Tag Archives: posture

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

5 tips for preventing back pain when caring for children

As I was walking home from class yesterday a father and his toddler walked past me.  The dad was taking tiny baby steps in time with his son, was crouching in a squat position to be at his son’s level and was leaning over to one side in order to hold his hand.  This reminded me of how Becky used to love to hold my finger as she walked – up until her hand was big enough to hold mine.  And how it hurt my back let alone nearly dislocated my finger!!!

The trouble with having bad posture when you’re caring for children is that you’re going to repeat that same position over and over again each day and this will take it’s toll on your body.  And because of the interconnectedness of our body parts, that pain could show up anywhere, with the back often being the prime suspect.

Here’s my 5 top positions to be aware of your posture:

  1. Bending over to change nappies and other jobs at waist height – stay in close, hinge from the hips and keep the upper back in alignment. You’re trying not to just round your shoulders and hang from your ribs.  If the task is lower down, bend at the knees into a squat or lunge
  2. Getting out of bed – roll over onto your side and push yourself up. Try not to just sit straight up – this causes pressure through your stomach and could prevent diastasis from improving as well affecting your pelvic floor and back.  I demonstrate this on video here
  3. Pushing the pushchair/shopping trolley – stand upright, not too far away, with your arms slightly bent and think of powering through your legs, it’s a great bum work out!  Don’t rest your weight on the pushchair and don’t think of it as pushing with your arms – your whole body is doing the job.  Applies even more so when going uphill!!
  4. Picking baby up from the floor – bend at the knees into a squat or lunge keeping your back in alignment, pull baby in close, exhale as stand up (using the knack).   The same with car seats – and it’s better if you can carry them close with both hands when baby is small.  Picking up from the cot you need to stay in close and again bend at the knees and hips
  5. Carrying baby – try not to lean back to rest baby on your chest.  Drop your ribs down and keep them in alignment with your hips – you will feel your core tire quicker but that will just remind you to change positions.  Try and keep baby high and in the centre.  If you carry to one side keep them high and let their head rest on your shoulder – try not to push your hip out and try to vary sides rather than always favouring one

Bear in mind that any continuing pregnancy conditions need to be assessed – pelvic girdle pain, piriformis/sciatica, diastasis, pelvic floor dysfunction.  These can all contribute to back pain as well.

 

Walk this way!

I’m a bit obsessed with walking…  There are so many health benefits to it and it’s so easy to fit into your day and yet I read a report that said that 45% of people would rather take public transport than a short stroll.  And 1 in 20 would use public transport rather than walk for 5 minutes!  And yet walking is the easiest way to fit in the suggested amount of exercise we should be doing plus is like medicine for all the health benefits it has!

For those of you, like me, with older kids who really aren’t excited about the prospect of going for a walk (to say the least) I highly recommend Geocaching!!  Unlike golf – “a good walk spoiled” (Mark Twain) – geocaching is a good walk made better – by a treasure hunt!  Becky even did a talk about it in school this week so must enjoy it more than I thought.  You can find out more here

And remember Mums, Tums & Buggies has plenty of walking in it if you fancy joining us!

Walk this way

When I was a kid I walked with very turned in feet.  My family did what lots of families do – mocked me for it!  So having not seen any kind of specialist I forced myself to walk with straight feet – I now have a twisted shin for my trouble!  So it’s always worth working on any of these postural changes incrementally – just play around with how it feels and notice your gait rather than aiming for some big change.  And there are plenty of specialists who can help if you need it.

Here are some steps you can start with

  • feet should be facing forwards – not turning in or out
  • feet bony hip width apart – in standing and when moving.  Feet should stay in parallel and your weight shifts slightly from side to side, rather than crossing into centre like you’re walking a tight rope or waddling!
  • land mid foot and roll through – your toes should hinge and be the last part to leave the floor
  • push backwards with foot – instead of falling forwards you should be using your leg like an oar.  So the leg spends most of the time behind the body and swings forward from the hip.  Knees shouldn’t be bending that much

Posture is important – the way we walk can have an affect on our pelvis and back health too.  For those of you with buggies, try to walk as you would if you weren’t pushing – the number of people I see leaning forward at a 45 angle…  Not great for the back and a missed opportunity to work your bum muscles! Your arms should be relaxed and think of the legs driving the movement – so you’re not really pushing at all.  Another tip I saw is to use just one arm, and stand off to the side slightly.

The other thing that is worth noting is that the way you walk also depends on the reason for the walk.  If like me you’re always rushing on the school run it’s harder to focus on your form.  In Germany they’ve actually had to put lights in the pavement so people on their mobile phones know when to stop!  Obviously you can’t keep good posture if your chin is dropping onto your chest as you check social media… But also one of the benefits of walking is the chance to think, to look and to be in the moment for once.

“All truly great thoughts are conceived by walking” – Friedrich Nietzsche