(Oh, & here’s HOW to do pelvic floor exercises )

How

Regular pregnancy exercise will improve fitness, maintain a better self-image, and help you to feel positive about your pregnancy, your labour and your delivery. Don’t try to dramatically increase your fitness during pregnancy, (however you can start exercising now, even if you didn’t before – start with just walking, and some of the exercises in this post) but look to maintain a basic fitness level.

Modify your pregnancy exercise programme as your pregnancy progresses, LISTEN TO YOUR BODY, and don’t over-exert yourself.

There is no evidence to support the fear that pregnancy exercise increases the risk of miscarriage, premature labour or of congenital defects. All available evidence indicates that a low-risk pregnant woman, with the consent of her Midwife or Doctor, will gain significant health benefits from continuing or starting a regular exercise programme.

What Type of Pregnancy Exercise Should You Do & How Often? Aim for a balanced pregnancy exercise programme, including both aerobic exercise (when your body keeps moving and your heart rate is elevated for a length of time) and resistance training (to build muscle strength). Aerobic exercise could include walking, low impact aerobics, swimming or cycling. Try to do 20-30 minutes of aerobic exercise, 3-4 times a week, and choose something you enjoy! Reduce intensity and/or duration as your pregnancy progresses.

A Fit Ball (sometimes called a Birth Ball) can be invaluable throughout pregnancy, during labour, and for exercising afterwards. Sit on the ball instead of a sofa or chair to maintain good posture and strengthen your core muscles (stomach and lower back). By focussing on sitting up straight on the ball you can help prevent backache and other discomforts caused by slouching and bad posture.

Try other positions on the ball to ease discomfort, and help your baby to move into the right position in later pregnancy.

Your pregnancy exercise programme should include strength training to tone and shape your body. Strength exercises will not give you big muscles, but simply strengthen the areas of the body most weakened by the postural effects of pregnancy, and your changing centre of gravity and posture.

The important muscles to strengthen during pregnancy exercise are your upper back (to prevent slouching), lower back and core muscles (for posture, support and strength) and the backs of your thighs and bottom (these muscles can get weaker and stretched during pregnancy due to postural changes).

The most important thing to remember when exercising during pregnancy is that weight loss, or reduced weight gain, should NOT be your primary goal or focus. You are exercising and eating well in order to be strong and fit, and to give yourself the stamina needed over the coming months… enjoy fresh air and exercise with this in mind, and you’ll look and feel great!

Put a baby in there... and it's going to sag, right? Same goes for your undercarriage, Ladies

Your pelvic floor is the set of muscles that encircle your urethra, vagina & anus. They attach at the front & at the back of your pelvic girdle (the bones that make up your pelvis) from pubic bone to tailbone, kind of like a hammock or sling.

Well it shouldn’t be shaped like a hammock. It should be nice & taut & *up there*. But for some mums, it gets to be kinda hammock-shaped…

When you think about what they have to support, it’s not surprising they need exercising to stay strong! 3 major organs of your pelvic region: your bladder, uterus & bowel are literally held in by your pelvic floor muscles. Pregnancy clearly means that the downward pull & weight from your uterus increases exponentially. You’ll also probably remember it puts a fair old weight & extra pressure on your bladder too, & squishes your bowel out of  position in the later stages of pregnancy too.

3 major organs, the weight of a baby, & the massive pressure of possibly hours of pushing down hard during labour. A c-section may mean you avoided the pushing or any tearing, but the weight borne throughout pregnancy will still very much apply.

There’s a lot more to pelvic floor exercises than ‘squeezing as if you’re trying not to urinate’. The odd squeeze while you’re waiting at the bus stop is not going to cut it.

See Pelvic Floor Exercises, But Not As You Know Them here.

You need to breathe right too.  Seriously… the breathing matters. See Yoga For Your Pelvic Floor here

You need to focus & connect with your body. Maybe this sounds a little ‘far out’ for you, but many women cut off emotionally & physically from certain parts of their body after childbirth because it doesn’t feel as sensitive, as sexy or fun as it used to be… if you don’t like the way parts of your body look right now, or how they make you feel, then you’re going to find it much harder to reconnect those nerve pathways & make the muscles do their job.

The most important part of doing your pelvic floor exercises is not to think of them as isolated little squeezes, but as integral to your core strength, emotional & sexual well-being, as well as your self confidence. Incontinence or prolapse are no fun at all So please feel free to ask questions as frank or as intimate as you like & I’ll do my best to give you the straight answers you’re after!

All mums know that once teas have been made, tantrums dealt with, night wakings comforted, toys tidied & multiple demands met… ‘getting down to it’ in the bedroom is often not exactly right at the top of your list of priorities.

Sleep is. Or cake. Or wine. But not sex. You’re totally exhausted. You’re probably a little stressed / emotional. You’re maybe feeling slightly less than gorgeous in the naked stakes. So no, sorry Buddy. Not interested.

But this lovely lady (who will remain anonomous – she’s probably too busy in the bedroom to be reading this anyway) who has attacked her MuTu System programme with gusto over the last 5 weeks (she’s not even half way in) is feeling trim & toned, full of energy, & you could positively bounce things off her pelvic floor…

So she’s up for it.

Have you noticed a slight wane in bedroom activity since having babies? Ok, that’s a ridiculous question, I’ll try again. A slight wane? Or tumbleweed? Or have you got any Mummy Mojo tips you can share with the rest of us? I’ll contribute the MuTu System to the conversation – if you have more ideas I’m all ears!

Actually no, & to really tone your undercarriage, we need to move onwards from pelvic floor exercises consisting only of static Kegels.

I recently  blogged about Yoga for your Pelvic Floor, about how you need to lift, not just squeeze & how your pelvic floor is part of your system of core muscles, including your transverse abdominis. These muscles don’t act alone, & so nor should they be only be exercised alone.

My dear friend & one of  our Master Trainers, Jenny Burrell  (she keeps the MuTu team at the top of their game!)  has scientifically tested (you don’t need to know how, just be glad she did it for you ) the effectiveness of various types of pelvic floor exercises. A typical Kegel, & the traditional pelvic floor exercise we’re all told to do – ‘squeeze as if you’re trying not to urinate’ – works… pretty well.

But to really find & work your pelvic floor muscles  you need to ‘connect’ with them. You can’t just go through the motions, you have to focus. There’s a front to your pelvic floor (where you squeeze to stop yourself urinating) but there’s also a back (where you stop yourself from passing gas), and lo and behold (you got pregnant & possibly had your baby using it, so I’m hoping you’re aware of it) there is also a middle.

Find all 3 places (you’ll have to focus!), and then imagine ‘picking up’ a cherry tomato with each orifice, individually. Now imagine it’s a raisin. Grain of rice? NOW you’re working your pelvic floor!

Now I say, imagine, I’m not suggesting you actually try it, although could be a novel way to spend the afternoon…

And do you know what REALLY works your pelvic floor muscles? Moving, jumping & turning. These real, everyday, functional movements make your pelvic floor muscles contract involuntarily. They have to, because you’re surprising them, stretching them and making them work to do their job (which is to support your organs: bladder, uterus & bowel).

Instability & vibration work too… (I was actually thinking swiss ball, bosu, power plates, flexi bars and other exercise equipment, but you know… whatever you’ve got to hand ) Bored housewives have been sitting on the washing machine for years, & now you actually have an excuse…

There’s a lot more to this, where specific exercise movements have been proven to stimulate the pelvic floor muscles many, many times more effectively than standard kegels. Training with a MuTu System trainer or following the MuTu System programme means you’ll have all these principles applied to your postnatal exercise regime in the most effective way.

But this is with my compliments:

If you’ve had babies (by whatever birth method) & you don’t exercise your pelvic floor, you risk prolapse, pelvic instability & leakage, if not now, then as you age.

FIND & CONNECT with your pelvic floor – all of it, not just the front – and then EXERCISE it.

And MOVE! Our bodies are designed to move – to squat, jump, pull, push, lunge & rotate – your pelvic floor will work harder, the harder you work the rest of your body & core, so shift yourselves Ladies!

You may also notice a rather miraculous change in the shape of your tummy when you do… And feel free to share your novel ideas for incorporating these ideas into your day

Pelvic floor exercises are often called Kegels, named after the (male of course) gynecologist who ‘invented’ them. According to Wikipedia, “Arnold H. Kegel M.D., F.A.C.S. (1894–1981) was a gynecologist who invented the Kegel Perineometer (used for measuring vaginal air pressure) and Kegel exercises (squeezing of the muscles of the pelvic floor).”

Don’t know about you, but I’m not crazy about the idea of having my vaginal air pressure measured, but I’ve also always found it rather amusing that a man *invented* the squeezing of the vaginal muscles (or is that just me?).

Since then, a random eminent french physiotherapist (bloke again. hmmm…) invented *his* own special brand of ‘negative pressure abdominal exercises’. Which yogis have actually been doing for thousands of years, but they use much more romantic sounding Sanskrit words like Pranayama (yoga breath), Mula Bandha (pelvic floor or root lock) & Supta Uddiyana Bandha* (lying down abdominal decompression)

I guide clients through elements of this Pranayama, Bandha & decompression practice as part of my MuTu System, but essentially it is a beautifully relaxing & highly beneficial breathing technique, which ‘draws up’ & contracts the pelvic floor muscles. It has the added benefit of helping you to really connect with & engage the vital core muscles.

A wonderful book I would like to recommend to you whether you’re pregnant or already a mum is Mother’s Breath, by Uma Dinsmore-Tuli – you can see more about her work here. I wish I’d been a student of hers when I was pregnant 3 & 4 years ago… possibly that helipcopter might have been avoided

So my advice today is:

1. DO your pelvic floor exercises. (PS. They’re yours, ignore anyone who tells you they invented them

2. Take just a few moments today to take some full, deep, yoga breaths into your rib-cage & your tummy, NOT just into your shoulders & throat. Without hunching your shoulders, fill your lungs, feeling your ribs & tummy expand. Then squeeze all the air out, pulling your pelvic floor up & your drawing your tummy button in towards your spine on the exhale. Do this a few times… you’ll be more relaxed immediately!

The above breathing practice is the fore-runner to the full Bandhas & decompressions of the abdomen, & can be done  safely at any stage of pregnancy or motherhood. Let me know if you like it!

And Relax……

* Concepts reproduced with kind permission, Copyright Uma Dinsmore-Tuli: ‘Mother’s Breath’ 2006

If you’ve forgotten how important these exercises are, as part of your pregnancy OR postnatal exercise routine, check out this previous post… or try skipping or trampolining for a quick reminder!

Keep squeezing ladies – these muscles matter!!

Your pelvic floor muscles act as a muscular ‘sling’ which supports your internal organs (it literally holds them in preventing prolapse), provides bladder & sphincter control & gives you better orgasms… So it’s pretty important.

If you’re pregnant now, you’re also going to need them to push your baby out.

Pelvic Floor exercises during Pregnancy are VITAL to keep your core muscles in shape as pregnancy progresses! If you have a vaginal delivery, strong muscles stretch more easily than weak ones, so a ‘toned’ pelvic floor has a better chance of avoiding episiotomy (cutting) & tearing. If you have a c-section, the pelvic floor is not spared I’m afraid – it will still have been stretched & put under pressure during pregnancy by the weight & gravity of your baby!

After your baby is born, postnatal pelvic floor exercises should be the first exercise you do – there is no time limit – start as soon as you can remember to! Many, many mums are all too familiar with ‘stress incontinence’: a slight leak (or worse) when coughing, sneezing, jumping, trying to run for a bus, laughing…

…and just like spilt abdominal muscles & a mummy tummy, a weak pelvic floor does not have be ‘just part of being a mother!’

Pelvic floor exercises (or Kegels named after the gynecologist who ‘invented’ them..) can be done anywhere, anytime. No one knows you’re doing them but you, & you don’t have to put your trainers on. You can be lying down, sitting or standing, in the car, in a meeting or feeding your baby.

How to do Pelvic Floor Exercises / Kegels:

Kegels are often described as stopping yourself from urinating, but there’s a bit more to it than that. (Um, the baby didn’t come out of that hole…) They can actually be more effective if you imagine you’re trying not to fart! Yes really – if you pull in your sphincter muscles, your vaginal muscles will also tighten slightly (the muscle system is all connected). Then imagine you’re trying to stop yourself from urinating – try to differentiate & identify front, middle & back. Squeeze & release them from front to back, then back to front… (having fun yet?! )

Once you’ve identified & focused on the very front (urethral opening) of the muscle, then  on the very back (sphincter), then you may find it easier to LIFT the muscles surrounding the middle, vaginal opening.

Try quick squeezes / lifts, as you contract & release the muscles for just a second at a  time. Do this 10 times, rest for a couple of seconds, then do another 10.

Also longer holds. Starting with 5 seconds, repeated 5 times. Take a minute break then do the set again. You can build up to 10 second holds with 10 repetitions.

Do both types, & aim to do the whole set 2-3 times a day. Seriously, it might not feel like much, but these exercises are the differences between post-baby bladder control & wetting yourself! They’re worth it!! Pelvic prolapse is the more extreme results of compromised pelvic floor muscles, & I’m afraid not as uncommon as yu may think

Important to remember when doing pelvic floor exercises / kegels:

• Don’t hold your breath! Try counting out loud to make sure you breathe
• When you release, don’t push out or down, just let go
• Make sure other, bigger muscles aren’t doing the work instead – there should be NO contraction in your backside or inner thigh muscles
• Your pelvis, tummy, shoulders or anything else shouldn’t move – make sure you isolate the important pelvic floor muscles
• MULTITASK! As you contract your pelvic floor muscles, gently draw your belly button towards your spine, activating your deep core muscle, your transverse abdominis

Finally, if you’re having trouble identifying the right muscles at all, try doing the exercises at first sitting on a fitball (swiss ball), as this can help you to feel the contraction in the early postpartum weeks when you may have limited sensitivity.

Good luck & get squeezing!

Cardio? A bit, to lose some extra flab maybe, but it won’t address the root problem.

Pilates? You could certainly borrow a few core & postural principles from pilates … but some moves could even exacerbate the problem & won’t be the most effective diastasi recti exercises

Yoga? Good for lower back & core strengthening if done correctly, which will help relieve back pain & improve posture, but it’s not going to fix your mummy tummy on its own

Or crunches? NO, NO, NO!!

Firstly, you need to differentiate between a flabby belly (ie excess fat over your tummy), & the mummy tummy which is partly caused by diastasis recti, a (perfectly natural) separation of the abdominal muscles during pregnancy which makes way for the growing uterus.

Incidentally, you may have a diastasis and a flabby belly, but we will deal with both, so don’t worry!

You can read about how to test yourself for diastasis recti here, but for now, we’re going to look simply at which diastasis recti exercises will work, & which won’t! Obvious indicators that you have a diastasis, are a bulging, or ‘doming’ above or below your belly button when you contract your abdominals (especially if you attempt a crunch or sit-up type movement).

There are a number of important muscles you need to exercise (in the right way) to repair a diastasis, the most important of which is the transverse abdominis. This is the innermost abdominal muscle which runs right around your middle like a corset. It is attached both in front of, and behind, the rectus muscles (the ones that have split), so if you work the transverse abdominis (TVA) correctly, your diastasis (the gap) will reduce, & stay put!

The fundamentals of effective diastasis recti exercises are to start identifying & ‘engaging’ your transverse abdominis, you need to breathe diaphragmatic-ally or into your belly & ribcage. Sit on a chair or cross-legged on the floor & place your hands on your belly. Breathe in, fill your lungs & let your belly expand. Then exhale, emptying your lungs, whilst drawing your belly button right back towards your spine. Keep your shoulders down & your neck relaxed.

Now try doing this from all fours.

There are a number of visualisations which may help, (this is where it can be useful to borrow from pilates & yoga as well as restorative core work) :

Imagine your recti (the vertical muscle we’re trying to put back together) as a string attached to your pubic bone. Now use the string to pull your pubic bone towards your belly button.

Imagine ‘zipping up’ the gap from below the belly button, to above.

Whichever works for you, remember to exhale as you draw your abdomen inwards, & inhale as you allow your tummy to expand & your lungs to fill. Don’t raise & lower your chest (it’s all in the belly), don’t hunch your shoulders, & don’t hold your breath!

You will find that as you do this, your pelvis will naturally tilt forward as you contract the transverse muscle.

OK, now add in your pelvic floor exercises (now we’re really multi-tasking!). As you draw in your transverse abdominis muscle, pull up your pelvic floor. Remember, don’t hold your breath, all these muscles work together best whilst breathing

Ready to get really clever? From the all-fours position, put a pillow between your inner thighs, & as you exhale, draw in your belly button and pull up your pelvic floor, squeeze the pillow between your thighs.

Do this 15 times, every day. (That took, what, 5 minutes??) & you really are on your way to repairing a diastasis recti & losing your mummy tummy, ‘muffin top’ or whatever charming term you refer to it as!

Do not, under any circumstances, do crunches or sit-ups post-baby, & certainly not if you know you have abdominal separation.

Any crunching, rolling or jack-knife straining or movement will serve only to widen the gap & make the ‘doming’ or bulging worse. Some pilates moves will fall into this category, so avoid those ones for now. For the same reason, avoid crunches or sit-ups that work the obliques (your waist) in a diagonal direction, until you know you have closed the diastasis gap. These movements are NOT effective diastasis recti exercises & will make it worse!

Strengthening your transverse abdominus & working your pelvic floor (because these movements work so well together it’s great way to remember to do your kegels) will repair a diastasis & close the gap. It will also help alleviate back pain, improve posture & increase pelvic floor control! If there is extra flab as well (which if you’re post-baby, is a distinct possibility ) then in order to see the difference, you will need to address your nutrition, & do some short sharp interval training (circuits) as well.

But your CORE is where you must start – so get belly breathing & ‘zipping up’ & find your pelvic floor… & you have the basis for the post-baby body you’re dreaming of!

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