pelvic health, Pregnancy, Prolapse, Self Care

Pregnancy After Prolapse – The First Trimester

~Read where you left off here~

So the line was pink. I was officially pregnant. Again.

It happened so much faster than we had anticipated. It was no longer a debate of being ready, because ready or not, it was happening. One week after learning we were expecting our second little one, my husbands parents were scheduled to come for a visit. We debated whether or not to share the news, it was SO early after all, but we decided if this pregnancy ended prematurely, their support would be so needed, so we told them.

That just reinforced how great it was. They were ecstatic! Of course they were, what grandparents aren’t excited to learn they will be welcoming more grandchildren? I looked to my mother in law for support, my husband and his older brother are only 13 months apart after all. She reiterated what we already knew, it would be hard in the beginning, but so worth it. And we had planned it after all, it will all work out in the end!

Overall the first few weeks I felt pretty good. I still had energy, continued my workouts, and kept up with life. Things were great!

Then I was struck with vertigo.

I had cared for patients with vertigo, and knew it was awful, but I always thought they were over dramatic. But let me tell you, from first hand experience, it is all consuming. When you feel like the world around you is spinning, and closing your eyes just makes it worse, and you haven’t figured out what triggers it so it hits you randomly, it is hard. So hard. Even harder when you have a toddler to care for, and pregnancy nausea has hit. The vertigo was the worst in the morning, which, lucky for me, coincided with when I was feeling the most nauseated. The two just fed off each other and I felt awful. Caring for Nugget was even harder, because bending down or doing anything that required me moving my head out of vertical, set it off. Add that to nausea and it was a sure fire recipe for a trip to visit the porcelain throne. But I was lucky, after couple of weeks, it self-resolved. I didn’t really do much besides give into my salt cravings and drink as much water as I wanted.

But all the vomiting did a number on my core. The force required for that really puts some pressure on the pelvic floor, I now understand why some women leak when they throw up! I started having a lot of heaviness and discomfort. I freaked out. I was so worried that I was causing my prolapse to return and went to a pretty dark place. The combination of vertigo, with pelvic floor symptoms and exhaustion all added up to my headspace being all out of whack. I had a lot of very negative thoughts. There were many moments where I freaked out that I was damaging my body beyond repair. I even had really low moments where I hoped I would just miscarry so I could not worry about it anymore. I laid in bed crying, feeling like a terrible person and mother for wishing this very much planned, very much wanted, pregnancy away. The emotional turmoil you go through after being diagnosed with prolapse can really mess with you, and I didn’t realize how deeply, until then. It was like I was back to the day I was diagnosed, spiraling down a dark hole of ‘what ifs’, fearing I would never get out again.

I talked to some other moms they offered so much great support. They validated my feelings and helped me see what was really important – that I wanted this baby and I knew exactly what to do to get him or her here as safely as possible.

My symptoms waxed and waned over the next few weeks, and came to a peak around 11 weeks. I finally asked my prolapse support group, and they all suggested I talk to my pelvic floor physio. I mean, I knew I should, but I was in a bit of denial. I let my ego get the best of me, and thought I knew everything I possibly could, and there was nothing she could tell me that would help. But I emailed her anyway, and I am so glad I did. She replied quickly, and said it was totally normal to feel like that at the end of the first trimester. The uterus gets heavy, but has not come up above the pubic bone yet, so the entire weight of it is supported by the PF muscles. She reminded me to take it easy and it should pass, but to call her if I had any questions.

And she was right! Within a week, all my symptoms were gone! I even went on an 8 km hike up a mountain, and felt totally fine at the end and still the next day!

Then I was just tired.

So. So. Tired.

I never really noticed the exhaustion with Nugget, because I didn’t already have a kid and could sleep or nap whenever I wanted. Not the case when you have a 15 month old who gets up at 6 or 7 every morning. No sleeping in when you’re a parent, and even less so when your husband is working 6 or 7 days a week. This did not work out well with working nights. I work nights the majority of the time, and it was catching up with me. I started getting reflux to the point where I avoided eating because it felt like nothing ever left my stomach, I basically felt like my digestion came to a screeching halt. I started losing weight, which is the opposite of what you want to happen in pregnancy. Not to mention I was basically a zombie whenever I was not working. My poor toddler had the worst mom.

I talked to my midwife, and we agreed it would be best if I stopped working nights. I felt so guilty coming to that decision. I actually quite enjoy night shift! Plus, as a nurse, working nights is a bit of a badge of honor. I felt like I was being a baby by giving them up so early in my pregnancy, but I knew I had to do what was best for me and this baby.

It was like the clouds parted. I was finally sleeping at the same time every night, and sleeping through the night again. Before, with such a wonky sleep schedule, I was waking every couple hours because my body couldn’t figure out it’s rhythm. My reflux resolved, I had energy to exercise and play with Nugget again, and surprisingly my skin almost completely cleared up!

Moving into the second trimester, I finally started feeling like myself again.

Pregnancy After Prolapse (2)

fitness, pelvic health, Self Care

Painless Periods are Possible

I got my first period at age 11. I was devastated. My mom and all of my aunts and older cousins didn’t get theirs until they were 14 or older, so it wasn’t even on my radar, or my mothers for that matter. I didn’t know what to do, and I didn’t talk to my mom about it until she approached me about my stained underwear. The conversation pretty much went, here’s some pads, don’t go swimming, there’s tampons too, but you’re too young for those. Welcome to womanhood.

I don’t remember my first period to be painful, but I do remember pretty much every single one after that to be. Menstruation was so awful, I was pretty much incapacitated for at least one day a month, from age 11 until the time I was 17. And up until that point, the only thing that would help the pain was drugs, or sleep, or a heat pack. Well, who can sleep or use a heat pack during classes in highschool? As much as I wanted to stay home and sleep all day, my parents weren’t a fan of having me stay home just because of my period, I mean, women get it every month and go to work and function, I should too. That’s just how it is. It’s like a badge of honor to brag about how horrible your cramps are.

Then I went on the pill for 10 years (side note: !!!!) and forgot about it. I went to university, moved in with my boyfriend, got engaged, got married, bought a house, moved across the country, got a great career, and then it was time to make another human. So I went off the pill. And OH. MY. GOD. My ‘regular’ periods came back with a vengeance! It was like my body was getting revenge on me for pumping it full of artificial hormones for all of those years. And there it was, I was back to having debilitating periods again.

But… Why? If you think about it logically, why did human females evolve to be completely incapacitated by this perfectly normal human function? If we were ‘wild’ it would leave us extremely vulnerable very frequently. I’ve spoken to many, many women who have similar experience to me when it comes to their periods. I am not an anomaly.

I listen to Katy Bowman’s Podcast regularly and she has an episode where she discusses menstruation, and it was mind blowing. To summarize what she says, when your uterus sheds it’s lining (the endometrium), it leaves a wound, of sorts, and the lining combined with the bleeding of the wound, is the bloody discharge we know as a period. Well in modern society, our limited movement means that the organs and muscles within our pelvis do not get the ‘movement nutrition’ that they require, which results in limiting blood flow to those parts over time. This results in the impaired ability of our body to heal the wound associated with menstruation, resulting in severe pain and excessive bleeding, also known as menorrhagia.

So what can you do about it? Well if you ask the mainstream, take painkillers or go on the pill. Or just deal with it. If you ask Katy, or a lot of ‘healthy pelvis’ movers and shakers out there, movement is the answer. I know, it seems crazy. How on earth can movement affect my periods? Well it’s almost a ‘use it or lose it’ sort of thing. You have to move those muscles and organs around in the way your body was designed to move, in order to signal your vascular system that they require blood flow in order for them to function optimally. Your body is very efficient, and only sends the minimum blood flow required to keep your cells alive, but keeping them alive doesn’t necessarily help them function at their best. Your cells have to be active and demand blood and nutrients!

In modern society, we basically stand or sit all day. Some of us walk a bit. But very, very few of us squat or sit on the floor or use our legs to their full potential in their full range of motion. Our bodies have adapted to this limited range, and stopped sending adequate nutrition to the parts we don’t use, like our hips and our pelvis. I wonder if this has some influence on the skyrocketting rates of infertility and hip fractures or replacements? Now, this is totally just my own personal theory, with absolutely no scientific evidence, but something to think about!

So what did I do that helped me? First, went to pelvic floor physio. They helped me connect with my pelvic structures and learn how to move and activate them in ways that I hadn’t been. Second, in the midst of my prolapse diagnosis meltdown, I bought the Nutritious Movement for a Healthy Pelvis program from Nutritious Movement and started doing it immediately. I cannot describe how much I love this program. After just one day of doing the movements, I was sore in ways I didn’t even realize one could get sore, and felt so much more connected with my body, at a time when I felt like I was falling apart.

But I digress. I was surprised to find, two months after starting to incorporate my (new) PFPT exercises and the Nutritious Movement for a Healthy Pelvis program, I got my first postpartum period. I had heard horror stories from women about how the first postpartum period is the worst period ever. Like your body has saved up those 10 months (in my case) of periods to give you all at once. This was not the case for me! It was like the only reason I knew I was having a period, was I was bleeding. That was it. I mean, I was a little cranky, but other than that I felt great! I wasn’t buckled over in pain. I did not have to take one single pain pill. Not one! That is completely unheard of in my lifetime. Even when I was on the pill, I still had at least one day per period that I had to take at least 1 pain pill.

I really wish I had known this when I was a teen. If I could go back in time and tell myself what I know now, I could have saved myself so much pain and discomfort. I hope this information helps some of you better deal with your periods, and hopefully get to a pain free period like me!soup-salad

pelvic health, postpartum, Self Care

Your Vagina Needs Therapy

It’s true.

I’ve said it time and time again. Maybe in nicer words, but I’ve said it. If you’ve had a baby (vaginal or otherwise), you need to see a physiotherapist (PT). And not for your back or your shoulder or your knee. For your vagina. More specifically, your pelvic floor (PF), or the muscles that surround your vagina and hold up your bladder, uterus and rectum. Those muscles that are *supposed* to stop you from leaking urine when you run, and are *supposed* to help you hold in a fart, and are *supposed* to relax and contract when you have sex and reach orgasm.

That’s what they are *supposed* to do.

I am putting *supposed* in between asterisks because they don’t always do these things, in all women. And that, my friend, is why your vagina needs therapy.

If you saw my previous post about PF dysfunction, and you are maybe having some issues, you’re maybe considering going to see a PF PT (first off, yay!). But maybe you’re nervous, ‘what exactly do they do at PF PT?’ you ask? Well that’s what I am here to tell you.

First off, most physio’s will have you fill out a questionnaire, so they can get a quick grip on your symptoms, your obstetrical history, and what your goals are. Most often the start off with an initial consultation, that is longer than your regular visits, so they can get to know you and do a thorough interview to assess where you are at. They want to know how many babies you’ve had, how you had them (vaginal or c-section), whether or not you’re currently having issues with leaking, discomfort with sex, and any pain or heaviness.

Then they will most likely assess your posture or alignment, movement patterns and sometimes feel the muscles on your back or sides while you move, like squatting up and down. They may also pay attention to your breathing while you move, or have you pick something up to see how you do it. They may even just assess your movement patterns without you even realizing, they are professionals and have a keen eye, and a lot of people move differently than they usually do when they know someone is watching! Then they will assess your abs, have you lay and lift your head and feel your belly to see if you have a diastasis recti (separated abs) and have you contract your transverse abs to see how well you are able to connect with them and how strong they are.

Then comes the fun part.

Okay maybe not fun, per-say, but the meat and potatoes of the visit, so to speak.

The Internal Exam.

This is probably what most women are nervous about, but I promise you, it is nothing compared to a pelvic exam by a doctor, a PAP or, hello, giving birth. I’ve been to two different PTs and both of them made me feel so comfortable, it didn’t feel awkward at all. They assess your tissues from the outside, get you to cough and bear down before they even touch you, then they touch the outside to see if there is any tension or tenderness anywhere. Then they insert a gloved, lubricated finger into the vagina and have you cough and bear down again to see if there is any prolapsing organs. Then they feel all of the muscles in your pelvic floor from the inside if your vagina, and assess them for tension or tenderness again. Then they have you do a pelvic floor contraction (or kegel) and assess how strong your muscles are and how coordinated they are with each other. They may also use their other hand to feel your abs to see if they are coordinating properly with your pelvic floor.

At this point it varies between PTs, but some may do some myofascial release, or scar tissue release or massage. Then most will work on teaching you how to do a PF contraction properly (if you don’t already, which most women don’t if they have been to PT before). Then they will work on improving your contraction, maybe positioning their hand in different orientations to assess how all of the different muscles are contracting. Depending on where you are at in your rehab, they may have you do some minor exercises (think lifting one leg up, or lifting your hips, no jumping jacks!) while laying on the table and assess how well your PF responds to the movement.

After that, they will conclude the internal,  and leave the room to give you a chance to get dressed. Then they will come back and discuss what they thought of everything, give you some exercises as homework and discuss whether or not you need to schedule another visit (or two, or more).

That’s it! It’s really not as bad as you may have thought (I hope!) but I promise you will leave with a whole new appreciation and understanding of your pelvic floor, and your body as a whole! The pelvic floor is an integral part of how your entire body functions, and supports some very important organs, I hope you plan to take care of it the same way you’d take care of any other muscle in your body if it were to go through a trauma like the PF does in bearing a child.

Don’t neglect the pelvic floor!

Birth, motherhood, pelvic health, postpartum

Don’t Put up With Leaking During Exercise

I’ve written a lot about my experience postpartum, and care I believe women should receive in the immediate postpartum period, but what about down the line?

What if you are 1, 2, 10 years out from your most recent birth?

What if I told you, once postpartum, always postpartum?

Growing a birthing a human fundamentally changes our bodies for the rest of our lives.

sneeze-and-pee

Do you relate? You would not believe how many women I’ve heard from who describe symptoms of pelvic floor (PF) dysfunction years after their last baby.

What do I mean by PF dysfunction?
Well there are varying degrees, but symptoms can include but are not limited to:

Peeing or leaking urine when you sneeze, jump, run, laugh or cough.
Feeling like you always have to pee, no matter how long it has been since you last went
Dribbling urine after you get up from the toilet.
Feeling like there is still urine in your bladder after you finished peeing.
Feeling like you have to bear down or push on your abdomen to fully empty your bladder.
Feeling like you have to push on your perineum in order to fully empty your bowel.
Pain in your perineum (the area between your vagina and your anus) with activity or prolonged standing.
Unexplained lower back pain.
Painful sex or decreased sexual pleasure.
Feeling as though the vagina is too tight or small for sexual penetration.
Feeling of laxity in the pelvic area.
Inability to consciously contract (or Kegel) or relax the pelvic floor .
Inability to distinguish between a bowel movement and passing wind.
Inability to control passing of wind or bowel contents.
Protrusion of internal organs out of the vaginal opening.

If you can relate to any (one, or more than one) of the symptoms listed above, it is possible you may be experiencing some degree of PFD.

mom-wet-pants

I know what you’re thinking; ‘But I’ve had babies, don’t all women just pee themselves after they have babies? Isn’t this normal?

The answer is a resounding NO!

If I could shout it from the rooftops, I would.

But what about all of those Poise, Always, and Depends commercials? They make it seem like it’s just something we have to accept.

mjaxmi1kmte3ytdmndfmotm2mtuy

Better buy some diapers, because you’re never going to keep your pee in again.

No.

No. No. No. No. No!

While urinary incontinence (one of the most frequent symptoms of PFD) is common it is not normal!

Some of you might now be saying “Well, that’s what I thought, and I told my doctor and he/she said ‘Just do your Kegels, you’ll be fine.

There seems to be a huge disconnect in the medical/obstetrical world when it comes to pelvic floor dysfunction. A lot of physicians and midwives seem to think that as long as your organs aren’t falling out, you’re doing okay.

This is not the case! There is help!

Can I get a Hallelujah?

So what can you do?

Do I really have to say it again?

I will. Because I can’t say it enough.

Pelvic Health, or Women’s Health Physiotherapy!

You’re thinking “But how? If my doctor doesn’t think anything is wrong, how can I get a referral?

Most Pelvic Health Physios don’t require a referral*!

Now you’re asking “How Do I find a physiotherapist?

Here is a list of websites that offer search within Canada to find local physiotherapists who specialize in women’s health and pelvic floor:
Pelvic Health Solutions
Pelvienne Wellness
Physio Can Help**

Once you’ve worked with a physio to determine where you are at, in addition you can work with a personal trainer who specializes in postnatal training to get your strength back! That’s what I am here for! I am now taking on a few clients to start building my personal training career and experience! Feel free to contact me for more information, either through this website, or on my Facebook page or Instagram page.

download

And please, please, do not think you have to live with wet panties for the rest of your life!

*some benefits/insurance plans do require a physician’s referral to pay for the service
**General physiotherapist lookup – not specific to PF
fitness, pelvic health, postpartum, Self Care

Let go of the Ego

Let me tell you a story.

Doing my personal training classroom training, included a ‘fitness class’ for one hour at the end of the weekend. Our ProTrainer had the intention of teaching us some lessons beyond ‘how to exercise’ and she certainly did.

Now to clarify, at this point I was 3 months postpartum, had only had one session with my physio and wasn’t really supposed to be doing any sort of intense exercise. However, I love intense exercise, I am supremely competitive and cannot stand the thought of others thinking I was lazy or not ‘fit’ enough.

Before the class began, we were told ‘bring something with sugar in it, like fruit or juice. Do not bend over so your head goes below your heart at any point during the class, do not let your feet stop moving, and above all do not leave the room alone’.

I knew things were about to get serious.

I was excited. I hadn’t had what I would define as a ‘real’ workout in months. We get through the majority of the class, lot’s of squats and lunges and such, nothing I couldn’t handle. Then our instructor says “If you’ve had a baby, you’re going to hate me”.

Oh shit.

I literally JUST had a baby. This isn’t going to be good.

She coaches us to skip (without the rope). Continuously. For what seemed like forever.

Now for most of the class, this was an intense physical workout, that challenged their body and fitness.

For me it was mental.

I nearly broke down in tears during the class. She had taught us earlier in the course to ‘check our ego’. To not focus our training on ‘being the best’ or comparing our clients to anyone but themselves, and train them at the level they are at, not the level we think they need to be. It took every ounce of me to listen to that message for myself during that class.

You see, physically I definitely could have kept up with the class, no problem.

At the expense of my pelvic floor.

That could have easily been one of those moments you hear about where the woman leaves with soggy underwear, or worse, my uterus getting ready to fall out. But no one in the room knew that, all they could see was that I appeared as though I wasn’t trying. From the outside it looked like I didn’t care enough to push through the class, because I definitely wasn’t tired, and it was obvious.

This killed me.

I always prided myself on at least giving it my all. Busting my ass, so at least if I didn’t ‘win’ or keep up, at least I gave it my all when it came to anything physical. But this time I was faced with limitations. I had to have a frank discussion with myself:

Is this worth it?
Is ‘pushing it’ in this class with a bunch of people you may or may never see again worth potential life long damage? 
Is it worth sacrificing your body to prove something to these people who probably don’t actually give a shit?

And the answer was, obviously, no.

But it killed me. I hated that I couldn’t push through the discomfort. That I couldn’t just ignore what my physio said and jump until my calves gave out.

Eventually one of the assistants to the instructor came over and asked me if I was okay. “Are you leaking?” she asked. She knew. I explained I wasn’t but I was in physio and not willing to risk it, she understood and showed me some modifications to help me continue to participate without risking injury. It was at this point that I realized in my own embarrassment I had slowly moved to the back of the room. I was almost against the back wall, unconsciously hoping that no one would notice that I wasn’t fully participating. Trying to shrink back into the shadows and not allow myself to be seen as ‘unfit’ or not trying.

That was the moment I vowed to never allow any of my clients to feel like this. To never let them feel like they weren’t good enough to participate, or that their level of participation was inadequate. It was a terrible feeling that I hope I never invoke in anyone I am hoping to help. It was in that moment that I learned that training isn’t about the ego. It’s about where are you are here and now. Not where you were 6 months ago, where you were before you got pregnant, not where you were when you were 18. Right now. It’s about maximizing the abilities of your current body, today, in this moment. Some days, you might be able to bang out a circuit and feel like a rock star, other days the baby may have kept you up half the night and all you’ve managed to eat is a toaster strudel and a litre of coffee, and that same circuit feels impossible.

And that’s okay.

We have to learn to accept the here and now and forget about comparisons or being good enough. We can find balance between challenging ourselves and feeling inadequate because someone else can do it better.

We are strong even in our weakest moments.
We are enough today, tomorrow and every day.

 

Let Go of the Ego

Birth, fitness, pelvic health, postpartum, Pregnancy, Self Care

Why the 6-week Clearance Isn’t Enough

So you’ve had your 6-week postpartum check-up with your doctor, OB or midwife. They say ‘All is good, you can resume exercise’. You think ‘Awesome! I’m going to go out for a run tomorrow!’. Then tomorrow comes, you start running, and you feel like a bowling ball is bouncing inside your vagina, you leak, or worse you lose control of your bladder or bowels.

No one wants this. Why didn’t they warn you?

You’re not alone. The fact is, it takes a lot longer than 6 weeks for your pelvic floor, abs and uterine ligaments to return to normal. I am 5 months postpartum and still only feel maybe 90% normal. I can’t tell you why doctors and midwives don’t talk about this, but I’m hoping by reading this you’ll have a little bit more insight into postpartum exercise.

I talked about relaxin and pregnancy before, but did you know relaxin influences you for up to 3 months postpartum? And other hormonal changes will influence the laxity and strength of muscles, tendons and ligaments as long as you are breastfeeding?

True Story, Bro.

Let’s look at this logically though. Even if we take the scientific mumbo jumbo out. Your uterus was just huge (relatively speaking), then within the span of 6 weeks (or less) it shrank back down to the size of a pear. All of those ligaments, tendons and muscles that were holding that giant uterus up for 9 or so months have been stretched and loosened to accommodate it. They are going to take time to get back to where they were before. Here’s some perspective, if you had your leg in a cast for 9 months, then got the cast cut off, do you think you could go out and run a marathon 6 weeks later? Doubtful. Why do we treat all those very stressed ligaments inside our abdomen and pelvis any different? They’ve gone through massive changes and we need to respect that. We need to slowly and gently start adding exercises back in to allow those structures time to re-adapt back to their former glory.

Think of your pelvic floor like a trampoline. Now imagine a 400lb sumo wrestler sitting on that trampoline. That’s what your pelvic floor is like at the end of your pregnancy. Trying desperately just to keep everything up. Now imagine that sumo wrestler sitting there for a few months. How stretched would that trampoline be?

Ya, let that visual sink in for a moment.

We want that PF to bounce like trampoline, and be taught enough to resist the pressure of the organs it’s holding up (uterus, bladder, bowels) but flex with breath and impact. If you were trying to fix that stretched out trampoline, and someone kept jumping on it while you were working, it wouldn’t be very effective, would it? This is how it works with your PF and impact postpartum.

So what do I mean by ‘impact’?

I mean jumping, skipping, running, jogging, box jumps, jumping jacks, basically anything where there’s a period of time where both of your feet are off the floor, no matter how short the period of time is. Yes, even if it is a split second. Yes, even if you land gently.

Now, this isn’t to say you can never do these things again. This is definitely something you can work your way back to eventually. But you have to take your time, be careful and do it right. If you want your body to be functional well into old age, it’s important to take care of it now. If you want to have more children and want your body to support those pregnancies well, it’s important to respect this postpartum period and recover appropriately.

So the next question is how?

Well first, go see a Pelvic Health Physio (do I sound like a broken record yet?). Then work with a personal trainer who specializes in postpartum (like me, soon!) or purchase a program that is designed for postpartum women, like Birth2FitMum.

The most important thing, though, is to be mindful of your body. If things don’t feel right, don’t do them! Let go of your ego, and just be proud of where you are at currently. Just because you aren’t in the same place you were months ago, doesn’t mean you are broken, it’s all part of the journey! You grew a human! Go You!

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While I am in the process of obtaining my PT certification with prenatal/postpartum specialization, I’m not quite there yet. Even then, I won’t be able to help everyone, but I don’t want that to hold you back from reaching your goals. My lovely friend Lorraine Scapens over at Pregnancy Exercise has most generously offered to give my readers a 10% discount on her programs that I used when pregnant and still use postpartum; Fit2BirthMum & Birth2FitMum as well as her other programs Super Fit Mum & No More Mummy Tummy Challenge. Simply enter the discount code ‘HMHB‘ at checkout to get your 10% off!

Birth, fitness, pelvic health, postpartum, Self Care

My Core & Floor – The Never Ending Saga

I am so thankful I was lucky enough to learn about diastasis recti (DR) and how it relates to pregnancy early on in my pregnancy. So many women I talked to had no idea what this is, how it develops and how it affects their lives going forward. Even some OB/GYNs are poorly informed on what DR is and what it means for their patients. One of my good friends was telling me about the coning in her belly while she was doing crunches in her 3rd trimester and how her OB just told her ‘oh that’s normal, don’t worry about it’ so she didn’t think anything of it and just pushed the coning down while she continued doing crunches! What her OB SHOULD have said was, this is DR, this is what it means, these are the exercise you should not be doing as they will aggravate it and make it worse.

DR is the separation of the abdominal muscles to accommodate the growing uterus, and it happens to up to 66% of women when pregnant. In order to heal this separation, you first need to reconnect with your deep core muscles, the transverse abdominus (TA) and your pelvic floor (PF) and re-learn how to engage them appropriately.

I had a DR at the end of my pregnancy, even though I worked to prevent it. Looking back now, I think poor posture was to blame, but we all know hindsight is 20/20. At birth my separation was about 2 1/2 finger widths at the widest. I was lucky in that simply following my training program, Birth2FitMum, I was able to heal it within 6 weeks. However, once I began seeing my pelvic health physiotherapist (PHP) I realized that it was probably my over-active TA that helped more than I realized. The problem was, even though my TA healed my DR quickly, they further delayed the healing of my poor stretched out PF.

See, the core muscles work in symphony, and when one component is over or under-active, it throws the whole system out of whack. Julie Wiebe does an excellent job of explaining this in her video here. I love her model of the piston system of the core muscles. I experienced the issues she discussed in this video. I was tensing my PF in hopes of counteracting my strong abs. Before visiting my PHP I found Julie’s program The Pelvic Floor Piston: Foundation for Fitness extremely helpful. I’ve since learned through visiting my PHP that I hold a lot of my tension in my core, through holding in my abs and PF and taking short small breaths (because you can’t really hold your diaphragm taught and stay alive!). I’ve been learning how to allow my abs and PF to relax and how to take bigger breaths, and it’s still a work in progress 2 months later. It seems once I get one issue sorted out, another pops up, and after visiting my family doctor today, it seems I am on my way to the pelvic floor clinic in my city.

Unfortunately, I won’t be able to get in for another 3+ months. In the meantime, I will continue doing my exercises prescribed by my PHP, the pelvic floor piston exercises, as well as a few other exercise I’ve found help me personally connect with my PF and breath. One of my favourites that I’ve been doing since I was pregnant is just sitting in a squat. And no, I don’t mean those awful hover squats like you’re trying not to sit on a public toilet. More like you’re squatting in the forest having a pee. I relax, and it really helps me feel my breath through my pelvic floor. If you are having a hard time understanding how your breath and your PF are connected, try this. I also like to flow through cat-cow poses while controlling my breath and PF contractions. I think the reason these exercises work for me is because it takes my TA out of the equation, because they always want to kick in and take over.

I’m hoping I can re-learn how to use my core effectively before it comes time to work on nugget #2, and I think I am on the right track. However, some days I just feel like I am missing a piece of the puzzle, and I’m hoping the pelvic floor clinic can help me with that. I encourage you, if you feel like something just ‘isn’t right’ to go to your doctor, or find a PHP near you to help you sort things out. Don’t be discouraged if it takes time, and multiple tries to figure out what’s going on and how to fix it. You don’t have to just deal with a dysfunctional body because you had a baby!

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While I am in the process of obtaining my PT certification with prenatal/postpartum specialization, I’m not quite there yet. Even then, I won’t be able to help everyone, but I don’t want that to hold you back from reaching your goals. My lovely friend Lorraine Scapens over at Pregnancy Exercise has most generously offered to give my readers a 10% discount on her programs that I used when pregnant and still use postpartum; Fit2BirthMum & Birth2FitMum as well as her other programs Super Fit Mum & No More Mummy Tummy Challenge. Simply enter the discount code ‘HMHB‘ at checkout to get your 10% off!

pelvic health, postpartum, Self Care

Strength Training and the Pelvic Floor

This week I finally kicked my own ass into gear and started gathering practice hours to prepare myself for my practical exam to finally get my Personal Training Specialist certification from CanFitPro. I sent out a plea on Facebook for anyone who would be willing to submit themselves to a session with me. I was thankful to have 4 wonderful ladies step up and come join me in my little home gym!

One thing that came up over and over again was the pelvic floor. I just always seem to find ways to work it into the conversation! I think it is because I was so blown away by the knowledge I have gained since become pregnant and giving birth that I just feel the need to share it with the world!

Did you know you can have pelvic floor dysfunction without having a baby?

Did you know you can induce stress urinary incontinence (SUI) through weightlifting?

Did you know most women don’t know how to properly connect with their pelvic floor?

Did you know a pelvic health physical therapist can help with all of these things?

Did you know that I think every single woman who has given birth should see a pelvic health physical therapist? (I hope you know this, from reading previous posts!)

It felt so good this week to share my knowledge of the pelvic floor with some lovely women, even though none of them had given birth, and some of them never plan to. The information was so well received by all of them! I think maybe they can feel my passion shining through.

One eye opening moment I had was watching this video by YouTube Vlogger Meg Squats. She and a fellow powerlifting friend discuss their issues with stress urinary incontinence and how it related to their weightlifting. I had never thought about the pelvic floor in this context, but it totally makes sense. The anatomy of the female core has the opportunity for weakness if the pelvic floor isn’t adequately engaged, thanks to the vagina. The vagina is essentially a hole in your core, and when you are exerting the levels of intra-abdominal pressure required for powerlifting, if you’re not functionally engaging your pelvic floor, it becomes a point of weakness, leaving women vulnerable to SUI or worse, prolapse.

I brought this up with the ladies I trained who are into power lifting or lifting heavy and they were blown away by the idea. I feel like every trainer who trains women needs to at least take the pelvic floor into consideration, especially when they start introducing concepts like using intra-abdominal pressure to brace for lifts. They were also surprised when they tried to engage their pelvic floor, they felt like they had no idea what they were doing! Which is a very common occurrence. I thought I was a champion at Kegels until I visited my pelvic floor physio postpartum and she helped me see that I was clenching so many unnecessary muscles when I thought I was only engaging my PF.

When I left my physio after my final (so far) visit, I took a handful of her business cards and have been handing them out to my post-partum mom friends like candy! We had a mom’s get together the other day, and I wasn’t surprised to learn that every single one of us had some form of pelvic floor dysfunction. And we are all fit, healthy women who were avid athletes and hit the gym regularly before we had our babies!

We need to talk about this more, ladies. Rather than ‘just wait until you pee every time you sneeze’ how about we say ‘have you made an appointment with a pelvic health physio yet?’

motherhood, postpartum, Self Care

Pain, Weakness, Defeat – How I felt Postpartum

As mentioned in my Birth Story, I had what they call a ‘prolonged second stage’ which means I actively pushed my baby out for over 2 hours, just over 3 hours to be exact.

It was the most excruciating, difficult, empowering thing I have ever done in my life.

It was worth it.

Would I do it again?

Absolutely.

Would I try and do everything possible to avoid doing it again if I knew it was an option?

Definitely.

Would I have chosen a C-section over what I went through?

Unquestionably, NO.

I believe everyone gets the birth they need. I will admit I went into labour cocky. After all my baby was so far engaged my midwife had never seen a baby that low before. When she checked me in early labour, she said he was ‘right there’. I thought when it would come time to push it would be, 1, 2, 3 he’s out, break out the champagne.

Nope.

And what do you think all of that pushing did to my pelvic floor?

Well… It wreaked a little bit of havoc.

No one tells you what it feels like AFTER you give birth. Sure they say it’s like a period, they talk about the cramping, and the breastfeeding difficulties, and the sleeplessness. No one talks about the fact that you might feel like you’re sitting on a swollen baseball or like your organs are going to fall out or you can’t hold a full bladder anymore. Or that doing something simple like walking around the grocery store might cause you pain in a way you hadn’t even considered.

No one talks about that.

Because you have a baby! And he’s amazing, and adorable and the greatest thing that has ever happened to you! (truth) But the fact that you have a perfect, healthy baby doesn’t negate how you are feeling. I was so caught off guard by the pelvic pain and weakness. After all, I had worked really hard when I was pregnant (I thought) to ensure my pelvic floor was in tip-top shape! I thought I’d be a rockstar, pop this Nugget out, and be back to normal in a jiff.

Not the case.

By my 6 week check up with my midwife, I was still having pain, and feeling weak and while I was lucky enough to not have incontinence, I still didn’t have the same control I once did. Luckily, my midwife had a contact for a Pelvic Health Physiotherapist (PHP) in my city and I booked an appointment.

6 weeks later I finally got in to see Michelle. (She’s that busy)

I recently was telling my friends about my experience with Michelle. I used words like ‘magical’ and ‘tender’ and ‘professional’.

You have a really intimate relationship with your PHP when you’re done. She helps you with things you may not even discuss with your mother.

She gave me confidence to know what is and isn’t normal within the context of my own body. She helped me realize my version of a Kegel was not very effective and helped me perfect it. She also made me realize I hold a lot of my stress and tension in my core by bracing it way more often than is necessary, which was resulting in a lot of tightness in my PF. She helped me learn how to relax and release that tension so I could enjoy things I hadn’t been enjoying before. She even helped me work through the grief I was feeling over the fact that I had worked so hard to keep my core strong, and here I was, so weak that wearing my baby for a trip to the grocery store was causing me pain.

Let’s just say, after I finished my last session, the first thing I did the next day was send her flowers and a Thank You note.

I truly believe every single woman should see a PHP after she gives birth. Regardless if it is vaginal or C-section, uncomplicated or complex, easy or traumatic. See a PHP!

What most women don’t realize is that during pregnancy your core all but shuts down. It get stretched so much that it is really difficult to connect with those muscles and keep them toned. A PHP will help you reconnect, and become more functional and I promise you, it will help you in every movement you make.