In my experience thus far as a personal trainer, I’ve met a variety of women at different stages of fitness. I enjoy the assessment process, asking relevant questions about health, fitness and eating habits, using that information to design a program to help my client become “Stronger Fitter Faster”, my tagline. However, after a recent conversation with Women’s Health Foundation (WHF) founder, Missy Lavender, I have come to realize there is a huge piece of my assessment that I have been missing especially in my female clients: pelvic health.
Yes, pelvic health.
Missy tells me that 1 out of 3 women will experience an “out of control” bladder or pelvic health complication or disorder, and that it is preventable! I have clients who tell me, “I’m afraid to do jumping jacks b/c I feel like I have to use the bathroom” or “I always have to use the bathroom, all day long”. It is not a coincidence that all of the women who made these statements are mothers. So why do I need to ask my clients about their pelvic health? Having a strong pelvic pyramid (which is comprised of the transverse abdominals, multifidae and pelvic floor) reduces the possibility of multiple disorders and also enables the possibility of a fit life after baby. We simply haven’t provided the proper education to women, Lavender states. In addition to their popular DVDs and online videos, the WHF has recently developed books for young girls beginning puberty to help them navigate their pelvic floor and thereby set them up for success early on in their lives.
A substantial portion of prenatal care focuses on the baby’s health, ensuring the mother gets adequate and proper nutrition and exercise to grow a healthy baby. The first post-natal visit is at 6 weeks, and by that time, if there is any pelvic disconnect it is beyond 90 days, which is then regarded as chronic pain. Fear not, at 6 weeks, your pelvic health can be strengthened and restored!
The pelvic pyramid sags after birth (and in menopause and even after chronic inactivity), there is no way getting around that. However, adding certain exercises that focus on stabilizing and strengthening the core will help to keep the pelvic pyramid healthy. A compromised pelvis can lead to various disorders such as incontinence, sexual dysfunction or pain during intercourse, and poor posture. Not to mention difficulty in performing strenuous exercises without having the constant need to urinate!
There are two things women who want to continue running or exercising after baby can do to improve or maintain pelvic health. First, ensure that core muscles are strong, in fact, this includes the entire pelvic pyramid. Second, for those who may need a little more support, Lavender suggests using a prop, such as a super tampon, to help absorb and provide support. (There are multiple other tools women can select from).
If you are dialed into the women’s running community, perhaps you have come across Stephanie Bruce, professional runner for Oiselle. She a new mother and a blogger for Women’s Running. I’ve been following her on Instagram for some time and most pointedly, her “journeywithSteph” hashtag where she openly and honestly talks about post-partum running. I turned to her to ask a few questions about pelvic health.
- RunAyeshaRun: What do you wish you knew about pelvic health before you had your baby? Is there anything in your pregnancy you would have done differently exercise-related?
SB: I did a fair share of research before I had my baby to help prepare me. I learned however you actually can’t prepare your body for the life changing task of giving birth. As an athlete I wanted to be prepared for the pain and be as physically “fit” as I could going into labor. For me this meant keeping up on back and hip strengthening exercises throughout my pregnancy. I was able to maintain this from 20-37 weeks. After that I was just a woman, uncomfortable, unmotivated and ready to have her baby. I listened to my body a lot and when it felt like doing something I did it. When it didn’t I wouldn’t. There’s not much I would change knowing what I know now. I sometimes wish I knew more about how the ligaments became so stretchy and hard to tighten back up, and how your entire core is shot after giving birth. Then again it’s probably better than it was a big surprise to me.
- RunAyeshaRun: How do you set yourself up for success post-baby as a professional athlete? Specific core exercises you perform for your pelvic pyramid?
SB: Post baby: I went through and am still going through a lot of physical therapy to strengthen all the parts of my body that lost strength and were damaged. There are a lot! It starts with kegels, kegels, and more kegels. These really get overlooked a ton for most women. Years post baby they’ll admit “damn should have done my kegels. It basically requires 5-10 minutes daily of quiet time. Moving from your inner pelvic floor you arrive at the core. As an athlete my natural tendency is to think “I have a weak core I just need to do hours of planks, side planks, push ups, v-ups and I’ll have a rock solid core in no time.” So far from the truth when we’re dealing with a post partum body. If you strengthen the outer portion of your core too much, you’ll miss working on the intrinsic muscles that actually support your hips, pelvis, and low back. Here’s a list of what I did the first 6-14 weeks post baby.
Ab bracing: Laying on your back with feet on the ground, you slightly tighten your TA while pulling your belly button up. Use your hands as a brace on the outside of your tummy. With a rubber band around your knees pull your knees apart and back in. Repeat x 10.
Next progression is in the same position without the rubber band around your knees called marching your feet. Place hands on hips. Draw belly button to spine without pushing the low back into the floor. Slowly lift your left leg 6-8 inches off the floor without letting your hips move. Alternate 10-15 each side, rest and reset abdominal brace as needed.
Last progression is the feet slide. Again start in same position with feet on ground, knees bent and slowly slide your heal until your leg is straight. Bring back to start and repeat on the other leg, x 10. Once you’ve mastered these moving on to general body strengthening would be my next recommendation.
- RunAyeshaRun: What is one thing (or two) you want to tell women who say, “I wish I could run or (insert strenuous activity) but I can’t because I feel the need to use the bathroom”.
SB: I would just say “run and who cares if you go the bathroom.” I hit a demoralizing day a few months after giving birth where it dawned on me that I was getting into great shape but I was also peeing my pants on every run. So you take precautions- wear a pad, for pee yes. Run a route where you know you’ll see a bathroom if the urge hits. Try to time your eating and hydrating with when you plan to run. I try to stop having coffee at least 30-45 mins before I run otherwise it doesn’t help my cause. At the end of the day your body produced a human, is different than before but your love for running hasn’t changed. So don’t be embarrassed just say professional runner Steph Bruce gets out there and pees her pants(sometimes more) too.
So there you have it. There is a running life after giving birth. Now go work on getting that pelvic floor stronger than ever!