Even Pilates Teachers Prolapse

My experience with birthing big babies and how Pilates helped my pelvic floor ‘come back’

Ah, the ‘P’ word. Prolapse. More specifically, vaginal prolapse. A word that expectant Mothers fear, and new Mothers don’t want to hear. When the pelvic floor is strong, it supports the pelvic organs to prevent problems such as prolapse. If you’re not familiar with what a prolapse is, emedicinehealth.com define it as ‘a condition in which structures such as the uterus, rectum, bladder, urethra, small bowel or the vagina itself -may begin to prolapse, or fall out of their normal positions’. Yikes. No one wants to imagine their bits hanging between their legs, unless you’re male, in which case, the more hang the better, right?! So, you can imagine my state of disbelief when the Pelvic Floor Women Physio examined me 6 weeks after the birth of my second child and told me I had stage 1 prolapse. Now I knew things were a bit dicey down there, but I didn’t know things were that bad?!

Image courtesy of womenshealthadvice.com

Image courtesy of womenshealthadvice.com

So how does a vaginal prolapse happen?

Damage to the pelvic floor occurs particularly:

1) when there is a long second stage labour (tick- both of my boys), 

2) during instrumental deliveries – vacuum extraction or forceps (tick- both of my boys), and 

3) in the delivery of large infants (tick- second baby 4.1kilos; Womhealth.org.au). 

I guess looking at the history of both births I had a fair chance of a prolapse.

After birth, I distinctly remember having a feeling of detachment - not to my baby, but to my body. It was like my organs and insides were just floating around aimlessly inside my skin, not quite sure what to do, where to be or how to behave, especially my bladder. I was wetting myself for a good week after baby number 2. Highly annoying! Don’t even get me going on having to sneeze or having a laugh at this time. I really had to tune into my bladder, the moment I needed to go to the toilet, there was no waiting,  I had to go right then!

I don’t blame you if you’re thinking, ‘but she’s a Pilates teacher, she must do her pelvic floor exercise ALL the time?’ Well yes, and no. 

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When I was pregnant (and subsequently immediately after birth for the next little while), I would specifically carve out some time in my day to activate my pelvic floor. Usually I was doing a routine, mundane task like, waiting for the kettle to boil in the kitchen or having a shower- anything that happened daily and more than once a day where I would get in the habit of doing them while I waited (more on those specific exercises later).

 

When I’m not pregnant I don’t really think about my pelvic floor all that much. Sure, I do Pilates and part of doing Pilates is having an awareness of how to engage those muscles in order to stabilise them while another body part is mobilised. But this ‘internal stabilsing’ is something that has become second nature. So, when I do my everyday tasks (e.g., bending down to pick up the many things sprawled across the floor- clothing, toys, mess, towels, animals, children) I first stabilise internally through my pelvic floor, and low abdominals before I mobilise my torso in the direction of the ‘thing’ I’m picking up. Pilates in this way has been a savior. When you can use your pelvic floor and deep abdominals, you are less likely to have low back pain, and I know how inconvenient and restricting back pain is when you have small children who want to be hugged and chased and comforted.

 
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Another important aspect of pelvic floor activation is pelvic floor release. Especially for me, as a Pilates teacher, I’m constantly thinking of drawing ‘in and up’. I do it along with my clients, so, when I’m telling them to do it, I’m unconsciously doing it along with them! If the pelvic floor becomes difficult to relax, it’s constantly in a state of being semi-flexed. Imagine flexing your bicep constantly and never fully letting go, after a while this would cause your arm to lose flexibility, strength and the ability to relax. That is similar to what happens to the pelvic floor (goop.com).

After birth, the body naturally starts to restore and repair. After a week of wetting myself, I could start to hold my bladder slightly longer, after a few weeks, sneezing wasn’t so scary. Still, after the confirmation of stage 1 prolapse at 6 weeks postpartum, I knew there was some further work to do.  When I went back to the Pelvic Floor Women Physio at 12 weeks postpartum, I had another internal and was relieved to hear everything was back to ‘normal’. 

So what are the actual exercises I did while pregnant and post pregnancy for strengthening and releasing the pelvic floor? Here are 2 simple things that I did:

1. Sitting down with a pillow or folded up towel between the bottom of your inside thighs, sit yourself towards the edge of the couch or chair (no kickin’ back in a slump!). Feet flat on the ground, lift up tall out of your pelvis up to the top of your head. Take an inhale breath to prepare, then on the exhale breath, gently squeeze the pillow or towel while thinking about stopping a wee mid-stream as well as holding in a fart. This will lift the hammock of muscles at the base of the pelvic floor from your front passage to the back passage in and upwards. Try and hold for 5 seconds (you can build up to 10, 15, 20, 30 secs etc.). Make sure that when you let go, you feel a proper distinction between the contraction and the release. If you feel like you couldn’t distinguish between holding the pelvic floor up and letting it go, try reducing the amount of time you hold on for. I was starting at about 3 sets and worked up to around 8-10.

 
Image unknown

Image unknown

 

2. Standing up, slightly bent over (kitchen bench is usually a good option), with your legs hip width apart (it’s harder to squeeze your glutes together in this position so you have a better chance of isolating the pelvic floor muscles), draw up and in through the pelvic floor when you exhale (remember, this should feel like you are holding a wee and fart). I often put my hand on my low tummy when doing this. You want to feel that your low tummy is pulling away from your hand towards your spine. Repetitions and durations are the same as the sitting variation.  

A couple of pointers to be aware of:

·         Don’t hold your breath. Breathe normally over the contraction of the pelvic floor muscles,

·         Don’t squeeze your bum cheeks together (can be tricky to isolate pelvic floor and the surrounding muscles- if you find it hard to switch off the glutes try the version standing up), and

·         Tune in to your shoulders- make sure they don’t creep up to your ears and start overworking.

 

Image courtesy of @neetaphotography on location at Authentic Pilates Melbourne, Hampton, Melbourne.

Image courtesy of @neetaphotography on location at Authentic Pilates Melbourne, Hampton, Melbourne.

Upon reflection, I think the odds were always going to be against me given my birth scenarios, regardless of my job and pelvic floor abilities!  However, I’d hate to think what state my insides might be in without the exercises I did during and after pregnancy… who knows?!

I credit Pilates as setting the baseline of my fitness and strength before I fell pregnant. Being attune to my body allowed me to work safely through exercise to maintain my strength and flexibility while I was pregnant, making the road back from the birth of my boys not as daunting as I initially expected.

I recently made this little video demonstrating the sitting down pelvic floor exercises. In the video I’m using a Pilates Magic Circle, however, a rolled-up towel or cushion would be fine.

 
 
 

For those of you interested in starting Pilates prior to, during or after your pregnancy in the comfort of your own home check out my website for more information and contact details.

Please note: This is not intended to be specific advice; pelvic floor muscle training is not necessarily one-size fits all. I recommend being evaluated by a pelvic floor specialist if you are experiencing difficulties.

You should also be sure to gain clearance from your Obstetrician/GP after the birth of your baby before you undertake/begin any exercise.

Trading Up from Suits to Leggings

Where to begin when you write your first blog? Especially when you NEVER write anything! Ok, sometimes I write things but mostly shopping lists, to-do lists or any kind of scribble on paper. Another thing is that I always write on paper, I even wrote my Uni essays on paper before typing them up, so this whole digital note pad stuff is foreign to me. I also have a terrible grasp on the English language, I stuff quotes up all the time and ask me what a proverb is and you’ll be met with a blank stare. So safe to say, this whole concept is a little nerve wrecking. 

 
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So, yes, it’s taken me a while to actually sit down and write my own blog. I really had to think hard about what I had to offer a blog *long pause* and to answer this I thought about the two things occupying my mind right there and then. Get me talking about these two things and I have verbal diarrhoea. Yep, you guessed it, my two beautiful sons (my partner, their Dad, deserves some kudos here. Without him, our sons and I wouldn’t be surviving and thriving as we are. Thanks
Bern x) and my very own new Pilates business. It’s really because of my two boys that I started my own business. They were my inspiration, even before they were born. 

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A little more about me … when I finished Uni I landed an awesome Government grad role which eventually turned into a ‘real’ job and I was there for 7 years. I was so sure for so many years that I would make my up the corporate ladder, buy a house, raise some kids, collect sick leave and long service, have some holidays etc. etc. However, when I think back to that mindset now it just seems so foreign (I wouldn’t mind a couple of those sick days up my sleeve though). At this time,
I was a client at a Pilates studio twice weekly and my teacher would often say that I’d make a great teacher. I would laugh and scoff to myself at the idea of this. I’d worked my butt of to get this corporate job, I wasn’t going to throw it all away to wear leggings and work a few hours here and there in the morning and night. I reflect on this now and it’s nice to know she had my back from the very beginning (thanks, Noels).   

It was after an organisation-wide restructure that I started to (seriously) evaluate what I wanted from my professional working career. I always knew that I wanted to have kids, do more Pilates, and the teacher’s schedule suddenly looked more appealing to me. My teacher was able to drop her kids off at school, pick them up again at the end of the day, and take her weekends off (a rarity for most in the industry but she had worked hard to get to where she was so employed
others to teach those times). As I said, this non-traditional working schedule was starting to look pretty good.

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So, I took the leap and fast forward years and I have quit my corporate job, completed my Pilates teaching qualification and had two sons (Maddox 3 years and Levy 18 months). I now work part-time at the same studio where I did my first ever Pilates class and 6-months ago I started my own Pilates business, Kirsti Pilates To You. My business is built on my own experiences of finding it hard to get out of the house and do exercise when children are in the picture. So with Kirsti Pilates To You I take the hassle out. I bring all the equipment to your lounge room and we get our Pilates on! I come whenever it suits my clients - babies can be asleep or awake or I can come after hours (some of my clients are corporate work long hours), I don’t mind. I have found that whatever the circumstance, my clients love my service because they can’t talk themselves out of a workout when their teacher turns up at your door ready to whip them into shape. 

To be honest, while the flexible working hours allow me to be with my boys during the day there are some cons. To make it work, my partner and I have to be on opposite schedules. He works in the day and I work mornings, nights and weekends (luckily he is a teacher so we all get to hang out during the holidays). The nights that I am home I’m usually working on some admin for the business or further Pilates development or trolling through Instagram (a perfectly good example of how to further my knowledge in the field, right? :)). Also, one thing that I sometimes miss about working in the corporate world is being part of a team. Some days are tougher than others but I honestly wouldn’t have it any other way for me and my young family. 

Joining HMC excited me in a lot of ways. Firstly, I am part of a team again! Secondly, I get to contribute to a project that I am passionate about. I understand that all Mum’s are time poor and trying to juggle looking after their children and themselves. If I ca help Mums with just one small part of that juggle puzzle, then that makes my heart happy. 

Well I guess that’s enough about me for now. I look forward to sharing my tips and tricks and ‘talking’ with you through this blog. 

Kirsti