Category: Post Natal

Core Exercises to Reduce Your Abdominal Separation

Post author By Melanie Platt
Post date January 10, 2022

Core Exercises to Reduce your Abdominal Separation

Wow what happened to my stomach? It looks like it’s split in half and not working. I feel bulging coming out when I stand up, it’s flabby and it feels so weak! I feel horrible.
Does this sound like you?
It’s very common after pregnancy, It’s called Diastasis Rectus Abdominis (DRA) or abdominal separation. Where the tummy muscles have stretched and the fascia has separated leaving you feeling weak and flabby.
Here’s what you can you do about it!Abdominal Separation

DRA: This is where the fascia (I like to think of it as a piece of glad wrap over the top and in between your muscles holding them all together) and connective tissue between your Rectus Abdominis (6 pack muscles) has stretched and weakened leaving a gap between your muscles.
Add in the skin over the top stretching and it looks and feels like a mess. Don’t worry! It doesn’t have to be this way.

So why is this a problem?

It can lead to weakness in the stomach muscles leaving you at risk of back pain and postural related pain.
It disrupts the lumbo-sacral support and muscle system. (lower back and pelvis area)
DRA and Pelvic Floor dysfunction often go together.
A thinner lining of the abdominal wall creates less support for your inner organs and can leave you at risk of a hernia of your bowels.

Alarming Facts:

100% of women have some level of separation of the abdominal muscles in the third trimester. (Hilliard and Brown 1996, Diane Lee 2013)
For a lot of women with DRA their gap closes significantly between day 1 and 8 weeks post baby. However if their gap remains widened at 8 weeks and if left untreated the gap at 8 weeks remains the same at 1 year post baby. (Cauldron et al 2008, Liaw et al 2011)
66% of women with DRA were also found to have a pelvic floor dysfucntion Eg Incontinence, pelvic organ prolapse. (Spitznagle et al 2007)

What NOT to do!

Typical Sit ups or crunches! This is a no no as it increases your intra-abdominal pressure and your stomach muscles and pelvic floor aren’t ready to cope with that. It can make your bulging worse and harder to recover from. Modified head lifts can be ok under the guidance of your Physiotherapist.
Planks without sufficient Pelvic Floor and TA strengthening first.
Bracing your stomach muscles – this can increase the bulge from within.
High impact sport without inner core and pelvic floor strengthening first.

What can you do about it?

Core exercises to reduce your abdominal separation, especially an exercise called a head lift which aims to ensure your pelvic floor muscles are switched on, your TA (deeper core muscle) is working and a slight head tilt to allow the outer abdominals to contract. Adding extra hand pressure to your muscles to push them closer together and down towards your spine. There is no bulging or doming from the tummy outwards! This is a key exercise of our New Mum Program which is so important given your best chance of recovering these muscles is within the first 8 weeks after birth.
Be careful with getting up from the chair or bed, use compression with a towel or your hands around your tummy for the first few weeks.
Be careful lifting your baby – try to use your pelvic floor muscles and TA as best you can.
Wear recovery support shorts – we love the SRC Recovery Shorts to give you that extra compression and support in your early phase.
Ease back into exercise slowly with gentle walking and a pelvic floor strength and recovery program first.

So even though you might feel like there is nothing you can do, there certainly is. Start with pelvic floor exercises to reduce your abdominal separation, then build up your core muscles through our New Mum Program. Remember the best chance at closing your abdominal separation is within the 1st 8 weeks of having your baby using core exercises.

Want to find out how strong your pelvic floor is?
Take your quiz

Tags abdominal separation, core exercises after birth, core exericses

Education Post Natal Pregnancy

Avoid These Common Pelvic Floor Mistakes

Post author By Melanie Platt
Post date November 22, 2021

I’m sure we’ve all done them at some point to try and get these elusive pelvic floor muscles working but stop right now! These mistakes are preventing you from feeling strong and getting back to the exercise you want to. They are preventing you from stopping your leakage and they are preventing you from having amazing sexual pleasure. Read on to see what you can do instead.

When you are doing your pelvic floor exercises try to avoid theses common mistakes below.

3 most common mistakes:

Tilting your pelvis – now we know this can be great for pelvis mobility and good for sexual pleasure but it does not help with your pelvic floor muscle activation while exercising! You want to find a neutral position with your spine and pelvis. So when you’re lying on your back, make sure your tailbone firmly rests on the ground without moving while you do your exercises.
Squeezing your butt cheeks together like there is a $100 note you don’t want to let go of – This is working your outside buttock muscle (your gluteus maximus) not your pelvic floor muscles. Yes your pelvic floor muscles go from your pubic bone at the front all the way to your tailbone at the back including around your anus but squeezing your butt cheeks is not going to get them working. Instead relax your buttock and focus around your vaginal area to connect with your pelvic floor when exercising.
Clenching your outer abdominals – this is probably the most common mistake I see in the clinic. We’re so used to our rectus abdominis (6 pack abs) working that we forget there are deeper layers of muscles underneath. It’s also very hard to take a deep relaxed breath with these muscles working (hint hint – if you’re struggling to breathe at the same time as pelvic floor exercises this is probably why) Put one hand under your rib cage and the other deep down towards your pubic bone. The hand under your rib cage shouldn’t feel anything working underneath just relaxed and resting while you’re exercising. You can also think about your body being in half – the top is breathing and the bottom is gently lifting and squeezing through your pelvic floor muscles. Remember the feeling is all internal.

Hot Tip: your pelvic floor muscle contraction won’t feel like a big bicep contraction, they are small muscles and they are internal. I think one mistake people make is expecting if to feel like this huge contraction. It won’t, it will be subtle.

Long term we do want our pelvic floor muscles to work with our deeper abdominal muscles with more functional exercises but that is down the track once you have mastered the pelvic floor muscles alone. Our Pelvic Floor strength systems for pregnancy and our new mum recovery program work with you every step of the way. Starting at the basics with video instruction and through to more functional exercises including your deep core and pelvis stability.

Unsure how strong you are?
Or if you can activate your muscles?

Take our Pelvic Floor Quiz for pregnancy or new mum’s to find out how strong you are!

Education Exercise Labour Post Natal Pregnancy

Pelvic Floor Muscles – All You Need to Know

Post author By Melanie Platt
Post date October 19, 2021

Everything you need to know about your Pelvic Floor Muscles

There is a lot of talk about pelvic floor muscles, pelvic floor exercises and kegels lately. Do you think your pelvic floor muscles are as important as everyone says they are?

Do you know what they do? Well that’s what I’m here to tell you about. To let you know everything about your pelvic floor muscles.

These muscles have so many roles and really important ones too:

Help keep your organs inside and lifted
Prevent and stop urinary incontinence
Supporting you during your pregnancy
They help guide your baby into your birth canal
Holding wee and poo in continuously without you even thinking about it
Helping you feel pleasure by arousing your clitoris and increasing the sensation of your orgasms

I’d say they are pretty important muscles! And ones I would want to know about! Wouldn’t you agree?

Especially considering most of this happens without you thinking about it. Pretty intuitive body we have!

Where are these muscles?

They are shaped like a hammock or a half moon running between your pubic bone at the front and your tailbone at the back around in a loop so when the muscles contract they shorten and close off the area. Obviously there is a lot of structures here from ligaments, bones, blood vessels, nerves and connective tissue but the muscles of the deep pelvic floor are:

Pubococcygeus (PC muscle)
Iliococcygeus
Coccygeus
Puborectalis – the muscles runs between the outer layer and the deep layer so it’s more like a middle layer but acts like a constrictor as an outer muscle does.

These make up your Pelvic Floor Muscles (Levator Ani)

So where do things go wrong? Why do the muscles stop working well?

Pregnancy – just the physical load on your body and the anatomy of your pelvic floor is enough to cause issues. Worse if you’re not strong to start with.
Labour – You are at risk of major trauma like perineal tears with a forceps & vacuum delivery. Where instrument use is necessary, episiotomy will significantly reduce your risk of OASI (Obstetric Anal Sphincter Injury – 3rd/4th degree perineal tears) especially if it’s your 1st child and you are needing forceps. OASI is a significant risk factor for anal incontinence. Also just add in the generic trauma associated with labour to this area, the muscles take time to recover and get functioning again.
Genetically – your pelvic floor consists of muscles and connective tissue based on type I & III collagen fibres. These fibres can have a genetic weakness factor, so some people are more prone to weakness in their pelvic floor muscles without any other contributing factors. (Hence why I love collagen support – read more on collagen )
Weight training – heavy prolonged weight training without the appropriate engaging of your pelvic floor or correct technique for your pelvis puts you at a higher risk of having pelvic floor dysfunction.
Coughing – prolonged coughing can increase the pressure load acting downwards on the pelvic floor muscles, if the muscles can’t sustain it with strength or active engagement when coughing pelvic floor dysfunction can occur.
Bowel Straining – As above with the pressure pushing down on the muscles, they sometimes weaken and reduce their resting tone with the pressure against them periodically. Especially if this has been chronic constipation or straining.
Alcohol, caffeine & dehydration – they can make your urine more acidic which can make you need to urinate more frequently which can change the way the bladder works and how it interacts with the pelvic floor. (read more on the bladder)
Pain & Swelling – pelvic pain, back pain, endometriosis etc can make these muscles switch off or slow down like they aren’t quite getting the message from the brain. Not to mention to trauma of birth within the pelvis.

So how does it feel when your pelvic floor muscles aren’t working properly?

Leakage
More frequent urination
Urinating through the night
Feeling of not being able to hold on to your urine (don’t want to jump or run)
Back pain
Lack of sensation during sex
Pain with sex
Constipation
Feeling like everything is falling out down below (heavy feeling)
Feeling your stomach bulging out when you get up of the chair
Lack of pelvis stability (wobbly or not quite working right when you exercise)

Tips to keep your pelvic floor and vagina working well and feeling amazing!

In General:

No soaps/moisturisers with chemicals – can irritate and cause infections.
Pelvic Floor Exercises regularly – start with one of our pelvic floor and core programs see results within 2 weeks. (See programs)
No straining to urinate or do number 2’s – This puts extra pressure on your pelvic floor muscles by increasing your intra-abdominal pressure downwards. This can lead to a pelvic floor dysfunction or to a risk of prolapse. Instead lean forwards with your trunk, lift up your heels so you’re on your toes and relax your pelvic floor muscles.
Pelvic floor muscles activated when doing weights or lifting anything including your baby. This is where you reach a functional level of pelvic floor control. It will make you feel stronger and also protect you from a possible pelvic floor dysfunction or risk of prolapse.
Good quality collagen for type 1 and II fibres to help improve the quality of your muscles and ligaments surrounding your pelvic floor.

Pregnancy & Birth

Ice Pads after birth or Padsicles – to help with the healing process and reduce any swelling. Spray your pad with water and witch hazel (distilled – avoid any that have alcohol in them) if you like, fold the pad back up and freeze in a freezer bag. Let them thaw for a few minutes prior to use, then use up to 10 minutes every hour as needed in the first 24-36 hours after birth.
Warm compress during pregnancy – helps your vulva tissue relax prior to labour.
Perineal massage during the late stage of pregnancy (from 34 weeks) to reduce your risk and severity of 3rd & 4th degree perineal tears, reduce your risk of episiotomies & decrease your perineal pain after labour. Follow the instructions and use a natural based lubricant. (Read more)

Sex

Well lubricated before sex – as the pelvic floor muscles help with stimulation to the clitoris and can increase arousal. Try doing some pelvic floor exercises before having sex in particular the Vagina Wink. Other options include using a natural based lubricant. We love Olive & Bee Intimate Cream.
Urinate after sex – can help reduce the risk of urinary tract infections which due to the increase in frequency of urination and the acidity can affect your pelvic floor muscle function.

Do we always need to do pelvic floor exercises?

The simple answer is yes. But think of it like this, do you always need to eat well to feel good? Or put petrol in your car for it to work? Do you want your muscles to be functioning well when you’re into your 80’s and live a great life being able to exercise and move about like you want to?

It’s also best to have a pelvic floor exercise program that targets your muscles specifically so you can feel what it feels like to you when your pelvic floor muscles are working well. Everyone is different and everyone will feel it differently. Then you can add more functional movements so your body learns to use these muscles again without you thinking about it. Like our programs at PPF!

No matter where you are on your journey we have a program for you.

So what can you do?
Well for starters take this Pelvic Floor Quiz so you have an idea of how strong you are!

Then try our 3 day trial on the PPF App and see for yourself. You’ll feel your muscles in 3 days and really see a difference in 2 weeks.

References:

Okeahialam NA, Wong KW, Jha S, Sultan AH, Thakar R. Mediolateral/lateral episiotomy with operative vaginal delivery and the risk reduction of obstetric anal sphincter injury (OASI): A systematic review and meta-analysis. Int Urogynecol J. 2022 Jun;33(6):1393-1405. doi: 10.1007/s00192-022-05145-1.

Dieb AS, Shoab AY, Nabil H, Gabr A, Abdallah AA, Shaban MM, Attia AH. Perineal massage and training reduce perineal trauma in pregnant women older than 35 years: a randomized controlled trial. Int Urogynecol J. 2020 Mar;31(3):613-619. doi: 10.1007/s00192-019-03937-6.

Abdelhakim AM, Eldesouky E, Elmagd IA, Mohammed A, Farag EA, Mohammed AE, Hamam KM, Hussein AS, Ali AS, Keshta NHA, Hamza M, Samy A, Abdel-Latif AA. Antenatal perineal massage benefits in reducing perineal trauma and postpartum morbidities: a systematic review and meta-analysis of randomized controlled trials. Int Urogynecol J. 2020 Sep;31(9):1735-1745. doi: 10.1007/s00192-020-04302-8.

Education Exercise Post Natal Pregnancy

Pelvic Floor Facts You Need to Know!

Post author By Melanie Platt
Post date February 3, 2020

Physio Mel Platt sitting on her studio floor

When talking about your pelvic floor muscles what are the essentials you need to know?
These small and sometimes seemingly insignificant muscles do a whole lot that you probably don’t even know about and wouldn’t even realise.

Reality is you can thank these muscles for pleasure and avoiding embarrassment!These important muscles form a sling like support system at the base of your pelvis. They work on some level without you even knowing it which is why sometimes they stop working as well as they should. Hence we need as strengthening program to get the working well but also learn to switch them off when needed.

Here are some must know Pelvic Floor facts:

The pelvic floor muscles are made up of Pubococcygeus, Iliococcygeus, Coccygeus & Puborectalis. They sound really long and complicated but make up our superficial and deep layers of the muscles.
Pelvic floor exercises are the same as “doing your Kegels” ( kegels is just the American term. You have no idea how many times i’m asked this)
When pelvic floor muscles are tightened or contracted you get a closing and a lifting sensation of the vaginal walls.
They are important to us throughout our whole life especially as a woman. During pregnancy, the post partum period and onwards.
The muscles play a role in starting and stopping the flow of urine based on a contraction of the detrusor muscles. For more see our bladder blog
Men have pelvic floor muscles too. Surprise, surprise They are important for avoiding the post urinating drip. They can also have issues when the prostate becomes enlarged and presses on the nerves innovating the pelvic floor muscles.
They provide support your pelvic organs from below. Vital for any kind of exercise especially jumping & running. Also anything that causes an increase in intra abdominal pressure Eg coughing, sneezing & laughing.
They play a role with sexual sensation. The pelvic floor muscles help the clitoris become enlarged with contraction and can increase the sensation of an orgasm when contracted at the same time.
Assist in baby delivery. The pelvic floor muscles help guide the baby’s head into the birthing canal when the time is ready.
They are just like any other muscles in the body. They have blood flow, you can strengthen them, relax them and they can become tight and cause other issues.
Slow twitch and fast twitch fibres. Which work like any other muscles, slow to perform endurance type activities and fast to stop the flow of urine quickly.
Pain and swelling can inhibit your muscle control. The same as a lot of muscles in the body when we have pain and swelling it can interfere with the function of your muscles.

So many reasons to be thankful for these muscles! And if you don’t think you know how to activate them or wondering how strong you are? Take our Pelvic Floor Quiz below and find out.

Education Exercise Labour Post Natal

5 Essentials for New Mums

Post author By Melanie Platt
Post date December 12, 2019

As a new mum, you generally forget about yourself and look after everyone else. Hands down it’s about survival. However, I’m here to remind you the 1st 8 weeks are by far the best time for your body to recover!
Research has shown the best recovery gains in your stomach muscle separation and function are within the 1st 8 weeks. Don’t freak out, there are very easy and gentle exercises that you can do at home within this time frame, none of which put your body at risk.
Read on for 5 easy things to do:

1. Work on your pelvic floor from day one! This is so vital and important. Make sure your pelvic floor muscles are working, strong and able to hold everything in. You can start activating your pelvic floor muscles 24 hours after giving birth, regardless of the way you gave birth. Remember you may not be able to feel much happening down there and it may hurt. Keep going slowly and start to connect the pathway from your brain to your muscles by trying daily.

2. Have your abdominal separation checked and go slow. Don’t even think about an abdominal crunch until your separation has been checked multiple times by health professionals and you feel strong within your pelvic floor. You have a window of 8 weeks post baby to really work on getting your separation as close together as it will go. See someone early and start gentle exercises early.

3. Start gentle lower tummy exercises. Transversus abdominis especially, this is a great muscle providing lower back, pelvis and stomach support. Start gently by lying on your back and trying to slowing draw your belly button to your spine without tilting/moving your bottom/pelvis or spine. This is a great one to help activate those deeper muscles to help with your abdominal separation. If you have a separation add gentle compressions with your hands to close the muscles together.

4. If you are keen to get back into running, surfing or more high impact exercise build up to it once your pelvic floor and deep stomach muscles are strong. You need to start by by building a base and this can be done with general walking. Move onto pilates, yoga and more dynamic exercises as you feel stronger, again ensuring your pelvic floor is working during your other exercises. Your hormones are still changing which means your muscles can’t possible be at their maximum strength until 3 months post baby so don’t even think about running or any high impact exercise before this time.

5. I’m all for women getting back into exercise and sport and reaching some kick arse goals but that takes time. This is the time to focus on strength, not weight loss or pre baby body etc. There is no such thing! Your body has gone through something amazing and is like nothing else you will ever go through. You can’t possible expect your body to be like it was. That’s way too much pressure on yourself. Relax, be kind to yourself and take away the pressure. Aim for strength and posture. The weight loss will come later.

I have seen some clients feel good and think their pelvic floor is strong and go back to the gym at 6 weeks post partum and end up with a prolapse. The inside takes time to recover and heal. Focus on healthy choices and gentle movement. My general rule is no running until you can hold your pelvic floor on for 10 full breaths while walking and even then not before 3 months post partum.

Hot tip: TAKE YOUR TIME! Your body needs nutrients to support you and your baby. Be healthy, eat good nutritious food and go slow getting back into exercise. Remember it can take a year to recover from pregnancy and labour. Be patient and kind to yourself, you’re a mum now.

There is help! Join our new mum recovery program and get all the exercises you need for your 1st 12 weeks.

10 exercises/week that are super gentle and don’t take up much of your precious time.

New Mum Recovery Program