Why all women should do pelvic floor work

On so many occasions I have been talking about pelvic floor exercises to a group of women and one of the regular responses I receive is, ‘ I have not had children so this is really not a topic relevant to me.’ There are an incredible amount of urban myths about pelvic floor exercises and this is one of the biggest! Women who have not had children are still prone to urine leakage throughout their life. With 24 % of women in Australia in their reproductive years remaining child free, this is a whole subsection of society being neglected.

When we are younger there are lots of activities that can impact on anyone’s pelvic floor: constipation, chronic coughing, always holding your breath. Basically anytime you increase the pressure in your abdominal cavity by bearing down you can impact your pelvic floor. Certain sports also have an impact; trampolining, horse riding and gymnastics to name a few. Many of these sports create a very strong pelvic floor but it is constantly turned on. Any muscle that is over active is not a functional muscle, and with pelvic floor, non-functioning can lead to leaking urine.

One thing that is inevitable in a woman’s life is menopause. When we head into menopause our hormone levels change. Oestrogen is a female defining hormone, it gives us our breasts, periods, and our waisted shape (this is why our waist thickens after menopause) and it affects how muscles contract and heal. The change in oestrogen affects the pelvic floor in two ways:

  1. Your pelvic floor does not contract or heal as well, and
  2. Your pelvic floor can atrophy (waste) by up to 1% a year post menopause.

So with your pelvic floor getting thinner and not contracting as well you are leaving yourself open to leaking urine.  If you do not work it, you will loose it!

My biggest bit of advice on pelvic floor health is ‘prevention is better than cure.’ As much as this all sounds very grim there is a simple solution – look after your pelvic floor. Start doing pelvic floor exercises! It does not take much time, but it can have a huge impact on your future life as well as your current one. Did you know that some studies have suggested that pelvic floor muscle strength may be related to increased sensation and sexual satisfaction? So why ignore your pelvic floor? Take control and make it work for you.

For instructions on how to work your pelvic floor head over to WHEN (www.when.org.au) and download your free information sheet on how to preform pelvic floor exercises.

One of our pelvic floor workshops setup to go.

Caring for your pelvic floor during cold and flu season

Cold and flu season is upon us!  Did you know that a chronic cough can affect your pelvic floor? If you have a slightly compromised pelvic floor a simple cough can push it over the edge!

Hopefully you will be able to stay health and well this winter but just in case here are a few ways you can protect your pelvic floor:

  1. Make sure you are doing regular pelvic floor work, even when you don’t have a cough! If you need a reminder about the best exercises to do  you might consider attending one of our monthly Pelvic Floor 101 workshops.
  2. Support your pelvic floor through a cough. You can cross your legs and squeeze your inner thighs together to do this.

The stronger your pelvic floor is at the beginning of a cold the better it will be afterwards too!

Back Care for Office Workers

We have all heard the evils of sitting too much in the workplace. Many of us have desk jobs and prolonged sitting is unavoidable. But let’s explore what this extended sitting does to your glute muscles. When we sit for long periods the muscles in our bottom can become weak and inhibited. Your glutes play a key role in helping take stress of the spine during movements, the muscles help control movement of the torso, hips, pelvis and legs. If your glutes are not strong enough your spine will have to take more of the load, especially in rotation. If you can get your muscles strong this will help protect your lumbar spine.

First port of call is to stretch your glutes and hamstrings. If these muscles are tight it will pull on your lower back. These stretches are really easy to do at home and you don’t need any special equipment!
Even if you do not experience back pain these exercises are a great preventative measure.
If you don’t feel any relief from these stretches please see your general practitioner or allied health professional for further assessment!

Stretch 1


Sit up straight in your chair and place the foot of one leg over the knee of your other leg. Gently press down to get a stretch through your leg. Swap to the other leg and repeat

Stretch 2


Sit up straight in your chair and put one leg on an object slightly lower than your chair, a rubbish bin is ideal! You can lean forward into this for an extra stretch!

Theraband Foot and Ankle Exercises

I love the fact we have such a diverse clientele! One of the joys of having a different client base is that as instructors we have to be able to apply the same techniques to different conditions and be able to modify the program and personalise it for the individual.

Recently we have had quite a few clients twisting ankles. We have done the normal rehab and they have returned to running only to twist their ankle again!

It made me think about some ballet exercises for strengthening feet and ankles I was given when I first trained by an amazing woman Margo Islop, who is a retired ballerina.
So far we have been using these exercises on runners, it’s great to be able to source different techniques from all sorts of fields then apply them to any client who will benefit from it. After we had success with this routine a few of our young dancers started asking about them, so we thought we would put the routine up on the blog so everyone could access it.

Jane’s daughter Lily loves to dance and is determined to build up enough strength to go “en pointe” one day. We thought she would be the perfect dancer to apply this to!

Here she is with a sequence of the foot and ankle strengthening exercises that can be performed anywhere with a theraband!

Lily looks amazing performing these exercises, they are great for dances but they are very diverse and can be used on runners, the elderly any client who needs to build foot and ankle strength.

 

 

Loop the band around your big toe. Flex the toe against the band. Then slowly extend the big toe, gently pulling backwards with the band.

 

 

Loop the band around the second and third toes, flex and extend the toes.

 

 

Loop the band around the fourth and fifth toes. Gently extend and flex the toes.

 

 

Place the band around the foot lengthwise, under and across the heels and toes. Flex and extend all toes against the band.

 

 

With the band still lengthwise around the foot gently rock your pelvis forward and lean towards your foot as you point the foot.

 

Huge thanks to our budding ballerina, Lily!

Feet

We have all heard the stories about women’s foot size increasing after pregnancy, I always thought it was an old wives tail and would never happen to me. Well it took me about 3 years to realise, mainly due to the fact that I had not had the opportunity to wear my going out shoes (after having 2 children close together) but low and behold I do not fit into my going out shoes anymore!

After researching this topic further I wish someone had explained to me the importance of looking after my feet during pregnancy. I know we have so many other body parts to concentrate on during pregnancy and generally we might get a foot rub from our partner if we are lucky. The main concern in most pregnancy are that our feet will swell and we will not fit into our shoes. This is a really common occurrence and we instantly revert to wearing the easiest thing to slip on our feet, Flip flops or thongs, dependant on where you grew up.

So I am here to tell you especially as its summer, don’t wear thongs unless they have some arch support!
There is limited research into this topic but the research that is available is well worth looking into.

It has been found that foot length and width can increase due to pregnancy and also that your foot arch can drop by up to 1cm!
This has been attributed to an altered gait pattern (the way you walk).

This can all be traced back to the fact we have an increase of weight when we are pregnant and also the change in our hormones. Our feet take a beating! The majority of change in feet seems to occur during our first pregnancy. There is a fantastic article: Pregnancy leads to lasting changes in foot structure ( 2013) where the researchers have suggested that the incidence of hip and knee issues are more common in older women who have had children, and they are suggesting this all relates to the fact our arches have dropped.

So when you are pregnant look after your feet!

Give them support, if you have to wear thongs there are whole heap of new thongs around with arch support. Do foot exercises to wake up those little muscles in your feet so your arches get a little extra support.

We use these hard yellow massage balls to wake up the feet. Try 10 to 20 presses on the ball of your foot, repeat on the arch and then the heel. Remember you arch is generally more sensitive so be gentle. We have our pregnant ladies sit down to do this work, just so we can ensure their pelvis does not shear with the movement. You can also substitute a franklin ball if you need something a bit softer.

Another exercise to try is scrunching your toes on a towel. Try to get the towel to move, focus on lifting your arches when preforming this exercise.

Diastasis During Pregnancy

Did you know that between 66% – 98% of women will have a diastasis during their pregnancy!
The amount of pressure placed on your abdominal muscles during this time leads to a thinning, or in some cases a separation of your stomach muscles resulting in a diastasis. Do not panic if this happens it is quite normal.

You may notice when you sit up quickly or are getting in and out of the bath your stomach looks like a triangle instead of a nice dome shape, this is a DRAM (diastasis of the rectus abdominus).
Once the muscles have separated during your pregnancy it will not come back together until after the baby is born (due to the fact that your tummy continues to increase in size).

What you do want to do is try and keep the separation to a minimum while you are pregnant.

One explanation we use for our pregnant mums is to compare the separation to that of a broken bone. If you set a broken bone as soon as it happens it will heal better, if you don’t set the bone for a few weeks it will be harder to get back together, may take longer to heal and have complications.

If your tummy muscles do separate you want to look after them and try and reduce the separation as early as possible. You can start this while you are pregnant. If you see your tummy going into that triangle shape you are putting too much strain on your tummy! Try give your baby a gentle hug (bringing your baby back to your spine) you are not trying to crush the baby, just a gentle hug. Remember to roll in and out of bed and to support your tummy when you are lying on your side.

 

 

Here are two of our amazing mums to be. This is both their second pregnancy and each has around a 4 finger separation at the moment. We are working with them and in general they now have more control over the separation. When both are lying on their side you can see how the lower side of their tummy dips down, keeping their stomach muscle apart and putting lots of pressure on an already strained muscle. We have popped a Pilates ball under their tummy to bring that separation back together.

So please be careful when you are lifting (especially toddlers!), getting in and out of the bath and exercising. If you can keep more tone in your tummy it WILL recover better after the baby. If you are pregnant or have just had a baby and would like some help getting your diastasis back together please contact us, we CAN help!

We would like to thank our beautiful pregnant clients who allowed us to use their pictures in this blog post and wish them both the best for their impending arrivals!

The Benefits of Gentle Mobilisation

As a nurse I have seen many ulcers through my career. When I moved into Pilates I thought that was the last of the ulcers. Last week one of our older clients had a fall and we encouraged her to come in for gentle mobilisation, it had been about 2 weeks since the initial fall.
When she fell she knocked the front of her shin, the skin was not broken but the area was swollen and looked angry and oedematous, it looked like a wound about to break down.
As we were getting her to do some gentle leg and foot work, I could not believe the improvement in the vascularity to the area and the decrease in swelling. I took some before during and after photos and you can see the amazing difference!

The general recommendation is to elevate these types of wounds, and I have seen the difference in drainage around the area this creates.
BUT seeing elevation WITH gentle mobilization just blew me away! I know that it is really hard when people have falls and that they are sore and lose their confidence. The first reaction is to rest, but the difference this gentle exercise created is amazing and a great reason to make sure people keep moving.

Peta

New pregnancy exercise guidelines – no more singing while you exercise!

I think I need to get out more!  It is sad to say but I was so excited by the release of the new Sports Medicine Australia (SMA) guidelines* on exercise and pregnancy.

So what do the new guidelines mean for us in the studio? 

Well the reason I am so excited the changes support what we have been advocating for years.

The first thing to note is that the statement by SMA is only aimed at women going through a bulk standard pregnancy with no complications, and to consult your health care provider (GP, OBGS, midwife or Physio) about physical activity during and after pregnancy. Which is as always sound advice!

 

The key changes to the current recommendations are:

  1.      An increase in the amount of aerobic activity recommended (now 150 – 300 minutes per week!)
  • During this aerobic activity you still should be able to talk (12 -14 on the BORG’s scale), with a special note that you should not be able to sing. Maybe I have been doing it wrong all these years and should have been trying to belt out a tune!!
  1. Types of exercise recommended
  • Brisk walking/jogging/running (see my thoughts on running below), Cycling but only on a stationary bike, and swimming.
  • The SMA have suggested moderate to vigorous exercise, which I find confusing as if I did vigorous exercise I would not be able to talk which is saying a lot! They also have said that every minute of vigorous exercise is equal to 2 minutes of moderate exercise.
  1. They have included light weights (I assume they are referring to hand weights) and resistance bands.
  1. As expected they have included the reasons not to exercise such as ruptured membranes and many other pregnancy complications.
  1. The other new addition is to avoid wide leg squats, lunges and unilateral leg exercise, anything that places excessive shearing or force on the pubic symphysis. Exercises which we have been avoiding in the studio for years for our pregnant clients!

At first I was shocked that they had put forward jogging as safe, but if you read the statement in full it states that there is actually no evidence to either say it is safe or not.

So really ladies, common sense should prevail, your pelvic floor is already under increased strain just with that extra baby and baby weight, why put it under further strain? We only get one pelvic floor please look after it!  Experts advise not to bear down or strain when you go to the toilet as it puts your pelvic floor under too much pressure, so why run? There are lots of other types of exercise you can safely do during your pregnancy.

 

What about exercises using weights?

The SMA have now stated that anything that increases abdominal pressure is considered unsafe and have made a strong statement in regards to weight lifting being contra indicated during pregnancy.

This is great news as there have been lots of images of pregnant weight lifters giving people the impression it’s a safe exercise for pregnant mothers.
The amount of times I had to argue with people about this point as people say, “they did it before they were pregnant so they can do while they are pregnant.”

What about exercise during the post partum period?

I was quite disappointed in the lack of guidance for the post-partum period. I truly believe this is one of the most neglected areas around the whole giving birth process and we get so many women come into our studio who have injured themselves during this period as they have not been guided correctly.

Hopefully research and guidance for this will come in the next version of the guidelines. Until then we will continue to recommend safe exercises for our clients during pregnancy and the post partum period!

Peta

 

* The last update from the SMA guidelines was in 2014