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abdominals in pregnancy

Should you work your abdominals in pregnancy?

What do you think?  Should you work your abdominals in pregnancy?  Or are they a no-go area?  And if so, what exercises are appropriate.

When I polled people about this recently I had a varied response but most tended towards yes you should, but gently.

My answer is… it depends.

It depends what you think of as the abdominal muscles.  For most people, it’s the ones you can see – the six pack muscles. The guidelines for these muscles (the rectus abdominis) is there should be no direct work on them after you reach the 12 weeks mark.

So that’s a no to these abdominals in pregnancy.  No crunches, sit ups, hanging knee lifts, or lying on your back with both legs lifted etc.

But the abdominals actually comprise of four sets of muscles and as a unit are essential in pregnancy as they support the spine, keeping it moving well, helping to maintain a good posture and minimising back pain.

The innermost set of muscles is the transverse abdominis. This is just one part of your core along with the pelvic floor, the back muscles and the diaphragm. So proper breathing, tied in with pelvic floor work, is also an essential part of core work – it’s never about the abdominals in isolation.

The best way to work the core in pregnancy – and postnatal and beyond – is with whole body, functional exercises.  The core should be stabilising the spine as you move your body.  So look at your posture when exercising.  Look at how you’re breathing (and if you’re breathing!)  Also look at how the exercise will serve you.  What’s the point of it?  Is a plank useful?  Or are there exercises that work your core in a functional way that also prepares you for your day-to-day activities?

For example, the exercise below uses a single heavy weight on one side to challenge the core to keep the spine stable by not leaning one way or the other.  Ideally ribs and hips should stay in alignment as you walk.  You should be breathing normally throughout the exercise.

It’s also great practice for when carrying a car seat or heavy shopping bags!

Farmers carry in pregnancy

C-Section Recovery

There is more to successful c-section recovery than just stopping driving and no hovering!  Do try to get as much help as possible in the early days – I know we always want to do everything but you have just had major abdominal surgery.  So even if you feel ok you still need to take it easy otherwise recovery can take much longer.  A general rule of thumb is to not lift or push anything heavier than your baby for the first 6 weeks – this includes the pushchair.

Other considerations are:

  • Continue to roll over to get out of bed – and reverse the action to lie down.  Check out my video here.  Some people find gently pressing a pillow on to their incision helps when rolling over and when standing up.
  • Remember to lift the pelvic floor and breathe out as you stand up – read about it here.  You need to use the same technique when lifting baby and during any exertion.
  • Be aware of your posture, especially when lifting holding your baby.
  • Make sure you are well hydrated and try to eat nutritious food instead of junk – more about healing nutrition here
  • After doctor’s clearance at 6 weeks, introduce scar massage to prevent adhesions.

Adhesions are tiny ropes of tissue (collagen) that bind together to help with healing after surgery and also after infection, inflammation, radiation therapy and trauma.  It is an important and necessary part of the healing process but unfortunately there seems to be no stop button.  This means the adhesions can remain and continue to grow for life – so even if you are way postnatal this may still be something that could help.

Something else to consider, especially for those of you who are way post surgery, is that NeuroKinetic Therapy proposes that other pain can also come from a stuck scar.  Scars are neutrally dense which means they receive all the messages from the brain instead of other parts of the body e.g. the abdominal muscles.  This could lead to pain and a lack of strength in other muscles – which may mean you don’t get the results from strengthening exercises that you think you should.  Deactivating the scar could make a huge difference – think I’m going to have to start practising what I preach!

Although you need to rest in the early days, movement is an important part of your recovery.  It improves the blood circulation helping to nourish your body, keep muscles healthy and prevent stiffness and constipation – gentle walks are perfect!

When you do consider a return to exercise after a C-section (at least 8-12 weeks later) you need to be aware of any pain/tenderness you experience.  A painful scar is a good indication that you need to ease off a little.  And it goes without saying – NO CRUNCHES!

Mother’s Day

A Mother's Day Love Letter

A Mother’s Day Love Letter

I’m often wary about mentioning Mother’s Day as it has different connotations for many. I’m particularly mindful of it following some of the conversations and emails I’ve had this week. But that has made me more grateful this year than usual, for my own mum and the sacrifices she made and also for how lucky I am to have my girls.

Sometimes being a mum is just so hard and thankless. There’s a never ending list of stuff that needs to get done. There’s our bodies which have irreparably changed in so many ways. There’s the scariness of being responsible for another human being and having to get it right. It’s a steep learning curve and just when you think you’ve got the hang of it, something new comes along…

But there are two people who at the minute think I’m the centre of their world. I’ve never known love like I felt for them the moment I set eyes on them.

In the words of Eden Ahbez “The greatest thing you’ll ever learn is just to love and be loved in return.” My girls have given me this and I’m so thankful for it.

Happy Mother’s Day

The Knack – pelvic floor health

Do you sneeze wee? You need the Knack!

Do you sneeze wee? You need the Knack!

I was listening to an interview with acclaimed women’s health physiotherapist Michelle Lyons last week and was surprised to learn that going from seated to standing puts more pressure through the pelvic floor than lifting a 20lb weight! Bearing down on the pelvic floor that many times throughout a day could lead to, or worsen, pelvic floor disorders – such as incontinence and prolapse.

I have been working on correct standing technique with my pregnancy class for a while now but changed the emphasis last week and gave ‘the Knack’ to them as homework.  Now it’s your turn to practice daily! This is not just for pre and postnatal women – 40-70% of ALL WOMEN have incontinence and 50% of women who have given birth will develop prolapses.  These are stats worth avoiding!!  The Knack is a preventative measure to be used throughout our lifetime.

How to do it

1.  Sit at the edge of your chair, up on your sit bones, heels in line with your knees.

2.  Breathe in.  As you breathe out allow your pelvic floor to relax.

3.  Breathe in.  As you breathe out think of drawing your pelvic floor in and up.

4.  Continue breathing out and lifting the pelvic floor as you stand up.

5.  Once standing, allow the pelvic floor to relax.

You can see a video of me showing the knack here

At first try to practise this standing up after every visit to the loo.  Once you get used to it start to introduce the Knack every time you stand up from a chair.  Keep practising until it becomes second nature.  I’m still practising!