in the pelvic floor used to be unequivocally linked to sexual (or other types) of abuse. However researchers are finding that the vagina automatically fires (tenses up) in almost any type of stressful situation. The vagina does this to protect the incredibly precious goods inside and this is a direct reflection of the fight or flight response.

Physical trauma: Constant physical stress (load bearing), repetitive pressures running, cycling, jumping can all cause an overworked hypertonic pelvic floor.

Tummy Sucking: Many of us have replaced deep, abdominal activity with “sucking our stomach in,” and think we are constantly using our muscles. In reality, the sucking in motion is a pressure that pulls the abdomen’s contents up (not in). You get a temporary flat stomach that looks fantastic on the beach, but you also get a tucked pelvis, no butt muscles used when walking, no real core engagement, and excessive friction in the lumbar spine, hips and knees…and a hypertonic pelvic floor.

So what’s a gal to do? First of all, get checked out by a physiotherapist to understand how your floor is functioning. The truth is, most of us only do kegels halfway (read: incorrectly). The “hold your pee mid flow” analogy we’ve been taught is crap. All you’re doing is lifting up, working in one direction. You need to practice “letting go” just as much as lifting. You need to do it full range! Any anyone who is hypertonic should just be practicing “letting go” and omitting the lift entirely.

And finally, another reason to perfect your pelvic floor muscle function is because properly contracting and releasing that area connects to your deepest layer of abdominal muscles…which means truly flat strong lower abs! Can I get a “hell yeah!”

Knowledge IS power ladies!