Tag: pelvic exercises

Pelvic physical therapy: Another potential treatment option

This treatment approach may help provide relief for many women with chronic pelvic pain and urinary symptoms.

The exact cause of pelvic pain for many women can be elusive, despite lots of tests and scans. In some cases, the symptoms are related to a problem that is often overlooked, says Dr. Eman Elkadry, an instructor in obstetrics, gynecology, and reproductive biology at Harvard Medical School. Pelvic pain may stem from a pelvic floor muscle problem that can be helped by a specialized form of physical therapy known as pelvic physical therapy.

“Although pelvic physical therapy may not work for everyone, it can be quite effective for certain individuals,” says Dr. Hye-Chun Hur, director of the Division of Minimally Invasive Gynecologic Surgery at Harvard-affiliated Beth Israel Deaconess Medical Center and associate faculty editor of Harvard Women’s Health Watch. She stresses that pelvic physical therapy is normally undertaken by a trained female practitioner.

An underdiagnosed issue

The pelvic floor is essentially a bowl-shaped set of muscles that supports your bladder, bowel, rectum, and uterus. Pelvic pain sometimes occurs when muscles of the pelvic floor are too tight, says Dr. Elkadry. This causes a condition called myofascial pain, or pain caused by muscle irritation.

Sometimes this pain is mistaken for other conditions or missed entirely. A 2012 article in the Journal of Obstetric, Gynecologic & Neonatal Nursing estimated that myofascial pelvic pain in women may be the underlying cause of chronic pelvic pain in 14% to 23% of cases and up to 78% of cases of interstitial cystitis, which is a type of otherwise unexplained bladder pain.

Myofascial pelvic pain may go undetected because it can only be identified by a focused internal examination, says Dr. Elkadry. “It’s very poorly recognized. Doctors often don’t understand it and don’t look for it,” she says. “Before my fellowship, I had never heard of this.”

Doctors in the field of gynecology are trained to focus on organs, not muscles. “If someone has unexplained pain in the shoulder, of course we would look at the muscles,” says Dr. Elkadry. But when it comes to pelvic pain, doctors tend to ignore the muscles and look for other causes, such as a problem with the bladder, uterus, or vulva.

Diagnosing the problem

Myofascial pain affects women of all ages, from teenagers to women who have already gone through menopause, those who have had children and those who have not. It’s not clear why some women are more prone to the condition than others, says Dr. Elkadry. Some women develop it after menopause, possibly because tissue becomes more sensitive as a result of hormonal changes, which can make women more prone to discomfort, she says.

Before making the diagnosis of myofascial pelvic pain, doctors should rule out other potential causes of pain, such as fibroids or bladder problems. Once myofascial pelvic pain is diagnosed, pelvic physical therapy should be considered, says Dr. Elkadry. It can be prescribed separately or alongside other treatments or medications. However, while medications may dull pain temporarily, they don’t address the underlying muscle problem as pelvic physical therapy is able to do.

What is pelvic physical therapy?

Pelvic physical therapy can help not only with myofascial pelvic pain but also reduce symptoms of other conditions caused by pelvic floor problems, such as urinary and fecal incontinence, painful intercourse, and sexual dysfunction. For myofascial pain, a specially trained physical therapist uses her hands to perform external and internal manipulations of the pelvic floor muscles, which are accessed through the woman’s vagina or rectum.

Relaxing contracted and shortened muscles can help alleviate pain in the pelvic floor, just as it would in other muscles in the body.

“Stretching in general helps muscles relax and prevents excessive cramping and tightening,” says Dr. Hur.

The therapist may recommend internal vaginal manipulation and massage. This component of treatment may not be an option for women who have a history of sexual abuse or assault or who have difficulty with internal vaginal exams, says Dr. Elkadry.

Finding a pelvic physical therapist

Pelvic physical therapy is performed by physical therapists who go through specialized training. Individual practitioners are regulated by the states where they are licensed, and state rules vary, according to the American Physical Therapy Association (APTA). However, APTA recommends that only physical therapists who have completed a particular type of training, including lab training, perform internal pelvic examinations and procedures.

APTA offers two types of certification to physical therapists who have completed this training.

  • The Certificate of Achievement in Pelvic Physical Therapy (CAPP) is awarded to physical therapists who have completed a comprehensive education, training, and testing program for the management of patients with diagnoses of pelvic health dysfunction, such as urinary incontinence and pelvic pain.
  • The Women’s Health Clinical Specialist (WCS) certification indicates proficiency in evaluating and treating a variety of women’s health diagnoses, including pelvic floor pain.

Looking for these certifications can help ensure that your practitioner has received recommended training.

It may be challenging for some women to find a pelvic physical therapist because there are a limited number of these providers, and they are often booked months in advance.

The APTA provides directories of certified providers on its website, at pt.womenshealthapta.org for WCS-certified providers or www.womenshealthapta.org/capp for CAPP-certified providers. Or you can ask your doctor for a referral.

Pelvic physical therapy is covered by insurance, although coverage may vary.

An unusual therapy that provides relief

Although pelvic physical therapy may sound a little unusual and invasive to some women, it can be effective. Dr. Elkadry says her patients have seen a good success rate using the procedure. “How effective pelvic physical therapy will always depend on the severity of the case,” she says.

Treatment for myofascial pelvic pain using pelvic physical therapy typically takes six to eight hour-long sessions. It can take longer, sometimes several months, to help women with more severe cases. Often women will need to return to physical therapy periodically to keep the problem in check.

If you’re hesitant to try the internal component of pelvic physical therapy, external physical therapy could also be an option to strengthen other muscles in the pelvic area, which may also help reduce symptoms. “Pelvic physical therapy can also serve as an adjunct therapy and does not always have to be the sole treatment,” says Dr. Hur. It can be performed in conjunction with other types of pain treatments or medications such as muscle relaxants or injections of Botox, a drug best known for its wrinkle-smoothing uses in the cosmetic industry.

Women should know that pelvic pain is not normal in menopause or at any other time. Getting treatment early is important, says Dr. Elkadry. The longer a woman experiences chronic pain, the more likely the nerve receptors will become sensitized to it. This heightens the body’s reaction to pain, often making it more severe and more difficult to treat. So, if you’re suffering from unexplained chronic pelvic pain, it may be wise to consult a urogynecologist who specializes in pelvic floor disorders.

Original Article: https://www.health.harvard.edu/newsletter_article/pelvic-physical-therapy-another-potential-treatment-option

 

Here’s Why Sex Can Be Painful Sometimes, According To A Doctor

Sex is so often depicted in movies and on TV as this hot, magical thing that always goes well for all parties involved. Everyone finishes at the same time in the same way (seriously?!), and no one seems to worry about things that real people have to deal with when they hook up IRL, like why sex can be painful sometimes.

To get more insight into why some people experience pain during sex, I reached out to Rachel Gelman, DPT, branch director of the San Francisco Pelvic Health and Rehabilitation Center. And first thing’s first: If you are feeling pain during sex, you’re not alone.

“I always want people to know that they are not alone,” Gelman tells Elite Daily. “It is estimated that 75 percent of women will experience pain with sex at some point in their life.”

So, what are some of the reasons sex can be painful, and how do you deal with it if it happens to you? The answer is that there are multiple things that can cause pain during sex, and any combination of these factors is a possibility, too — which means dealing with it varies from person to person. But regardless of the cause, the good news is that there are plenty of ways you can still enjoy having sex. Here’s what you need to know.

It can be caused by various medical conditions & infections.

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According to Gelman, there are a variety of medical conditions that can cause pain during sex — namely, endometriosis, polycystic ovary syndrome (PCOS), fibroids, and irritable bowel syndrome (IBS), all can cause pain during sex. One common issue, Gelman says, is pelvic floor dysfunction. “The pelvic floor is a muscular bowl in the pelvis and it supports the pelvic organs (bladder, colon, uterus or prostate),” Gelman explains. “Just like any muscle in the body, the pelvic floor can become restricted, spasmodic or hypertonic. This can lead to pelvic pain in general or difficulty inserting anything in the vagina, including tampons, dildos, or a penis.”

Along with medical conditions like these, sometimes an infection (be it a UTI, a yeast infection, or an STI) can be a factor in painful sex.

“Certain STIs [and] STDs can also contribute to pain with sex, along with things like urinary tract infections, and yeast infections,” Gelman says.

Hormone levels & birth control can cause pain, too.

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Another thing that can contribute to experiencing pain during sex? Your hormones.

“The vulva, primarily the vestibule (vaginal opening), clitoris and urethral tissue are all mediated by hormones, both estrogen and testosterone,” Gelman explains. “So, certain life events like menopause and childbirth lead to a decrease in estrogen, which can lead to these structures not getting enough estrogen — which can lead to vaginal dryness and pain with sex.”

And that means that birth control methods like the pill can impact how sex feels for you, too, since they affect your hormones.

“Things like oral contraceptives can also impact hormone levels by leading to a decrease in the same hormone levels, which again can lead to the structures mentioned becoming irritated, atrophic, and less supple which again can lead to pain,” Gelman says.

And it can be due to any combination of these things.

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As Gelman points out, there could be a combination of factors at play, and a person who experiences pain during sex might have more than one of these conditions.

“It is common for me to see someone that had multiple yeast infections, [has been] on the birth control pill for 15 years, and has endometriosis and pelvic floor muscle dysfunction, so pain with sex often requires a team of providers to address the different components,” Gelman says.

Another thing to note is that some things that might seem like standalone issues, like vaginal dryness, could be due to a bigger problem.

“Things like vaginal dryness can also play a role,” Gelman says. “A good quality water-based lubricant can help, but it may not be addressing the root cause of why that is happening.”

What should you do if you’re dealing with painful sex?

via GIPHYBecause any number of medical conditions could be contributing to painful sex or penetration, it’s important for people who are experiencing it to talk openly about it to their doctors.”If possible, talk to a healthcare provider ASAP,” Gelman says. “I know patients report that providers don’t always ask about sexual function, but it is important to bring this up to a clinician because there are a lot of options to help pain with sex.”

It’s also important — always, but especially when it’s an issue like painful sex — to find a provider who will listen to you, be understanding, and take your pain seriously.

“There are many treatment options and providers who can help,” Gelman says. “So, if your provider dismisses you or tells you to ‘drink a glass of wine,’ find a new provider. And as frustrating as our healthcare system can be, don’t give up!”

Gelman also recommends asking your doctor for a referral to see a pelvic floor physical therapist, and finding a therapist to help you cope with how your pain symptoms could be impacting your mental health.

“Many patients also benefit from working with a therapist because pain with sex can be emotionally draining and having that kind of support is key,” Gelman says.

And what about having sex you can actually enjoy?

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The good news is, even if you’re experiencing discomfort with penetration or other painful issues during sex, there are still other ways to have sex and be intimate.

“I often remind people that sex is so much more than a penis in [a] vagina,” Gelman says. “Sex can be digital or oral stimulation, it can be mutual masturbation, it can be anything that feels good.”

Not to mention, the genitals aren’t the only part of the body that can be stimulated, Gelman notes. It’s all about finding what works and feels good for you. And if you want to make sex with penetration feel better, you have some options.

“If someone really wants to still be engaging in penetrative sex, using a good lubricant and communicating with their partner is important,” Gelman says. “[And] certain positions may be better than others.”

In the end, when it comes to sex, all that really matters is that you have consent, enjoy yourself, and put your health first — no matter how you do it.

Original Article: https://www.elitedaily.com/p/heres-why-sex-can-be-painful-sometimes-according-to-a-doctor-9119954  18/05/2018 – Brittney Morgan

Other Articles:
http://zenithphysiopilates.com/2018/04/28/pelvic-floor-exercises-pregnant-women/
http://zenithphysiopilates.com/2018/04/30/6-exercises-that-help-stop-post-baby-pee-dribbles/

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Urinary Incontinence Is Real & It’s Time We Stop Joking About It

If you spend time in mommy groups on social media, you probably know that a lot of moms pee a little when we sneeze, cough, or run. It’s become such an acceptable part of new motherhood that we actually joke about it. But those jokes are starting to piss me off (pun intended). I mean, as someone who carried and birthed three babies, and now has urinary incontinence, I find it humiliating… not funny. So, can we please stop joking about urinary incontinence? It impacts so many new moms, so I don’t think it’s a laughing matter.

Like a lot of moms, I have urinary incontinence. I totally wish I didn’t, though. And what people consider laughable is what I consider to be particularly embarrassing. I pee when I cough or laugh. I pee when I run, which as a marathoner really gets in the way of me actually enjoying life. I also pee when I vomit, which made having severe morning sickness with my youngest totally unbearable. And if I try to play on the trampoline with my kids? You guessed it, I pee.

I am an adult woman who frequently has to change my pants more than once a day. I am a woman in my 30s who has purchased incontinence pads, underwear, and pessaries. I’m sorry, but WTAF? This is not what I imagined being an adult women would be like.

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Worse, I had no idea that other moms experienced the same. No, it’s not just me, my friends… not by a long shot. It turns out that postpartum is less of a punch line and more of a way of life for many, if not most, new moms.

According to one study published in the Journal of the Scandinavian Association of Obstetricians and Gynaecologists, one third of new moms had postpartum incontinence three months after delivery. New moms who had a vaginal birth experience incontinence twice as often as moms who had a C-Section. Another 2015 study of 1,574 new moms showed that 49 percent still had urinary incontinence a year after giving birth. That’s half of new moms. A full year after childbirth. OMFG.

I HONESTLY THINK THE FACT THAT MOST MOMS HAVE TO DEAL WITH URINARY INCONTINENCE, AND ALSO HAVE TO HEAR JOKES ABOUT IT, IS A SYMPTOM OF OUR CULTURE’S GENERAL DEVALUATION OF WOMEN AND MOMS.

But before you schedule a C-Section in the hopes of side-stepping the whole incontinence thing, you should know that even C-section moms are not immune. A study published in the New England Journal of Medicine showed that women who had C-Section deliveries had a higher risk of urinary incontinence than women who had never been pregnant, so there’s really no way to avoid peeing all over yourself as you try to live your postpartum life.

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Given how prevalent it is, it’s kind of unbelievable that more of us aren’t talking about urinary incontinence. Instead, we suffer in silence, wear black pants, and hope no one notices that we vaguely smell like pee once in a while. Or maybe that’s just me. And, perhaps even worse, we make jokes about it, essentially making fun of any new mom in the vicinity who is too embarrassed to speak up and say something. You don’t have to be in high school to still be negatively impacted by high school-aged humor. Trust me.

I DON’T ACTUALLY WANT TO TELL OTHER PEOPLE ABOUT MY PELVIC FLOOR ISSUES, AND I DEFINITELY DON’T WANT TO ADMIT THAT I CAN’T STOP FROM PEEING MYSELF RANDOMLY AND UNINTENTIONALLY.

I honestly think the fact that most moms have to deal with urinary incontinence, and also have to hear jokes about it, is a symptom of our culture’s general devaluation of women and moms. I mean, I think if men regularly peed themselves after becoming dads they wouldn’t think it was funny, either. Instead of an endless stream (another pun intended) of jokes, there would probably be a cure for postpartum incontinence. What plagues mom and is considered laughable would be taken seriously and addressed head on.

You would think that with the postpartum incontinence prevalence rates being as high they are that women would receive information about these risks and effective treatment for urinary incontinence, especially from their OB-GYNs or midwives, but that wasn’t my experience at all.

As Fit Pregnancy reports, treatments are available for postpartum incontinence, including physical therapy and even surgery. But, as I have learned, in the U.S. that means spending money on co-pays, deductibles, and co-insurance. If you can’t afford to “fix” your pelvic floor or urinary incontinence issues, you just have to deal.

UNFORTUNATELY, SQUEEZING THE HELL OUT OF MY PELVIC FLOOR MUSCLES DIDN’T SEEM TO MAKE ANY DIFFERENCE AT ALL WHEN IT CAME TO PREVENTING INCONTINENCE,

And it’s not something that anyone really wants to talk about, either. I mean, it’s more than a little bit embarrassing to admit that you pee when you don’t want to. Utterly humiliating, actually. And for me, it’s actually worse that everyone— especially other new moms — joke about it all the time. I don’t actually want to tell other people about my pelvic floor issues, and I definitely don’t want to admit that I can’t stop from peeing myself randomly and unintentionally.

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Part of the problem, I think, is the blame game that occurs when moms have incontinence. My OB-GYN led me to believe that if I did enough Kegels — or pelvic floor squeezes — during pregnancy, I wouldn’t have incontinence issues. Unfortunately, squeezing the hell out of my pelvic floor muscles didn’t seem to make any difference at all when it came to preventing incontinence.

A few weeks ago I finally saw a physical therapist for my incontinence issues. He — yes, a man, which was awkward AF — told me that postpartum incontinence was really common for moms. He also told me that a few weeks of physical therapy and at-home exercises could potentially make my pelvic floor issues and incontinence issues improve. He also told me that Kegels would not be a part of my treatment plan, which made me regret all of the time I had spent trying to tone my pelvic floor.

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This made me wonder why postpartum women aren’t regularly offered physical therapy as a part of their regular postpartum care. The American Physical Therapy Association has started offering a certification in Pregnancy and Postpartum Physical Therapy for their members, who are trained to treat conditions such as urinary incontinence and pelvic pain, but my midwives and OB-GYN didn’t refer me for care.

As HuffPost reports, in France, apparently, new moms pretty much automatically get 20 weeks of pelvic floor physical therapy after childbirth. They also, not surprisingly, report fewer cases of postpartum incontinence than American moms. Go figure.

So yeah, I am done with jokes about moms peeing themselves. It’s not funny. It’s a medical condition. And instead of laughing, it’s time we demanded effective treatment for incontinence and as a part of regular postpartum care. After literally growing human beings inside our bodies, we totally deserve it. No joke.

Original Article: https://www.romper.com/p/urinary-incontinence-is-real-its-time-we-stop-joking-about-it-9159730  05/23/2018

Other Articles:
http://zenithphysiopilates.com/2018/04/28/pelvic-floor-exercises-pregnant-women/
http://zenithphysiopilates.com/2018/04/30/6-exercises-that-help-stop-post-baby-pee-dribbles/

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Physical Therapy for your Pelvic Floor – Video

 

I Tried Pelvic Floor Therapy After Having A Baby

“My bladder was like a slow faucet drip that refused to turn off.”

I used to think kegels were only done for the sake of stronger orgasms.

I’m not sure I’d ever truly done one—or at least done one properly—until last summer. By that point, I’d been peeing in my pants for oh, a good six months.

Something had to be done.

My beautiful baby girl is to blame for my current condition…well, at least the start of it. I’ll take responsibility for the lingering issues. When I gave birth to her in November 2016, I thought I’d prepared my body for her arrival.

I had a very uneventful pregnancy, with few physical complaints. I walked daily, and down-dogged my way through my second and third trimesters like a champ.

But when she dropped down into my birthing canal sometime around her due date, I felt a serious shift of pressure in my pelvis. I was full-on waddling everywhere for a week until I felt the first signs of labor.

I labored at home for six hours, then headed to the hospital for another 20 hours of very. hard. work until I could cradle my girl in my arms. I had one small vaginal tear as well as some tissue the doctor had to “retrieve” from my uterus, but otherwise, I seemed fine. In fact, the doctor told me the very next day that, because I was healthy, I’d physically feel back to normal in a few days.

I couldn’t walk like a normal person for six weeks.

‘SOMETHING MUST BE WRONG…’

…I told the doctor at a follow-up appointment I made two weeks after birth. He did a quick exam, said I was healing, and advised me to start taking sitz baths (a warm shallow bath meant to ease pain and swelling down under). That was the first time I’d ever even heard of such a thing.

Despite my thrice-daily sitz baths, I couldn’t ignore the nagging pressure on my pelvis. Something as simple as a short walk around the block with my dog made me uncomfortable, not to mention the leaks when I’d cough, laugh hard at a joke, walk down a hill—even the sound of water would do it. It was like a slow faucet drip that refused to turn off. Not catastrophic, but a real nuisance.

I eased back into exercise and tried to wish the issue away. From the outside, I looked like the picture of perfect postpartum health. I even signed up for dance classes with new mom friends just six weeks after birth. Who cared that I could never do the jumps and always had to wear a pad? Life is full of trade-offs, right?

At my six-month postpartum appointment I confessed to another doctor in the practice, “Something is still wrong.” She replied with a story about how one time her sister was walking down the street a few months postpartum and peed all over herself. “Just give it time,” she promised.

This response didn’t sit right with me—or my pelvic floor. But I wanted so badly to believe her. While some very lucky women do heal over time (although, let’s be honest, are our vaginas ever really the same after pushing a human out of them?), I didn’t seem to be one of them. An estimated one in three women suffers from some type of pelvic floor disorder, including urinary incontinence, according to a study from Kaiser Permanente. So why did I know so little about it?

‘AS TIME PASSED AND NOTHING IMPROVED, I KNEW MY BODY DESERVED MORE.’

Dr. Google brought me to the words “pelvic floor therapy” and my most research-obsessed mom friend confirmed that this was a thing and I should check it out.

At my first appointment with my physical therapist, Ingrid Harm-Ernandes, my suspicions were confirmed. She asked me a litany of questions—rating my pain, describing my accidents—before doing a physical exam.

What started out like a pap smear (I was naked from the waist down; she was gloved) turned into a series of tests on the current state of my muscles inside my vagina. She asked me to cough to see if the muscles would contract like they should (lifting up against the downward pressure of a cough), and then she very slowly and carefully used a finger to press on each tight muscle until it loosened up. The tighter the muscle, the more uncomfortable it felt for me. But as she loosened each muscle—which usually took around 20 to 30 seconds—I felt better. Her diagnosis: stress incontinence (when physical movement causes leaks) and slight urge incontinence (when the urge to pee can’t be controlled).

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“The pelvic floor is like a hammock—stretching from your pubic bone to your tailbone and side to side—that holds up your bladder, bowel, and uterus. Just like other muscles in your body, your pelvic floor muscles can get tight, weak, function poorly or can become painful,” says Harm-Ernandes. “In your case, they’re weak but also tight at the same time,” she told me.

So anytime my bladder was put under sudden pressure, my muscles were too tight to contract quickly and block off the flow of urine. But there was good news! If I did daily kegels and core exercises to build strength and visited her on a regular basis, I could recover.

It turns out you can’t just start doing kegels and cross your fingers. You need a professional to assess the damage and tailor a recovery program just for you. “A proper kegel is an isolated contraction of your pelvic floor muscles without using other muscles around the pelvic floor,” she says. “Think of it more as a drawing-up-and-in sensation than a squeeze.”

The first kegels I did properly took an enormous amount of concentration, but now I’m doing five daily sets of them. I do 10 long ones—drawing up and in for 10 seconds and then slowly releasing—as well as 10 one-second ones. I also do core exercises, which include alternating leg and arm raises, one-legged squats and a marching isolation exercise. And to be honest, for being a fairly disciplined person, I’ve had a tough time making this a priority. I’ve made excuses to myself about being too busy, I’ve set alarms on my phone as reminders. I have good days where I do them all, and others where I’m lucky if I do it once.

I used to think kegels were only done for the sake of stronger orgasms.

Every two to three weeks, I visit my therapist and we walk through what I’ve done, I promise to drink more water (not drinking enough actually irritates the bladder and makes it worse), and then we finish with an internal exam. In an experience that could easily feel invasive and uncomfortable, her professionalism and empathetic approach makes all the difference.

Any progress is better than none, and besides a few setbacks (turns out it’s hard to hold your pelvic floor when you’re full-body coughing with the flu), the leaks are less and less frequent, and the pressure is slowly lifting overall. My goal is to go for a run this summer—something I haven’t been able to do in two years!—and sign up for dance classes again by the fall.

Original Article: https://www.womenshealthmag.com/health/a19725028/pelvic-floor-therapy/  04/12/2018 – Jourdan Fairchild

Other Articles:
http://zenithphysiopilates.com/2018/04/28/pelvic-floor-exercises-pregnant-women/
http://zenithphysiopilates.com/2018/04/30/6-exercises-that-help-stop-post-baby-pee-dribbles/

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http://zenithphysiopilates.com/services/pelvic-health/ 
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The Best Move To Make Sure Your Bladder Never Leaks Again

No, we’re not talking about kegels.

Whether you’re getting ready to have a baby and want to strengthen those below-the-belt muscles, you leak a little every time you do box jumps, or you just want to keep things nice and strong down there—it’s a good idea to start strengthening your pelvic floor.

“If someone is having symptoms of any kind of leaking urine, that means they have pelvic floor dysfunction—they inherently have a weakness,” says Debbie Cohen, P.T., C.S.C.S., owner of Fundamental Physical Therapy & Pelvic Wellness in Poway, California. She adds that while a lot of CrossFitters tout a little leaking as a badge of honor, no amount of leakage is normal.

If you’re sick of kegels, a lot of the moves you do for glute and hip strength actually work your pelvic floor, too. “All the hip muscles attach at the pelvic bone, so those will help with strengthening,” says Cohen.

Two of the best: marching glute bridge and a goblet sumo squat.

Both use the pelvic floor as an accessory muscle to the glutes, hamstrings, quads, and adductors, Cohen shares. But beginners should start with the marching glute bridge.

“The main difference between these two moves is that one is against gravity and the other isn’t. In the sumo squat, your pelvic organs are weighing against the pelvic floor, not to mention the dumbbell in your hands, so it’s a little more challenging as you go down and up,” she explains.

The glute bridge, on the other hand, has your pelvis horizontal with gravity. As with any weakness, you want to fix it by starting with the foundational exercise with minimal resistance and work your way up to the one that’s harder as your strength progresses.

Cohen adds that while both these moves are a great addition to your workout routine, if you’re having semi-regular urine leakage or pelvic pain, you should consult with a specialist. “The best moves to strengthen your pelvic floor are personalized to the problem, so working with a trained professional can really help,” she adds.

Here’s how to do both moves:

MARCHING GLUTE BRIDGE

How to: Lie faceup on the floor with your knees bent and your feet flat on the floor. Raise your hips so your body forms a straight line from your shoulders to your knees. Lift one knee to your chest, lower back to the start, and lift your other knee to your chest. Continue alternating back and forth.

GOBLET SUMO SQUAT

How to: Grasp the head of a heavy dumbbell and hold it in front of your chest. Set your feet at about twice shoulder width, your toes turned out slightly. Lower your body down by pushing your hips back and bending your knees. Pause, then slowly push yourself back to the starting position. That’s one rep.

Original Article: https://www.womenshealthmag.com/fitness/a19760745/best-move-for-pelvic-floor/  04/13/2018

Other Articles:
http://zenithphysiopilates.com/2018/04/28/pelvic-floor-exercises-pregnant-women/
http://zenithphysiopilates.com/2018/04/30/6-exercises-that-help-stop-post-baby-pee-dribbles/Our Services:

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These Common Myths Will Change The Way You Think About Exercise During Pregnancy

There are many myths out there about what you can and cannot do during pregnancy, and because I teach both prenatal and postnatal yoga, I spend a lot of time myth-busting and teaching mamas how to tune into their maternal instincts to figure out what is and is not good for their baby and body.

This is complex, because what is right for one mama may not be right for another. We are all unique, beautiful, fascinating creatures. So, how do we know which advice to take from friends and family, or from our personal trainer or yoga teacher? I recommend starting by sorting out the old wives’ tales from actual wisdom. Take a look at these myths and consider where they came from. Perhaps there is some wisdom in there after all.

Myth 1: Don’t lie on your back.

With the right props and pelvic alignment, you will absolutely get on your back in a yoga class. One of the concerns associated with lying on your back is vena cava syndrome, which involves the heavy uterus obstructing a major blood vessel, but that hardly means you should avoid lying on your back altogether. Instead, listen to your body, and take a look at this guide to give you insight into whether a pose isn’t working for you.

Myth 2: Do your Kegels every day.

Before you commit to a regimen of daily pelvic floor exercises, I highly recommend seeing a pelvic floor physical therapist to help assess whether your pelvic floor needs to be strengthened or whether you need to learn how to relax. If you’re already a yogini, odds are that you need to focus your effort on learning how to relax your mula bhanda.

Myth 3: Don’t start any exercise you’ve never done before.

True, it’s probably not a great idea to start training for a marathon if you’ve never done one before. But the reality is that pregnancy is a time to modify your exercise regimen, which probably means trying something new (like prenatal yoga!). This is not about focusing on what you cannot do but tuning into areas of your body that you’ve possibly never considered before.

Myth 4: Inversions will turn your baby upside down.

This one depends on what you consider “upside down.” Inversions can help you to turn a baby that is breech (bum presenting instead of the head). I have personally worked with a few women who have used a modified shoulder stand to help their baby turn. That being said, don’t do anything you’re not comfortable with or that feels unsafe—especially if you don’t already have a regular inversion practice!

Myth 5: Don’t do any “core” work.

Yes, you can do work that enables you to properly engage your abdominal muscles and pelvic floor. This myth is telling you not to do the old-fashioned “sit-ups” that mostly engage your rectus abdominus (the superficial “six-pack” abs at the front). There are several other core muscles that we should absolutely continue to work with because they will help you to birth your baby (and carry him/her around afterward!). I love the Tupler Technique™, which is outlined in the book Together Tummy.

After teaching thousands of women, my wise and beautiful prenatal yoga teacher Colette Crawford taught me to always explore the risks, benefits, and alternatives associated with any decision related to pregnancy, birth, and babies. So for every piece of advice (or myth!) you hear, please consider the risks and alternatives, get a second opinion, and then make up your own mind. You’ll probably end up busting a few myths of your own.

Original Article: https://www.mindbodygreen.com/articles/the-top-five-myths-about-yoga-during-pregnancy by Blair Fillingham (https://www.mindbodygreen.com/wc/blair-fillingham?mbg_ifs=0&mbg_p=a&mbg_ref=body)

Other Articles:
http://zenithphysiopilates.com/2018/04/28/pelvic-floor-exercises-pregnant-women/
http://zenithphysiopilates.com/2018/04/30/6-exercises-that-help-stop-post-baby-pee-dribbles/

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8 Natural Ways To Treat An Overactive Bladder

About a year ago, I began noticing I was getting up several times a night to pee. Once I thought about it, I realized I was peeing a lot during the day, too. The problem escalated and escalated until I was getting up three to five times a night, leading to severe sleep deprivation. Desperate for a solution, I got tested for interstitial cystitis, ovarian cysts, diabetes, kidney stones, you name it. But with all the results negative, I instead got the frustrating diagnosis of overactive bladder (OAB).

I describe an OAB diagnosis as frustrating because it doesn’t have a simple cure. Your options are to go on medication, to see a physical therapist who can teach you helpful exercises or an osteopath who can manipulate your nerves, to try a more drastic treatment like Bladder Botox injections or electrical bladder stimulation, or to make a bunch of small changes to your lifestyle that can gradually alleviate the problem. “Even though treatment options exist, many patients opt for natural and homeopathic remedies, since no single treatment has been proven to be most effective,” Caleb Backe, Health and Wellness Expert for Maple Holistics, tells Bustle.

There are two main symptoms of OAB, Los Angeles-based urologist S. Adam Ramin, MD tells Bustle: urgency frequency (feeling like you have to pee a lot) and urgency incontinence (not being able to hold it in). Some people with OAB (like me) only have the first symptom, while others have both.

“Whether it’s that sense of urgency when you laugh or the incessant fear of not making it to the bathroom in time, women who suffer from an overactive bladder or urinary incontinence are often embarrassed by their condition and sometimes feel like the only people on the planet who must endure it,” says Ramin. “In reality, nothing could be further from the truth. While urinary incontinence does affect women more often than men, millions of women deal with some type of bladder control issue at some point in their lives. And the truth is this: If you suffer from an overactive bladder, it doesn’t have to be a condition that puts you in adult diapers for the rest of your life. In fact, there are some simple diet and lifestyle changes that can put you back on the road to bladder control.”

I know this is true because when I make it through the day without caffeine and alcohol, avoid sugar in the evening, relax before bed, and refrain from drinking anything a few hours before bedtime, I only get up to pee once or twice. I initially discounted this advice because, hey, I don’t want to give up alcohol or caffeine or sugar or *gasp* stop working at night. But after I tried a few medications that all had undesirable side effects, I realized lifestyle changes were worth it — and would probably make me healthier in the process.

If you’re experiencing symptoms of overactive bladder, like an urge to pee eight or more times a day, urinary leaks, or the need to wake up to pee twice or more per night, see a urologist. There are a lot of underlying conditions it could be related to, and you can learn more about treatment options. Whether there is some underlying cause or it’s just plain old OAB, though, these strategies should improve the condition.

1 Cut Back On These Bladder Irritants

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Just this evening, I realized my bladder was feeling much more irritated than usual. Then, I thought back to what I’d just eaten: Thai curry and a smoothie containing orange juice. Curry, oranges, and juice are all on Urology San Antonio’s list of bladder irritants. “Studies show that spicy foods can sometimes be an irritant to the lining of the bladder,” says Ramin. “Fare like spicy chili, chili peppers, or horseradish are examples of foods that can cause such irritation. Likewise, highly acidic foods can trigger a similar response.”

It may not be realistic for you to give up all foods that could irritate your bladder, but you can start to take note of which foods are worst for you, and avoid those when you can (especially before bed).

And a word to the wise: People often say you should drink cranberry juice for bladder health, but that’s to ward off UTIs. When it comes to bladder irritation, cranberry juice — along with most kinds of juice — could have the opposite effect you want. “Due to its high acidity, it can actually worsen the condition,” says Ramin.

2 Cut Back On Diuretics Like Caffeine and Alcohol

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Caffeine and alcohol are both double trouble, says Ramin. They’re diuretics (they make you pee) and they stimulate bladder function. “If you suffer from urinary incontinence, one of your worst enemies can be caffeinated beverages,” he says. “Though it can be much easier said than done, limiting or eliminating caffeine altogether has been known to be successful in diminishing and resolving issues of urinary incontinence in some women.”

Similarly, he adds, “alcoholic beverages act as bladder stimulants and diuretics in most people. So when you have a problem with urinary continence, consuming even slight amounts of alcohol can make matters worse.”

If you can’t function without your daily cup of coffee, try to keep it to the morning so you’re not getting up to pee at night. And if you like having a glass of wine to wind down, at least limit it to one and keep it as far from bedtime as possible. Or, just take a break from caffeine or alcohol for a week or two, and see if the benefits you notice are worth it.

3 Stay Hydrated

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So what should you drink, then? When you’re already a peeing machine, drinking water may be the last thing you want to do. According to a 1,000-person survey by Poise, almost half of women believe that limiting water intake will limit their bladder leakage. The problem with this is, dehydration dilutes your urine, making it more concentrated and consequently more irritating to your bladder, Poise partner and OB/GYN Dr. Jessica Shepherd tells Bustle.

However, you have to balance this information with the knowledge that drinking before bed will increase your chances of waking up to pee. So, Shepherd recommends drinking eight eight-ounce glasses during the day and then cutting off fluids four hours before bedtime.

4 Do Kegel Exercises

Ashley Batz/Bustle

Kegel exercises — when you repeatedly squeeze and relax your PC muscles (the ones you use to hold in pee) — have a ton of benefits, two of which are reducing urinary incontinence and urinary urgency, Brent Reider, an author and referee for medical and scientific peer review journals and designer of several FDA-cleared medical devices including the Yarlap, tells Bustle.

“Exercise therapy to tone and re-educate the pelvic floor muscles is an essential aspect of pelvic care and often recommended by physicians as the first line of overactive bladder treatment,” he says. “The muscle contractions that cause urge/OAB (and can be the cause of nocturia) are like spasms caused from inactivity and where the muscle needs respiration. Blood flow from the workout gets the muscle respirated.”

How do you do them, then? “One of the most promising techniques is for patients to trigger their pelvic floor muscles (kegels) as soon as they sense the urge to urinate and engage these muscles for around 10 seconds,” says Backe. “Alternatively, you can do five to seven rapid contractions until the urgency diminishes, and then go to the toilet.”

If you can’t find the energy to do Kegel exercises or want to make sure you’re doing them right, a device called the Yarlap will do them for you by delivering electric pulses to your vagina that cause it to contract. As an added bonus, many Yarlap users also find that they start having better sex, says Reider.

5 Try Physical Therapy

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Regular sessions with a pelvic floor physical therapist can help retrain your bladder muscles and nerves through kegels and other exercises. “Although this modern form of physiotherapy can be extremely time-consuming and frustrating, it offers patients the best chance of regaining control of their bladder,” says Backe. “These bladder drills function to retrain the brain to retain the power of the bladder’s muscle contractions.”

The exercise program to help with overactive bladder is called “bladder retraining,” Rachel Gelman, DPT, PT, Branch Director at the Pelvic Health and Rehabilitation Center, tells Bustle. “Many people have developed habits over time, like going just in case, so then the bladder starts to send a signal that it is full when it really isn’t,” she says.

“Sometimes, the pelvic floor muscles can become restricted or hypertonic/spasmotic, which can lead to urinary urgency and frequency,” Gelman says. “Working on the myofascial restrictions with manual therapy and exercises to help relax the muscles may be beneficial can help address these symptoms as well. Many times, patients actually have poor bowel habits and suffer from constipation, which can lead to pelvic floor dysfunction and bladder issues, so working on bowel mechanics can actually improve bladder symptoms.” Since the problems are different for each person, the exercises will be, too, so a physical therapist can recommend the right ones for you.

6 Reduce Stress

Ashley Batz/Bustle

When my bladder issues first started, a psychic and a spiritual intuitive both told me the main cause was anxiety. I didn’t listen until my urologist, a Yale Medical School graduate, said the same thing. The nerves in your brain connect to the nerves in your bladder, he explained, so anxiety can lead to hypersensitive bladder nerves.

After learning this, I think I figured out what happened to me. I was dealing with crippling insomnia when my bladder issues started, and I’d become obsessive about everything that could keep me up, my bladder included. I’d lie in bed for a few minutes then get up to pee again and again out of fear that if I didn’t, I wouldn’t sleep. By thinking about my bladder so much, I must have built up the connections between it and my brain, developing a hyper-awareness. That’s my theory, at least.

This is just one way that anxiety can lead to bladder issues. Whatever the mechanism, it’s pretty clear that it does. One 2016 study in Urology found that overactive bladder patients had more anxiety than controls. “Mental stress can cause increase autonomic nervous system activity,” says Ramin. “This leads to increased bowel and bladder activity. Increased bowel leads to irritable bowel syndrome (aka IBS). Increased bladder activity leads to overactive bladder.”

Stress reduction can mean many different things, from seeing a therapist to spending time doing things you enjoy. If you have issues with peeing at night, doing something relaxing before bed can be a huge help (taking a bath helps for me).

7 Get Acupuncture

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Acupuncture — a Chinese healing technique where someone places tiny needles in your skin near pressure points — can help with all sorts of physical ailments, and research suggests overactive bladder is one of them.

One study by Whipps Cross University Hospital and University College of London Hospital found that 79 percent of overactive bladder patients saw significant improvement after 10 weeks of weekly 30-minute sessions. These patients had already tried typical treatments like behavioral changes and medications. An advantage to acupuncture is that unlike medications, it doesn’t tend to cause many side effects (though there are a few rare ones).

8 Get Visceral Manipulation

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For a fairly new technique called Visceral Manipulation, an osteopath uses their hands to move around the nerves in your pelvis and abdomen. “Visceral manipulation refers to manual therapy techniques that work directly with organs and their surrounding connective tissues to restore normal motility, structure, and function,” OB/GYN Eden Fromberg, DO tells Bustle. Connective tissue is the scaffolding that connects different parts of the body, from the surface of the skin to the internal organs.

“Removing stuck stress from the tissues, literally hydrating and unsticking dry connective tissue, restores the sensitivity of the core and neurofascial system and kicks in repair and healing processes,” Fromberg says. Visceral manipulation can help alleviate overactive bladder by changing the way your bladder nerves communicate with the rest of your body.

Living with OAB is truly awful. I would know — with all the sleep mine has lost me, I don’t remember what it’s like to not be exhausted. But I try to think of it this way: Discomfort is your body’s way of telling you something’s wrong. And maybe if you fix whatever’s wrong by making the changes needed for a healthier bladder, your whole body and mind will also become healthier in the process. At least that’s what I’m hoping.

The common but embarrassing side-effect of hay fever plaguing women

Stress urinary incontinence is when pee leaks out from the bladder when it is under stress – like when you cough and sneeze
There’s a little side effect of hay fever that few people talk about – pee.

For women who suffer with incontinence, every sneeze hay fever brings on comes with a side of panic.

A simple sneeze during hay fever season can be enough for a woman to suffer incontinence

ALAMY

The condition is essentially a loss of bladder control caused by weakened muscles down there.

Incontinence is more common in women who have given birth because of the incredible strain it puts on the pelvic floor muscles, but it can affect anyone.

Stress urinary incontinence is when wee leaks out from the bladder when it is under stress – like when you cough and sneeze.

So women with this condition who also suffer from hay fever can suffer through a pretty rough few months.

Stress urinary incontinence is when wee leaks out from the bladder when it is under stress - like when you cough and sneeze

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The sunny weather is set to shine, but that brings with it a higher pollen count and, you guessed it, more sneezing.

Luckily, there is one exercise you can do to strengthen your pelvic floor and help put an end to incontinence.

Training your pelvic floor muscles not only boosts your sex life, it also prevent incontinence

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Pelvic floor muscle exercises also help prevent the unthinkable – prolapse of a woman’s internal organs, something that can happen after giving birth.

Pelvic floor exercises strengthen the muscles around the bladder, vagina or penis and back passage.

Also known as kegels, the exercises can help prevent urinary incontinence, treat prolapse and even make sex better by increasing sensitivity and boosting orgasms in women.

How can you do pelvic floor exercises?

To strengthen your pelvic floor muscles, sit and squeeze and release 10-15 times in a row.

Don’t hold your breath or tighten your tummy, bum or thigh muscles at the same time.

When you get used to the exercises, you can hold the squeezes for a few seconds – and do more reps.

Each week add more squeezes to your daily routine and within a few months you should notice results, enjoying greater sensitivity during sex.

Keeping your pelvic floor strong can also prevent the unthinkable – prolapse of a woman’s internal organs, something that can happen after giving birth.

In severe cases a uterine prolapse can result in a woman needing to undergo a hysterectomy, leaving her infertile.

9 Things You Should Know About Postpartum Exercise (and Probably Don’t)

There’s a lot of confusing information out there about how fitness can change once you’ve had a baby. Here we clear things up.
There is no bigger wake-up call than the difference between how a woman pictures herself as a mom and the actual reality of the situation. Set aside all of the “I’ll definitely do X, Y, or Z as a parent” claims—especially when it comes to exercise.

Postpartum fitness will likely be an entirely different ball game than you anticipated. (Just look at star trainer Emily Skye, whose pregnancy journey was totally different than she planned.) Even the best-intentioned new moms may find that their fitness takes a backseat when they have a new little one in the house. Here, some need-to-know facts about postpartum exercise that may not be on your radar.

1. Your core will be stretched—or even separated.

Unsurprisingly, one of the biggest differences between your pre-baby workouts and postpartum exercise lies in your core. One 2015 study suggests that virtually all women experience diastasis recti (when the right and left abdominal muscles separate) at the end of pregnancy and that up to 39 percent still have some level of separation at six months postpartum. (Related: Kelly Rowland Gets Real About Diastasis Recti)

Diastasis recti aside, “most women are surprised by just how different their core feels once baby has arrived,” says trainer Maura Shirey, a certified pregnancy fitness educator and owner of Bodies for Birth. “The core remains overstretched and the woman is left with a belly that feels very different. Women will describe feelings of vulnerability, disconnection, absence, vacancy, and nonexistence when referencing how their postpartum core feels in the early days.” Combined with a weakened pelvic floor, this can make returning to fitness quite challenging for new moms, since core strength is vital for overall health and basic fitness. Shirey recommends a focus on strengthening the transverse abdominis (the deepest muscles in your core) to regain strength and stability. (Try these abs exercises that can help heal diastasis recti or go see a physical therapist or trainer who specializes in postpartum training.)

2. Every labor and healing experience is different.

“Postpartum recovery time is different for every woman,” says Gina S. Nelson, M.D., fellow of the American College of Obstetricians and Gynecologists and ob-gyn at Kalispell Regional Medical Center. “My impression, based on experience alone, is that your pre-pregnancy level of fitness is the biggest determinant of how you’ll do in postpartum recovery.” If you have good fitness habits and a degree of conditioning beforehand, you’ll likely have an easier transition back to fitness after giving birth. “That said, the vast majority of women will be able to resume all normal activities, including exercise, by six weeks postpartum,” she says.

There are several complications that can interfere with postpartum exercise, including “postpartum depression, c-section, postpartum hemorrhage, excess weight gain in pregnancy, pubic bone symphysis, and diastasis recti,” says Dr. Nelson, but all of these situations have solutions. A six-week post-partum check-up is the standard, but Dr. Nelson says you shouldn’t wait that long if you suspect something is wrong. “Many caregivers now are seeing patients at one or two weeks postpartum to identify problems early,” she says. Ideally, your doc will bring up the topic of exercise and give the go-ahead to get active again. But you should also have questions ready for your six-week visit and can ask specifics about returning to workouts that you may have been doing pre-baby.

Even without complications, Dr. Nelson suggests starting exercise “gradually and gently with much more mindfulness than before.” She says women should use the first three months of postpartum exercise to get their bodies used to working out again and not to make gains. For example, runners can start with walking, then walk-jogging.

3. You’ll experience brand-new aches and pains.

You hear all about relaxin (the hormone that helps loosen joints for labor) during pregnancy, but it actually stays in your system well beyond the birth of your baby. “Some sources believe that relaxin can stay in the body for up to 12 months after weaning,” says Shirey. This means your joints remain looser than usual. That lack of stability means your body is more prone to aches, pains, and injury.

Your new lifestyle could result in some aches too: “Motherhood can be a very ‘reactionary’ time, where we’re not slowing down to think about how we’re moving and positioning our bodies because there are needs that feel (and often are) more urgent (baby is crying, needs a diaper change, is hungry, etc.),” says Shirey. “You find yourself hanging out in super-uncomfortable positions until a leg or foot goes numb, with a full bladder, in an attempt to keep baby sleep.” She recommends focusing on alignment both during exercise and in everyday life.

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4. There are emotional challenges, too.

Postpartum depression (PPD) has gained a lot of attention in recent years—and rightfully so, since the American Psychological Association estimates one out of every seven new mothers will experience PPD. Even women without diagnosable depression will likely experience hormonal shifts and possible mood swings as a new mom. (Emily Skye and Kate Middleton have both shared their personal experiences with the “post-baby blues.”)

“I witness this being a very emotional time for many women at some point or another,” says Shirey. While many women experience some mild mood changes during or after the birth of a child, 15 to 20 percent of women experience more significant symptoms of depression or anxiety, according to Postpartum Support International. Symptoms can appear any time during pregnancy and within the first year after childbirth. (Here are some signs and symptoms of PPD to keep an eye out for.)

While PPD or general postpartum mood swings may lead to a lack of interest in exercise, Dr. Nelson says working out will help improve your mood and boost confidence—which is especially important when you’re bombarded with crazy expectations of what your post-baby body and fitness should look like.

“I often find that there are very unrealistic expectations about what postpartum fitness should look like,” says Shirey, “I credit this to social media and the overall lack of good information found on the internet. With a general emphasis on ‘getting your body back’ postpartum and Instagram images of celebrities in waist trainers wearing their skinny jeans with a 6-week-old in tow, it can be overwhelming to discern what’s realistic for postpartum recovery.”

5. Sleep is as important as ever.

Sure, your new little bundle of joy will sleep about 20 hours per day at first, but that happens in several increments. This means most mothers have trouble getting enough consecutive hours of sleep to feel well-rested and to feel like they have the energy to work out.

“This can be a bit of a ‘catch-22,'” says Shirey. “Exercise has the potential to provide more energy, but it also has the potential to be completely depleting—especially when you’re already sleep-deprived.” Exercise should not add to exhaustion, so listen to your body and consider less-strenuous workouts when necessary. “One day, a higher intensity walk including some hills might feel great,” she says. “On another day, when feeling particularly fatigued, some stretching and breathing work might be the right fit.”

6. It takes a village.

One potential barrier to postpartum exercise is the fact that baby needs a place to be while you work out. Your days of grabbing your gym bag and heading out the door without a second thought are history. Now, you have three options: work out with baby (which often means your workout takes a backseat), pay for childcare (some moms are not comfortable with a stranger babysitting early on), or leave baby with your partner or another trusted family member or friend. This means your support system is key. “A disorganized family life where there is inadequate help is a big barrier to resuming exercise,” says Dr. Nelson. (Take a peek at these mommy-and-me fitness classes that actually give you a solid workout.)

7. Jogging strollers come with caveats.

Before becoming a mom, most female runners probably think they’ll just load up the stroller and their annual half marathon schedule won’t need to budge a bit. But there are some things to consider. First, do your research and make sure your stroller is actually built for jogging. (Believe it or not, there are strollers that have “jogging” in the name but aren’t suitable or safe for jogging.) Just like any baby product, there are options in varying price ranges. But expect a jogging-appropriate stroller to set you back more than its non-jogging counterparts.

In addition, Shirey says you should check with your baby’s pediatrician and your jogging stroller’s manufacturer to find out when your little one can safely tag along on a run. Most babies aren’t ready until they’re 6 to 8 months old. After all of the above, “They can be surprisingly challenging to push and get used to using,” says Shirey, “so it’s best to be patient, take it easy to start and focus on alignment/core strength while working with this extra resistance.” (This Pilates stroller workout can be a great place to start.)

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Photo: Tomsickova Tatyana / Shutterstock

8. Breastfeeding burns calories, but it’s not a workout.

Nursing may not count as strength or cardio, but breastfeeding and making milk does demand a large amount of metabolic resources, says Dr. Nelson: “Breastfeeding requires an additional 300 calories above that required at the end of pregnancy,” she says.

Because you burn calories from breastfeeding (but it doesn’t necessarily count as exercise), you may notice the scale dropping while your clothes still don’t fit the way they did the last time you were at that weight. Shirey says that most women experience some degree of de-conditioning during pregnancy. She recommends slowly and methodically progressing resistance training to build or rebuild strength and muscle tone. (Related: This Woman’s Heartbreaking Confession About Breastfeeding Is #SoReal)

Very strenuous workouts can actually impact breast milk too, though your supply should stay intact as long as you’re eating enough and drinking enough water. Dr. Nelson recommends consuming extra calories and increasing water intake by one or two liters per day while nursing.

“Beyond sheer calories and hydration, I know of nothing about working out that diminishes milk volume,” says Dr. Nelson. Studies show that regular exercise at moderate to high intensity does not alter the quality or quantity of breast milk, but that extremely intense anaerobic exercise (read: jumping, sprinting, etc.) may alter the taste of milk due to physiological byproducts of exercise (such as lactic acid) and may impact your baby’s nursing behavior, according to a review published in Clinical Obstetrics and Gynecology.

9. Take it easy and know it’s worth the effort.

With all of these challenges and precautions, it’s still worth it to carve out time for exercise as a new mom. “When women resume workouts after a baby is born, they often comment on how much it means to them,” says Dr. Nelson. “The time they spend on themselves takes on a heightened importance which they cherish.”

There are so many benefits to postpartum exercise, says Dr. Nelson. “I encourage new mothers to be patient with themselves, their babies, and their families. I would like them to be self-accepting and to give themselves permission to take time for a workout once they have recovered. They should be encouraged that it will be good for them and good for their family too.”

Original Article: By Andrea Blair Cirignano | May 07, 2018  https://www.shape.com/fitness/tips/things-you-should-know-about-postpartum-exercise