Sit ups … the fastest way to a flat tummy after having a baby (I lied)

I’m starting with a little rant. Sit ups, crunches and ab curls, call them what you will, are possibly the worst exercise choice you could make after having a baby. Unfortunately, large organisations like Bounty are still recommending sit ups as a tried and tested way of getting a flat and toned tummy.  This is not only incorrect but (in my opinion) shows a failure to care for the needs of a new mum. Show me the folk that this has been tested on and I might change my mind but until then, let me share with you some information based on fact and science which I hope will empower you to make an informed choice about your tummy muscles.

No amount of sit ups will give you a flat tummy. It is scientifically impossible. Your post baby tummy is not flat for the following reasons:

  1. It has spent the last nine months learning how to stretch (muscles have long memories). Your six pack actually grows extra cells, causing the muscles to lengthen in order to accommodate your baby bump. According to scientists this takes two years to return to it’s pre-pregnancy state.
  2. It takes time for your uterus to shrink back to its regular size and go back to it’s pre-pregnancy place.
  3. The most common reason for a fat tummy is FAT – and the only places you’ll lose fat are in the kitchen (nutrition is 80% of fat loss) and in the gym/park/church hall, wherever you choose to workout.

The humble sit up is literally a contraction of your rectus abdominus or six-pack muscles. If these are distended (as they commonly are post baby), performing sit ups could make the distention worse. If there’s fat on these muscles then all a sit up does is squidge the fat into big rolls and makes you feel rubbish about yourself.

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Sit ups could make common post natal conditions like diastasis recti or pelvic floor dysfunction worse.

Pelvic floor dysfunction is the broad term used for any pelvic floor issues, ranging from accidental pees when you sneeze (stress incontinence) to pelvic organ prolapse. These issues are most common in post natal women and post menopausal women. When you perform a sit up, you increase the pressure inside your torso (you are literally squeezing it). Any weakness in the pelvic floor area could be worsened by repeated pressure on the area. There are worse things you can do for a weakened pelvic floor (running, jumping or high impact exercise being the top three) but ask any Pilates teacher which exercise is most likely to produce accidental farts from participants, and generally it involves loaded forward bending, like a crunch or roll-up.

Diastasis recti is the term used when the sheath that connects both sides of the six pack (which commonly stretches during pregnancy) does not return back to its pre-pregnancy state after birth. This means some women are left with a gap between the left and right sides of the six-pack. It won’t kill you but it is really important to focus on the deeper abdominal muscles, like the transversus abdominis (the big corset like muscles) and the pelvic floor before considering any loaded forward flexion or sit ups. Both my experience and the experience of the physiotherapists I work with has shown that focusing on the pelvic floor can really help ‘flatten’ any abdominal doming caused my diastasis recti.

But my doctor said …

I fully respect medical doctors but they are doctors of medicine and illness. There is a reason doctors refer their patients out to exercise specialists – because a doctor or GP is not an exercise specialist. I am! I would never prescribe you with drugs I know only through personal experience or try to diagnose your illness based on a few symptoms but I can explain a great deal about the post natal body and the associated exercise implications, which is why I work with, and educate medical professionals in my field of expertise.

What’s the difference between Pilates and sit ups?

Pilates is a whole body form of exercise. If you come away thinking, ‘ooh what a great ab workout’ you’ve possibly missed the point. It’s so much more than that. Too much for one rather longer than usual post about flat tummies (for more information check this post out: https://alittlefitter.com/2012/08/30/pilates-whats-all-the-fuss-about-why-bother/). In my post natal classes we start slowly, focusing acutely on the deep abdominal muscles and pelvic floor, really making sure that they are working effectively before sending you out to ‘melt fat’ (love that term – means nothing but wanted to get it into a post one day). No you won’t feel ‘the burn’ like you might in a gym abs blast class but you will be taking care of your still very delicate and very wonderful body.

For more information on nutrition for flat tummies check my post: 10 ways to lose fat and get more energy.

And for more about post natal recover check out this popular post: https://alittlefitter.com/2013/08/02/the-princess-the-bump-your-body-how-long-does-it-really-take-to-recover-after-pregnancy-and-birth/

Karen Laing is a pre and post natal exercise specialist and journalist. Karen teaches Pilates (including pregnancy specific classes) in Epping, Essex and London and blogs about fitness, women’s health and wellbeing at http://www.alittlefitter.com.
Karen co-directs Fit School with her husband Chris. They run fitness classes, ladies only training camps and Pilates classes in Epping and Essex.
TWITTER: @fitschoolessex
FACEBOOK: ccfitschool

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Ante Natal Pilates: What’s all the fuss about?

alittlefitter

So you’re pregnant. Yay!  Congratulations. How are you feeling?

Nauseous? Overwhelmed? Excited? Relieved?

It’s a time of your life when there are so many expectations on you and of how it will feel to be pregnant but when it actually happens, and your body is invaded by a beautiful, yet essentially parasitic baby who is draining all your resources, it can leave you feeling, well, confused.

This is where someone like me steps in. A fitness professional with a passion for all things women’s health, which basically means I care about you being as comfortable and happy as possible during your pregnancy. I also care about ensuring your experience of labour and birth is the best it can be for you and perhaps most importantly, I care about you, as a woman, recovering after birth and getting back to being you!

Yes, ostensibly I’m a Pilates teacher, but given my…

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Is your pelvic floor ready for high impact exercise?

So you’ve had the baby, the stitches have healed, you’ve done a few pelvic floor exercises and you’ve attempted ‘relations’ with daddy. All seems good so far … then one day you get onto a trampoline with your tot or perhaps even attempt jump jacks at the local circuit class and suddenly it hits you. Things just aren’t the same anymore!

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If you don’t know what I’m referring to then you’ve either had a C-section or you’re one of the lucky ones. Exceptionally fast or very slow pushing phases of labour, high reactivity to hormones during pregnancy, big or multiple babies, age at which first baby was delivered vaginally, intervention such as ventouse or forceps and occasionally even a baby coming out at an awkward angle can all damage you up there. And I say up there because that’s the point, it’s just so hard to know what’s going on up there because we can’t see it and until you try to do something energetic you might think all is well!

So is there anyway of screening pelvic floor health to know if you’re safe to start energetic exercise again? The simple answer is no, it’s all very individual and unless you have an ultra-scound scan it can be difficult to get any conclusive, measurable evidence. But all is not lost. There are some good places to start!

How is it all supposed to work?

Think of your trunk or your core like a box of Pringles. The sides of the box are, for the sake of simplicity, your deep abdominal muscles and lower back muscles. The top is your diaphragm and the bottom, is your pelvic floor. If you were to stamp on the packet (not that you would do this) and the bottom was not completely secure, it would pop off, expelling crushed Pringles all over the floor and making a nasty mess.

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The same is true of your pelvic floor. Think of it like a hammock, or a trampoline, it has more give than a Pringle pot’s bottom to allow for some pressure build up but still needs to be able to clamp shut and secure the pressure within. If there’s a little bit of damage, an over stretch or similar then when put under extreme or continuous pressure, like a set of ten jump jacks, it might not hold up to the intensity.

How do I know if mine is damaged?

Again, you don’t know until you try. When it comes to high impact exercise we need to consider how your fast twitch pelvic floor muscles are working. Here are a few key pointers:

  • Do you leak a little when you sneeze?
  • Do you leak a little when you sneeze in a squatting position?
  • Can you bounce on a trampoline with confidence?
  • Can you do a squat jump, jump jack or series of jump jacks without leaking?

Pelvic Organ Prolapse

Now I’m all for exercise. It makes you feel great, helps manage weight and fat stores, can be sociable etc etc but too much high impact exercise when your pelvic floor isn’t competent could lead to further, avoidable problems, such as pelvic organ prolapse. I should also mention at this point that it’s absolutely nothing to be ashamed of, I spoke with a top level physiotherapist/Pilates expert who experience a vaginal prolapse following the birth of her second child due to running too soon. It doesn’t mean you’re unfit, it just means you’ve been injured. You wouldn’t try running with a torn hamstring.

What to do now?

In my next post I’ll be going into more detail on specific exercises you can do to build strength and competence in your core and pelvic floor. But in the mean time, get familiar with what’s ‘up there’. Do do your pelvic floor exercises and whenever you’re exercising remember to engage your core, from your floor. So literally pull up from your tail and your tummy to make sure everything is tucked in! Remember to do slow wave like exercises first, followed by the quick squeeze all the way up and all the way back down AND do exercise to fatigue. A quick squeeze isn’t going to cut the mustard if you’re injured.

Pelvic floor: the key to great orgasms for life.

Last Thursday, I stepped into my presenter boots and discussed the finer points of women’s health to a bright and attentive, female audience at Moody’s, London. Mid way through the presentation I realised I was actually discussing the female orgasm, with full Karen style hand actions, half way up 1 Canada Square! The last time I’d been presenting in a similar environment I’d been discussing user interfaces and SQL programming – oh how life has changed! So it’s time to share some of the more intimate and fun facts about your lady organs.

Orgasms. You’ve probably heard it said somewhere that sporty folk have great sex, or perhaps conversely that older women just can’t be bothered – it’s not worth the effort anymore. Did you know that problems during intercourse could be an indicator of a bigger issue, such as pelvic organ prolapse? Or (and here’s the juicy bit) that you can actually improve the quality and intensity of your orgasms by strengthening your pelvic floor?

Painful sex (dyspareunia)

For some women, penetrative sex is painful. In many cases this can be because of a psychological barrier but there’s a specific pelvic floor condition known as hyper-tonic pelvic floor where the pelvic floor muscles are so tight that any type of penetration is painful. This specific condition needs diagnosis and treatment by a gynaecologist and/or women’s health physiotherapist.

Posture can make a hyper-tonic pelvic floor worse, particularly for those with shortened hamstrings who tend to sit on the sacrum rather than the sitting bones, so a slouchy posture. For women with hyper-tonic pelvic floor, focusing on relaxing the muscles of the pelvic floor is key. This exercise, usually reserved for women in their last months of pregnancy is a good place to start: https://alittlefitter.com/2012/06/12/ready-for-birth-connecting-with-your-rose/

Pelvic organ prolapse

For some women the most obvious signs of a pelvic organ prolapse will be during intercourse. If, for example, the prolapse is coming through the vaginal wall, this will be felt during penetrative sex. Vaginal flatus (fanny farts) during sex are another sign of pelvic floor dysfunction. You need to get these issues checked out. First by your doctor for a referral or you could make a private appointment with a women’s health physiotherapist. Pelvic floor exercises are generally the first course of treatment for any prolapse and classes like Pilates which focus on the pelvic floor and core are a great way of maintaining good pelvic floor health for anyone recovering from prolapse. Here are some great tips on pelvic floor training from women’s health physiotherapist Melissa Millman: https://alittlefitter.com/2012/10/19/how-to-train-your-pelvic-floor-like-an-olympian/G spot and P spot sign

Orgasms

Eve Ensler (of Vagina Monologues fame) reminded the world of the fact that the clitoris has around 8,000 nerve fibres, twice as many as those found on the head of a penis. This little pleasure button is where it all starts. It also happens to be surrounded by the muscles of the pelvic floor AND that the pudendal nerve, the nerve that triggers orgasm, is deeply rooted in the muscles of the pelvic floor. Take your attention further upstairs and it’s the muscle of the pelvic floor and the uterus contracting which gives you (and your partner) that Bingo! moment.

Weakened pelvic floor muscles will generally result in weaker contractions and it’s thought that these primary contractions during the female orgasm, stimulate secondary contractions, as in the big ‘O’. Put simply, the reason sporty girls have great sex isn’t just about their physical stamina, it’s about their great pelvic floor tone.

As women age, have babies or go through the menopause, the muscles of the pelvic floor are prone to becoming weaker and less elastic BUT staying active and keeping up with classes like Pilates can really help improve things in the bedroom department by maintaining or improving pelvic floor strength and tone. I have plenty of anecdotal research (husbands paying for Pilates renewals) to back up this point! It’s not just for older ladies though. If you’ve found sex is leaving you more ‘oh’ than ‘AUUURRGGGHH’ then it’s time to rev up the volume on your core training.

For loads of ideas on training your pelvic floor take a look at the following posts:

https://alittlefitter.com/2012/09/04/ten-ways-to-find-your-pelvic-floor-for-your-friends/

https://alittlefitter.com/2012/08/01/why-women-should-get-intimate-with-themselves/

Ante Natal Pilates: What’s all the fuss about?

So you’re pregnant. Yay!  Congratulations. How are you feeling?

Nauseous? Overwhelmed? Excited? Relieved?

It’s a time of your life when there are so many expectations on you and of how it will feel to be pregnant but when it actually happens, and your body is invaded by a beautiful, yet essentially parasitic baby who is draining all your resources, it can leave you feeling, well, confused.

This is where someone like me steps in. A fitness professional with a passion for all things women’s health, which basically means I care about you being as comfortable and happy as possible during your pregnancy. I also care about ensuring your experience of labour and birth is the best it can be for you and perhaps most importantly, I care about you, as a woman, recovering after birth and getting back to being you!

Yes, ostensibly I’m a Pilates teacher, but given my experience of now 100’s of different pregnancies (I hasten to add just one of my own but 100’s of women I’ve seen through classes and one to one training), my second and third jobs of health writer and mummy, and my growing networks of fellow health professionals I can call on for advice, I like to think of myself as a one stop shop.

So, back to Pilates, if you’ve never done it before you might be puzzled as to why it’s so damned good for those in the pudding club.

Here are just a few reasons based on my experience and the experiences of my beautiful bumps and ladies!

MAKING YOU MORE COMFORTABLE DURING PREGNANCY

  • Pilates is a gentle, mat based class (although can be adapted to use swiss balls etc), and as such is very controlled form of exercise. Perfect for mums-to-be who want to do something positive for their bodies, without risk of injury.
  • When you’re in a class, you’re not exercising alone, so if anything does happen, there are experts on hand to support you.
  • Pilates specifically focuses on muscles in the trunk and pelvic floor, which can all help mum’s body to support a growing baby.
  • During classes we focus on exercises to relieve common aches and pains, like back ache or pelvic pain. Many women, after trying a class, find the relief so great that they sign up for two a week!

LABOUR AND BIRTH

  • Pilates focuses on breathing and relaxation, some of the techniques we use can be used during labour to help you relax, thereby enabling you to cope with pain better (or just take in gas and air without feeling sick)!
  • We incorporate exercises that encourage optimal baby positioning for birth and you can do these at home too. We’ve had quite a few stubborn breach babies go head down after class!
  • We also do gentle pelvis mobility exercises which are essential for easing baby’s head out of that very small space!
  • A strong and healthy pelvic floor is better equipped to both stretch and push during birth. In my classes we don’t just squeeze, we all understand how to train and engage our pelvic floor muscles. Did you know they go virtually all the way up to your cervix!

POST NATAL RECOVERY

  • Whilst Pilates won’t strip belly fat, healthy abdominal muscles do make your waist appear smaller. I’ve lost count of the number of women who have received compliments after doing Pilates because they appear slimmer, even when they’ve not lost any weight!
  • Getting your abdominals and pelvic floor strong again post delivery will ensure you can go back to all your favourite activities without fear of incontinence or prolapse and without risking distended abdominals.

So what would you do in my ante natal Pilates classes? Here’s my take on things: Pilates for Pregnancy

For more general information on exercising safely during pregnancy, check out https://alittlefitter.com/pregnancy-health-fitness/
For more information on classes visit https://alittlefitter.com/classes-and-training/

How to Zumba without fear

What do Zumba, aerobics, trampolining and tennis all have in common?

They all require a certain amount of jumping. Not just jumping up and down with your legs together, in a controlled manner, but launching yourself, legs akimbo and hoping for the best.

Whilst this might have sounded like fun when you were twelve or even before you popped little Lola out of your fandango, if the thought of spread eagled exertion fills you with fear, you are not alone.

A am -of course – referring to that pesky pelvic floor. It might just about hold things together when you sneeze or run but the spontaneous jiggling or jumping in some exercise classes or sports can prove a slightly damp hop too far for some women. And, quite frankly, can put you off.

Now I’m all about getting you moving. And not just you, but your buddies, your grannies and your great grannies too. Your body loves to move about in lots of different directions (in the biz. we call this multi-planar movement) so Zumba, aerobics and multi-directional sports are really good for you.

Here is my plan for strengthening your lady bits so you can enter your next local Zumba-thon without fear:

STAGE ONE: Identify your pelvic floor muscles.

This doesn’t mean do a quick squeeze, this is about getting to know your pelvic floor muscles. A common misconception is that they are just on the outside, controlling your vagina, urethra (wee hole) and anus. However, they go way deeper than this and according to Blandine Calais-Germain, author of The Female Pelvis, it is the deeper pelvic floor muscles, inside your pelvis that are often the cause of prolapse.

As you engage your pelvic floor muscles, imagine the intensity comes from behind your perineum, forwards, as if you were drawing everything up from your tailbone to your vagina.

If you’re not confident that you can engage your pelvic floor take a look at these posts:

https://alittlefitter.com/2012/09/04/ten-ways-to-find-your-pelvic-floor-for-your-friends/

https://alittlefitter.com/2012/08/01/why-women-should-get-intimate-with-themselves/

When you perform the exercises (below) focus on holding the middle layer of your pelvic floor muscles, as if you were trying to hold your bladder, uterus and rectum in position.

STAGE TWO: Hold-Wave-Quick-Relax-Fatigue

There are five key elements of pelvic floor conditioning:

  1. Start by performing controlled holds of your pelvic floor muscles. Keep a note of how long you can hold before you start to fatigue and each time you train, try to beat your time.
  2. Progress to slow wave like movements, where you slowly squeeze up and then release in as controlled a manner as you squeezed. Again, keep a note of how many you can do before tiring and progress with every training session.
  3. Then comes the sprint finish. Quick, strong squeezes, all the way up and all the way down. Make these intense and perform until you lose intensity.
  4. Always relax completely between each contraction (some pelvic floor or even back issues are caused by pelvic floor muscles that are too tight at the top).
  5. Always perform your pelvic floor exercises to the point of fatigue, just like you would with any resistance training.

STAGE THREE: Legs akimbo

Once you’ve mastered the exercises standing or seated, challenge yourself by standing with your legs wide. It makes the exercises much harder but will prepare you for those wild and crazy Zumba thrusts!

How to train your pelvic floor like an Olympian

Last night the lovely women’s health physiotherapist, Melissa Millman came to talk with my pregnant and post natal ladies about the very important subject of pelvic floor.

I’ve interviewed the top gynaecologists and experts in this field for features and I’ve attended workshops with the top women’s health exercise professionals in the UK but I’m always learning. This part of a woman’s anatomy is still the subject of a great deal of scientific research and in particular, its role in sexual function.  I wanted to share some important reminders and some new learnings from last night’s talk.

Conversations with your midwife in your booking in appointment.

How many of you, during your booking in appointment, had a conversation with your midwife about pelvic floor health? Did you know it’s part of the NICE guidelines for your midwife to talk about it at this point (National Institute for Health & Clinical Excellence)? Why? Well prevention is better than cure. If you start training your pelvic floor effectively from ten weeks into your pregnancy you have around seven months to make a difference.

Stress incontinence in early pregnancy.

It’s not all about post natal leaks. Some women experience a little leakage in the first trimesters of pregnancy. Why? According to Melissa it’s most common in women who are sensitive to hormonal shifts. In early pregnancy your oestrogen drops and progesterone rises, this is to ensure your body tissues become lax enough to allow for foetal growth. However, this laxity affects your whole body.

Take the urethra, your wee tube. It’s surrounded by two layers of pelvic floor muscle. One is conscious and can be trained much like you’d train a bicep, but the other is unconscious or involuntary. So in some women, the involuntary muscle becomes a bit too lax and allows leakage. This can be particularly unpleasant if you’re suffering from morning sickness.

Training the ‘trainable’ muscles can help make up for involuntary muscle weakness but also just knowing this is normal and non-permanent can help.

Train until you fatigue

It’s one thing doing a quick squeeze every now and again but if you really want to build up strength in your pelvic floor muscles you need to train them like you’d train your body in the gym – until you reach fatigue. You need to finish your training session and feel like you’ve worked out. The same is true for your pelvic floor muscles.

Slow and quick

Don’t forget that you need to do your quick, strong squeezes immediately after your slow ones. Think of it like warming up in the park before you do your short sprints.

Squeeze before you sneeze

If you are aware of a little leakage when you sneeze, research has shown that if you squeeze your pelvic floor before you sneeze you can minimize the problem.

Never stop!

The biggest age group of women experiencing pelvic floor dysfunction is post menopausal.  You need to work pelvic floor exercises into your life, for life, to ensure you don’t become one of the one in three women who frequently visit the shelves next to tampons in the supermarket.

Pilates and the very post natal participant – banishing saggy bottoms everywhere

WE ♥ GRANNIES. Well in fact in my Pilates classes we love everyone but someone asked the other day, ‘just how post natal can you be to come to Pilates?’

We have a special term for ladies who are on to their second generation of parenting and that is: VERY POST NATAL. Not because we are shy of the grandparent word but because it’s important to recognise the unique needs of women who are peri-menopausal or who have indeed tipped over the other side of hot flushes.

You see (and here’s me chatting about lady parts again) once women enter a certain time of life, hormonal changes, combined with the effects of giving birth some years previous and the lacklustre reality of ageing muscles can spell lady troubles.  Not necessarily big ones but perhaps weaknesses in one’s nether regions that we’d rather weren’t there.

Then you get the whole fat redistribution thing, where your formerly pert buttocks suddenly reappear somewhere around the top of your trousers and your metabolism plummets as your lean muscle mass ebbs off into the ether.

You can do something about all of these things.  Pilates isn’t a cure all for everything but it’s a great start. Especially when it comes to strengthening your buttocks, tummies and pelvic floor to help bolster your body against injuries.

Here are a few things Pilates can really help with for those in their golden years:

  • Balance and reduced risk of falls
  • Reduced risk of prolapse or incontinence
  • Better sex and orgasms – I actually have this on good authority from one participant’s husband who shall remain nameless
  • Improved posture
  • More restful sleep
  • Fewer chronic back issues and/or joint related injuries

I should also add that my oldest male participant was 75 and my oldest female, 80. Both were fabulous and kept up with the youngun’s whilst barely breaking a sweat and only occasionally breaking wind. Mr Pilates was nearly 84 when he died, still fighting fit (he died of smoke inhalation from a fire in his New York studio).