BOUNCING BACK!

IT HAS BEEN A LONG-HELD BELIEF that beauty comes from within. If you feel good about yourself, and are happy and relaxed, you’ll look radiant and healthy. But that doesn’t help much straight after childbirth – when sleep deprivation fogs your brain, your stomach still resembles a pregnant woman and you’re clutching a delicate little bundle who only knows how to do three things – drink, squawk and fill his nappies. But there is hope. Physiotherapists Jill Wood and Vicki Holmes, who have spent more than 10 years working in maternal health, have a motto: “Form follows function.” If you get your body doing what it used to be able to do before you became pregnant, you’ll feel a lot better about yourself – and ultimately look a lot better. However it’s important to take it easy on your body for the first three months, when the hormone relaxing (which softens connective tissues as your body prepares for birth) is still having an effect, but there are exercises that will have you feeling good before you know it. The most common physical problems women face after childbirth are perinea discomfort, incontinence, sore back, bad posture, a floppy stomach that keeps moving long after you’ve stopped, exhaustion and stress. Wood and Holmes say there are simple exercises that, in most cases, will cure problems such as incontinence and restore a woman’s dignity. And while it takes six to 24 weeks to get the body’s muscles back to pre-pregnancy condition, that isn’t too bad given that it took 40 weeks to get them that way. On the following pages are their strategies for getting back into top health following the birth of your baby. The first two weeks Pelvic floor exercises: You can begin these from day two. It helps if you already know how they should feel. If you have stitches or are still sore, lie on your tummy with a pillow under your hips, and practice gentle pelvic floor contractions. Simply squeeze and relax, squeeze and relax. Don’t worry if you “can’t find” your muscles in these early days. They will return! As well as strengthening your pelvic floor, these exercises help “pump away” any swelling and make your bottom feel more comfortable. They will most probably be good for hemorrhoids as well. - While you are squeezing and lifting, it’s important to keep breathing normally, so don’t hold your breath (this may take practice). Breathing also helps with relaxation. - Hold for three to five counts (if you can). For many women, it’s a case of becoming familiar again with the sensation of squeezing and “deciding” to let go. For some, that might initially be after the count of one, but it will improve. Repeat the squeeze and hold three to five times. Do it three times a day. As comfort allows, do more repetitions and for longer, aiming for six times a day. It takes three to six months for the muscles to recover. Quick flicks: When comfort allows (and this will vary from woman to woman), work on “three flicks”. This uses the same group of pelvic floor muscles in a fast, powerful way. It’s as much a mental thing as physical. You need to tell your brain to tell your pelvic floor to work hard and fast. “The muscles need to be able to do two things,” explains Holmes. “They need to be able to hold on for a long period of time to keep the urine in the bladder and they also need to be able to cope if there’s any increase in abdominal pressure – like with a jump, a lift, a walk, cough or sneeze.” If you’ve had a vaginal delivery, your reaction time will be slower, so practicing quick flicks helps speed it up. Transverse Abdominal Exercises: These exercises work the deep abdominal muscles. Using a chair sit up tall with your feet flat on the ground and slightly apart. Place your hands on your hips, think of an imaginary piece of string that’s attached to the muscles just below your belly button. Then visualize someone is behind you pulling the string (very gently) so that your tummy is being drawn towards your spine. Then hold is there gently. Whilst keeping your tummy in; lift your right foot 12cm off the ground. At the same time, lift your left arm and hold for five counts. Repeat with the opposite arm and leg. If you’ve had a Caesarean, ensure you do these exercises very gently and always within your pain tolerance. NOTE: Don’t do crunches (sit ups) initially as these only work the outer layers of the abdominals and increase pressure on already weakened pelvic floor muscles. Two to four weeks Posture exercises: Posture is very important at this time. After standing with stretched abdominal muscles and with your weight propelling your body forward for nine months, getting yourself back to an upright position with your tummy tucked in will take some conscious effort. Whenever you’re standing, it’s good to take the time to think about your posture and basically “tuck yourself in” – simply by pulling in your tummy muscles, straightening your knees and pull back your shoulder blades you will automatically assist in correcting your posture. Stepping out: If you feel up to it and are starting to feel your pelvic floor muscles strengthening, it’s time to get out for a short walk once or twice a week. Walking is low-impact, time efficient, and you can take the baby. Take a friend along, too. Walking and talking is a great combination and you should not be so puffed that you can’t talk. But don’t just walk! While you are walking use the times to do both your pelvic floor exercises and your transverse abdominals. It’s good to do at the same time as the two have a natural connection and work together to improve incontinence, posture and back strength. Note: If you had a Caesarean, avoid pushing a buggy up hills for the first three to four weeks. Rectos Abdominals Muscles: During pregnancy, the outer shield of this muscle separates, leaving a gap but it should be coming together by now. To test this: Lie on your back with your knees bent and your feet flat on the floor. - Place your fingers just above your tummy button and push your fingertips firmly down into your abdomen. - - Lift your head and shoulders off the floor and feel for a gap. You’ll If the gap is more than two fingers wide, feel the ridges of the - left to right, and then you need to do more transverse abdominals to bring the muscles in and back together. - If the gap is large, consult a women’s health physiotherapist. Check the gap weekly, working towards having it closed by six weeks. Four weeks to six months Walking programmed Walking is great for reducing stress – a good blast in the fresh air may help you cope with the demands of your new baby. It may even help you sleep better, too. To use walking as a means to improve your fitness, set specific walking goals. Aim to walk for 45 minutes, three times a week. Vary your routine Keep up pelvic floor exercises and transverse abdominals, which you should do for the rest of your life – but are especially important for the first 24 weeks after giving birth. After six weeks you can do other sorts of exercises for your stomach too, but make sure your transverse abdominals and pelvic floor are working while you do them. By three months, you should hope to have a good body awareness of pelvic floor and lower abdominal muscles and you should be able to work them both individually and together. If you want to take your exercise further, you could now join a gym, if you’ve been a runner before you became pregnant, you could try some gentle running at around six weeks, but only if you have full bladder control. If you’ve never been a runner, don’t attempt such a high-impact activity for three months, and make sure you wear shoes with good support that are the right fit (remember, your feet can change size after pregnancy!). Instead, you could look at doing some low-impact exercise that will build up your cardiovascular fitness. Go for a power walk, swim, or ride a bike.