Showing posts with label childbirth. Show all posts
Showing posts with label childbirth. Show all posts

Thursday, December 1, 2011

Kegels may not be good for you.

In our prenatal exercise section, we recommend doing Kegels because we were told they are good for you. Florence took the Bradley Childbirth classes many years ago and Kegels were highly recommended.

We came across an article which says Kegels may actually not be good for you!

We are reprinting this article with permission.





Not too many of us want to talk about this, although we might with our closest training partners, especially if say, one of them makes us laugh in Boot Camp while doing burpees or during a run. “Stop it!” You might cry, “I just peed in my pants!” There’s that dribble from urge incontinence (there, I said it) from a cough or sneeze that comes out of nowhere and then the continuum of unpleasantness goes on from there. I know women who’ve had to slip a pad into their shorts in the transition area of a duathlon before running. I know runners who no longer run because the leaking is so bad. I find that unacceptable. And if you’re having problems–anywhere on that continuum–so should you.

I’ve written a lot about pelvic floor health in the last year and have learned a great deal. First and foremost: It’s not really your bladder’s fault, it’s a weak pelvic floor. And while pregnancy and birth can certainly compromise that tiny area of muscles between our pubic bone and tail bone that essentially hold up all of our organs (is that all?), that weakness can (and most often does) effect everyone eventually, even men, because yes they too have a pelvic floor.

Here’s a run down of the most eye-opening pelvic floor facts I’ve learned from two people who have studied the pelvic floor extensively. This is the information that can mean the difference between wet and dry running shorts, and for some working out again with confidence.

1. The Pelvic Floor needs to be stretched and strong. When I interviewed biomechanical scientist Katy Bowman last year she blew me away with the very obvious:

One of the biggest misnomers is that tight muscles are “strong” and loose muscles are “weak.” In actuality, the strongest muscle is one that is the perfect length – you need Pelvic Floor Goldilocks – it’s juuuuuust right. The Kegel keeps making the PF tighter and tighter (and weaker and weaker). The short term benefits are masking the long term detriments. Ditch the kegels and add two to three squat sessions throughout the day (anywhere). The glutes strengthen and as a result, they pull the sacrum back, stretching the PF from a hammock to a trampoline. Viola!

And because that seemed so incongruous to so many people I interviewed Katy again to get a “say what?” on that:

The muscle tissue in your PF is the same as the muscle tissue in your biceps. When you’re done realllly working your biceps, you’d like your arm to go back to its original length, right? What if, when you were done doing your curls, your elbows stayed as bent as they were when your muscles were the TIGHTEST? If you equate strong with tight, then you’d have “strong,” contracted arms with bent elbows all the time. Tight muscles. Unusable arms. That’s not what TONE is. Tone is having the MOST strength and the MOST length.

2. A flat butt indicates a person has a weak pelvic floor (and likely pees when sneezing). This is why squats are the new kegel. Again, I bring you Ms. Bowman:

The muscles that balance out the anterior pull on the sacrum are the glutes. A lack of glutes (having no butt) is what makes this group so much more susceptible to PFD. Zero lumbar curvature (missing the little curve at the small of the back) is the most telling sign that the PF is beginning to weaken. Deep, regular squats (pictured in hunter-gathering mama) create the posterior pull on the sacrum. Peeing like this in the shower is a great daily practice, as is relaxing the PF muscles to make sure that you’re not squeezing the bathroom muscle closers too tight.

3. That hip, knee, foot, or back problem might really be a pelvic floor problem. The biomechanics lessons from Katy provide endless insight to the the many connections involved with our health. In the case of the pelvic floor, lots of important body parts connect to it: abs, glutes, hip flexors. If these supporting muscles aren’t strong enough our pelvic floor suffers; likewise, calling on these muscles to do the work of weaker muscles will trigger new problems. Katy posted four fast fixes for pelvic floor disorder on her blog. One of them: Not using the treadmill. I am so down with that!

4. In a well-aligned muscle-balanced body, kegels would not be necessary. Yup, if all of our muscles maintained their ideal strength and length so that our alignment kept our body in good working form, then there would be no need to “spot train” problem areas. And if you do need to “spot train,” understand that more than your pelvic floor is compromised (see #3 above). In another post by Katy (more prolific about the pelvic floor than I) she says:

PFD is a sign that your entire body is collapsing, from the inside-down. While the sneeze-pee and organ prolapse may seem like a huge deal it is nothing compared to the neurological damage to the spine, nerves, and tissues that those nerves supply (especially the nerves running to the lower legs.) The kegel is a drop in the bucket to what someone with PFD needs to do to heal all their structures. PFD is a whole-body situation and for optimal, whole-body outcome, the body has to be treated holistically. Otherwise it’s like putting a new roof on a termite-ridden frame.

5. A kegel is a two-part process, not just a contraction. Since most of us aren’t perfectly balanced and aligned, we still need to know how to do a kegel but only if they’re done correctly. Doing them incorrectly is only going to exacerbate pelvic floor disorder. And no matter what, you still need to be able to engage your pelvic floor. Guess what? A Kegel is more than a contraction. The next step is to relax the pelvic floor so as to lengthen it (see #1 above). The Kegel Queen emphasizes the relaxation step in her program and why she insists you can’t do kegels anywhere, like while we’re driving, as we’re often told.

6. If you can totally relax your pelvic floor you can completely relax your body. The ability to completely relax your pelvic floor allows you to completely relax your body. Can you do this pelvic floor party trick?

7. Doing two kegels is good, but doing 200 is NOT better. Both Katy Bowman and the Kegel Queen agree that too many equates to a too-tight pelvic floor. Katy points out that a too-tight pelvic floor can pull the sacrum out of alignment (hello back pain!) and the Kegel Queen explained it to me in a recent interview in terms I can understand as a fit mom:

Kegels work by increasing your control of the pelvic floor muscles, and by building mass and tone in the pelvic floor. How would you build mass and tone in any other muscle in your body? As anyone who does weight training knows, you’d do a small number of strong, sustained reps. Not 200 “quick flicks,” or 200 anything! Your pelvic floor is no different.

8. Even if your pelvic floor is in good shape, even if you’ve had corrective surgery, you still need to maintain pelvic floor strength. This is forever people. It’s like strength training any muscle. Once you feel like you’re in a good place you can’t just stop. This applies to all fitness, so of course it applies to pelvic floor fitness. Even my pelvic floor expert, Katy Bowman, discovered she needed to get back in touch with her pelvic floor after the birth of her baby (she’s human!)

I know that’s a lot of links. All that in one post is, “Everything Kara Learned About the Pelvic Floor That She Wants Every Fit Mom to Know.” So please share it with your sweaty sisters at your next workout. No one needs to worry about what will happen while running or laughing. And if you’re working out with your sweaty sisters you need to do both at the same time.

Wednesday, November 2, 2011

In And Out, That’s What It’s All About

You and a friend are going for a walk, chatting as you stroll along. A while down the road you think you’re ready to head back but she says “no, let’s go farther, and let’s jog a bit.”

So you continue on.

A bit farther down the road your side is cramping and your lungs start to ache. “I want to stop” you mumble. But your friend takes your hand and tugs you along even faster. You can no longer see your house, and you see no end to the trail you’re on.

She is now dragging you along at a rapid pace. Your lungs are screaming for air, your heart racing, panic in your eyes as you realize you are far less prepared for this than your eager friend…

****


It's silly to think anyone would take off for a long run without preparation, and yet many moms go into labor not knowing how to pace themselves, breathe or handle the exertion that labor will require.




So just how are you supposed to practice breathing; something that you don’t typically give a second thought to?

Try this:

If you can, close your eyes, if not, that's okay, practice anyway!
Take a deep breath in your nose, fully extending your diaphragm. If you extend your belly so you look 12 months pregnant, you’re doing it right! As you slowly inhale, focus on relaxing those facial muscles, you know, the ones giving you wrinkles! Relax your forehead, eyebrows, jaw, and lips.

Now exhale slowly through your mouth, keeping your face relaxed and focusing on relaxing your shoulders, arms, hips, thighs, toes and everything in between!

Exhale completely and pause until your body requests more air. Slowly inhale again. Focus your thoughts only on your breathing and on relaxing your body. Repeat this pattern about 10 times. It’s ok to make deep sighs or moan-like sounds on your exhale.

If you want to verify the calming and distracting effects of relaxed breathing, do this little test:
Have your labor partner time this for you and in the second step he can breathe with you and give you verbal reminders to relax.

Step one: For one minute hold an ice cube in your hand. Look at your hand, think about how it feels.

Step two: Hold ice in the other hand for a minute, but this time close your eyes and do the breathing and focus on relaxation and your breathing pattern.

****


Just as a runner understands the value of stretching before a race, you should understand the value of deep relaxation breathing in labor:





* More oxygen is delivered to your baby; helping to keep her heartrate stable.

* More oxygen delivered to your muscles. With well oxygenated muscles, (uterine muscles specifically) pain in contractions can be reduced.

* Breathing in this pattern is soothing and calming. It will follow the rhythm of labor, increasing in intensity as labor does, but continuing to sooth and oxygenate.

* It can be distracting. Focusing on your breath and your muscles relaxing over all your body keeps your mind busy.

* It may help regulate your heart rate and blood pressure by keeping your body and mind in a calm state.

* It can reduce or prevent the fear-tension-pain cycle.
EEK! There’s that P word! Yes, I said it: pain. Did that word trigger some fear or anxiety? Did you feel your body tense, perhaps your eyebrows furrowed a bit or your jaw clamped shut? You’re not alone!

Childbirth and all the many decisions leading up to labor and delivery can trigger stress and anxiety. Each moment of stress is a perfect opportunity to practice your deep relaxation breathing.

If every time you begin to have fear or anxiety, you “go to” your breathing, your mind will become occupied with breathing and relaxing, thus pushing the negative thoughts aside and clearing your mind of them. When you finish breathing, only allow positive thoughts. Refuse to let negativity and fear settle into your mind. Replace them with breathing and positive phrases such as “my body knows what to do” “labor is a productive process” “labor is not an illness and my body will not do to itself what I cannot handle.”

(note* some fears need to be addressed or are a result of prior trauma, birth or otherwise, please address this with an experienced birth professional who understands the fear-tension-pain cycle.)

By training your mind and body to respond to stress, fear or anxiety with deep relaxation breathing, you will be ready for labor. You will respond to each sensation and rush of adrenaline with calming breaths. Start training now, the race is coming!

Shannon Santamaria ~ Doula
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