Week 6 for Elaine included a Doctor’s visit and some new fitness goals!
Week 6 for me was a busy & interesting one! I was definitely chomping at the bit a little, hoping to amp things up a bit exercise-wise, once I had attended my 6 week check-up with the Doctor.
As a little fitness goal for myself that 6th week, I had also pre-booked an entry to a 5km Fun Run – The Great Pink Run, August 2015 – to power walk, at pace, with my baby Harrison in his buggy! I felt great during the 5km, and was delighted with a time of 39:22 for my walking efforts!
The Reality of the Post Pregnancy Body
The day after the race however, my low back & right hip were not feeling too happy and I was swiftly stopped in my tracks. The whole area felt tired & very tight, and I felt strained when I lifted my baby – not good!!!
I had my doctor’s 6 week check-up that same week, but given how general that check-up is, I also booked an appointment with a Womens’ Health Physiotherapist, for an assessment of my Pelvis, Abdominals & Pelvic Floor Muscles (PFM), to see what exactly was going on. This appointment too would determine the elements of my post baby training program going forward.
What exactly is women’s health physiotherapy?
Women’s Health Physiotherapy (WHP) is the therapeutic treatment of all disorders affecting the pelvis and pelvic floor, such as Pelvic Girdle Pain (at the SI Joints, Pubis Symphysis etc), Lower Back Pain, Stress or Urge Incontinence, Pelvic Organ Prolapse etc.
A postnatal WHP session normally entails
1. An assessment of your static posture, with particular attention paid to the alignment of the pelvis and spine;
2. A movement assessment, looking at the mobility of the spine and the stability of the pelvis with some weight bearing tests;
3. An internal assessment of the tone of your pelvic floor muscles ( I.e. Their ability to contract and relax properly)*
4. An assessment for the presence and/or healing of Diastasis Recti – a naturally occurring separation of the Rectus Abdominals muscles during pregnancy.
*Whether you gave birth naturally, with assistance (forceps, ventouse, episiotomy), or by C-Section, having a postnatal WHP session is a really great idea, whether you present with pelvic dysfunction or not. Actually, I would especially recommend it if you hope to return to exercise that incorporates a lot of impact or load (e.g. Running, Strength & Conditioning classes, Bootcamps etc). This type of assessment will give you a clearer picture of how your body has dealt with (and healed from) pregnancy, labour and birth.
In fact, the French Government, as part of their Sociale Securite (welfare system), fund 10-20 sessions of pelvic floor physiotherapy for each new mother as part of their postnatal care programme”
Why is it important to check Pelvic Floor Muscle tone?
PFM can be Healthy (it contracts & relaxes optimally); Hypotonic (meaning it has little tone, is weak and is unable to properly support the pelvic organs) or Hypertonic (meaning it holds too much tone, is unable to properly relax, thus also affecting its ability to activate correctly also I.e. It is weak, in a different way to Hypotonic PFM). The misconception is that if any symptoms of PFM dysfunction (like back pain, pelvic pain, incontinence etc) are present, then strengthening exercises like Kegels are the answer –they are not! Someone with Hypertonic PFM, would need PFM release work first, before strength work….
- My WHP assessments revealed some unexpected findings!
- A lot of stiffness in the right side of my back & torso, which was altering my pelvic alignment*
- Discomfort in my lower back region when performing hip range of motion tests;
- A LOT of tightness in the deep lateral rotator hip muscles and tenderness in my outer hip muscles (especially right side), which was affecting my sacral alignment*;
- A tendency to recruit my Obliques, as I engaged my Transversus Abdominals ie I was not isolating my PFM contractions as well as I thought – apparently quite a common problem post pregnancy
- My sacral misalignment was also affecting optimal PFM activation!
* I know I can probably attribute most of this to overuse (ie over-demonstration on my Right side as teacher!), more than the pregnancy itself. But the joint laxities & muscle tensions that can come with pregnancy had likely exacerbated it..
So, while I hoped I could steam ahead with a return to my running, and more dynamic Pilates, what I really needed to concentrate on, activity-wise was:
- Improving thoracic mobility
- Myo fascial release work on my hips
- PFM exercises which focused on lengthening rather than strengthening
- Diaphragmatic Breathing
- Practicing not to over-recruit certain abdominal muscles
On a positive note, the therapists assessment of me for Diastasis Recti showed a gap of approximately 1 finger width and a well functioning Linea Alba (the connective tissue that lies between Right /Left halves of the Rectus Abdominals), which meant my Transverse Abdominal was activating sufficiently.
Catch my post on Friday on movements I started integrating to help with my recovery.