Back To The Core: Post Pregnancy Health & Fitness With Kuur Rehabilitation

Kuur takes us through the do’s, the don’ts and the must know’

Pregnancy and birth is a miraculous thing, mamas, but the effects on your body can be stressful!
We may joke about ‘peeing our pants’ a little at every cough or movement after delivery but actually complaints like this are really common and no laughing matter – and as for the post-baby-belly, there can be medical reasons as to why it’s just not shifting. We spoke to the team at Kuur Rehabiltation about what you can do to look after all those important pelvic floor and abdominal muscles and get your body back on track!

What exactly is the pelvic floor?!
The pelvic floor is a muscular platform at the base of the pelvis, which attaches from the pubic bone at the front to the base of your spine (the coccyx) at the back like a sling. The pelvic floor supports your bladder, bowel and uterus – which is why we work with you to make sure it’s strong and doing its job!

We’ve all been told to do our pelvic floor exercises – why are they important, when should we be doing them and how?
The pelvic floor muscle has several important functions so you want to make sure it’s being worked out! The pelvic floor helps with bladder and bowel control so when it’s weak, there can be embarrassing consequences. You may notice this weakness when you cough, sneeze, run or bounce on a trampoline. The pelvic floor is also vital in supporting your lower back and pelvis, which is why it is not uncommon to experience pain in these areas during pregnancy or after childbirth.

Many of these symptoms can be improved and reversed by doing daily pelvic floor exercises and it is not just pregnancy and childbirth that can make the pelvic floor weak, lack of exercise, menopause and being overweight are also causes so it’s a good idea to do these exercises regularly into the future. The exercises are simple and don’t require a trip to the gym!

There are 2 types to try:

1. This exercise comes in two phases – first tighten up the pelvic floor muscles as if you are trying to stop yourself passing wind. Try to keep your buttock muscles relaxed while you do this. Then tighten up the muscles as if you were trying to stop yourself from having a wee. Hold for as long as you can – e.g, for a count of 8 and then relax for another 8. Slowly increase the length of time that you hold each contraction for and do as many as you can until you feel your muscle getting tired.
2. Pull up the pelvic floor muscles as before, hold for one second and then relax. Repeat 5-10 times or until your muscles feel tired.

There are other symptoms that many women may not realize are linked to poor pelvic floor function. If you have concerns about any new symptoms you are experiencing in this area since being pregnant or giving birth, please get in touch with your Women’s Health physiotherapist. Do not suffer in silence, ladies!

We’re not sure our abdominal muscles have ‘knitted together’ after having babies – how can we tell and what can we do?
It’s amazing how much the stomach stretches during pregnancy – and no wonder therefore that Diastasis Recti (or abdominal separation) is a common condition where the right and left halves of the Rectus Abdominis muscle separate to accommodate the growing baby. Most of the time these muscles then close a few months after delivery but if you’re worried that you still have separation then you can use this simple self-test:

• Lie on your back with your knees bent, and feet flat on the floor.
• Place one hand behind your head and the other hand on your abdomen, with your fingertips across your midline-parallel with your waistline – at the level of your tummy button.
• Roll your upper body off the floor, gliding your ribcage towards your pelvis.
• Move your fingertips gently back and forth across your midline, feeling for the right and left sides of your Rectus Abdominis muscle. Test for separation at, above and below your tummy button.

Separation of more than 2 to 2.5 finger widths, or 2 centimeters, is considered problematic.

To help prevent or lessen the severity of diastasis recti you can strengthen the deepest abdominal muscle, your Transverse Abdominus or TvA. The TvA is the body’s internal “corset” and when contracted, compresses the abdominal wall in turn bringing the edges of the Rectus Abdominis together. At Kuur, we can help with getting you on the right track with those abs!

What is the role of the abdominal muscles and why is it important to pay special attention to them at this stage?
The primary role of the abdominal muscles before, during and after pregnancy and childbirth are to stabilise and support the pelvis and lower back, support the abdominal and pelvic organs, maintain correct pelvic alignment, increase abdominal pressure during coughing, sneezing or lifting, and aid expulsive movements (during the second stage of labour, for example).

What are the key areas to focus on when we start exercising again after having a baby?
It is important to establish good foundations in terms of baseline fitness prior to returning to higher level exercise and competitive sport (if that’s your thing!). The key areas to focus on include: control of the pelvic floor and TvA; control and maintenance of good sitting and standing posture, which will include strengthening of the buttock and thigh and inner thigh muscles, abdominals, back, shoulder and deep neck muscles.

What are your do’s and don’ts with post-baby exercise?
Do get started with your gentle pelvic floor and TvA exercises as soon as possible. In fact, retraining the pelvic floor is most effective during the first 6 weeks.

Do pelvic exercises regardless of whether you had a natural delivery or a C-section.

Do wait to get the all clear from your GP or OBGYN at your 6-week post natal check up before you increase the intensity of your exercise routine. Also remember that the increase in intensity should be gradual. The ligaments around joints will be still be lax for some time following delivery which makes high impact sport and contact sports risky for women in the post natal phase.

Don’t be afraid to exercise whilst breastfeeding. Breastfeeding and exercise can be successfully combined without any disruption of milk production and flow as long as special attention is given to adequate fluid and energy intake. Remember to wear a good-fitting bra!

Don’t despair over your post natal weight. It took 9 months to grow your baby so give yourself time. Your body needs the extra energy to support new demands including breastfeeding, sleep deprivation and increased physical activity such as lifting and carrying.

Don’t opt for sit-ups and crunches. These exercises are inappropriate and will NOT flatten your tummy. They are more likely to cause lower back pain and may make any abdominal separation worse. They will also increase the pressure on your weakened pelvic floor.

We don’t have as much time for exercise as we used to – how can we get results without spending hours?!
Don’t panic, and try to do all your exercise in one go. Split them up throughout the day and try to incorporate exercises into your daily activities. For example, do your pelvic floor exercises whilst you are sitting feeding your baby or while your baby is having a kick on their play mat or while you are standing changing a nappy. Try to practice your postural exercises while you are sitting feeding or standing cooking.

Remember the time it takes to return to physical fitness will vary for every woman depending on their fitness levels before pregnancy, physical activity during pregnancy, their birth experience, the amount of support they have at home and their readiness to exercise. Try to enjoy the journey and your new baby. And remember that we’re here to help!

Kuur Rehabilitation are offering all of our readers 2 fabulous services for FREE! 

Free diagnostic ultrasound scanning for muscle and joint problems
Post-natal assessment for safe return to exercise inc. Diastasis Recti screening.

To redeem simply contact them on +971 4 425 3318 before Saturday, 30 April and quote Sassy Mama.