Tag Archives: incontinence

How you can help your pelvic floor

I was asked by someone this week about rehabbing the pelvic floor post birth, in preparation for getting back to running.  I was so pleased that she was aware of the importance of taking her time – things keep popping up in my timeline about postnatal classes where people are running with buggies, skipping and even doing jumping jacks! All of this can have a deleterious effect on the pelvic floor and continuing to overstress a weakened pelvic floor can lead to prolapse.

However taking your time, making a few lifestyle changes and building up core strength can mean that even if you’re currently experiencing pelvic floor dysfunction (any leaking, back pain, heaviness in the pelvis) you may be able to get back to your previous exercise routine.

I prolapsed after my first child and was given very little advice about it other than being told I would probably need a hysterectomy when I go through menopause.  Because of this experience I have spent my time learning more and applying it to my own life as well as in my work with others.

First thing I implemented was no impact.

As someone who wasn’t a runner, this wasn’t a big change.  But I did have to stop jumping around in my aerobics classes and also give my trampette a wide berth…!  I can now run for the bus without worrying and I played rounders in the summer where I was sprinting for quite a while with no effect.  So I could probably run now if I wanted to but I’m still choosing to stay low impact most of the time.

Second thing was no crunches

The downward pressure created by crunches/sit-ups will push on the pelvic floor.  Full planks and press-ups and exercises with both legs lifted also creates a lot of pressure and so I avoided them.  However there are alternatives – for example in press-ups performing them on an incline, plus incorporating crunchless core exercises – so there is no reason to stop exercising, just make a few changes.  Bear in mind that sitting straight up in bed is also a crunch (and how many times do you do that a night?) – I roll over to get out of bed instead.

It’s not all about what you shouldn’t do though. There are things that I needed to start doing:

  • alignment/posture

particularly the with respect to the pelvis.  Try tucking your tailbone under and bringing your hips towards your ribs.  Lift the pelvic floor now.  Then take your hips away from your ribs, allowing your lower back to arch more, then lift the pelvic floor.  Then bring yourself to a neutral pelvis where your level through the front and the back of the pelvis (think of it like a bowl) – the pelvic floor lift should feel easier in this position.  Pelvic floor works best when we are in alignment, with the head, shoulders, rib cage, pelvis and heels all stacked up in line

  • breathing

both looking at how you breathe during exercise and from day to day.  During exercises you need to breathe out on the effort and lift pelvic floor at the same time.  This also applies when you are lifting a weight – baby, shopping etc. – and also when you go from seated to standing (The knack – as you go from sit to stand but vice versa too).  The other aspect of breathing is to stop breath holding and sucking your stomach in.  When you breathe in your stomach should actually swell not suck in.  I see so many people who’s stomachs stay still when breathing and instead their shoulders lift.  Try lying on your back with your knees bent, feet flat on the floor.  Put one hand on your chest and one hand on your stomach.  As you breathe in you should feel your chest move first then your stomach.  Your stomach lowers as you breathe out and then your chest.

All these changes I’ve made have meant that my prolapse has improved and I’m hoping to avoid that hysterectomy!  I know that there’s still work to do and I’m currently learning more about another part of the puzzle:

  • relaxation

stress can affect the pelvic floor, there’s also some evidence that lower limb injuries and back injuries will impact the pelvic floor too, even years after healing or the pain has stopped. There may also be scar tissue from episiotomies or tears.  I’ve just learnt some trigger point release for that – sitting on one of the spiky balls!  It’s uncomfortable but definitely has an effect – I will let you know how that goes!  And it’s also helped to introduce deep breathing, mindfulness and relaxation practices into my daily life.

 

So when looking at rehabbing the pelvic floor, it’s not just about a list of exercises to do – we need to think of the body as a whole and the pelvis at the centre of that, and looking at improving in all these areas

Incontinence Part 2

November was national incontinence and bladder health awareness month in the U.S. As lots of the training resources I use come from there it seemed an ideal time for me to bang on about my favourite subject again!

I’ve already covered stress incontinence, which is the most prevalent

http://sarahparkerfitness.com/stress-incontinence/

But there are other types as well. And bear in mind incontinence isn’t just urine, it can also be faecal

  • Stress – leaking due to a change in pressure on the bladder eg jumping, running, sneezing, laughing
  • Urge – a sudden and overwhelming urge to go. Leaking before have chance to get to the loo
  • Overflow/dribble – bladder doesn’t empty fully so leaking occurs without necessarily having had an urge to wee

Incontinence is not an unavoidable consequence of ageing and childbirth. Things can be done to prevent it and/or improve it. It’s always worth seeing a doctor and getting a referral to a women’s health physiotherapist. Instead of masking the problem with pads etc – you need to find the reason and make a lifestyle change!

Things that can affect the pressure within the pelvis:

  • Posture – try to keep your ribs stacked up over your pelvis when standing and sitting
  • Clothing – too tight clothing can compress and move your organs. High heels will make you tilt your pelvis in order to be able to stand upright
  • Diet – avoid foods/drinks that irritate the bladder or cause gas
  • Exercise – move more, sit less

Exercise needs to be functional, so that you’re using movements you need in everyday life – squats, lunges in all directions, hip hinges. Exercise can also have a negative effect if the exercise you’re doing is too much for the pelvic floor to withstand. Any exercise that makes you hold your breath, bear down, shake, really clench, lose postural cues or leak needs to be avoided for now.

Another useful part of your life to look at is your toilet habits as straining can cause huge problems.

  • Wee every 3-4 hours – try to avoid going ‘just in case’. You just need to relax to wee so don’t hover above the seat. Rocking the hips a little at the end can help if you feel like you haven’t emptied fully.
  • Poo when you feel the urge – don’t hold it in as this can cause compaction. Knees should be higher than your hips – feet up on a kids stool or just use 2 loo rolls. Don’t strain. If the pelvic floor won’t relax you can help by vocalising – try a grrr or ssss now and see which one makes you feel like your pelvic floor relaxes. Then use that sound when on the loo.

And finally – keep practising the knack

http://sarahparkerfitness.com/knack-pelvic-floor-health/