The Three R’s of Postpartum Recovery: What Every New Mom Needs to Know

You’ve recently given birth, and at your six-week follow up appointment, your obstetrician clears you for exercise. They don’t say much more on the topic, and you wonder:

Should I get a gym membership? My stomach looks and feels like mush — should I get back to crunches right away? Can I do sit ups after a c-section? Can I run my first half marathon in five months? These are just a few of the questions that might cross your mind, with the biggest one being: where do I even start?

With 15+ years of answering these types of questions, I’ve boiled it all down to a simple framework. To maximize postpartum healing and return to physical activity with minimal risk of injury, you must respect the Three R’s.

#1. Reactivate

Definition: learn to contract weak and overstretched muscles again.

At 40 weeks of pregnancy, your four abdominal muscles are stretched maximally. Immediately after delivery, it’s important to learn how to reactivate the two down the middle, as they have been stretched the most: the transverse abdominus (TVA), followed by the rectus abdominus (RA, known commonly as the “six pack”). Because 100% of pregnancies result in diastasis rectus abdominus (also incorrectly called “split abs”), TVA’s are needed to create tone between the middle edges of the RA, and therefore allow your diastasis to recover. Learn to activate your TVA’s by gently drawing your navel in and up and wrapping your abdominals without puffing up your chest or changing the shape of your spine.

It is also important to learn to reactivate your pelvic floor, regardless of whether you’ve had a vaginal birth or c-section. It is possible to experience urinary incontinence for weeks or months following childbirth, and/or painful sex. Despite anecdotal advice, this isn’t considered normal and should be addressed early on.

Finally, you will never spend more time sitting in your life than during the first few months postpartum. Along with deceased physical activity, the end result are sleepy gluteus maximus (buttocks) muscles. Because these muscles are incredibly important in posture, sports and preventing low back pain, I teach every new mom to properly contract their glutes and supporting musculature.


Strengthening doesn’t have to happen in a gym exclusively. You can do your core strengthening using your couch while your baby plays next to you.

#2. Repattern

Definition: learn to move weak and overstretched muscles correctly.

Muscles don’t contract in isolation — to accomplish a movement, your muscles contract in groups and in a particular sequence. However with pregnancy, your body changes the sequencing (or muscle patterning) to accommodate a growing fetus. In other words, your baby gets in the way of moving normally.

Pregnancy compensations occur with many movements including breathing, sitting up, and spinal alignment/posture.  Since these incorrect movement patterns can remain long after childbirth, teaching the body to move correctly will greatly reduce the chance of injury when returning to physical activity/sports.

In my practice, I have seen women skip this Repatterning stage of healing and return to physical activity/sport. This is premature and will cause chronic pain and injuries of seemingly unknown origin — it is only a matter of time. Common examples include low back pain, knee pain and rotator cuff strains. Don’t be a statistic: do your repatterning homework and do it well!

A diastasis that is not controlled will dome when the rectus abdominis (6 pack muscle) is contracted (first photo). Learning to activate your TVA will eliminate this doming (second photo).

#3. Restrengthen

Definition: loading of movement patterns with correct form.

Only when the first and second R’s are completed does Restrengthening make sense. And nailing the correct form always matters.  

I see this frequently: people at the gym squatting, deadlifting and bench pressing impressive weights…but they’re doing it wrong, resulting in chronic pain and, eventually, inevitable injury.


The same applies to new moms. In the postpartum phase of restrengthening, we must rethink what “getting strong” looks like. It doesn’t have to mean a sweaty, hour-long workout at the gym; loading can be accomplished in infinite ways. Sure, you can do it with dumbbells and barbells. But you can also increase load by doing one extra rep of an exercise, or exercising one extra day, or exercising one extra minute, or running just a bit faster than the last time. When load is progressively increased, you get stronger. It’s that simple.

Overall, my Three R’s apply to recovery from just about any injury, not just childbirth. And yes, childbirth is considered an injury — despite being natural, the symptoms and path to recovery are similar — the only difference is that this injury is totally worth it. ☺

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Janette Yee is an athletic therapist and massage therapist in Toronto offering in-home pregnancy and postpartum rehabilitation. Over her 15-year career she has worked with amateur to elite athletes from every sport, specializing in running and rugby injuries. The toughest athletes by far are her moms. She fills her days with mandatory play time with her two kids aged 1 and 4, and is currently training for her return to competitive 5 km running.

Connect with Janette at @askjanette and www.janetteyee.com

Email: info@janetteyee.com

The ABC’s of Fixing Diastasis Recti

We talk about diastasis recti a lot over here. Women want to know if they have it, what exercises they can do to fix it, and how to avoid it. Google “ab separation pregnancy” and you’ll get lots of results on a very common condition that is estimated to affect 1/3 of pregnant women. The trouble is, not all advice out there is appropriate as it focuses SO much on exercises to “close your abs”, and not enough on the root cause. Like anything, the best way to address a problem is at its root rather than by treating the symptom.

Basic RGB

 

Diastasis recti is a condition of an overstretched linea alba. The linea alba is a vertical line of connective tissue that separates your rectus abdominus muscle. Think of it as the midline of your 6-pack muscle.

Diastasis recti results in a weak dysfunctional core and is often accompanied by loose pooched skin. It’s caused by too much intra abdominal pressure (IAP), often from but not limited to, a growing baby during pregnancy. (Fun fact: men with large beer bellies can also get diastasis recti.) A pregnant woman’s connective tissue is meant to stretch to a certain degree to make room for baby, but too much pressure can cause too much stretching, resulting in diastasis recti. There are several things you can do to prevent too much intra abdominal pressure during pregnancy, and they all have to do with how you breathe and move.

Did you get that? The root cause of diastasis recti isn’t just a function of how large the baby is, but rather how the pregnant mother sits, stands, moves and breathes.

I’ll cut to the chase. If your posture right now includes a swayed back, tucked bum, popped ribs and tight hip flexors, you’re more likely to have pelvic floor issues and get diastasis recti during pregnancy. You might not think this sounds like you, but if you sit daily for long hours at a desk, carry little people around, have a habit of sucking in your tummy (don’t we all from time to time?!) and wear high heeled shoes, you likely have some aspects of this posture.  Oh and former dancers and gymnasts, you probably have this going on too. Awesome, I know.

Why does posture matter so much?! Because your posture impacts the position of your muscles and organs. And the position of your organs impacts how you breathe. How you breathe impacts how much PRESSURE goes into your abdominal wall. Here’s a fantastic video by physiotherapist expert Julie Wiebe explaining how alignment impacts your diaphragm and pelvic floor function.

Take home point: bad posture = tight muscles and squished organs = restricted breathing = pressure pushing forward into your abdominal wall with every respiration.

 

katy Bowman
Photo cred: Katy Bowman, Alignment Matters

SO, if you want to both avoid and fix diastasis recti (and incontinence issues for that matter), you must begin with fixing your alignment, so you can breathe diaphragmatically.  Think of breathing into the back and sides of your lungs and let your rib cage open like an umbrella as you inhale.  Breathing this way will help you get the most out of your exercise choreography. I call it the ABC approach. Alignment →  Breath → Choreography.

The problem is that when it comes to repairing diastasis recti (often referred to with the somewhat cringe worthy nickname “mummy tummy”), everyone wants an exercise prescription. There’s a lot of hype and fear around the topic, and many exercise programs claiming to fix it.

The idea of following a set of specifically targeted exercises in order to get guaranteed results is simple, powerful and very popular.

Headlines like “7 Moves for Flat Abs!” sell a lot of fitness magazines and get a lot of web clicks. People have come to believe that if they know the right moves to do, and how often, they’ll get results.  I’m calling BS. If someone could go ahead and pass that memo on to the editors at every Fitness and Shape magazine, that would be grrrreeeeat (channeling my Office Space Lumbergh voice here). I’m so over it.

If I only had a dollar for every time I heard “Give me the best exercises I need to do, how many reps and how often, and I’ll do it! I just need a program to be on track. Just tell me the best moves!”

I want to say slow down! Take time to restore your core. You just birthed a human. But slowing down can be hard.

No motivated postpartum woman looking to “get her body back” wants to be told to chill out and breathe. I completely get it.  Stretching tight muscles and breathing doesn’t feel productive. But I’m saying it. Chill out and breathe.  Have faith that these small adjustments in how you breathe and move will lead to large changes. It might be the most productive thing for your body that you’ve ever done. And by the way, your body didn’t go anywhere. You’re beautiful. You got this, and we’re here to help.

Our Bump Method Prenatal classes teach you how to manage that intra abdominal pressure and minimize diastasis recti. Our Bump Postpartum mom & baby classes teach you how to reconnect to those deep core and pelvic floor muscles to repair diastasis recti. If you’re not able to join a class, please check out our online programs. Knowledge is power!

xo

Postnatal Running: What New Moms Need to Know

You just had a baby! Congrats! You go to your 6-week post-delivery check up and get “all cleared” to resume exercise. Ready to reclaim your pre-baby body, you lace up your sneakers and hit the pavement for a run. Halfway around the block you start to feel something is “not quite the same down there” and realize you are in fact leaking pee. Holy sh*t. You feel a combination of surprise, frustration and anxiety that this is a normal part of motherhood you must now learn to deal with.

This is a story told by thousands of moms around the world. But it doesn’t need to be that way.

In dealing with the scenario described above, most women do one of two things:

  1. Throw on a panty liner and keep running – leaking be damned.
  2. Hold back tears, walk home feeling disempowered and weak, and avoid exercise of all kinds for the next 3 months or more.

There’s a much better option than either of those choices, and it offers better results for your fitness, mental health AND pelvic floor. It starts with learning how to restore your core, right after you give birth. There is NO need to wait until 6-weeks post delivery. In fact, most of your body’s natural spontaneous healing happens in the first 8-weeks after birth. Use this time to practice diaphragmatic breathing, gentle postural realignment exercises and pelvic floor lifts and releases (dynamic kegels). The problem is that most women in our medical system are not educated about the importance of this kind of post-baby self-care. They wait to do any exercise for 6-8 weeks, missing the best window during which to harness their body’s natural healing capacity. Furthermore, they get the ‘okay’ from their physician to resume exercise often without having an internal exam to test pelvic floor function. That’s kind of the equivalent to getting knee surgery, doing no rehab whatsoever for almost 2-months and then being told to just “resume your normal fitness activity.” Makes. No. Sense.

I am not an expert runner, so for more tips on returning to running after having a baby, I turned to Janie Sheppard, running coach, registered Kinesiologist and recent new mom herself. She’s part of The Runner’s Academy in Toronto that offers sport specific training and comprehensive programs to improve running gait and rehabilitate injury. I went to their facility and had my running gait analyzed on video – fascinating stuff! I’m a “prancer” (surprise surprise) Janie was able to correct my form in literally just 10 minutes of drills.

 

Here’s a short interview I did with Janie on the topic of returning to running after giving birth:

1) What is the number one mistake you see in postpartum women returning back to running after having a baby

The number one mistake I see in postpartum women attempting to return back to running is not allowing sufficient recovery and jumping back in to early!  Depending on the situation of course, we often recommend waiting at least 4 months before returning to running and even then, we recommend not returning to full bodyweight running.  That’s where our Anti-Gravity Treadmill comes in (seen below)!  It’s a great tool to ease back into 100% bodyweight running! 

treadmill
Feeling like a ballerina in my zipper “tutu” that attaches to the treadmill to make you up to 80% weightless while running

2) What are your top three tips to help new moms get back to running and avoid pelvic floor problems? Can leaking be avoided?

First really embrace the 6-week recovery time after baby comes and don’t try to do too much!  Focus on pelvic floor restoration. This is hard especially for athletic type personalities, but it really is the best in the long run for your pelvic floor!  Let it heal!

Second, be really mindful of your posture in the first weeks with baby.  The changes that your body goes through; first growing that baby, and then suddenly having that baby exit your body, then add in the constant carrying/cuddling, and often breastfeeding and your posture/core is like “whaaaat”?  Use pillows and use other people and use good chairs! This will help keep the pelvic floor in decent alignment.

Finally, rehab! Give yourself the gift of rehab with the right exercises and usually a pelvic floor internal assessment!  Find the right instructor/therapist to help with these things!  

Spend the time to do these three things and you are putting yourself in the optimal position to get back to running safely and with ideally no leaking!


3) What was it like as a recent new mom and Kinesiologist/Trainer experiencing postpartum running for the first time? 

Well….you don’t know what you don’t know!  It was a learning experience for me too!  I hope that I can now help other moms (new or experienced!) to understand the best methods of returning to an active lifestyle and feel good about the choices they make!  The biggest thing to accept is:  there is no rush!  We all know that being injured really sidelines you and so building back up properly will give you the best chance at avoiding injury later on when you really want to be active with your kids!

Be good to yourself! 

 

New Ways to Restore your Core after Baby

New Perspectives on “Mummy Tummy”


Oh yes, the joys of motherhood are accompanied with vast physical, hormonal and emotional changes. The female body is transformed during pregnancy from head to toe. The most obvious change is the growth of the abdomen, stretching to accommodate the growing fetus. In fact, studies show that 1 in 3 pregnant women develop a condition of over-stretched abdominal muscles along the linea alba (the middle of your 6-pack muscle), medically referred to as diastasis recti, and often called “mummy tummy”.

tummy
Severe case of diastasis recti

In the case of repairing diastasis recti, it’s vital to strengthen the deep core muscles (we’re not talking crunches and planks here!) and to establish functional movement mechanics. Exercise programs that include deep diaphragmatic breathing and correct pelvic floor kegel work are important places to start for new moms looking to fix diastasis recti. However, Osteopathic methodologies can also offer a new, alternative outlook towards the restoration of your core post-natally.Basic RGB

First of all, what is Osteopathy?
Osteopathy is a natural form of medicine that views the body as one interdependent system. Osteopathy aims to restore normality and function throughout the entire body by determining the cause of imbalance and discomfort. The treatment itself involves a subtle manual manipulation of bone and soft tissue. Osteopathy, is often recommended for the relief of musculoskeletal dysfunctions and pain management. However, the scope of practice extends to the treatment of respiratory and digestive issues, menstrual irregularities, migraines, headaches, insomnia, anxiety, depression and peripheral or local pain management.

How can Osteopathy help repair my abdominals after pregnancy? 

1) Feel your Fascia

Osteopathy treats Fascia. Fascia is often overlooked, but so very important to the restoration of your core after pregnancy. Fascia is a layer of connective tissue that encases all the muscles, bones, organs, nerves and blood vessels of the body. It stretches a great deal during pregnancy. I like to think of fascia as one big sheet of “saran wrap” that covers the entire body. Have you ever seen meat hanging in the window of a butcher shop and noticed that white outer sheath encasing the muscle? That’s fascia. 

The fascia has an incredible capacity to distribute and absorb forces placed on the body. With diastasis recti, the fascia surrounding the abdominal muscles may become distorted, rendering it unable to perform its normal function. The result?  Other parts of the body will essentially “pick up the slack” (pun totally intended!). A disturbance within this fascial chain can create compensations elsewhere in the body. This may help explain why we often see rounded and weak shoulders, tight pecs and traps, and a tucked pelvis in postpartum women.

Imagine the fascia of the abdomen as a heavy anchor, pulling all of its connected structures down towards it. Movements of the arms, which involve the collar bones, pecs and traps, will have a strengthening effect on your 6-pack muscles via this fascial layer. Exercises such as supine (lying on your back) arm circles and arm snow angels, coordinated with diaphragmatic breathing and pelvic floor contraction, will engage the fascia and the muscles underneath! These types of exercises are extremely beneficial during those first few fragile weeks postpartum and recovery.

2) Organ Love

Love your liver! The liver is the commander organ of the abdomen, taking up sixty percent of your sub-diaphragmatic space. There are so many reasons why you should LOVE and take care of your liver. It is responsible for several key functions including: blood detoxification, vitamin storage, blood sugar regulation, fat metabolism and hormonal metabolism to name a few. If you are still not convinced, allow me to give you one more reason to adore your liver: the healthier your liver, the stronger your deep core.
Your liver is suspended in the abdomen, just under the diaphragm by several ligaments. One of which, the falciform ligament, is connected directly to the rectus 6-pack muscle and refers into the connective tissue that surrounds your bladder, uterus, sacrum and pelvic floor! Proper deep core activated belly breathing will have a positive effect on your liver.  The inverse is also true: a healthy functioning liver will have a positive impact on your deep core! Here are 12 tips on how to keep a healthy liver.

3) Thoracic and Lumbar Mobility

It’s common for women to report weakness in the shoulders and tightness in the upper and mid-back during and after pregnancy. This can be attributed to a number of factors including: enhanced & tender breast tissue, nursing & holding the baby, and the influence of the hormone relaxin on the joints and ligaments of the body.

The thoracic region of your body houses many vital organs. The nerves that exit this area are responsible for stimulating the digestive organs of the abdomen, such as your liver, stomach, pancreas, small intestines and spleen. As the uterus grows to accommodate the fetus, the abdominal organs are pushed way up against your diaphragm. It is possible that the upper back and shoulder discomfort is actually referred pain originating from irritated and squished abdominal organs.

Additionally, this upward displacement of the abdominal organs can do quite a number on your diaphragm, increasing tension and causing shortened chest breathing. Shallow and tense chest breathing can essentially “turn off” your pelvic floor, causing extra pressure in your abdominal wall every time you take a breath. Your organs get pushed forward and out and make your diastasic recti worse.

In short, tension in your diaphragm = chest breathing = pelvic floor goes to sleep = more pressure in your abs = more overstretched tissue (aka diastasis recti).

Strengthening and mobilizing the spine can establish balanced neurological and vascular input to your abdominal muscles and organs. Exercises like gentle spine twists and Pilates style breast stroke extension will help soften the tight tissue surrounding the nerves, arteries and veins. With proper neurological stimulation, the abdominal organs can settle back in the abdomen where are meant to be. This will help the core muscles function optimally, and help repair that mummy tummy!

Alright, what the heck does all of this mean?

What it means is that the body is extensively interconnected.

Typically, one might assume that Rocky Balboa style sit ups, abdominal curls, sucking belly button to spine and planks are the best way to erase mummy tummy. And yet research has shown that this intense local approach can actually worsen an existing abdominal separation.  Rather, a global approach to pre and post-natal fitness, one that involves the mobilization of the spine and engages the fascial chains offers a safe and more effective approach to core restoration!

New Motherhood: How I Survived the First 100 Days

 

Alyson and baby Ingrid
Alyson and baby Ingrid 

 

It’s the honest truth – the first 12 weeks with a newborn are tough, at times hellish.  My expectations were intentionally low once we brought our little one home.  I didn’t assume she would sleep through the night and only cry when hungry or wet, but rather assumed it would be incredibly hard.  And I think these realistic expectations helped me get through her first weeks.  Here are some other tactics I used during her first three months.

Take it Hour by Hour

Days can be long with a newborn, and overwhelming.  For me, rather than wake up each morning wondering how I was going to get through the next 24-hour period, I’d segment the day into 1-2 hour intervals.  Once I started transitioning my brain into that way of thinking, the daily mommy duties became less daunting and more attainable.  And I started to relax a bit, rather than wake up anxious about how I would tackle everything.

Look At Your Baby, Not the Clock

I found so many baby advice books speak about the importance of “getting your baby on a schedule, right from day one”.  I’m a firm believer in the importance of routine, but those first few weeks with a newborn are so chaotic.  While routine is important, it’s more about survival.  A really good piece of information a friend of mine told me was to throw out the clock, and instead look at the little one for “scheduling cues”.  And once I started to do this, my mind relaxed.  Rather than think “oh, she’ll need to sleep in an hour”, I would look for yawns and eye rubbing.  And when she was hungry, she’d let me know with her cries.

Accept the Good, Bad and Ugly

Looking back, those first few weeks gave moments of complete euphoria mixed in with utter exhaustion, defeat and frustration.  I dreaded Ingrid’s bedtime, as it was usually a battle with a fussy baby from 4 – 7 pm, and putting her to bed at night usually took about 90 minutes (let’s be honest, sometimes 2-3 hours).  What helped me was when I decided to change my train of thought.  I accepted those feelings of frustration and defeat wholeheartedly, told myself it was ok I felt that way, and then moved on.  And when I was alone and felt frustrated, I would place my little one in her crib, knowing she was safe (albeit unhappy), gave myself a few minutes alone (sometimes crying in the bathroom), and then went back to her with a clearer mind.

Eat Good Food

Healthy, home cooked food can be incredible therapy, especially during trying times.  I have a few vivid memories of those first few weeks with my little one.  One is of my sister who flew in for 36 hours from Montreal when Ingrid was 6 days old, and she cooked up a storm in my kitchen – breakfast cookies, gluten free vegan mac and cheese, chickpea peanut stew.  Another memory is of a friend who dropped off a vegan and gluten free fruit crisp and lasagna on our door step, with merely a text that said “I was in your neighbourhood and dropped off some food for you”.  No expectation of a visit or to meet our baby, but simply a “I’m a mom and I know what it’s like”.  These two memories still make me a bit weepy, because food was my medicine.  And those dark chocolate almond squares my sister brought me helped me get through those first 72 hours of non-stop cluster feeding.

 

Reach Out

When our little one arrived, my stubbornness kicked into high gear where I was determined to try and do it all on my own.  But boy was it tough and I quickly realized I needed help – emotionally as well as physically.  A colleague of mine wrote me detailed emails those first 7 days that had to be about 700 words each, which I cherished, and actually saved to read during the early morning hours, to feel more normal.  Girlfriends back home would text and BBM me constantly, not expecting a reply, but simply to check in with a sounding ear.  And my husband was my rock.  Sure he felt completely useless during those first weeks when our little one only wanted my boob and/or chest, but he’ll never understand how much I cherished everything he did, despite him thinking it was nothing – a shoulder to cry on when breastfeeding was so incredibly hard and my body ached from delivery, his willingness to clean and keep the house in order when everything completely out of control, his culinary skills and the countless pharmacy visits he made to try and find a Sitz bath.

Minimize Commitments

I’m a home body to begin with, and I knew I would become a hermit those first several weeks once our little one arrived, and I’m glad I did.  With most of my family out east, family visits were few.  And my husband and I were both committed to telling our friends we’d need a few weeks on our own before we introduced our little one.  I also felt it incredibly difficult to even try and schedule any kind of visit or appointment when our little one was so young, as I was really flying by the seat of my pants.  Fewer commitments helped me place my full attention on my little one.

Get Out of the House

I’m such a homebody, probably close to a bit of a hermit.  I was very happy those first few weeks of staying housebound with our little one.  But when I started cornering our dog walker for 20-30 minutes of adult conversation everyday (and making her late for her other dog clients), I realized I needed to get outside.  Was it easy?  Absolutely not – and instead, incredibly daunting thinking I had to get this little creature dressed and in her stroller, along with trying to remember clothing myself.  But each day became a bit easier, and the outside world helped provide me with a bit of normalcy, which was very therapeutic.

It Will Get Easier

When you’re in the depths of parenthood with a newborn, daily struggles are so frequent that you think it’s impossible for it to get harder – and then it does.  So you quickly learn to adapt to a challenging lifestyle and a little person who constantly depends on you.  But then one day you realize that the usual 3-hour cluster feeds have reduced to a bedtime snack, your baby goes to sleep on their own in their crib rather than on your chest and you can fathom staying up past 7 pm to have an adult conversation with your partner.  It is true – it does get easier.  A lot easier.  And yes, there will still be days and nights where you want to cry and pull your hair out, but you’ll also start missing the night time feeds because of those newborn baby snuggles (even if you don’t want to admit it!).

So take it all in now mama, and breathe!

 

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!

“Mummy Tummy” Makeover

There’s been a recent slew of media attention devoted to so-called “fat shaming” fitness moms who have been posting online pictures of their lithe bodies soon after giving birth. It’s certainly controversial and (despite their “intent to inspire”) leaves many other women with feelings of jealousy, inadequacy and hopelessness. Promoting health and fitness is an honourable pursuit; scouring for external validation and public attention via social media is another.

The competition for women to give birth and then immediately erase any evidence from their bodies that they just created a child has become crazy. Another blogger called it obscene (I don’t entirely disagree). Ultimately we’ve become too obsessed with being skinny and hot and MUST shift focus back to promoting mothers’ HEALTH – physical and mental. STOP reading these magazines, IT IS ALL BS!!! kim-kardashian-on-star-magazine-cover

At some point the psychology of motherhood changed. What happened to women being celebrated as maternal life-creating goddesses? Give yourselves a damn break ladies! You just created a human being, are chronically sleep deprived and may not have the genetics of Heidi Klum (who walked the Victoria’s Secret runway 6 weeks after baby).

This kind of pressure to get rid of mummy tummy has postpartum women working too hard, too soon and doing the wrong type of exercise. This video of women peeing during Cross Fit absolutely horrifies me, not only because they are normalizing urinary incontinence – something that is NOT normal – but also because of the long term consequences of untreated UI (organ prolapse, hernias, bladder sling surgery… etc). What’s going to happen when you’re 65, 70?? FYI: second only to dementia, the leading cause of institutionalization – being put in nursing home – is due to incontinence.

This is not a bashing of intense Cross Fit style training. Cross Fit has its place. This is a plea to all women out there: please take the time to rehabilitate your inner core muscles after giving birth. You just popped out a human being, helloooo!
What’s the use in losing all your baby weight if your inner organs are dropping and you leak every time you sneeze? Learn to do proper kegels to reconnect your abdominal walls and strengthen the deepest layer of abs (transversus abdominis). My pelvic floor physio colleagues at Pelvienne Wellness have this helpful kegel how-to article.
diastasis-recti

To all moms, new and veteran: Get yourself checked for diastasis recti (abdominal wall separation seen above) which can still exist for years after giving birth. If you have a stubborn pooch, chances are it could be because of lingering diastasis. It can more often than not be repaired through proper exercise, and we can help.

Get rid of your mummy tummy from the inside out by restoring your inner core through mindful abdominal exercises (NOT traditional crunches). There’s no crash diet or crazy cardio bootcamp that will do it safely or effectively.

Whoever said it would be easy, lied. What they meant to say, is that it’d be worth it!