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I've Had A Baby...Can I Ever Exercise Again?

Posted: Thursday, April 10, 2014 at 3:17:36 PM EST by Alyssa Tait

If you are keen to get back into exercise after having a baby, congratulations!

The motivation to exercise after having a baby is a great thing. If you can be keen to exercise amidst a life turned upside down by a wee new arrival, that’s a great start! Returning to exercise after baby has so many potential benefits:

  • improved energy and resilience to stress
  • keeping up with the physical demands of kids
  • a better body image
  • help with your libido

But wait…what about the pelvic floor?

What about wetting yourself on the trampoline, what about your pelvic organs falling out?  Is exercise going to be detrimental to pelvic floor function? Could it even cause irreversible damage?

Some women return to exercise after the baby only to suffer serious setbacks; the mum who returns to netball and becomes incontinent, the mum who starts Pilates and develops a prolapse. These are serious side effects and not only impact on your ability to exercise, but can cause a major blow to your self-esteem. It’s essential that your return to exercise takes into account your pelvic floor “situation” and is graded accordingly.

But how do you know what is safe – how much your pelvic floor can take?

There is no one-size-fits-all approach here. That’s the bad news. Any general advice you hear does not take into account your individual circumstances, such as:

  • Your episiotomy tear took a while to heal and still hurts
  • Bub had a huge head and weighed over 4kg
  • You had pubic symphysis pain during the pregnancy
  • You had a five-finger abdominal separation (diastasis rectus abdominis muscles)
  • You did yoga until the day before you gave birth
  • You’ve been a runner for ten years
  • You put on 20kg during the pregnancy
  • The vacuum didn’t work and they ended up using forceps

All of these factors influence exercise suitability after birth.

The great news is, you can be given an individualised, progressive exercise program based on your pelvic floor risk.

Very recent research allows us to now measure how “risky” a pelvic floor you have after childbirth. Some aspects of this risk, such as your pelvic floor muscle strength, can be changed. An individualised assessment with a pelvic floor physiotherapist trained in this approach can answer such questions as:

  • Am I safe to return to netball?
  • Can I ever run again? If not, how can I keep fit?
  • Is Pilates going to be good for me?
  • Can I do stomach crunches?
  • How can I reduce my risks to the pelvic floor?
  • What other alternatives are available to me – I’m bored with swimming and walking!

If you would like to find out exactly what exercise you are able to do without harming your pelvic floor, give us a call.

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About Alyssa Tait

Alyssa runs Equilibria Physiotherapy & Nutrition, a clinic focusing on integrative solutions for pelvic health issues including all types of pelvic pain, bladder and bowel control issues, fertility, and irritable bowel syndrome.

Alyssa’s website www.equilibriahealth.com.au is an information hub related to all things relating to the function of the female pelvis.

She aims to help as many people as possible restore balance to their pelvis through education, effective treatment and empowering lifestyle choices.

Alyssa enjoys playing the clarinet and rollerblading, though (much to the gratitude of her patients), not while she is consulting.

Connect with Alyssa  |  Facebook  |  Google Plus | linkedin | Twitter

Pelvic Floor-Safe Exercise - The Ten Most Non-Boring Options!

Posted: Tuesday, January 27, 2015 at 2:08:01 PM EST by Alyssa Tait

We hear it over and over again: exercise that's safe for your pelvic floor is walking, cycling, and swimming.

And actually, cycling here probably means boring, easy cycling on flat (as we know that standing cycling puts enormous pressures on the pelvic floor). Or stationary cycling. Stationary cycling so predictable and unchanging that you could do it in your sleep (or that it puts you to sleep). Stationary cycling that may as well be stationary.

(Of course, I am exaggerating. Stationary cycling CAN be made challenging and interesting. But if you find it so, this post is not for you.)

So without a stationary bike, or in the absence of living on top of a plateau or a vast, unchanging plain, we are down to walking and swimming being our options for pelvic floor - safe exercise.

Boring!

Now, perhaps you love walking. Perhaps you find it stimulating and regenerating, and it fulfills both your physical and mental health requirements of exercise. But if that is the case, you will probably not be reading this blog post (or will stop reading it at this point).

So let's think laterally. What are some other options...

...for exercise that is a safer option for your pelvic floor, whether you have (or are at risk for) incontinence or prolapse? And/or, you have ever had a baby or been pregnant and actually want to exercise again? And (rather more self-indulgently) what is my favorite option?

Let's look at the requirements for pelvic floor safe exercise.

We are looking for

Low impact.

No excessively high intra-abdominal pressures generated.

This generally translates into no jumping, no running, no heavy weights, no sit-ups or crunches, and no uncontrolled/unexpected movements.

Sadly, this seems to rule out all forms of running, jogging, racing and fun-runs, virtually all team sports, most gym classes, most standard personal training sessions, boxing, and most styles of dancing, whether Latin, ballroom, modern, ballet or just leaping around the room to your favorite opera or hard rock album.

I would like to interject in my own blog post here. (That is one of the major benefits of blogging - that no one can stop you interjecting). I am not saying that all of these restrictions apply at all times for all women at risk of pelvic floor problems.

In fact, despite the excellent intentions and professional expertise behind these standard pelvic floor safe exercise recommendations, I believe that the best action any woman can take is to have an individualised assessement of her exercise "risk" via a pelvic floor examination with an experienced pelvic floor physiotherapist that offers this expertise.

(Ask your pelvic floor physiotherapist how specific they can be about your exercise risks upon having an assessment, and keep searching until you find one who will offer you more than the general recommendations). Individualised pelvic floor assessments have evolved in the last few years with pelvic floor physiotherapists undergoing further research-based training to give you much more individualised exercise advice than ever before. How, you ask? Ve have vays, my friend, ve have vays!

But until you have had an individual assessment, your safest non-walking, non-swimming options which are possibly the least boring, include:

Tai Chi.

Yoga.

Belly dancing.

Rock climbing.

Pole Fitness.

Scootering.

Skateboarding.

Surfing.

Rollerskating.

Rollerblading (i.e. inline skating).

Please don't take this list absolutely at face value. All return to exercise - and, especially, starting a new exercise regime - should ideally be advised upon by your pelvic floor physiotherapist and based on individualised assessment, that is, assessment of YOU.

More about these fantastic options for your new exercise life in a future blog post.

And I plan to play favourites here. The final option - rollerblading - being my favourite option, will have its own blog post devoted to it.

Prepare to kiss boring exercise goodbye!

Any other suggestions for fun pelvic floor-safe exercise? Let's have a conversation about it!

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About Alyssa Tait

Alyssa runs Equilibria Physiotherapy & Nutrition, a clinic focusing on integrative solutions for pelvic health issues including all types of pelvic pain, bladder and bowel control issues, fertility, and irritable bowel syndrome.

Alyssa’s website www.equilibriahealth.com.au is an information hub related to all things relating to the function of the female pelvis.

She aims to help as many people as possible restore balance to their pelvis through education, effective treatment and empowering lifestyle choices.

Alyssa enjoys playing the clarinet and rollerblading, though (much to the gratitude of her patients), not while she is consulting.

Connect with Alyssa  |  Facebook  |  Google Plus | linkedin | Twitter

Get Ready to Shimmy: Belly Dancing For The Pelvic Floor

Posted: Tuesday, January 27, 2015 at 2:03:16 PM EST by Alyssa Tait

Ever been drawn to the exotic world of belly dancing? Feel intrigued but a bit scared at the same time?

You may have some of the same questions I did.

My last post brainstormed some options for pelvic floor-safe exercise that aren't boring. So here, as promised, is the first in a series that goes into these fabulous options in more detail, especially from the point of view of the pelvic floor.

In this post I interview Lorelle Hawes, experienced belly dancing teacher and physiotherapist.

We talk about the reasons it's a pelvic floor safe exercise, when to start post-partum, and the lure of the music!

Can you summarise your background – how long have you been teaching, and how did you get into belly dancing?

I first tried belly dancing back in 1990, my final year of physiotherapy. The UQ Sports Association was running an 8 week course and a friend convinced me to come along. She dropped out after a couple of lessons, but I was instantly hooked! I think I taught my first class in about 1993, but didn’t teach regularly until about 1997. For the last 5 years, I have only taught as a ‘relief” teacher and try to keep my hand in by attending classes when I can. lorellehawesbellydancing

What do you love most about belly dancing?

I would have to say the music, and how your movements are intimately guided by the music and the emotions that it evokes. Whether it’s plaintive vocals, energetic drum rolls or complex orchestral arrangements – your body has an answer!

"Your body has an answer!"

What advantages does belly dancing have over other forms of dancing – and exercise in general?

Belly dancing doesn’t feel like exercise. It is fun, creative, sensual and expressive. There are many different Middle Eastern dance styles taught under the umbrella of belly dance so you never get bored. Belly dance is accepting of all body types and ages, so it is accessible to a wide range of women. Just in case anyone is wondering, you don’t need to expose your belly in a belly dance class  - but of course you can if you want to!

"Belly dance is accepting of all body types and ages"

What makes belly dancing pelvic floor-friendly?

On the whole, belly dance is low impact and you can pace yourself within the class environment. It is a woman friendly environment and the pelvic floor is often referenced during a class.

You don't need to expose your belly in a belly dance class - but of course you can if you want to!"

Any warm up exercises a woman should learn before launching herself into the world of belly dancing?

Not really, a good teacher will always start with a warm up and break down new movements slowly.

Is there any special care a woman should take if she has a prolapse?

Yes. There are some folkloric styles that involve some light jumping, so be careful with that. Also, there are some movements that can potentially bear down on a prolapse if the pelvic floor is not responsive. For example strong undulations/belly rolls; sharp hip movements and vigorous shimmies. Ideally, the pelvic floor co-contracts with all of these movements to counter any downward pressure, but if you have a weak pelvic floor you should ease off the intensity with which you perform these moves. There may be some moves you will want to avoid if you feel downward pressure.

"Ideally, the pelvic floor co-contracts with all these movements"

How soon can a woman start belly dancing postpartum – if she has never done it before?

I would say 3- 6 months.  I will never forget one of my past students turning up to class 4 days after having had her baby! That was definitely not on my advice! She was so passionate about it and couldn’t bear to miss anything.

Does a woman need to think about her pelvic floor while belly dancing?

If you do have some pelvic floor weakness then take care with the above mentioned movements. When you are learning new movements, you should be cued to draw in your lower abdominals frequently during class – take that as a prompt to also draw up the pelvic floor. However, once you have the basics under your belt, you should be able to enjoy dancing freely.

"You should be able to enjoy dancing freely"

Some critics say belly dancing might over-emphasise the global abdominals. What are your thoughts on this?

Compared to a typical gym or Pilates class where you might be performing curl ups and table top exercises, belly dance is far less focussed on the global abdominals. A lot of belly dance movements are generated through the legs only to look like an abdominal action. We do use the oblique muscles (and quadratus lumborum) quite a lot  to achieve different movements, but there is usually no resistance, including from gravity, involved.

"A lot of belly dance movements are generating through the legs only to look like an abdominal action."

How might a woman find a good belly dancing teacher?

It is trial and error to find someone whose teaching style you enjoy and are comfortable with. There are no regulations governing belly dance teaching. I would advise to ring around and ask the teacher how many years she has been teaching, how many people in class (ideally less than 20) and whether she has any group exercise teaching qualifications. If you have a prolapse, let her know, so she is aware you may pace yourself or modify some movements to suit.

I must admit, I would not recommend belly dance to women who have no pelvic floor contraction. There are many moves where you would hope there is automatic co-contraction happening.  However, compared to sports and most gym classes it is PF friendly.

Thanks for the opportunity to be part of your blog!

Thank you Lorelle, and shimmy on!

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About Alyssa Tait

Alyssa runs Equilibria Physiotherapy & Nutrition, a clinic focusing on integrative solutions for pelvic health issues including all types of pelvic pain, bladder and bowel control issues, fertility, and irritable bowel syndrome.

Alyssa’s website www.equilibriahealth.com.au is an information hub related to all things relating to the function of the female pelvis.

She aims to help as many people as possible restore balance to their pelvis through education, effective treatment and empowering lifestyle choices.

Alyssa enjoys playing the clarinet and rollerblading, though (much to the gratitude of her patients), not while she is consulting.

Connect with Alyssa  |  Facebook  |  Google Plus | linkedin | Twitter

When was the last time you felt exhilarated?

Posted: Tuesday, November 3, 2015 at 11:56:21 AM EST by Alyssa Tait

This morning? OK, this post is not for you…it’s for the rest of you, which would have included me at one point.

There’s lots of talk about stress. Plenty about depression and anxiety. But far less about positive human experiences. That’s why I want to talk about exhilaration today.

Exhilaration is a hard feeling to define but one we instantly recognise. It’s a sense of freedom and quiet inner joy. It’s when you feel a sense of rising above the banalities of life. You are lost in the moment.

Something like what I’m calling exhilaration has been described well in a book called “Flow” by Mihaly Csikszentmihalyi (and if I’d been able to spell his surname from memory, that probably would have been a cause for momentary exhilaration.)

Abraham Maslow, in classic psychology literature, talked about something he called “peak experiences” in life. I’m not sure that that is quite the same as what I’m describing, in that peak experiences are described as “rare” and “exciting” –  whereas the experiences I’m referring to don’t need to necessarily be grand or exceptionally memorable. However, he does use the term “exhilarating”, which is the feeling I’m describing here. We might call them “peak moments”, and they are worth pursuing.  

I have felt this sense of exhilaration in many contexts:

  • Running while listening to music through various times in my life… lost in Angels & Airwaves, Placebo, the Cure, Queensryche (although you may not agree with the specifics, feeling exhilaration while absorbed in music is a common experience)
  • Playing the clarinet alone in my room for hours
  • Doing astanga yoga in silence in a room full of yogis with Krishna Dass thumping through the speakers
  • Singing with a huge choir at maximal volume
  • Riding my bike down a hill at breakneck speed through Toohey Forest (actually, I’m not much of a daredevil, and the “breakneck speed” is undoubtedly mainly in my own mind)
  • Rollerblading at maximal speed
  • Rollerblading at maximal speed while singing at (submaximal) volume (aren’t you glad you don’t live in my neighbourhood?)

I’ve had periods of my life when that feeling of exhilaration was lacking, or at least very rare. This is not the same as being depressed or even apathetic. It’s almost more a “forgetfulness” about how to experience the full range of inner experiences. Now, before I get any more philosophical, let me defer to an expert.

Csikszentmihalyi (yes, I had to look back to spell it) presents some aspects of a concept called “flow” that describe what I’m attempting to here.

  • Complete absorption in what you are doing
  • Merging of action and awareness
  • Loss of reflective self-consciousness (this describes well the rollerblading + singing example above!)
  • Distortion of temporal experience – meaning time passes faster than normal

As suggested by the last point, you “lose time” when you feel exhilarated. But in a strange way, you gain time as well, because nothing exists except in that moment. It is the ultimate experience of living outside of time.

Why am I writing about this? Because I think we underestimate how incredibly valuable this experience is for our health and well-being.

Euphoria is known to relate to the production and binding of endorphins and endocannabinoids in the brain. These are involved in the experience of the so-called “runner’s high”. Interestingly, the experience of music involves these substances as well as dopamine (the “reward” neurotransmitter).

Producing endorphins enhances your stress response and is linked with feelings of pleasure.

Sounds like something we should all be pursuing a bit more, don’t you think? What’s your favourite way to experience exhilaration?

 

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About Alyssa Tait

Alyssa runs Equilibria Physiotherapy & Nutrition, a clinic focusing on integrative solutions for pelvic health issues including all types of pelvic pain, bladder and bowel control issues, fertility, and irritable bowel syndrome.

Alyssa’s website www.equilibriahealth.com.au is an information hub related to all things relating to the function of the female pelvis.

She aims to help as many people as possible restore balance to their pelvis through education, effective treatment and empowering lifestyle choices.

Alyssa enjoys playing the clarinet and rollerblading, though (much to the gratitude of her patients), not while she is consulting.

Connect with Alyssa  |  Facebook  |  Google Plus | linkedin | Twitter

Avoiding Muscle Soreness of Olympic Proportions

Posted: Tuesday, August 16, 2016 at 9:03:55 AM EST by Alyssa Tait

Inspiring watching the best athletes in the world, isn’t it? It makes you participate in your chosen physical pursuit with just that bit more enthusiasm…until you wake up the next morning and every movement is agony, and you realise you overdid it.

You’ve got DOMS (delayed onset muscle soreness).

catweightlifting

So is it just a lack of conditioning? Just need to improve your fitness? (Just push through. No pain, no gain, right?)

No way.

Of course you are likely to get less DOMS as you get fitter, particularly if you keep doing the same thing. But the amount of DOMS you experience along the way has everything to do with the biochemistry of nutrition within your cells.

To fix it, we need to understand what actually causes DOMS (without the boring detail). So in a nutshell:

They used to say DOMS was caused by “a build-up of lactic acid”. More on this later. But for now, it’s worth knowing that:

DOMS is a reflection of injury to your muscle cells.

That’s right. When you wake up feeling every muscle in your body, and you say you smashed yourself at the gym, you are pretty much right.

Get your muscle cells under a microscope and you’d see all the signs of inflammation and muscle damage.

Does that mean you just have to progress slower? Stick to a more tame level of activity?

Thankfully not. It would kill me with boredom to do a progressive walking, gym or jogging program.

{Everytime I go on a group inline skate I am feeling it in every fibre of my body for several days. If I backed off and took it gradually, it would take me months to work up to it and I would have a whole lot less fun in my life.)

By optimising your nutrition before and after your chosen pursuit, you can have your cake and eat it too.

(Well uh…maybe not cake.)

But does this mean expensive, fancy, hard-to-get supplements? Not at all. There is lots of research for things that might either be in your kitchen, or in your vitamin cabinet.

So what does the research say about food, plant extracts, and nutrients to prevent/reduce DOMS?

Eat straight after the workout, preferably a decent amount of protein.

Take a relatively modest dose of antioxidants (vitamin C and vitamin E) for the ten days leading up to the workout.

Take fish oils, 6g/day, for 7 days before the exercise bout.

2.7g/day may be enough if done for 30 days before the exercise (that is, taken as a daily supplement).

Take curcumin (an extract of turmeric spice) twice a day, 2.5g.

Ginger 4g/day for the 7 days before the workout won’t help the DOMS, but will accelerate your muscle recovery.

Simple as that? Well, probably not.

The amount of DOMS you get is also affected by the general health and functioning of the cell – your cellular nutritional biochemistry. There are many things that can go wrong here even with apparently normal, healthy people.

If you are bothered by bad DOMS which is affecting your life after exercise, see a clinical nutritionist trained in functional medicine.

We can select the right tests to diagnose the underlying problem and get you active and loving it, minus the price tag of the severe DOMS afterwards!

Enquire about an assessment now.

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Tags: DOMS, exercise,
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