"Do Your Kegels" or Is it, "Never Kegel"?

Carolina weights.jpg

For years there’s been a trend to tell everyone to “do your kegels” and we are currently seeing a shift in the other direction. We’ve recently heard both other pre/postnatal professionals and pregnancy care providers telling women they should never kegel.

We’re here to help clear up that contradictory information and educate you on why we think a general statement one way or the other is dangerous.

If you've taken class with us, you are familiar with the cue, "Pump & Kegel".  We remind you to fire this inner core unit constantly.  But why are we so focused on that? 

The muscles of your pelvic floor support your uterus, bladder and bowel.  They are important for sexual function AND work with the rest of the muscles of the core to stabilize and support the spine.  They also support the extra weight of the uterus and growing baby during pregnancy.  

Many of us don't realize that the pelvic floor, like our diaphragm, is part of our core.  Having an over active or under active pelvic floor negatively effects all the functions associated with breathing, digestion, eliminating toxins and moving through our every day lives.  It also helps neutralize intra-abdominal pressure, making us less susceptible to developing a Diastasis Recti (abdominal separation).   Your pelvic floor should contract and release with every single diaphragmatic breath which is why we cue the contraction AND release in all our classes at FPC.

We are bringing a hyper awareness to what your core should be doing naturally because most of us are dysfunctional movers and breathers. We do this because training your muscles to move functionally means that they will be able to properly support you in your day to day movements outside of class as well.

This is why we disagree with the general, blanket advice to either A: do your kegels or B: never kegel. A fully functioning pelvic floor does both! Everyone should understand the muscles of their pelvic floor. Some women need to strengthen them, some need to learn to relax them. If this isn’t information you can assess on your own (many of us can’t), you should seek out someone who can help you assess whether or not you are doing kegels correctly and if you need to devote time to training them to function properly.

If you are given the advice to either kegel or never kegel, what should you do?

Ask follow up questions! Does your care provider notice something specific that has led them to make that recommendation? If so, ask them what they see and what are they concerned about. Another thing you should do is ask for a referral to see a pelvic floor therapist to address the issue. Your midwife or OB is excellent at what they do, but they don’t have the credentials to assess your pelvic floor and prescribe exercises in the way that specialist that can. It’s important to get the help you need.


Want to learn more? Join us for one of our upcoming Protecting your Core and Pelvic Floor for Birth and Postpartum workshops. We’ll teach you to assess your pelvic floor and give you all the information needed to understand how to exercise through pregnancy and postpartum safely.

Debunking Exercise Myths: Returning to Exercise Post Pregnancy

The Myth: It's safe to return to your pre pregnancy workout as soon as you get the "green light" from your care provider.

Screen Shot 2018-06-07 at 8.46.46 PM.png

The FPC Answer: Most care providers will give you the green light at around 6 weeks to resume exercise.  But what does that mean?

Did you know that the first 12 weeks post birth are known as the "critical healing period"?  (Read 12...not 6).  Many women return to their favorite workouts too soon and too hard and put themselves at risk of developing complications.  Even if you feel amazing, the exercise choices you make during those initial weeks can effect your body for the rest of your life.  We could probably write you a book on the topic, but you're busy so here are some important bullet points instead: 

Before returning to exercise post birth:

  • It takes 4 months after you're done breastfeeding for your body to stop producing the hormone relaxin.  As long as relaxin is present, the connective tissue between your rectus abdominis (6-pack abs) is still vulnerable.  Thats why we continue to offer safe "core" alternatives for all our newly postpartum moms.  

 

  • No matter how good that new mom, "yoga teacher", "fitfluencer" looks on instagram, when she tells you it's safe to do crunches at 3 weeks postpartum, it's important to remember that traditional abdominal work like crunches, twists, planks, etc. are absolutely out of the question during those first 12 weeks.  

 

  • If you still have ab separation at 12 weeks, you need to continue to modify your workout and also be working with a postnatal specialist that can help you heal.  

 

  • You can't trust YouTube or even an instructor with a general pre/postnatal certification to do a Diastasis Recti (abdominal separation) assessment.  They have a very limited knowledge of the topic and they may "assess" that you are fine when in fact, you are not.  Or tell you that a DR is present when they don't understand the true definition of what it means to heal it.  Find a specialist. Come see us at FPC, or see a pelvic floor therapist for a proper diagnosis.  

 

  • Don't go for a run just yet!  Regardless of the type of birth you had, vaginal or Cesarian, you have to continue to train with your pelvic floor in mind.  Damage to the pelvic floor doesn't usually come from the actual birth.  It comes from the months of weight and pressure on those muscles leading up to the big event.  After birth, those muscles need time to rest and recover.  If we return to high impact movements right away, you are putting your pelvic floor at risk of developing a prolapse.  

 

This is just the tip of the iceberg when it comes to postpartum fitness.  FPC is passionate about educating every woman that walks through our door on how to make a complete recovery post birth.  If you are postpartum and looking to get back into fitness, join us at the studio!  

Postpartum Rehab and/or Pump & Kegel are the 2 best places to start! Check our schedule for times!  

The Second Stage of Labor: Pushing and Protecting the Pelvic Floor

Screen Shot 2018-04-18 at 3.43.33 PM.png

Contributed by Chantal Traub

Throughout the years of assisting women in birth, I realized that many moms are unprepared for the 2nd stage of labor. The second stage is when the mother assists her body by pushing the baby out. As a doula, I've heard many interesting stories about labor and delivery. I would find myself at the playground with my children or at a party and chat with a mother who would say “oh you are a doula, let me tell you about my birth!” Sometimes it is a beautiful birth experience, often, it is a story about a disappointing or a physically traumatic birth that led to ongoing pain with intercourse or urinary incontinence. A woman past childbearing age might tell me she had developed an organ prolapse or leaking.

During pushing, the muscle tissue in the pelvic floor will give as far as it needs to. Sometimes, this can result in a small tear, which eventually heals well, but could subsequently contract or atrophy due to the trauma and cause problems later in life. There are ways to prepare and protect the pelvic floor, for example: choosing the right providers, the positions you use to allow your baby to descend, the provider's patience at the time of crowning, your nutrition, and habits and lifestyle, and exercises that strengthen and tone the pelvic floor.

Over the years, I have talked with providers about better preparing mothers for the 2nd stage of labor. One of the answers that I'm given is that “she will figure it out while doing it and she only has to do it once, for her first vaginal birth, because pushing is so much easier and shorter the second time”. And I would think, yes that's true. The muscle strength and ability is there and there is a normal learning curve in the beginning of the 2nd stage, but...?

We, as pre-and postnatal providers, keep seeing so many postpartum issues, shouldn't moms prepare better? Wouldn't it be good to know beforehand how to strengthen your pelvic floor during pregnancy and before entering menopause?

In my workshop, you will learn how the pelvis and fetus interact as well as simple exercises to bring awareness to your pelvic floor. You will review breathing and positions for pushing, and I will offer you tools and tips to prepare.

One of the many ways to help tone the pelvic floor during pregnancy, post-baby and beyond is the practice of yoga. Below are some of my personal favorites. In my yoga classes, I will tailor the poses to your levels and abilities.

 

Chantal Traub is a certified doula, childbirth educator and yoga teacher who has been
assisting expectant mothers for over 15 years. She maintains the passionate belief that there is a better way to help mothers prepare to push more effectively and protect the pelvic floor during pregnancy and birth. Chantal offers expertise and guidance to
pregnant women who want to prepare for birth and beyond. She is certified by both
Lamaze International and the Childbirth Education Association of Metropolitan New
York and is a board member of the Childbirth Education Association of Metro NY.
Chantal runs a private doula practice and offers private childbirth workshops. She's a
mom of two children.

5 questions answered about Elvie

front-style-shoot-copy-1.jpg

 

Contributed by Dr. Erin Williams, DPT

I am not affiliated with Elvie but I am a Pelvic Health Physical Therapist who understands how difficult it can be to perform a kegel (pelvic floor muscle contraction) correctly and I am always looking for tools to better assist my clients with accomplishing a strong and healthy pelvic floor and took it upon myself to personally try out Elvie! Here is what I found!

1. What is Elvie?

Elvie is a small green sensory device that is placed into the vagina during use and connects with the Elvie app that can be downloaded for free onto your smart phone. The app provides strengthening and endurance training exercises with visual aids and performance tracking to better help you connect with and provide feedback for your pelvic floor muscles. 

2. Does it work? 

The short answer is, YES! I found that it was very accurate and responsive to correct pelvic floor muscle contractions (kegel) and would notify me when I was (purposely) doing a kegel incorrectly, or “bearing down” which is a common error made my many women. An important point to note is that Elvie is an up-trainer for the pelvic floor so all of the exercises are geared toward strengthening the pelvic floor and not for relaxing the pelvic floor muscles. Although less talked about, the pelvic floor can have too much muscle tightness/tension (think pain with penetration/sex or constipation) and strengthening the muscles will not benefit this presentation. If you feel like this is you, I would strongly advise getting evaluated by a Pelvic Health Physical Therapist first before trying Elvie. Overall I loved using Elvie to track my progress and identify where I was weak! I am a visual learner and competitive with myself so seeing that I was improving over just 1 week of training and having visual aides to facilitate my kegel was very helpful!

3. Is it uncomfortable/painful to place and use?

Elvie is quite comfortable and easy to place and use! If you feel like you bear-down when initiating a kegel the Elvie device will slip out of you so this can be helpful immediate feedback!

4. Can I use it while Pregnant and postpartum?

Yes, Elvie can be used while pregnant. The Elvie website states that it can be used with non complicated pregnancies and to seek medical advice from your doctor if unsure. It can be used 6+ weeks postpartum. There is no need to use it immediately  following postpartum as the pelvic floor muscles are healing and just need to rest.  

5, How much is it and where can I buy it?

Elvie is normally $199 however for Fit Pregnancy Club mammas I was able to get a DISCOUNT CODE (elvie15b) which you can enter at checkout and enjoy 15% off! www.elvie.com

I would recommend this device to anyone looking to have improved awareness of their pelvic floor muscles for pregnancy, postpartum, urinary incontinence or better sex! I would strongly encourage women to have a pelvic floor assessment completed by a Pelvic Health Physical Therapist first to make sure Elvie is a good fit for you! 

If you have any questions or are interested in getting to know your pelvic floor better please do not hesitate to reach out to me at erin@womenshealthnyc.com and let me know you read my blog on the FPC website and receive $50 OFF your first session with me! 

-Erin Williams, DPT

www.womenshealthnyc.com

Instagram: eewilliams20