core

This one thing may delay you feeling "normal" again after baby.

After having a baby there is all the talk about getting back to normal.

What is normal really?

Why is it so important to get back to anyway?

After having two children and working with countless new moms I'm here to tell you,

You're never going to normal again, and it's okay!

Normal is over rated.

Normal can be boring.

You, mama, are anything but over rated and boring.

You are wonderfully unique!

Let's embrace your non-normalcy.

If what you seek; however is feeling connected and in control of your body after having your baby, then that is a WHOLE other story.

Pregnancy and birth can be a joyous, unpredictable, whirlwind of a time. Your body changes so much that it can be hard for your systems to keep up.

Leaving you feeling disconnected and out of control of basic functions, like holding in pee when you sneeze.

I get it if that is what you mean by normal.

Of course you want to feel in control of you body again.

And over the next year after baby is born your body will naturally find it's way through healing and for the most part you'll feel normal.

Unfortunately, this is not the case for every mom, for various reasons.

Birth injury, medical interventions, csection, episiotomy, epiderals, long labors and pushing, really quick labors, these different factors play a role in how long your body will heal.

Not to mention all your past injuries and habits.

But the one thing that I've seen as a common thread despite the type of birth, injuries etc is breastfeeding.

After delivery your estrogen levels plummet. Then remain low if you breastfeed.

Why does this matter?

Estrogen plays a large role is tissue function, especially in your nether regions.

Just think a mini menopause after delivery, dry, thin, weak, itchy vagina (though really your vulva but you get the idea).

When this happens the pelvic floor doesn't function 100%.

And this can last the whole time you breastfeed.

I experienced it with my daughter. I breastfeed for 2 years, about 3-4 months after stopping, I felt like a different woman.

Now, I'm not telling you to stop breastfeeding, heck my little guy is nurse sleeping as I type. Only you and your baby can set the timeline.

But be aware that some of what you are experiencing with pelvic floor dysfunction or how your feeling may be partially due to low estrogen from breastfeeding.

Once I tell my patients this I usually see a wave of relief. That no you aren't crazy, yes you're doing everything you can do to mitigate the symptoms your having.

So I ask again, what is normal? Do you really want to be normal or just in control again of your body?

If you want help finding your normal reach out to me by setting up a free consult call. We'll figure out your next step together!

Reconnect to your Body like a Baby

As my son becomes more active and works really hard to crawl [forward] I can see how similar movement patterns in babies are like those I use with my moms.

Most of us can picture the stages of gross motor development in infants. They start off as blobs not able to move much and when they do move they expend a tremendous amount of energy. Gradually being able to pick up their head, lift their arms and legs while on their back, push up while on their belly, roll, and so on.

There are similar movement patterns that we look for in all babies, but how they achieve those goals and how long it takes them may be slightly different for each baby.

Typically they can't move on to the next skill until they've mastered the one before. And even when the skill has been mastered, they may relapse a little when they are working on the next skill.

Babies have very little core strength to start with and need to build it up through movements that start in positions where gravity has no influence on their core. These positions are on their back, stomach and side.

Then they are able to gradually work into a sitting position. Then kneeling, hands and knees, and eventually standing. Standing takes the most amount of effort to stabilize the body against gravity before they start to move in a standing position. Even in each position babies pause to find stability and balance...like rocking on hands and knees before crawling.

There is a reason why babies work through different stages to find and build core strength. They have to create stability in the trunk before they gain mobility in the limbs. The further away an object from their center of gravity the harder it is to control. Think lever arms from physics - even a light object can feel heavy is you hold it away from your body.

Remember when you were a kid on a see-saw (teeter-tauter) and if you were evenly balanced with the opposite kid you would either have to had another kid which ever side was lighter or the heavier kid could move closer to the center.

We are hard wired to work on being stable around our center of gravity [belly button/low back area] then work outward.

This is why when your core is weak after having a baby reconnecting to your core LIKE a baby makes the most sense.

Finding balance through very little movement in positions that don't require work against gravity and working to more dynamic movement that require work against gravity.

The big difference between your body and baby is your body as the influence of years of other habits and patterns intertwined into the weak core. Tight muscles, poor posture, joint position, injured tissue [scarring], uncoordinated muscles etc.

These all influence how your body will reconnect.

So simply doing "core" exercises on your back may not be enough.

Recognizing the influencers, using props and modifying the movements to reduce the effect they have on your body, then working through the natural progression of movement will help you achieve the most connection to your core.

And just like your baby, it will take you time, you may relapse a little on a past movement when you move on the next step, you may get frustrated when you can't do what your mind is telling you to do and you'll be super excited when you do achieve your goal.

You may THINK lying on your back and doing breathing exercises or arm raises are super easy. But when you have to incorporate your alignment, good posture, stability and breath, it's not so easy at first.

So when you resume core exercise after having a baby, think of it this way, simple to complex movements are the way to go.

This is how I work with my clients and how the way I progress the core exercises in my almost complete 4th Trimester program in Expecting Pelvic Fitness.

If you're ready to start reconnecting to your core but don't know how to work through the different positions let's chat!

Or head over to Expecting Pelvic Fitness to learn more about the almost finished but still available to purchase 4th Trimester program!

 

Running after Birth: How to Safely Run with Baby

Running with baby can be a great way to get your endurance exercise on without having to carve out time away from baby.

However, there are many factors that need to be considered when running with baby to make sure you are supporting your body as it continues to heal from birth.

Factor 1

You have been cleared by your OB/Midwife to exercise. Even if you ran prior to and during pregnancy you'll want to discuss returning to exercise with your birth practitioner.

Your body just went through tremendous change, quickly. Whether you had a natural vaginal delivery, a csection, episiotomy, tearing, or other trauma your body has to heal.

Much of your tissue healing will occur in the first 6-8 weeks after delivery. But this doesn't mean you're fully healed. But it does give your birth practitioner an idea of how well your body is healing and when you may be ready to return to more rigorous exercise.

Factor 2

Be screened for a diastasis recti. Most women have some form of abdominal separation during pregnancy, which should heal on it's own over the next year after birth.

For those with a diagnosed diastasis recti, it takes more support to regain full functioning of the abdominal wall.

Running takes a lot of core activation to support your joints and pelvic organs. If your abdominal wall is not up to coordinating with the rest of your deep core to withstand the forces placed on the body, it can cause imbalance in the intra-abdominal pressure. This can lead to incontinence, pelvic organ prolapse, low back or pelvic pain, or a hernia.

Factor 3

Make sure you can do a proper pelvic floor contraction.

If you have never had a pelvic floor assessment, testing what your pelvic floor awareness and control is, this is a must after birth.

It gives you a chance to deepen your understanding and awareness of the pelvic floor. Find out how pregnancy and birth affected your pelvic floor, even if you had a csection.

Your pelvic floor has to do A LOT of heavy lifting when running.

Every time your foot hits the pavement the pelvic floor contracts to protect your organs, joints and prevent any unwanted pee or poo escaping.

If you don't know how to voluntarily contract the pelvic floor, your body won't know how to do it on demand.

Leaving yourself at risk for causing [more] damage to your pelvic floor leading to incontinence and prolapse.

Factor 4

Timing your run to avoid breast issues.

When you breastfeed running can be a challenge for many reasons.

One, your breasts need more support.

Two, baby may want to eat in the middle of a run.

When breastfeeding your breast tissue is more susceptible to damage. The force placed on the breast tissue when running is tremendous and unfortunately you can't just contract your pectoral muscles to keep your breasts stable.

Side note: yes, having strong pecs will help with breast support, but typically these muscles are tight in postpartum, so don't over do the chest presses.

The best way to support your breasts is to double up your sports bar. You want to make sure there is no to very little movement of your breast tissue as you run. But also not be too squeezed that you are cutting off blood supply. This will reduce the shearing that can occur on the ligaments and milk ducts, as well as reduce friction on the nipples, while keeping proper nourishment to the tissues.

The second thing you'll want to do is time your run to just after a feeding. This reduces the size of your breasts prior to running, so less needs to be supported, but also making sure you don't get engorged while running. Avoiding the risk of blocked milk ducts and blips.

Factor 5

Start off slow [even if you ran before and during your pregnancy] and always warm up.

Warm up with some dynamic stretches like knee lifts, leg swings and arm circles.

Then begin with intervals. Walk 5 minutes to get your blood flowing then run for 1 minute. Really focus on proper form during that 1 minute versus going as fast as possible. Gage what feels right in your body [which will be different for everyone], my stride will be different than yours which will change my pace. Going too slow will also be awkward. 

Doing intervals will give you time to really tune into your body as you build your endurance and stability for longer run periods.

Then to avoid tight, achy muscles afterward. Cool down with some static stretches or rolling out your fascia.

Factor 6

Lastly, don't be a robot.

Allow your trunk to twist when you run. Just a little rotation through your spine and pelvis is necessary to run in proper form. It gets your abs and hips really working and improves your overall spine mobility.

This can be challenging when you are holding onto a stroller, so you can do one of two things [unless you figure out another safe way!].

One, hold the stroller with one hand allowing yourself the freedom of movement through the other arm. This is helpful if you have less than optimal shoulder mobility, which is common in postpartum from breastfeeding and carrying baby. There are two caveats to using one arm...you want to switch it up and it's harder to control.

You will want to change which arm holds the stroller, so you aren't always using one arm. This will ensure you are building up strength in both arms and allowing both sides of your body to be mobile.

Plus, using one arm may be harder to control the stroller, especially if you are on uneven pavement or surface.

Two, improve your shoulder mobility, so you can twist with anchored arms. Doing exercises that increase your shoulder/rib disassociation is ideal in postpartum, not only for running but for other tasks through out the day. One of my favorites is a kneading action (bending the elbows) through the arms while on all fours.

There you have it!

The major factors you should be considering before running with your baby [or running in general]!

If you've checked all these factors and feel ready to run...have fun!

If you don't know where to begin, comment below or send me a message, we'll figure it out together!

Breastfeeding...Tips to Reduce Upper Back Ache

My first experience breastfeeding was in an ER.

My delivery was pretty by the book. I went into labor Friday night, I was able to sleep between the contractions, we were up by around 7:00 am and two hours later I was to the point I couldn't stay home anymore.  We arrived at the independent Birth Center by 9:00 am.

I tried the tub...man was that hot and not for me...even though I LOVE water.

But clearly my body was saying, nope and I respected that.

Instead I climbed into the queen sized bed and pushed on my hands and knees.

Everything was going well, as far as I could tell...even though I joke with my husband that I only dropped the f-bomb once, he chuckles and says if you say so.

But even though I was in pain I was riding the waves of it, resting in between and in a total state of euphoria.

It was REALLY hard work, but I have a hard time describing just how painful and hard of work it was even just 3 years later.

Mostly, I remember things being in a haze around me, the midwives encouraging me, my husband by my side, my mom helping me stay hydrated.

But then, everything changed.

The midwives had me flip onto my back. They insisted I get my baby out.

So after a few pushes her head emerged.

This is when things really get blurry.

Apparently, unlike other circumstances when the umbilical cord is wrapped around a newborns neck it can be removed or does so on it's own during decent.

This was not the case for our little one.

I was strangling her with every push and if I had kept going she may not be here with us today.

This is why the midwives think it took me as long as it did to actually get her head out.

So instead of being able to keep her cord connected as long as possible, as my plan intended, they needed to cut it even before she was fully delivered.

I had 30 SECONDS to get her out after they cut the cord!

Well let me tell you there was no amount of time you could have told me to get my baby out if I knew her life was on the line.

Needless to say with that last push, she was born and I tore.

They placed her on my belly and told my husband and I to rub her vigorously to try to get her to cry.

This didn't work.

They removed her from my belly and had to perform rescue breathing on her to get her to breath.

It has been 3 years and I still tear up thinking about how our vivacious, head strong, wonderful daughter may not be with us, if my awesome midwives hadn't been on the ball.

Within minutes the ambulance came to pick her up and bring her to the hospital.

I was not able to go with her because I tore and needed stitches before I left.

So last I saw her was partially limp, but breathing on  the bed next to me.

My husband followed the ambulance and my mom stayed with me as I was cleaned up.

When I arrived at the hospital, the nurse at the ER desk didn't seem very concerned that there was a newborn infant waiting for her mother in one of the rooms and it felt like eternity to get me back to her.

My midwife was not impressed and rather cross.

When we finally arrived, my husband had our daughter all bundled up and was letting her suck on his finger with sugar water.

The whole time I was being cleaned up and driven over to the hospital and then waiting to be reunited, I was petrified that I wouldn't be able to breastfeed because we had been away from each other too long.

I climbed into an ER bed, in a dark room tucked away from the hustle and bustle of the other goings on and my daughter was handled to me.

When I held her to my breast, it felt so awkward and she seemed so tiny that I was fumbling. But my midwives again encouraged me my daughter latched.

It was a miracle.

We were fortunate that we had no issues nursing, after I was so terrified that I wouldn't be able to.

We went on an nursed for 2 years.

I can't say that through those 2 years it was all sunshine and roses though.

Hello teething!!!

She never really bit, but holy cow her suck became so strong to sooth those tender gums.

But the trickiest part for me was finding positions that wouldn't hurt my neck and back.

She was a nurse to sleep kind of girl.

And sometimes, she would stay nestled in my arms for hours and any time I moved she would scream.

So if I wanted her to nap, I needed to stay put in my rocker.

Fortunately, we found a super comfy glider, rocker combo with ottoman, but even that wasn't enough.

I had pillows galore and would stuff them in all the crevices to get me from slouching down to meet her.

This helped, but still my muscles would ache.

Of course being the physical therapist that I am, I was determined to stop the ache.

This meant not only making sure my posture was in good alignment or that I switched up the position I was in so I wasn't always using the same muscles but I stretched.

I stretched my neck, chest, upper back, hips and buttocks after every feeding.

But stretching isn't enough to make sure you don't slouch. Our core plays a HUGE roll in our posture. After pregnancy and birth our core muscles have to heal, shrink, and remind themselves what their roll is.

Most of the time, they need our help.

This meant when I was sitting or lying down or standing while nursing I did sets of pelvic floor and core exercises.

Some of you may question me when I say exercise, when I not breaking a sweat.

But exercising a muscle does not always require us to be jumping around or moving our whole body to gain benefit.

Actually, in the postpartum period smaller, slower, more intimate exercises will help you heal and get back to those more intense, vigorous exercises without long term issues.

So to recap my tips:

  1. Make sure you are in good posture while breastfeeding. This means if you are sitting - not sitting on your tailbone, bringing the baby to your breast and supporting with as many pillows as necessary. If you are lying down try to switch up the sides you lay on and again prop baby until she is big enough to not need support. If you are standing, the easiest way to breastfeed a newborn without a carrier is in football hold.
  2. Stretch. Tight muscles will lock in the chemicals that help our muscles to work, but over time this build up and constant shortening and pulling on the joints will cause pain. So balance out your muscle by stretching those that are most shortened while nursing. Try out these!
  3. Work on your Core. Starting simple and easy with breathing exercises is the best way to reacquaint yourself with your core. If you had pelvic floor trauma or a cesarean this reconnection may take longer and you may need help from a specialist to figure out what muscles your are targeting and if there is anything may be inhibiting your reconnection, like scar adhesions. Check this video out!

To find out more about proper nursing postures, postpartum stretches and reconnecting to you core sign up here for your free consultation with a maternal pelvic health specialist.