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Prolapse and Exercise - so what is to know?

Prolapse and Exercise - so what is to know?

What is Vaginal Prolapse?

Usually our pelvic organs (bladder, uterus and bowel) are supported by a hammock of connective tissue and muscles. If this support system isn’t working as it should, it can lead to one or more of these organs descending into the vagina, which is called a ‘vaginal prolapse’. 

A prolapse can be categorized into different types – a front (or anterior) wall prolapse, which is the bladder or urethra coming down, a back (or posterior) wall prolapse, which is the rectum or small bowel coming down, or a uterine prolapse, which is the womb dropping down. It is still possible for the top of the vagina to drop down if someone has had a hysterectomy. 

It often seems to be assumed that it’s the uterus that most commonly drops down, but actually the front wall of the vagina is the most common type of prolapse to occur. 

Prolapses can also be divided into ‘stages’, depending on how far down the lowest part descends when you do a maximal downward strain:

  • A stage 1 prolapse means that the lowest part of the wall/organ is still more than 1cm inside the vagina 
  • A stage 2 prolapse means that the lowest part of the wall/organ is between 1cm inside and 1cm outside the vaginal opening. This stage of prolapse, when the organ descends to the opening, is often when women become aware of their prolapse for the first time. 
  • A stage 3 prolapse means that the lowest part of the wall/organ is more than 1cm outside the vaginal opening
  • A stage 4 prolapse means that essentially the whole organ has come outside the body – this is relatively rare. 

 

How do I know if I have a Vaginal Prolapse?

The symptoms of a vaginal prolapse are different in everyone, and it’s important to note that sometimes people with mild to moderate prolapses don’t have any symptoms. 

The most common symptoms are:

  • A bulging sensation (or being able to see a bulge) or a feeling of ‘something being there’ in the vagina
  • A feeling of not being able to completely empty the bladder or the bowel (usually because the prolapse is causing a sort of ‘pocketing’ making it difficult to evacuate).
  • Lower back or lower abdominal ‘dragging’ pain

Sometimes women can complain of a ‘heaviness’ or ‘pressure’, but this needs to be confirmed on diagnosis as this can also be a symptom of over-worked, tired pelvic floor muscles. 

Sometimes prolapse can be associated with discomfort with sex, and sometimes with bladder or bowel leakage, but again – this isn’t always the case and should be confirmed on a physical examination, because there are many people who have these symptoms without having a prolapse. 

The health professionals who work specifically in the area of Women’s Health are best placed to make this diagnosis – gynaecologists, Women’s Health & Continence Physiotherapists, or Continence Nurses. However, your GP is a good place to start and many GP’s will have a vast degree of experience in diagnosing and staging prolapses, and can then refer on to one of the aforementioned professionals for further management. 

 

How common is a Vaginal Prolapse?

Unfortunately, it’s very common for women to experience vaginal prolapse, mainly due to our anatomy. We are animals that stand upright, and have a large proportion of our body weight going through our pelvis, but we also need a wide pelvic opening to be able to birth very large offspring through!

That mix of a large pelvic opening with a heavy load on top of it is unfortunately not ideal for supporting pelvic organs.

Studies have shown that up to 50% of women who have given birth will have some degree of prolapse, with other research showing that 1 in 3 women will have a prolapse that extends at or beyond the vaginal entrance (ie a stage 2 or more prolapse). 

Unfortunately, there is a high proportion of women who will require surgery for either prolapse or stress urinary incontinence. Statistics show that 1 in 9 women will undergo one of these surgeries, which are not without risks and have relatively high recurrence rates. 

 

What factors increase your risk of Vaginal Prolapse?

The main risk factor for prolapse is having had one or more vaginal births, with specific risk factors including:

  • Forceps deliveries
  • Giving birth to a baby over 4kg (9 pounds)

Prolapse is not limited to only those who have delivered babies vaginally, however, with other risk factors including:

  • Pregnancy
  • Family history of prolapse
  • Increasing age
  • Increasing BMI
  • Constipation
  • Chronic Cough
  • Heavy lifting

The main reason that pregnancy and vaginal childbirth are risk factors is because of their effect on what is called the ‘levator hiatus’. This is the name for the space in the pelvis between the two sides of the pelvic floor, and is essentially ‘the gap into which things can fall’. 

Studies on women who have recently given birth show that this ‘gap’ in usually increased from normal for up to 4-12 months after having a baby. This is one of the main things that Women’s Health Physiotherapists will assess for when doing a vaginal examination at a postnatal assessment, because it helps to determine your individual risk for prolapse occurring or worsening with return to higher load or impact activities. 

This ‘gap’ would be increased more significantly, and more permanently, if the woman experienced a birth injury called a ‘levator avulsion’. This means one or both sides of the pelvic floor muscle having a partial or full tear away from the pelvis bone. This can also be assessed for with a vaginal examination. 

 

How is Vaginal Prolapse managed without surgery?

Pelvic Floor Muscle training, under the guidance of a physiotherapist with post graduate qualifications, is recommended as the first line of treatment for vaginal prolapse. 

We probably assume that this training is all about improving the strength of the pelvic floor muscles (measured out of 5), but studies have shown only a minimal link between a woman’s maximal squeeze pressure improving and prolapse improving. 

This makes sense, because a vaginal prolapse needs to be supported all throughout the day while you’re in an upright position, but we probably only maximally squeeze our pelvic floor muscles for 1% of the day – at times like in response to a big sneeze or lifting something that’s heavy. 

Instead, it is more likely that pelvic floor muscle training helps to decrease prolapse signs and symptoms because it improves the ‘stiffness’ and support of the area, and it decreases the ‘gap into which things can fall’ (the levator hiatus) both at rest and under load. 

Other management strategies would include:

  • Teaching women how to empty their bladder and bowels effectively and without straining
  • Determining if symptoms can be improved by incorporating rest periods in ‘anti-gravity’ positions throughout the day
  • Weight loss 
  • Exercise modification
  • Use of support pessaries

 

What is a Vaginal Support Pessary?

Vaginal pessaries are devices worn inside the vagina that help to give support to the vaginal walls. If fit properly, they should give symptom relief, be comfortable and should stop a prolapse from descending. 

They can be a huge help for women with prolapse who wish to remain active or become more active. Pelvic Floor Muscle Training, while essential in the overall management of prolapse, can take a long time for symptoms to improve. Pessaries could be used in a ‘stop gap’ role to prevent further descent, and possibly give feedback on what types of things cause descent to occur, while concurrently working on pelvic floor training.

 

 

What exercise should I avoid if I have a Vaginal Prolapse?

Now this is an interesting one… and if you’re after a list of Do’s and Do Not’s, I’m sorry… it’s not coming from me!

Let’s start with what the recommendations are for exercise for general health. The Australian Government’s “Physical Activity Guidelines for Adults” states that we should participate in:

Cardio exercise:

  • >150 minutes of moderate intensity activity/week
  • OR 75 minutes of vigorous activity/week (or a mixture)

Resistance exercise:

  • >2 days/week 
  • >1 set of 8-12 reps per area
  • Maximum health benefits are gained when you would struggle to do another set

And recommendations for Bone Density and prevention/management of Osteoporosis:

  • Regularly doing a combination of resistance training and moderate to high impact weight-bearing activities

But historically (and I’m not talking that far in the past either) the recommendations for anyone diagnosed with, or at risk of, vaginal prolapse were:

  • Minimise weights
  • Keep all exercise low impact

But although well-intentioned, how evidence-based was this blanket recommendation?  And by giving this advice, are we compromising overall health (in particular our heart and bones) for the health of the vagina? 

Recent studies have looked a lot more into the pressures created in the abdomen, and more specifically in the vagina, during different types of exercise and although we can extrapolate some general information, the main message that comes out is “It’s not what you do, it’s how you do it”. 

If you give the same exercise to a variety of different women, then their individual anatomy, injuries, technique etc will mean that the way they perform that exercise results in a wide variety of different effects to their pelvic floor muscles and vaginal walls. 

It’s highly recommended that in order to tell a woman what exercise they should and shouldn’t do, we should understand:

  1. Their individual risk profile for prolapse occurring or worsening
  2. Whether a certain exercise is likely to be on the higher or lower end of the ‘risk’ spectrum

 

How do I know which risk category I fall into for Vaginal Prolapse?

A Pelvic Health Physiotherapist is a physio who has done a huge amount of extra training in Women’s Health and Pelvic Floor Health. They can do vaginal examinations to check a number of things such as:

  • The Pelvic Floor Muscle function
  • The structural support of the vaginal walls both at rest and on straining (and very important to assess this in standing too!)

There’s a specific test that we can do called ‘GH+PB’, which measures the amount of movement of the tissues at the opening of the vagina when you strain. This measurement, taken externally, has been proven to be a good indicator of what’s happening internally to the size of the space into which our organs could potentially descend. The larger the GH+PB measurement is (in cm) the higher the risk is that a prolapse could occur or worsen when the area is put under strain. 

Some important points to note:

  • It’s important to check if you currently have a prolapse (it’s not always symptomatic) but it’s just as important to pick up those who don’t currently have a prolapse but are at high risk of it developing
  • Pelvic floor muscle exercises are important but there’s a lot more to it than just getting the best maximal squeeze possible, especially for endurance activities like running and playing a game of sport (because when you think about it… how much help is a grade 5/5 squeeze going to be during a run if you’re not squeezing maximally while you’re running?)

 

Which exercises are likely to be higher risk?

There are lots of unknowns here, and we don’t know what the ‘safe’ level of intra-abdominal pressure is for preventing prolapse. We also don’t know, without individual assessment, how different women respond to the same exercise. 

But we can understand generally which exercises tend to come out as creating higher intra-abdominal pressure and perhaps these can be the ones that are more closely tested and monitored. 

Things we can assume about strength and resistance exercise:

 

  • Standing exercises have higher pressure than sitting, and both of these have higher pressures than lying down. On this note – abdominal crunches and lying down abdominal exercises usually come out as one of the ‘lowest risk’ exercises in the studies that have been done, although traditionally these have been amongst those that were the most highly cautioned against. 
  • Increasing weights and resistance increases intra-abdominal or intra-vaginal pressure

Things we can assume about aerobic exercise (note that this is probably the hardest type of exercise to investigate, but there is some exciting current research happening in this area):

 

  • Running, jogging, skipping etc are likely to be high risk due to the fact that they have an endurance nature to them, they’re always done in upright positions, and there are ground reaction forces involved.

Things we can assume about Crossfit-style exercise:

 

  • In low risk women (those who are young and have never had children), there is unlikely to be a negative impact on prolapse between those who choose to do Crossfit compared to those who choose to do ‘gentle’ exercise (but there are likely to be many benefits in other areas of health)
  • There is limited/no research on prolapse risk in women who are considered ‘high risk’

Things we can assume about pilates exercise:

 

  • Most pilates mat and reformer exercises are considered low risk and are unlikely to increase intra-abdominal or intra-vaginal pressures significantly (many are performed in lying down and with relatively low resistance)
  • There are lots of benefits to pilates but in isolation it doesn’t meet the guidelines mentioned previously about Disease Control and Prevention and needs to be considered in conjunction with other forms of exercise. 

 

How can a Women’s Health Physio give you individualized information about the type of exercise you should consider?

A Women’s Health Physio should be able to put all of this together and come up with a plan that suits you regarding an exercise regime. 

They might assess you and find that you’re very low risk for prolapse occurrence or worsening, and then you can work out together whether any monitoring needs to occur as you increase your load and intensity in your workouts. 

They might assess you and find that you’re currently in a high risk category and they can help you to work on a pelvic floor program (and possibly a pessary fitting) to allow you to gradually return to the exercise you love with close monitoring. 

They might assess you and find that you fit somewhere in the middle. Perhaps there are certain things that either make your prolapse symptomatic, or that cause vaginal wall descent without you realizing. Rather than advising you to stop exercising completely, they should be able to help you to come up with regressions or variations of these movements, and perhaps supplement them with other forms of exercise that you enjoy to allow you to still meet the health guidelines. 

 

Some final points to remember about Prolapse and Exercise…

  • Exercise is vital to overall health, and women unfortunately often decrease exercise due to fear of worsening a prolapse. 
  • Remember that a large number of exercises that were previously suggested to be ‘not pelvic floor safe’ don’t actually have much evidence to back that up (and might be really good for overall health)
  • Individual assessment and reassessment is key – and remember that you can’t assess prolapse or risk of prolapse with only an external examination. So if you’ve only had a real time ultrasound screening assessment on your abdomen, this isn’t able to be used to determine your risk profile. 

If you’d like to see a specialist physiotherapist in Western Australia, there’s online Directory for both private and public referrals:

Also, if you live in Perth or Mandurah, we have compiled a list of post-graduate trained physiotherapists who are particularly good with pregnancy, postpartum and exercise – see the FitRight website!

And remember – the whole aim of FitRight is to keep you moving, even if you do have a vaginal prolapse. Chances are that multiple women if every one of our classes are managing a prolapse and the instructors will be aware of this and know how to modify the classes to suit individual needs. 

Whether you’re pregnant, early postnatal, a Mum of young children or heading into peri-menopause, we have classes to suit you!

 

Article was written by Taryn Watson owner of FIT Right. She holds a 

Beating the Summer heat if you are Pregnant or Breastfeeding

Beating the Summer heat if you are Pregnant or Breastfeeding

SUMMER for many is their favourite season of the year...until they get PREGNANT and then it becomes uncomfortable!!! There are a few things to take note of as you brave the heat this summer.

PREGNANCY

It's not just that it's hotter outside, but pregnant women are hotter too: In the first trimester, the progesterone hormone increases body temperature. Pregnant woman's body temperature is already higher than normal so add in scorching summer temperatures and if you are not careful dehydration or other medical problems could arise.

Dehydration is common in the summer months. Did you also know pregnant woman is more prone to sunburn than non-pregnant woman? Other not so nice side effects of the summer heat is swelling, chaffing, 

 

Surviving the summer heat is necessary if you are pregnant and here are some tips:

1. Avoid direct sunlight.

Do outside activity early in the morning or after the sun sets. 

2. Stay hydrated.

Water intake should about eight to 10 glasses per day and should be more if you are exercising. Drink low-sugar electrolyte fluids, especially if you’re going to spend time outside. 

3. Dress for the heat.

Wear loose, breathable clothing and a hat to reduce sun exposure. 

4. Spritz water often.

Carry a spray bottle with you and spritz yourself with water to cool down your body temperature. 

5. Be smart about exercise.

Swimming is a terrific way to exercise and keep your body cool. Or stay inside and work out at the gym or walk laps at the mall. 

6. Wear sunscreen.

Be sure to reapply after sweating or swimming. Choose a brand with at least SPF 30 and make sure your face is protected. 

BREASTFEEDING

Newborn babies need extra care and attention when it becomes hot. Quite often they will want to breastfeed more reguarly, though become agitated due to the sweaty nature of skin to skin so might feed more less time.  

 

The Australian Breastfeeding Association reports the following:

"Most parents worry at some stage that their fully-breastfed baby may not be getting enough to drink in hot weather and they ask if they should give boiled water or fruit juice 'just in case'. The answer in most cases is that extra fluids are not required if your baby is breastfed whenever he needs and this may be more often than usual - just as you are drinking more often.

Breastmilk contains a perfectly balanced ratio of food and water to meet all your baby's needs. It is a living fluid, ever-changing to suit your baby and even in response to the weather! The first milk your baby gets from a full breast has a low fat content and naturally quenches baby's thirst. Once the let-down has occurred, the fat content of the milk gradually increases as the breast softens. This later milk has a creamier appearance and satisfies baby's hunger. 

In hot weather a thirsty baby may want to breastfeed more frequently but for shorter periods. In this way he is getting more low-fat milk and so is satisfying his thirst. If you need to be away from your baby, it is preferable that he has your expressed breastmilk (EBM).

An older baby or toddler who is no longer exclusively breastfed may be encouraged to drink water between breastfeeds. You can also offer extra 'snack' breastfeeds to keep him well hydrated. Another refreshing idea for toddlers is to freeze fruit pieces, such as orange quarters, peeled banana or slices of pineapple - cooling and fun, just be prepared for the very sticky mess!

  • Some babies become sleepy travelling in hot weather. You may need to stop and wake your baby for feeds.
  • The effect of car airconditioners can cause some dehydration - so extra breastfeeds may be necessary on long trips, even if you are cool.
  • Prams that are enclosed are airless and can get very hot. An open-weave bassinette, cradle, layback stroller, baby hammock, cot or portable cot is probably cooler for your baby to sleep in."

As a result of Mum needing to feed more often and the heat making her dehydrated she needs to increase her water quantity. Signs of dehydration include irritability, headache, dry mouth, a feeling of thirst, and darker-than-usual urine. Prevent dehydration by carrying a refillable water bottle with you. It is suggested  drinking a glass of water every time baby drinks. If water’s not really your thing, eat more high-water-content fruit, like watermelon, as well as frozen fruit and other fresh fruits and vegetables.

 

Outfits should also be loose, comfortable and made from a performance/breathable fabric. You may also want to carry a bamboo/cotton sheet to place between yourself and the baby during a feed. Our new cotton breastfeeding tshirt is a great idea as the zip allows for easy discrete access and there is material that remains between you and bub.

 

Stay vigilant and HYDRATED this Summer!

 

 

Have you read the NEWS?? Exercise in pregnancy and breastmilk reduce the risks

Have you read the NEWS?? Exercise in pregnancy and breastmilk reduce the risks

A new study finds even moderate exercise during pregnancy increases a compound in breast milk that reduces a baby's lifelong risks of serious health issues such as diabetes, obesity and heart disease.

 

A new study led by researchers at The Ohio State University Wexner Medical Center and College of Medicine finds even moderate exercise during pregnancy increases a compound in breast milk that reduces a baby's lifelong risks of serious health issues such as diabetes, obesity and heart disease.

They already know that exercising during pregnancy is beneficial to the unborn baby but they wanted to also understand the WHY. When they did their original study they found that the health benefits from fit mums transferred to the pups, proving that they were, in fact, passed through breast milk and not simply inherited genetic traits.

Researchers followed about 150 pregnant and postpartum women using activity trackers and found that those who had more steps per day had an increased amount of a compound known as 3SL in their breast milk, which they believe is responsible for these health benefits.

They are now trying to see if they can extract this 3SL so that maybe they can add it to baby formula to help Mums who were maybe on bed rest or can’t breastfeed.

Dorothy M. Davis states: “Exercise is also great for your overall health during and after pregnancy, so anything you can do to get moving is going to benefit both you and your baby."

So there you have it even more reason to get out and get moving with your bump on board!

 

Information from the study was published in ScienceDaily.com

Exercise and the clinging baby stage...

Exercise and the clinging baby stage...

Many of us have experienced days, weeks and months whereby the baby, toddler does not want to be put down. This may be the result of new teeth coming in, separation, a leap, fussiness from tummy upset/gas/reflux/colic etc. Many then chuck the baby on the hip and try to carry on with the normal household duties etc because we all know that the jobs just dont get done by themselves!

This way of carrying puts pressure on one side and eventually tilts/unbalances the pelvis region like below:

One of the ways that can help this issue is baby wearing. Purchasing a good quality carrier and getting it fitted for to you. Carrying a baby in a sling or snuggled in a wrap has more benefits than simply being a hands-free carrier – it can aid colic relief, bonding, physical development and more.

When selecting a carrier it is important to remember the following:

  • Head and neck support for babies and sleeping infants/children
  • Wide base of support that supports the thighs and flexes the knees
  • Postural curves support
  • Wide or cushioned adjustable shoulder straps
  • Ability to distribute the baby’s weight evenly across the parents body
  • Ease of loading/unloading, so that the parent can keep their spine in a neutral position

When it comes to exercise you can still get it done and we have found an uplifting fun and motivating class that is for you. It is called Kangatraining.

Kangatraining is a babywearing fitness class for mum and babies. One of the biggest positives of Kangatraining, is that not only do you bring your baby to class, they are an active and important part of the workout! 

PreKanga is the best activity program during pregnancy. KangaOnWheel, KangaTrail, NordicKanga, ReactivKanga and KangaMix are our outdoor classes. KangaBurn is the most efficient workout without your baby. Each of our workout concepts is based on sports science and created with experts such as gynecologists, sport scientists and physiotherapist. The best bit is you can take part with a small bub or even with a toddler. 

Kanga-Classes are being offered in over 25 countries. Here in Australia they have over 100 Kangatrainers running sessions across Australia in both regional and metropolitan areas. Their programs include-: PreKanga (the prenatal program)KangaTrail, KangaOnWheel and KangaMix.

You can get more info HERE

 

 

 

The CORONAVIRUS and PREGNANCY

The CORONAVIRUS and PREGNANCY

The world has gone into a panic over the Caronavirus- there is NO toilet paper on supermarket shelves, people are panic buying their staples and don’t even mention HAND SANTISER...

So should pregnant woman be worried?

Pregnant women tend to have more serious flu infections than people the same age who aren't pregnant, according to the Centers for Disease Control and Prevention. That’s because pregnancy changes the immune system somewhat and lung capacity decreases as a woman’s pregnancy progresses. Though this doesn’t mean that pregnant women will experience coronavirus more severely. There are just not enough studies on pregnant women and coronavirus for experts to say.

“There were some reports of women who are pregnant that have been published, but they're very small numbers,” Adalja said.

Basically what this means is that pregnant women are as at risk for coronavirus as any one else whose immune system is currently compromised and should take precautions as such.

While this might sound worrisome, the experts recommend that pregnant women follow the same smart behaviors that everyone should practice.

“This is a virus that doesn’t have a vaccine or any kind of treatment so the best protection is really just common sense hygiene that you would use during flu season anyway,” Adalja said.

Wash your hands, avoid sick people

This means frequent and proper hand washing. Pregnant women (and all people) should use soap and warm water and rub their hands — including their palms, wrists and between fingers — together vigorously for 20 seconds or about the length of “Happy Birthday.”

“Wash your hands, avoid sick individuals, if you are sick cover your cough,” Adalja said.

While influenza is a different virus than coronavirus, pregnant women should get a flu shot if they have not already received one. It will protect them from getting the flu, which can be more serious in pregnant women. And, fewer flu infections means that doctors can focus their resources and energy on helping patients with coronavirus.

“The more people that are vaccinated against influenza, the less of a burden we're going to have in our hospitals,” Adalja said. “We need to have room to take care of patients that may have the novel coronavirus.”

Do you need a mask if you're pregnant? Nope

Pregnant women do not need to buy masks to protect themselves. Only N95 respirators are effective and a mask prevents you from spreading coronavirus.

"If you put a mask on if you’re sick, that prevents you from spreading the germs to other people,” Dan McGee a pediatric specialist at Helen DeVos Children's Hospital in Grand Rapids, Michigan, told TODAY Parents. “But to go out in public wearing a mask, especially the flimsy lightweight surgical mask you see people wearing, it's not going to prevent the virus from coming in contact with you.”

There is still little known about the virus and how it effects each age and individual. 

So the news is a mask isn’t going to protect you- increasing your personal hygiene standards will! 


 

 

 

Info from TODAY and Pop sugar news site

What’s the pain down there 👇?

What’s the pain down there 👇?

1 in 5 pregnant woman develop some degree of pelvic girdle pain. It doesn’t have an impact on the unborn baby but Mum to be struggles with pain and movement.

PGP in pregnancy is a collection of uncomfortable symptoms caused by a misalignment or stiffness of your pelvic joints at either the back or front of your pelvis. PGP is not harmful to your baby, but it can cause severe pain around your pelvic area and make it difficult for you to get around. Different women have different symptoms, and in some women PGP is worse than in others. Symptoms can include:

  • pain over the pubic bone at the front in the centre
  • pain across one or both sides of your lower back
  • pain in the area between your vagina and anus (perineum)

Who is more at risk of developing this painful condition in pregnancy?

Factors that may make a woman more likely to develop PGP include:

  • a history of lower back or pelvic girdle pain
  • previous injury to the pelvis, for example from a fall or accident
  • having PGP in a previous pregnancy
  • a physically demanding job
  • increased body mass index
  • emotional distress and smoking

So what can be done?? Treatments for pelvic pain in pregnancy...

The earlier invention happens the better it is.

  • Be as active as possible within your pain limits, and avoid activities that make the pain worse.
  • Rest when you can.
  • Get help with household chores from your partner, family and friends.
  • Wear flat, supportive shoes.
  • Sit down to get dressed — for example don’t stand on one leg when putting on jeans.
  • Keep your knees together when getting in and out of the car — a plastic bag on the seat can help you swivel.
  • Sleep in a comfortable position, for example on your side with a pillow between your legs.
  • Try different ways of turning over in bed, for example turning over with your knees together and squeezing your buttocks.
  • Take the stairs one at a time, or go upstairs backwards or on your bottom.
  • If you’re using crutches, have a small backpack to carry things in.
  • Use an ice pack (gel pack, frozen peas, wrapped in a pillow slip) over the pelvic joints (front and back ‘dimples’) to reduce pelvic joint pain and inflammation. Use for 10 to 15 minutes only, several times a day.
  • If you want to have sex, consider different positions such as kneeling on all fours.

You should also avoid:

  • standing on one leg
  • bending and twisting to lift, or carrying a baby on one hip
  • crossing your legs
  • sitting on the floor, or sitting twisted
  • sitting or standing for long periods
  • lifting heavy weights, such as shopping bags, wet washing or a toddler
  • vacuuming
  • pushing heavy objects, such as a supermarket trolley
  • carrying anything in only one hand (try using a small backpack)

Physiotherapy aims to relieve or ease pain, improve muscle function and improve your pelvic joint position and stability, and may include:

  • manual therapy to make sure the joints of your pelvis, hip and spine move normally
  • exercises to strengthen your pelvic floor, stomach, back and hip muscles
  • exercises in water
  • advice and suggestions including positions for labour and birth, looking after your baby, and positions for sex
  • Pain relief, such as TENS
  • equipment if necessary, such as crutches or pelvic band.

 

 

 

 

 

 

info captured from www.pregnancybirthbaby

Why This Mum Is Not Rushing Back Into Fitness After Pregnancy....

Why This Mum Is Not Rushing Back Into Fitness After Pregnancy....

Nadine is a Brisbane Mum of two, a personal trainer, Emergency Military Nurse, blogger and a health and fitness enthusiast. Nadine has lived and breathed fitness for many years and was motivating the troops at F45 until she went on maternity leave.

 

During both pregnancies Nadine suffered from severe HG (Hyperemesis Gravidarum) or extreme morning sickness where she had to be hospitalised a number of times due to dehydration/monitoring. For those of you who know Nadine would appreciate that she gives everything 110% and will train anywhere/anytime. Due to unforeseen circumstances Nadine went into labour 6 weeks early and underwent an emergency caesarian. She then spent the next few weeks going back and forth to the special care nursery-pumping around the clock to nourish her little one.

 

For Nadine, exercise is like brushing her teeth, it is part of her day so when she made the conscious decision to NOT return to exercise postpartum it was a big thing. Listening to her inner dialogue and body is an important message for all Mums. Some tend to rush back into a regime which they may not be ready for mentally or physically- the fourth trimester is just as important as the first three…

 

“As you guys know I made the very conscious decision to NOT return to ‘Training’ at 6 weeks when I was cleared to begin ‘light’ exercise. Hear me out tho!! It’s interesting seeing me talk about my birth because birth trauma is REAL and what we experienced to bring Beckham here safely was incredibly scary for all involved but that is a story for another day perhaps, this is something I deal with everyday…. Anyhow this isn’t just about my birth experience….because….I hadn’t felt ready and I had to listen to that internal dialogue. I knew my recovery was going to be longer in duration due to what occurred physically and mentally for me and I know that i have had to be very meticulous, careful and very structured and progressive with my recovery. Slow and steady is absolutely what is needed for me and my body. Physically and mentally my mind and body have been through the wars. And my body has needed REST and a chance to do some internal repair on its own.-mind, body and soul without the additional stressors….Irrespective of my birth experience, I also DECIDED that the 4th trimester was something again that I wanted to immerse into, to truly soak in the time with my newborn and my family…time I’ll never get back, time to bond, time to find our groove. And without the added pressure or ‘postpartum bounce back’ that seems to be on the trend which I refuse to enter into….

 

Project ‘get my body back’, and some rapid postpartum mum bod has been so far out of my priorities it is not funny. That may seem interesting for someone whose life is revolved so heavily around health and fitness…(if your new to my page you may not know that I have a background in personal training, group coaching, have my online coaching and mentoring business, published fitness modelling and heavily involved in this industry) BUT  and that’s not to say others that return sooner are doing the wrong thing, I would hope we are all guided by the professional advice and pave our own path unique to our journey, but what I am saying is this is MY journey and my decision making and  SLOW RETURN is and has been my PRIORITY.

 

But THIS to me is HEALTH! Its looking after ME in all life pillars- the physical sense, the emotional sense etc etc. I have had times where I’ve wanted to get back into it. Let’s not lie. BUT it was in those moments I reminded myself of THIS. Newborn life is fleeting and Ive focused my time and energy into my baby, my family and my WELLBEING OVERALL and gentle walks with Beckham a couple of days a week and that is it, focusing on nutrition especially when a prep baby is exclusively breastfed and that is my HEALTH, my body right now is still an extension to someone else aka BABY BECKS and will be for a while. These decisions have been easy to make-especially when it involves a MIRACLE baby that was born prematurely after a traumatic birth and him being in hospital in special care for the first few weeks of his life and heck a whirlwind pregnancy with trials along the way from the get-go, trust me when I say that we were a bees dick away from our birth being the catastrophic WORST day of our lives with the outcome being potentially VERY different…now as a result; my core and abdominals have needed and will be needing progressive rehab work just like anyone would need to; but perhaps on a grander scale due to what occurred that day. Which i too have been and will continue to be working on. My c-section fortunately and unfortunately had to be rapid, had to be severe, had to be rough and was complicated to say the VERY least. What happened had to happen in order to BRING our baby out alive.

 

Someone doesn’t recover from birth trauma overnight. Im a resiliant  person but Im not immune from that- it rocked me and Dane too- because our birthing partners experience it too lets not forget them. And it still does. It takes time. And I work on that in various ways everyday. We are appreciative and grateful with what eventuated in the end but it was a harrowing experience that perhaps I’ll share one day.

 

In a nutshell, taking this time slow but smart, meticulous and planned, progressive in nature and ensuring reassessment on all fonts along the way, but more importantly being discerning of where I focus my time and energy while I recover has been my priority.  I know where my body ‘can go’, what it ‘can’ look like, what it is ‘capable’ of doing and achieving. But doing that in record time would be foolish and detrimental long term. Pregnancy and birth is short term, my postpartum is FOREVER. AND I choose to honour and look after that!!!!!

 

I’m 4 months postpartum this weekend. I now move into a new phase of my rehab. Take note, in my opinion I started rehab day 1- it just looks different which is MY VARIATION OF NORMAL. And being in a ‘gym’ hasn’t been part of it until now. 4 months postpartum now involves a progressive program that I have taken time to develop with so much intention and will be assessing as I go, and with the necessary health professional checks and advice along the way with a women’s health physiology which also will be ongoing! This new phase isn’t some crazy step up, its simply simply the next part of my progressive step in my current rehab and restrengthening this mind and body. The bi-product of all of this of course will be some aesthetic change but again the focus isn’t that solely!! Im excited to be entering this phase and Ill be sharing it with you and I hope my journey will and can inspire others to also LOOK AFTER AND TAKE MUCH CARE IN THEIR POSTPARTUM JOURNEY……”

 

*Nadine has released her birth story on Dear Mama Project Podcast if you are interested in hearing more.

Why We Shouldn’t Lift Your Arms Above Your Head During Pregnancy- MYTH?!?!!

Why We Shouldn’t Lift Your Arms Above Your Head During Pregnancy- MYTH?!?!!

It was once believed that lifting weight above your head would result in the umbilical cord being wrapped around the babies neck.

 

This sounds a bit bizarre at first, but surprisingly, many women have been subject to urgent warnings not to raise their arms above their heads for fear of strangling the baby in the womb with the umbilical cord. The truth is a woman’s arm movements have no bearing on a fetus, as her arms are not in any way connected to the umbilical cord. Babies often tangle themselves in their umbilical cord with resulting harm.

 

 

Education has taken a big step forward since then because it is ok as long as care is taken. Be especially careful lifting weights over your head in the last three months. It is also advised to not use heavy weights, hold your breath (known as the valsalva manoeuvre) and consult to gym staff/qualified professionals/obstetrician about technique if you are concerned. Overhead lifts will increase the curve in your lower spine so it is recommended to use seated position on a bench to reduce the curve.

 

 

(Swapping to front shoulder raises and lateral raises to shoulder height is preferable)

 

 

“Exercising during pregnancy, including weight training, comes with many benefits, such as help with labor and delivery, with improving your stamina, and strengthening back muscles to limit back pain,” explains Dr. Alison Mitzner, MD.

 

“Research has shown that women who exercise regularly are less likely to develop gestational diabetes, and on average have shorter labors, less constipation, and less swelling in the extremities,” says Dr. Jamil Abdur-Rahman, MD.

Why HIIT Is A Great Option For Time Poor Mums

Why HIIT Is A Great Option For Time Poor Mums

How would you feel if I told you, that you could do a 15 minute workout anywhere at any time at any stage of your fitness journey that could burn a large amount of calories and did not require equipment?

Well the training method called HIIT offers you exactly all of that.

Hiit Style training is a great introduction if your looking to come back into fitness or it’s a great challenge if you’re a seasoned exerciser.

Here are the benefits of Hiit Style Training –

I have put them in order of what I know are the biggest concerns mum's have when thinking about Hiit Style training -

1 – I’m not fit enough to do Hiit 

 Perfect for all fitness levels.

If you’re a mum and you're just thinking about where to start with the whole exercising thing as you want to start feeling good again, Hiit training can help. You start with a 15 minute workout and you will notice in a short amount of time you can increase the length of these.

HIIT workouts offer experienced or fit gym goers a new challenge, and beginners a quicker way to see results. You are constantly pushing yourself out of your comfort zone with the shortened rest phases.

2-  I don’t want to train at a gym

You can do it anywhere

HIIT is such a simple concept of work phase and rest phase, you can take it anywhere with you – to the kids park, the gym floor, the beach, your lounge room or a hotel room on holiday. And you can choose the exercises that you have enough space to complete! 

3 -  I have no time to think about exercising even though I know I should

 Time efficient

 HIIT is great if you have a limited amount of time to work out. You don’t need to spend hours in the gym to reap the benefits of regular exercise and Hiit helps play a huge part in this.

  1. 4. I don’t own any equipment

 No equipment required

HIIT workouts are so great as no equipment is required. All you need is a little bit of space. HIIT workouts can focus just your own body weight, so any workout that gets your heart rate up quickly such as plyometric, high knees, and jumping jacks can be implemented into a HIIT workout. particular muscle group – and of course if you have any injures regressions of all movements are available and still great to use.

 

5.. Will this help me  lose this baby weight  

Burns calories and helps with fat loss

The harder you exercise the harder your body has to work to fire up those muscles. Hiit is challenging for the body as you are pushing yourself through each working phase.

 

6 . I am more interested in making sure I can run with my kids

Great for cardio conditioning

During the high intensity periods (working phase) of exercise, HIIT takes you into an anaerobic training zone (where your body's demand for oxygen exceeds the oxygen supply available).

With consistent training in this zone, you will be able to out run your kids and be able to show them up in no time.

 Article written by Cass Wilson, Mum of two who runs and co-owns HIIT That Group Fitness  in Perth. 

She is on a mission to help women to take better care of their bodies, and give them the confidence to get stronger both physically and mentally as their embark on their journey as a new mum. She has a special interest in pre and postnatal woman and is passionate about educating them on how to lift weights and exercise correctly,

 

What Is An Irritable Uterus And Is It A Problem In Pregnancy?

What Is An Irritable Uterus And Is It A Problem In Pregnancy?

What is an irritable uterus?

Some women develop frequent, regular contractions that don’t produce any change in the cervix. This condition is often called irritable uterus (IU). IU contractions are much like Braxton-Hicks, but they can be stronger, occur more frequently, and don’t respond to rest or hydration. These contractions are not necessarily normal, but they also aren’t necessarily harmful.

INTERESTING FACT:

In 1851, a Dr. McKenzie wrote a piece in the London Journal of Medicine describing the condition. He started by remarking on the dueling titles of the time— hysteralgia and irritable uterus. The latter coined by a Dr. Gooch in 1831 

In the early 1800’s, “irritable uterus” was actually used to describe a condition in non-pregnant women and unrelated to contractions!

 

The HEALTHLINE.COM states that:

"There have not been many studies done on IU and pregnancy. In 1995, researchers explored the link between IU and preterm labor and published their findings in the American Journal of Obstetrics and GynecologyTrusted Source. They uncovered that 18.7 percent of women with uterine irritability experienced preterm labor, compared to 11 percent of women without this complication.

In other words: Irritable uterus contractions might be annoying or even scary at times, but they are unlikely to significantly increase the chances of your baby coming too early."

What causes an irritable uterus?

It is unclear as to what causes it and isn’t necessarily the same in all women.

Some of the causes include anything from dehydration to stress to untreated infections, like a urinary tract infection. Unfortunately, you may never learn the cause of your irritable uterus contractions.

 

What Are The Symptoms Of Irritable Uterus? 

 

Irritable uterus can feel similar to Braxton Hicks contractions but the contractions occur more frequently, are more painful, and tend to be more regular in length and frequency. Due to the intensity of the contractions many women mistake them for real labour. The contractions can also be accompanied by a feeling of pressure and/or pain in the back. Unlike Braxton Hicks, irritable uterus contractions worsen with increased activity. Irritable uterus can also feel like a constant tight belly, which can become worse when standing or walking. The tight belly can last for over an hour at a time. -

To deal with the symptoms you may want to try:

  1. Keep your bladder empty; a full bladder can create further irritation
  2. Stay hydrated
  3. Reduce your stress levels
  4. Get plenty of sleep
  5. Avoid lifting heavy items
  6. Lie on your left hand side
  7. Eat small meals, more frequently
  8. Avoid caffeine
  9. Take magnesium supplements (but check with your care provider first). 

 Our Pregnancy/Postpartum leggings have also been reported to help avoid the irritable uterus as there are no constricting seams through the uterus area. (This is a reported claim and not a research/investigated link)

References

1. Roberts WE, Perry KG Jr, Naef RW, Washburne JF, Morrison JC. The irritable uterus: a risk factor for preterm birth? J Obstet Gynecol. 1995 Jan;172(1 Pt 1):138-42.
2. Kehinde S. Okunade, Ayodeji A. Oluwole, and Maymunah A. Adegbesan-Omilabu. A Study on the Association between Low Maternal Serum Magnesium Level and Preterm Labour. Advances in Medicine. Volume 2014, Article ID 704875, 6 pages
http://dx.doi.org/10.1155/2014/704875
3. Irritable Uterus and Irritable Uterus Contractions: Causes, Symptoms, Treatment. http://www.healthline.com/health/pregnancy/are-your-contractions-normal

See more at: https://www.bellybelly.com.au/pregnancy/irritable-uterus-during-pregnancy/

 

To Support Or Not Support The GIRLS

To Support Or Not Support The GIRLS

Support in bras is oh so important.

 

Did you know:

 

That a pair of D-cup boobs weigh in at 7 to 10kg. “That’s more than enough to pull your trunk forward, force you into a hunched-over running posture, decrease your stride’s efficiency, and up your risk of injury,” McGhee says.

 

If you haven’t noticed, pretty much the only thing keeping your breasts up during a run is your bra’s shoulder straps, which take a lot of weight. When straps are thin, the pressure can be so great they not only leave dents in your shoulders but hit the brachial plexus nerve group, causing numbness in the pinky fingers.

 

We recommend a razor back or full back and should support for high-intensity exercise.

 

How much your boobs bounce depends almost entirely on breast size and elasticity of the skin covering your breasts, McGhee says. However, skin tends to lose its elasticity with age and “excessive breast bouncing.” So, the more your breasts bounce, the more they will bounce during future runs. Add in breastfeeding or post breastfeeding and your lady friends could be dragging on thin ice mid run….

 

How much do breasts bounce? Measuring the bounce of both bare and bra-covered breasts during treadmill workouts, McGhee found the average 38D moves about 13cm from top to bottom during running. Smaller breasts bounce about 7.5cm, which can still be uncomfortable. And breasts don't just bounce in an up and down motion; some larger breasts bounce in figure-eight shapes.

 

While they can’t completely eliminate bouncing, high-support sports bras can cut the range of motion in half (approximately), McGhee says. The goal is for the breasts to move in unison with your torso and not bounce independently of one another.

 

During pregnancy there is evermore of a concern. When you're pregnant, your body has very high levels of oestrogen and progesterone, hormones that stimulate your breasts' milk glands and milk ducts, respectively. The result of all this can be a big change in bra size, but growth usually slows or stops at the end of the first trimester. No special foods, massages, exercises, or creams affect breast growth during pregnancy, so spend your money on a good supportive bra instead. 

CrossFit In Pregnancy

CrossFit In Pregnancy

To train or not to train....

Generally if you have been doing CrossFit of F45 for a period of time prior to pregnancy you are ok to continue and scale/modify the activities. This is of course if you have no medical problems and have been generally cleared to from your doctor.

The BOXLIFE magazine sums up some great myths around this topic.

MYTH OR FACT? “Women should scale their workouts while they are pregnant.”

The most important thing for the woman to remember is to listen to her body. Each day will be different and certain movements may begin to feel awkward or uncomfortable. The competitive nature of CrossFit can cause women to feel frustrated when their bodies are telling them to slow down. Remember: It’s only for nine months!

What modifications should be used no matter what?

Whether you’re pregnant or not, form is king. Form should never be compromised when performing a lift or during a workout. As a woman’s belly grows, it will be impossible to maintain an optimal bar path. This means there will come a time where a switch to kettlebells or dumbbells is called for. Also, pregnant women release a hormone called Relaxin which causes ligaments to be looser and can affect balance. Therefore, movements such as box jumps should be avoided after the first trimester. Double-unders, for example, should be left to each individual and how she feels on the given day.

MYTH OR FACT? “Intense workouts will harm the baby.”

Intensity is a relative term. Exercise is very beneficial to your baby. Mom and baby share everything, including hormones. If mom releases endorphins while exercising, baby will reap the benefit as well. Studies also show that moms who exercise during pregnancy have larger placentas which mean more oxygen exchange for the baby.

MYTH OR FACT? “I need to monitor my heart rate when working out during my pregnancy.”

This is also an outdated fact. It’s more important to listen to your body and take breaks as needed. Over the course of a pregnancy, a woman’s blood volume increases by as much as 50%! This is why women feel short of breath during workouts a lot sooner than they are accustomed. Every minute on the minute (EMOM) workouts are great for pregnant CrossFitters as it gives them built-in rest.

MYTH OR FACT? “My diet needs to change tremendously.”

That depends on what you were eating before you were pregnant. A Paleo or Primal diet is ideal for pregnancy as it ensures that moms are getting adequate protein, minerals and good fats. The best book I’ve read on this subject is “Beautiful Babies” by Kristen Michaelis.

MYTH OR FACT? “I just found out I’m pregnant and want to start CrossFit to start living a more active lifestyle. Is it safe for me?”

Newly pregnant women have asked me this very question. I think the functional movements we do in CrossFit are definitely beneficial for pregnant women. However, if you’ve never done it before, I recommend you find a personal trainer or coach who truly knows about the pregnant body. Have them work with you one-on-one. I design programs for women with little to no CrossFit experience as well as those with many years under their belt. Beginners can benefit greatly from some of the basic movements, but I would not recommend that a newbie jump into a CrossFit class newly pregnant!

MYTH OR FACT? “Miscarriages are more likely if you CrossFit.”

It’s hard to know what exactly causes a miscarriage. It’s also easy for women to blame themselves for something they did, something they ate, etc., when sometimes nature just has other plans for us. I know many newly pregnant moms worry about this, but I would say, again, take it easy for the first trimester. You may feel tired and nauseous or you may feel awesome. Each day is different. Use this time to move your body and release endorphins, even if it’s by walking or doing something lighter until you feel more confident jumping back into a workout.

Just tell us…Is it safe to CrossFit while pregnant?

As with any exercise, as long as you’ve been doing it for at least six months prior to pregnancy, you should be fine. The functional movements we do in CrossFit are extremely beneficial for helping women get through labor. Squatting is one of the best exercises for the pelvic floor and tends to help CrossFitting mamas have shorter pushing times.


I tend to be conservative when it comes to some of the more “controversial” topics regarding pregnancy. For example, I am adamantly opposed to going upside down while pregnant. It’s one of those instances where you will probably be OK, but what if you aren’t? Why risk it for a handstand push-up? I think it’s important to take a step back and put it all into perspective. Women must also remember not to compare themselves to anyone else. Just because your friend is doing muscle ups while pregnant doesn’t mean it will feel OK for you. Listening to your body each and every day is key.”

 The BARBELLPHYSIO.com recommends not doing the following exercises:

 

  1. Bench press

Despite the common misconception otherwise, resistance training is actually very beneficial for pregnant women. But one situation you should avoid is lying flat on your back for too long, especially as you advance into your second trimester and the weight of the uterus puts pressure on the major blood vessels running alongside your spine. Replace the bench press with an incline dumbbell press to avoid this issue.

  1. Sit ups

Although exercise during pregnancy is definitely good for you, the muscles of the abdomen are being put under considerable strain as the baby forces them to stretch and thin. Side planks and Pallof presses are good alternatives to sit ups with lower risk.

  1. Push ups and burpees

Although your body is still capable of doing these in muscular terms, the simple mechanics of the situation may well defeat you as your rapidly growing belly starts to press the floor. Luckily, all you need to do is raise the upper part of your body, either on a bench or bars, to give yourself enough space to enjoy these CrossFit basics.

  1. Snatch and clean

Again, this becomes difficult due to the sheer mechanics of your protruding abdomen as pregnancy progresses. Perform the power version instead and then move to squatting under control.

  1. Pushing your personal best

OK, so this isn’t a specific exercise, but it’s pretty much the bread and butter of CrossFit, so it’s worth addressing. Although the old ‘don’t let your heart rate rise above 140 bpm’ myth has almost completely died out, there’s a consensus that putting your body under too much stress while exercising may be uncomfortable for your growing baby as his oxygen levels drop.