Got a great new question on the perinatal fitness community I run. This one comes from Australia.
She wanted some more specifics on weight training during pregnancy.
Here are my thoughts in no particular order:
-All preggers SHOULD lift weights throughout pregnancy (obviously I mean healthy, non-complicated pregnancies)
-Really, all the "rules" for non-preggers apply such as technique, breathing, core engagement and are just the same (don't hold your breath, focus on good technique, etc.)
-Weight training is a great way to avoid gestational diabetes (I would argue a better way than cardio if I had to pick between the two)
-If you have been lifting regularly before getting pregnant, there is no need to stop. As the trimesters go along you will naturally lower the intensity (good idea). But don't be another one of those women who lifts the little itty bitty pink dumbbells for a million reps! Long sets with no resistance wastes your time. Lift something challenging but that leaves you with a few more reps in the bank. You should finish your sets slightly uncomfortable.
-If you haven't been lifting before getting pregnant, definitely get started! Obviously, just like a non-pregger, progress and get some professional advice on technique and appropriate exercises. The old advice that you can't start new physical activities during pregnancy is crap.
-Heavy squats, deadlifts, etc. do put a lot of pressure on the pelvic floor and can make hemorrhoids worse. Depending on your situation, this may be an area to make changes during pregnancy workouts.
-Work the whole body, including legs, back, chest, buns, core, and arms.
-I don't advocate crunches during pregnancy (or after). Other core work is more appropriate.
-Focus on the back and the posterior chain to help posture and avoid pain
-Learn to control your scapulae to avoid new mom neck and shoulder pain
-Focus on standing exercises (use free weights and cables). Obviously don't lay on your belly after it gets uncomfortable (generally after the first trimester but for some women sooner, especially if it's not the first baby)
-Laying flat on your back gets uncomfortable too as your belly grows so limit to a few minutes or avoid. It's no longer an absolute ban like it used to be as all women are different. If you are one of the ladies who gets uncomfy or dizzy, avoid exercises on your back. Seated or inclined is another option.
-Yes you can lift things over head (contrary to old wives tale), just watch that you can maintain a neutral curve in the lumbar spine.
-Training uses up calories so make sure you eat before and after. Also drink water before, during, and after.
That's all I can think of for now! Remember, pregnancy is not a disease and pregnant women are not ill.
Post your questions and comments below!
Wednesday, June 17, 2009
Sunday, May 3, 2009
Is it safe to do isometrics during pregnancy?
I got a great new question from one of my Pregger Fit program users. She wondered about safety of useing isometric exercises during pregnancy.
Isometrics are exercises where you contract muscles without movement. For example a wall squat, carrying grocery bags, the plank abdominal exercise, etc. Imagine making force with your muscles without moving a particular joint.
Yes, isometric contractions increase blood pressure and this is where the original "ban" came from. However, ANY exercise increases blood pressure and it needs to! Otherwise the body can't function to pump more blood to the heart and the working muscles. :)
This only becomes a problem for women with preeclampsia (pregnancy induced hypertension) because their blood pressure is already too high. Also, it would be a problem if the blood pressure didn't come back down to normal after exercise. (In that case any exercise would be problematic, including sex!) The studies done on pregnant women and isometrics demonstrated that blood pressure returned to normal after the exercises.
There was another study done on women in advanced pregnancy that demonstrated that yes, blood pressure and heart rate go up during isometric exercise, yet there was no change in placental circulation.
One action that can cause problems is the valsalva maneuver. This is when you hold your breath during exercise. This is contra indicated for everyone, not just preggers, as it increases blood pressure on top of the normal exercise induced increase that is needed. Often isometrics get accidentally done while holding your breath. That would be a no-no.
In our daily life we do isometrics every day at varying intensities. With babies our poor biceps do marathons of isometrics as the little one decides to finally fall asleep in our arms and will ONLY sleep there and in one position and we are stuck holding our biceps tight for hours. :) Another example of a beneficial isometric is a constant activation of the core and pelvic floor. This is one of the best ways to prevent problems in that area. Our postural muscles also work isometrically all day long keeping us upright and elegant.
The question was more specific to a wallsit with an arm slide. This exercise is safe to do assuming you stay within the general pregnancy exercise intensity guidelines. Exercise when pregnant should be done at a "comfortable" level. For example in this exercise, you should feel challenged yet when you finish a set, you should feel like you could have done it a bit longer. So whether an isometric squat or a "regular, moving" squat, you should at most be in a "somewhat hard" category on the intensity chart. And just like during any exercise, keep breathing to avoid an exaggerated increase in blood pressure.
Here are links to a couple of studies about pregnancy and isometrics:
http://www.ncbi.nlm.nih.gov/pubmed/8238141
http://www3.interscience.wiley.com/journal/102520398/abstract
Isometrics are exercises where you contract muscles without movement. For example a wall squat, carrying grocery bags, the plank abdominal exercise, etc. Imagine making force with your muscles without moving a particular joint.
Yes, isometric contractions increase blood pressure and this is where the original "ban" came from. However, ANY exercise increases blood pressure and it needs to! Otherwise the body can't function to pump more blood to the heart and the working muscles. :)
This only becomes a problem for women with preeclampsia (pregnancy induced hypertension) because their blood pressure is already too high. Also, it would be a problem if the blood pressure didn't come back down to normal after exercise. (In that case any exercise would be problematic, including sex!) The studies done on pregnant women and isometrics demonstrated that blood pressure returned to normal after the exercises.
There was another study done on women in advanced pregnancy that demonstrated that yes, blood pressure and heart rate go up during isometric exercise, yet there was no change in placental circulation.
One action that can cause problems is the valsalva maneuver. This is when you hold your breath during exercise. This is contra indicated for everyone, not just preggers, as it increases blood pressure on top of the normal exercise induced increase that is needed. Often isometrics get accidentally done while holding your breath. That would be a no-no.
In our daily life we do isometrics every day at varying intensities. With babies our poor biceps do marathons of isometrics as the little one decides to finally fall asleep in our arms and will ONLY sleep there and in one position and we are stuck holding our biceps tight for hours. :) Another example of a beneficial isometric is a constant activation of the core and pelvic floor. This is one of the best ways to prevent problems in that area. Our postural muscles also work isometrically all day long keeping us upright and elegant.
The question was more specific to a wallsit with an arm slide. This exercise is safe to do assuming you stay within the general pregnancy exercise intensity guidelines. Exercise when pregnant should be done at a "comfortable" level. For example in this exercise, you should feel challenged yet when you finish a set, you should feel like you could have done it a bit longer. So whether an isometric squat or a "regular, moving" squat, you should at most be in a "somewhat hard" category on the intensity chart. And just like during any exercise, keep breathing to avoid an exaggerated increase in blood pressure.
Here are links to a couple of studies about pregnancy and isometrics:
http://www.ncbi.nlm.nih.gov/pubmed/8238141
http://www3.interscience.wiley.com/journal/102520398/abstract
Saturday, April 25, 2009
Invitation
I would like to invite you to a brand new perinatal fitness community! It's a great supportive site to share experiences while learning about health and fitness during pregnancy and postpartum.
I started this community because I was getting lots of questions on facebook or by email and I thought I could be more helpful putting all the info in one place and by making an interactive site. I hope you like it!
Come and join us at http://www.perinatalfitness.ning.com
I will be uploading content each week so keep checking back for new stuff!
I started this community because I was getting lots of questions on facebook or by email and I thought I could be more helpful putting all the info in one place and by making an interactive site. I hope you like it!
Come and join us at http://www.perinatalfitness.ning.com
I will be uploading content each week so keep checking back for new stuff!
Friday, April 17, 2009
The 40-day postpartum quarentine is 40 days too long
Many women are still told not to exercise for 40 days (or 6 weeks) after birth. This well intended advice from medical professionals is unfortunately causing lots of problems for postpartum women such as incontinence, sexual dysfunction, back problems, “jelly bellies”, and poor body image.
The general consensus from gynaecologists and midwives is for women to adhere to a 40 day waiting period after giving birth before starting to exercise. These 40 days are meant to wait for lochia (postpartum bleeding) to stop, stitches to heal, and the uterus to shrink down to its normal size.
While the intention is good, this “rule” causes problems. How can all women, younger, older, first time moms, 10th time moms, with C-sections, with episiotomies, with water births, women who were fit before birth, women who have never exercised, professional athletes, fit into the same 40-day quarantine category?
Also, when told not to exercise, women are left to define exercise themselves. Does this include walking? What about Kegels? And once the 40 days are over, are women allowed to now start running and going to aerobics? Does the body magically recover in 40 days while avoiding exercise?
Women post partum are vulnerable physically and emotionally. It is a time when life is upside down and thinking of her own body becomes a last priority while learning to be a mom and taking care of the little one(s) 24-7. For some, the 40-day rule provides a nice “excuse” to not have to start doing something about the alien postpartum body she has been left with for 6 weeks. While it is great for a new mom to focus on being a mom, this long wait makes recovery MUCH longer and MUCH harder. The longer the wait, the harder it is to get the pelvic floor musculature to respond again. And in many cases, physical therapy machinery is needed to get the process started well. Being a great mom is a lot easier with a properly functioning body.
The other problem with this general guideline is that some women wait the required 40 days and then jump into their normal pre-pregnancy exercises (aerobics, weight training, tennis, etc.) without ever doing the necessary work to reactivate and strengthen the core. This can cause a slew of problems including incontinence, a protruding abdominal wall, and muscular compensations that can lead to back pain, knee pain, etc.
The solution is to give more specific advice. So, instead of this general advice, here are some more specific guidelines for exercise after birth:
1.) Start doing Kegels as soon as able. Ideally this means moments after birth and definitely before leaving the hospital. This actually speeds up perineal healing.
2.) As soon as you can, start walking around and doing some basic mobility exercises. For a normal non-medicated birth this could be within hours. For a medicated birth you may need a little more time to get moving due to the anaesthesia.
3.) Even with lochia, gentle exercises for core recovery can be started within those early days.
4.) Diaphragmatic suction exercises should wait until the uterus has shrunk. This varies from woman to woman. You can try them a month after birth and should definitely be able to do them after the 40 days.
5.) From here the progress should be constant towards brisk walks and core stability.
6.) The 40-day rule is probably a decent guide to follow before starting heavy lifting or other exercises with impact. And even then, a better gauge is for women to have first recovered the core before adding external loading or impact.
7.) The most often skipped step in this recovery series is RESISTANCE TRAINING. The best way to recover a pre-pregnancy slim body, is resistance training accompanied by a clean diet with adequate calories to support breastfeeding. As soon as the pelvic floor can hold its own again and the core is stronger, adding a few days of full body circuits can really speed up the recovery process and best of all, prevent achy backs and necks from all the forward bending that comes with taking care of a baby.
The old-fashioned 40-day guideline is too vague, very conservative, and in most cases harmful. Yes, women should ease back into exercise and should progress through pelvic floor recovery, abdominal reconditioning, and then general conditioning but they definitely should not spend the first 40 days after birth waiting to start exercising. Since after the birth of a mom, life can be quite complicated, it is good to remember that exercising and bonding with the baby are not mutually exclusive. Most postnatal recovery exercises can be done with baby!
The general consensus from gynaecologists and midwives is for women to adhere to a 40 day waiting period after giving birth before starting to exercise. These 40 days are meant to wait for lochia (postpartum bleeding) to stop, stitches to heal, and the uterus to shrink down to its normal size.
While the intention is good, this “rule” causes problems. How can all women, younger, older, first time moms, 10th time moms, with C-sections, with episiotomies, with water births, women who were fit before birth, women who have never exercised, professional athletes, fit into the same 40-day quarantine category?
Also, when told not to exercise, women are left to define exercise themselves. Does this include walking? What about Kegels? And once the 40 days are over, are women allowed to now start running and going to aerobics? Does the body magically recover in 40 days while avoiding exercise?
Women post partum are vulnerable physically and emotionally. It is a time when life is upside down and thinking of her own body becomes a last priority while learning to be a mom and taking care of the little one(s) 24-7. For some, the 40-day rule provides a nice “excuse” to not have to start doing something about the alien postpartum body she has been left with for 6 weeks. While it is great for a new mom to focus on being a mom, this long wait makes recovery MUCH longer and MUCH harder. The longer the wait, the harder it is to get the pelvic floor musculature to respond again. And in many cases, physical therapy machinery is needed to get the process started well. Being a great mom is a lot easier with a properly functioning body.
The other problem with this general guideline is that some women wait the required 40 days and then jump into their normal pre-pregnancy exercises (aerobics, weight training, tennis, etc.) without ever doing the necessary work to reactivate and strengthen the core. This can cause a slew of problems including incontinence, a protruding abdominal wall, and muscular compensations that can lead to back pain, knee pain, etc.
The solution is to give more specific advice. So, instead of this general advice, here are some more specific guidelines for exercise after birth:
1.) Start doing Kegels as soon as able. Ideally this means moments after birth and definitely before leaving the hospital. This actually speeds up perineal healing.
2.) As soon as you can, start walking around and doing some basic mobility exercises. For a normal non-medicated birth this could be within hours. For a medicated birth you may need a little more time to get moving due to the anaesthesia.
3.) Even with lochia, gentle exercises for core recovery can be started within those early days.
4.) Diaphragmatic suction exercises should wait until the uterus has shrunk. This varies from woman to woman. You can try them a month after birth and should definitely be able to do them after the 40 days.
5.) From here the progress should be constant towards brisk walks and core stability.
6.) The 40-day rule is probably a decent guide to follow before starting heavy lifting or other exercises with impact. And even then, a better gauge is for women to have first recovered the core before adding external loading or impact.
7.) The most often skipped step in this recovery series is RESISTANCE TRAINING. The best way to recover a pre-pregnancy slim body, is resistance training accompanied by a clean diet with adequate calories to support breastfeeding. As soon as the pelvic floor can hold its own again and the core is stronger, adding a few days of full body circuits can really speed up the recovery process and best of all, prevent achy backs and necks from all the forward bending that comes with taking care of a baby.
The old-fashioned 40-day guideline is too vague, very conservative, and in most cases harmful. Yes, women should ease back into exercise and should progress through pelvic floor recovery, abdominal reconditioning, and then general conditioning but they definitely should not spend the first 40 days after birth waiting to start exercising. Since after the birth of a mom, life can be quite complicated, it is good to remember that exercising and bonding with the baby are not mutually exclusive. Most postnatal recovery exercises can be done with baby!
Wednesday, April 15, 2009
5 Ways to Jazzercise Your Privates!
The pelvic floor (pf) musculature is really complex and intricate. Fortunately, it is very simple to work because all these muscles have two basic functions that we can consciously control: closing/opening sphincters or lifting up the floor of the pelvic girdle. This is good news because working this delicate area is very simple but can also get boring with only a few options for our daily exercises.
So, here are 5 ways to do Kegels to spice it up for you:
1.) Hold steady
This is the basic Kegel you probably already know. Just squeeze, lift, and hold! Release and repeat. Simple yet effective. These you can get good at doing while multitasking such as driving, working on the computer, talking on the phone, brushing your teeth, etc. Change up the hold time for variety from 3 seconds all the way up to 30 seconds or more.
Warning! Don’t do while driving unless you are good at multitasking. My mother-in-law tried this while driving and almost had an accident. Multitask with other more benign activities until you reach mastery.
2.) Quick fire
To get the most out of our pfs, we need to work them at different speeds. This drill entails contracting and releasing as fast as you can for 10 seconds, resting, and repeating.
3.) Rhythm Squeeze
Pump your perineum with Michael, Britney, Usher, or Elvis! This one is my favourites and gives us endless options by inviting different artists to join us. Just as it says: squeeze and lift with the beat of the music. When you get more advanced, you can trade off between the slow beat and the double beat of the music.
4.) Elevator
These last two require a bit more concentration and fine motor control. In the elevator exercise we can imagine the pf as an apartment building with 3 or 4 floors and activate the musculature in phases. For example, totally relaxed is the basement, 20% contraction is the first floor, 50% is the second floor, 70% is the third floor, and the fourth floor is maximum contraction. Remember that elevator rides can be just up, just down, or you can be a kid on the elevator and joy ride up and down and between floors.
5.) Back to front, front to back
This last exercise is quite tricky and takes some time to master. Here you need to distinguish between the anal, vaginal, and clitoral/urethral parts of the pf muscles. In general, the difficulty increases back to front. The exercise consists of starting the contraction at the anal sphincter and moving to the vagina and then the urethra/clitoris and as usual, releasing and repeating. The harder version is the same but starting at the front and moving to the back.
There you have it. 5 different ways to Jazzercize our private parts!
Monday, March 16, 2009
Chinese vaginal balls
Today's blog comes to you thanks to my lovely postpartum ladies. If it wasn't for them, I wouldn't be the proud owner of some "CVBs".
First, let me give you a fair warning. My blog is about perinatal fitness and wellness. This includes sexual health and the pelvic floor. Pelvic floor includes the anus and the vagina (among other items). So, if any of these topics are not your cup of tea, stop reading now. Please don't continue reading and then write me a comment/email that you were grossed out or insulted in some way. Ok?
So the story goes like this.
Ladies in my postpartum groups were talking about how sex wasn't all that appealing now, how it was a bit painful, how they didn't have much libido, and how all this was effecting their lives and their relationships. Thankfully at my studio we talk about these issues openly with no embarrassment and the women are comfortable sharing intimate details about their health and well being. So, at the end of the conversation we had decided to have a "tuppersex party". This is like a Tupperware party but the items on sale are sex toys, lubes, massage oils, etc. This way the ladies wouldn't have to fight their way to a sex shop with baby, the stroller, the diaper bag in tow just to get some items that can bring sexy back to their romantic lives. It's all about making it easy for the new moms.
Here in Catalunya/Spain one of the common recommendations from gynecologists and physical therapists for strengthening the pelvic floor are these Chinese vaginal balls (CVB). In Catalan they are just called "Bolas chinas" or "Chinese balls". Basically they are 2 silicone balls a bit smaller than a golf ball attached by a silicone string. The balls have little weights inside and at the end of the string there is a silicone loop. The task is to insert these balls in the vagina and keep them there. That's it. When the pelvic floor is weakened (like after pregnancy and birth), it is difficult to keep the balls in the vagina and they may even fall out.
Second warning: Now comes the personal bit. If you are uncomfortable reading about me and my experience with these balls, stop reading now.
So, I bought some of these balls from the tuppersex lady. I always try everything that I suggest to my clients whether diets, workout plans, masseuse, osteopaths, acupuncturists, etc. I am my own guinea pig always first. So, if I am to suggest these Chinese balls to my clients as an aid to rehab the pelvic floor, I better try them myself.
They sent me pink balls! I ordered purple balls! :( (they didn't have blue ones. I really wanted some blue balls. hehehe)
One of the reasons I wanted to buy these balls now was to see more objectively the changes in my pelvic floor through pregnancy, birth, and recovery. We all know you don't know how far you've come (nice pun there...) if you don't know where you started. So, now I have a good baseline reading. For me, these balls stayed put through walking around my apartment, running in place, and doing some deep body weight squats. I get an A for pelvic floor strength!
These particular CVBs were like balls within balls. There was a weighted little ball inside the bigger ball. So what happens as you move is the inner ball bounces off the outer ball which creates a stimulus to the vaginal walls and they contract in response. Well, that is all well and good but this process makes noise! So, there you are, shopping at the local supermarket working on your pelvic floor strength and someone will ask, "What's that noise coming from your crotch?".
So, for now I can only say that the CVBs can help you work your pelvic floor; however, I'm not sure they are any better than doing regular old Kegels that don't require any equipment and don't make any noise. I can see a benefit to using CVBs after birth to re-establish the neuromuscular connection to perineum as they provide an external stimuli to help you reconnect your brain to your vagina.
Anyone else had an experience with a post partum pelvic floor recovery product or method? Did it work? Do you recommend it?
Sunday, March 15, 2009
Top 2 mistakes in post partum recovery
Top 2 mistakes in postpartum recovery:
1.) Waiting too long to get started
2.) Choosing inappropriate exercises
Waiting too long to get started
Stimulus to the traumatized perineum immediate after birth helps re-establish neuromuscular control much better than waiting weeks or months to get started. Waiting too long to address the recovery of the abdominal wall that stretches immensely, and in many women separates at the midline, can be impossible if waiting longer than 6 months to get started.
The good news is that postnatal recovery programs are designed with a new mom in mind. Many of the exercises can be done while breastfeeding or in just a minute or two while the baby is a sleep.
The most common misconception about abdominal recovery is that traditional crunches will help create a thinner waist and a smaller belly. This is very incorrect!
Postpartum women should avoid traditional abdominal work and be very careful of the exercises they choose. Many typical abdominal exercises (including Pilates) will worsen separated abdominals and can make the belly bigger.
Pelvic floor should be strengthened, the deep abdominal muscles re-toned, and the compensations left over from pregnancy should be corrected first before adding any load to the body. Corrective exercises and “diaphragmatic suction exercises” are the best methods for postpartum recovery.
A new mom needs time to recover. Her body has gone though an incredible journey of pregnancy and birth, and continues to have special needs for lactation and recovery. The hormonal soup within a postpartum mom’s body doesn’t stop with birth and joint laxity can last for months postpartum.
The very best method to aid postpartum recovery is thinking ahead and creating a fabulous connection to your pelvic floor and abdominal muscles before and during pregnancy.
Women who invest the time in prenatal fitness recover much faster postpartum as the neuromuscular connection is stronger, the muscles are more elastic and responsive, and the habit of exercise is more ingrained thus making it easier to get started again after giving birth to your precious child.
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