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Abdominal Diastasis and Pelvic Floor

Original writing by Kim Vopni

Lately there has been a lot of talk about the changes in the body of the woman in the postpartum , especially of the bulging belly, a consequence of the abdominal diastasis . For many women it is simply an aesthetic issue, however, the diastasis of rectus has a great impact on the health of women, especially in pelvic health. If you suffer from abdominal diastasis, it is important that you know what it is, why it happens and why it is important to rehabilitate it. Keep reading, this information will also help you recover!

WHAT IS ABDOMINAL DIASTASIS?

It is the separation of the rectus muscles by the middle line. That is, our abs are separated leaving a space in the middle.

BECAUSE IT HAPPENS?

Abdominal diastasis can occur for several reasons, the most common being pregnancy and childbirth . The forward pressure that occurs in the abdomen with the growth of the baby generates a continuous stretching and pressure of the connective tissue of the area that can cause the straight abs to lose their “alignment”. In addition, in pregnancy there are also many postural and hormonal changes that contribute to the creation of this space as well.

ABDOMINAL DIASTASIS AND ITS RELATIONSHIP WITH PELVIC FLOOR

Many women do not feel comfortable with the appearance of their abdomen after pregnancy and try to improve with diets, traditional abdominals and cosmetics. These tactics are used to treat the aesthetic aspect, which is the main motivator, but it is important to know that abdominal diastasis is a problem rather than aesthetic .

The two straight abs join from the sternum to the symphysis of the pubis (pubis). Due to its fixation points in the pelvis, a gap between them and weakness in the connective tissue, directly affects the pelvic cavity and the pelvic floor musculature. In fact, 52% of women with pelvic floor dysfunction have diastasis of recti.

Science says that 100% of pregnant women will have abdominal diastasis in their third trimester (Mota et al 2014), and that some women also stretch abdominal muscles and lose muscle strength (Brauman 2008). So it is logical to think that many of the women who try to get rid of their postpartum belly have to pay attention to their pelvic floor as well. 

Rehabilitating abdominal diastasis is important because if left untreated it can contribute to back pain, constipation, and as we have already said, to pelvic floor dysfunction. The good news is that it’s never too late to work on it, although the sooner recovery begins, the better the result will be.  

Postpartum body with abdominal diastasis. Photograph by Jade Beall http://www.abeautifulbodyproject.org/

Postpartum body with abdominal diastasis. Photograph by Jade Beall http://www.abeautifulbodyproject.org/

HOW TO CURE ABDOMINAL DIASTASIS?

The abdominal diastasis is only “cured” or rehabilitated alone in the first 8 weeks postpartum. Beyond this time intervention is necessary (Coldron et al 2008). And what does intervention mean? Work of posture and alignment, exercises of abdominal gymnastics . These exercises also improve the pelvic floor dysfunctions, so they are ideal in the postpartum period.

The use of the abdominal girdle in the first 8 weeks after delivery is a good way to help the abdomen and pelvic muscles and helps to provide the way to close the pelvis temporarily while exercising the muscles to rehabilitate the area. After 8 weeks after delivery, the girdle may still be useful in some women, but not always. The best thing will be to go to a pelvic floor specialist to evaluate the case.

Although often considered independently, the pelvic floor and abdominal muscles are intimately connected and deserve more attention than they usually receive.

About Kim Vopni

The Doula-Fitness. Author of the book “Ready to push – What your abdomen and pelvic floor want you to know after pregnancy and delivery.” Owner of Pelvienne Welness and Cofounder of Bellies.

Kim is a mother of two children and certified in professional fitness and how doula. It combines help as a doula with the principles of fitness to help its clients optimize their rehabilitation.

Postpartum: the first months

Postpartum is a stage that is often forgotten, as relegated to a second row. We do not consider what will happen to us once we have given birth, we do not ask too many questions. During pregnancy we are basically focused on the here and now, and the most we project forward is towards the day of birth. But girls, postpartum exists, postpartum costs and it’s a pretty stage, yes, but sometimes you can be much less idyllic than we had imagined. In this post I will try to summarize a bit of what this postpartum is about, with physical and emotional changes and my advice both professionally and personally for my experience as a mother.

For this, we will consider two clearly differentiated stages in this postpartum, on the one hand the quarantine or first month postpartum and on the other hand the following months until the sixth month postpartum.

FIRST MONTH POSTPARTUM OR QUARANTINE

Thus, we begin with the first postpartum month, a time of many changes and mixed emotions:

  • Emotional changes: It is usual that during the first two or three days you have uncontrolled “attacks” of tears and without knowing how to explain very well why. It is what is known as “baby-blues”. It is a passenger and you should not give much importance as long as it does not last much longer than a week. Tricks to try to minimize it? Sleep, sleep and rest. It is very important that the first days at home visits are of maximum confidence and allow you, if you have spent bad night (something more than likely), sleep during the day. Think that for many times that baby has been awakened at night at some time of the day will sleep, then it is also your time to rest! Another thing that worked for me was great to go out for a walk without the baby, for one hour or so, the day after arriving home.
  • Changes in your body: You will notice strange in your body, a bulging and soft belly, discomfort in the area of episiotomy  (the cut they make is made in the perineum during delivery when the tissues are not stretched enough to avoid a tear) or in the scar of caesarean section, pain in the chest … Advice: do not despair, little by little everything will be put in its place. The pain of the stitches lasts at most a week, then it will be time to take care of your scar to recover the elasticity of the area and avoid future pelvic floor problems. For the breast, to which you and your baby are compenetréis the issue of cracks and discomfort will disappear. If you can not always go to lactation consultants. And for the subject of the belly: I am not very supportive of postpartum strips, especially when you are at home quiet with the baby. If you are going out for a long walk, it can help you feel a little more collected, this will appeal to you. I did not use it after either of the two deliveries. Wear the belt all the time, does not allow the muscles of the abdomen to begin to tone. The important thing is not obsessed, after a month the belly will be almost in place, although it is true that much less toned than before giving birth. Put on a good firming cream twice a day. And you think that to be great as if you had not given birth is almost a year away, and you have to do your part: physical exercise,hypopressive abdominals , healthy diet …
postpartum selfie
Erica’s viral selfie in which she shows the beautiful but not idyllic postpartum image
  • Losses: It is normal to have losses in quantity similar to a rule during the first month. And it is also very normal that these losses are intermittent, so always take compresses in your bag and patience and tranquility. They are not usually accompanied by pain type rule, so they “tolerate” well.
  • It is not convenient that in this first postpartum month you use tampons, you should not bathe (neither in the sea, nor in the pool or in the bathtub) nor maintain relationships.
  • Take care of your pelvic floor. Although I do not recommend to start with exercises or physiotherapy until the quarantine has passed, during this first month you can acquire good habits that your pelvic floor will appreciate : do not load weights or make important physical effort, do not practice sports (yes, I say that Do not do sport! It is only during this first month, to give your body time to “reposition”), remember to pee every 3 hours and avoid constipation as much as possible. When you have the visit of the quarantine with your gynecologist it will be time to make an assessment of how your pelvic floor is and what exercises you should do.
  • Food: You must maintain a healthy and balanced diet, but it is not the time to make a hypocaloric diet if you want to lose some weight. In the first month postpartum it is usual to have a little anemia, so it is good for you to eat well. And if you are breastfeeding, it is recommended that you drink a lot of water and take a polyvitaminic with calcium.
  • Finally, it is very important that if during the first weeks postpartum you have a fever consult with your gynecologist to be able to rule out any cause linked with childbirth or breastfeeding.

MONTHS FOLLOWING QUARANTINE (MATERNAL LEAVE)

And we continue with the months that follow the quarantine, those months of maternity leave in which little by little you are integrating the baby into your daily routine:

  • Rest: The thing about not sleeping followed by the nights you’re going to get it, every time you tolerate it better and you know your baby a lot better. Little by little you will see how you are ordering your dream, it is normal that a few months take a nap in the morning, one before eating, one after lunch and one before the bath. Then, successively, they will eliminate some of these small naps and the most normal thing is that they stay with a nap in the morning and one in the afternoon.
  • Rehabilitation of the pelvic floor: It’s time to focus on the pelvic floor, trying to do physiotherapy and hypopressive abs. By now you will have begun to notice if the pelvic floor is as before or not, if you have some small loss of urine, feeling of weight in the vagina, hemorrhoids or discomfort in sexual intercourse. You are low maternal, physically you feel much better and have much more free time than when you go back to work. So now is the time, I consider it absolutely essential to do recovery of the pelvic floor. My advice? First, get yourself a physiotherapy center with specialists in pelvic floor recovery. Be realistic, you have to stay at a comfortable distance, because the goal is to go to a minimum of 5 or 6 sessions. Then,
  • And how do we continue at home with what we learned in the physio? With a little will, a little bit of discipline and a lot of outside help. Today there are fantastic apps, such as B-Wom, which based on your initial state offer you a whole series of pelvic floor exercises that you can perform quietly at home. It is super practical because it proposes sessions of 10 minutes, with exercises in audio, and is really focused on working well on the pelvic floor. After my deliveries there was no such app, so I had to choose to do the abdominals only at home, and then I discovered a great ally, which I still use now and then: pelvic one! It is a silicone sphere that is placed in the vagina and the goal is to hold it without falling. We do it reflexively, and it’s a very good way to strengthen the pelvic floor almost without realizing it. The ideal? Use a couple of hours a day from 2 or 3 months after delivery until the baby is 6-8 months and then plan maintenance once or twice a week for as long as you want. My little daughter is now 4 years old and I use it approximately once a week! If you have symptoms such as loss of urine, pain in sexual intercourse or feeling of weight in the vagina, it is advisable to consult a specialist before using them.Pelvic floor toning spheres , since the causes are not always lack of tone.
hypopressed sitting
  • The belly : Another of the great hits of these months: the belly! Yes, it’s still soft and weird, we see each other in the mirror and we do not like each other, we see little toned, with different breasts and a belly there that does not go away. My advice? Patience, patience and tranquility. Sport, healthy diet, hypopressive abdominals and physiotherapy. In this Bwom can also be your ally, with hypopressive abs. The good thing about this type of exercise is that in addition to toning the abdomen, it also tones the pelvic floor and helps “reposition” the pelvic organs in place, making it a perfect postpartum recovery method. You have to be constant and realistic, until 6-9 months after delivery you do not become “worthy” again, and it is a year after having given birth when you will be practically the same as before. From personal experience, the treatments of esthetic centers to reaffirm, cryolipolysis, etc … serve rather little. Or we do it a little grassroots or nothing at all, miracles do not exist!
  • And sports, what about him? Well, once the quarantine is over you can return to take up the time little by little to do sport. I recommend an aerobic sport that does not have an important impact on the pelvic floor, so the ideal is the bike, swimming, walking and the elliptical machine. Six months after childbirth (or one year), once you have recovered your physical form enough, you can start running, aerobics, steps, tennis or whatever you want. But seriously, wait for those first six months, your pelvic floor will thank you so much!
  • Dedicate time for yourself: Finally, one last recommendation, which just seems a bit frivolous but for me it is not: do not forget yourself during these months! It is true that the baby monopolizes practically all our time, but really, it is basic that you find time for other things like:
    • Waxing, hair, manicure, etc … .. feeling pretty on the outside helps lift the mood and fatigue to anyone, and during the postpartum months the fatigue is there, I assure you!
    • Your partner: you have to find time alone, look for moments like those before the baby. It is good at times to disconnect a bit from motherhood and make plans again “boyfriends”
    • Some hobby: seriously, the baby sleeps naps or at times will be his father who will be aware of him. Take advantage of those moments to do something that you really like, something totally yours, that fills you up. I got into knitting with my second daughter, hahaha, and we set up snacks with friends and babies and all there talking about our things with the babies napping.
    • Ask how you want to face your career from now on, start thinking if the schedule suits you, if you want a reduction, a leave, if on the other hand you want to return to the rhythm of before, if you want to start on your own. The maternity leave is a bit of a turning point, take advantage!

In short, so far this very extensive post about the postpartum. I hope you found it interesting! Any questions, I’m happy to help you solve it.

Why Kegel exercises improve your sex life

Most women know that they are Kegel exercises . But did you know that they are much more than exercises for the prevention and control of urine leaks? It is true! In the mid-1890s, Dr. Arnold Kegel developed a type of exercise to help women who were experiencing urinary incontinence . Many women who tried these exercises, in addition to having better control over their bladders, also experienced an improvement in sex .

Kegel exercises are known for their benefits in the preparation and recovery of labor, to improve feelings in sexual relations and enhance orgasms, even to improve constipation . The best: it is not necessary to go to the gym!

Before delving into the main benefits of Kegel exercises in regard to your sex life, let’s see how Kegel exercises on the pelvic floor .

HOW KEGEL EXERCISES WORK

  1. The Kegels improve the ability to have orgasms

The orgasms are unpredictable. Even when you have really good sex, reaching orgasm can be difficult. In fact, only 25% of women report that they always reach climax during intercourse.

😉

Although very few women can achieve orgasm through vaginal intercourse alone, they can increase their chances of having it strengthen the pelvic floor. Kegel exercises tone the pubococcygeus (PC) muscle, which is one of the muscles that we contract during orgasm. And although the orgasmic contractions are involuntary, the more toned you are, the easier it will be for your body to use it in orgasm. Also, since the contraction capacity is greater, orgasms can also be more intense. Sounds good? 

2. Kegel exercises improve blood circulation to your vagina

Doing Kegel exercises helps tone and strengthen the vaginal muscles, and therefore increases the amount of blood flow in the vagina. This is a key element in the excitement: the blood flow in your vagina increases when you do Kegel exercises, which makes the blood reach the clitoris more quickly and your whole genital area is more sensitive. This results in faster excitement and can increase your interest in sex. Even  your natural lubrication!

Kegel exercises can help you improve your sexual relationships. Artistic GIF created by EYEBODEGA & LAZYMOM

Kegel exercises can help you improve your sexual relationships. Artistic GIF created by EYEBODEGA & LAZYMOM

3. The Kegel also help you relax your intimate muscles

If you have pain or discomfort during intercourse, the cause may be hypertonia (excess tension) in your pelvic floor muscles and vagina. For this, there are also inverse Kegel exercises , which can help you learn to relax your intimate muscles to facilitate penetration and feel more pleasure in your relationships.

4. More pleasure also for them

Oh, and let’s not forget the pleasure in them! Kegel exercises can help your partner also have a better sexual experience  by feeling the vagina stronger and more flexible. You can even make Kegels during intercourse! – Some men have reported that they can achieve orgasm only with the vaginal contracting of their partner.-

And Kegels for men? Yes too! Men can increase their erection time by doing Kegel exercises. It’s worth trying, right?

5. Kegel exercises increase your sexual confidence

For all these reasons, Kegel exercises are drivers of your sexual confidence. Having more control over your body and your sex life can increase your confidence and self-esteem .

In addition, if you increase the quantity and quality of your sexual relations, you will increase your levels of oxytocin, endorphins and dopamine, chemical substances that your body releases when having sex and that provoke a feeling of satisfaction, well-being and tranquility. 

KEEP IN MIND THAT NOT ALL EXERCISES ARE THE SAME. IF YOU