Early Postpartum Tips for Pelvic Floor
Women’s health expert Physiotherapist Jenny Devlin gives insight on what you might expect from your postpartum body and the best approach to begin exercise and optimise your recovery
WRITTEN BY JENNY DEVLIN, MSK PHYSIOTHERAPIST AND SPECIALIST WOMEN’S HEALTH PHYSIOTHERAPIST AT PHYSIO EFFECT
So, you’ve just had a baby… CONGRATULATIONS!!
The first days and weeks postpartum can be a blur and prioritizing pelvic floor exercises might not be at the forefront of everyone’s mind. There are some things you can do, however, throughout the day to start working on your pelvic floor while also enjoying sweet baby cuddles.
BREATHE
Something that we do every day but often don’t do well. Once we have had a baby our breathing is often altered as our baby has been taking up the space in our abdominal cavity and achieving a deep breath might have been tricky for the past few months. Remembering how to take deep breaths can help with the healing process. Our diaphragm and pelvic floor move together and as a result breathing deeply in can help relax and lengthen the pelvic floor muscles and conversely exhaling can help engage the same muscles.
Women’s health Physiotherapist, Mariam Kilpatrick, educating a patient on diaphragmatic breathing.
Getting the muscle pump of the pelvic floor working can aid pelvic congestion and help heal the tissues through lymphatic drainage.
Deep breathing can also help us enter into ‘rest and digest’ mode which can help us feel calm and decrease anxiety and enjoy being present with our baby.
You can practice breathing anywhere but it might be easiest sitting or in a semi-reclined position. Make sure you’re comfortable. Inhale slowly through the nose, feeling the air fill the lungs and the pelvic floor lengthen. Exhale gently through the mouth and feel the recoil of the tissues. Keep your shoulders and jaw relaxed. You can learn more about the structures that make up your abdominal cannister, including your pelvic floor in our recent Blog Post.
Posture
Throughout the day, check in with your posture while sitting, standing and moving around. Has your posture changed since having your baby? Can you find your way back to your previous position?
How we hold ourselves while feeding baby for many hours per day is important. Make sure baby is supported to come up to you, so that you don’t have to hunch over to feed. Try to maintain an upright posture for feeding as much as you can - it has an impact, not only on your back, neck and shoulders, but on your pelvic floor too! This NHS guide has ideas alternative breastfeeding positions from the commonly adopted ‘Cradle Hold.’
Image Credit: Shutterstock. Breastfeeding in a reclined position can ease the tension of a painful back and shoulders.
Have a think when you’re holding baby, are you always holding them on one side? Can you switch? Can you wear them for a while in a carrier instead of carrying them? Try placing your hands on your ribs and stacking them over your pelvis.
There are lots of little ways we can improve postures throughout the day to make our pelvic floor a little happier and function better too!
Pelvic Floor Exercises
Throughout the day try to practice a few pelvic floor muscle contractions. You may find it easier to do it lying down or in sitting. Check in with yourself and see what you can feel. You should be able to feel a gentle lift of the pelvic floor without your pelvis tilting and without your legs or bum muscles working hard. You should also be able to feel it relaxing. Try for some longer contractions and some short, fast ones too.
Women’s health Physiotherapist Mariam Kilpatrick demonstrating the ‘Butterfly’ Technique to connect with your pelvic floor.
Gentle Exercise
In the first days postpartum, take it easy. No matter how your baby was born, the body goes through a lot to bring your little one into the world. You might feel like you can do more exercise wise, but do you really need to? Give your body time to rest and recover and gradually build in your exercises. The first days or weeks might start out just thinking about pelvic floor, core and posture and progress from there. We are all about getting you back to doing the things you LOVE so let’s make sure you’re doing them sequentially in a way that’s right for your body and will allow you to continue doing them long term!
We offer ‘CryBaby Pilates’ classes in our Studio to women and their babies from 6 weeks postpartum.
See a Pelvic Floor Physiotherapist
Pelvic floor symptoms are common, but they are not normal! We hear a lot of people normalizing pain or incontinence. Often ladies don’t know there is help out there but there is level 1, grade A evidence to show that pelvic floor assessment and treatment can improve pelvic floor function. Enjoy baby cuddles and gentle progressive exercises and anywhere from the 6 week mark, come and see us and have a pelvic floor evaluation so we can do an assessment, assist with any symptoms and help you work towards your goals, no matter what they are.
The Core
Think your core muscles are just a ‘six pack?’ You’re wrong! Learn more about your core and it’s importance in movement.
Written by Jenny Devlin, MSK Physiotherapist and Specialist Women’s Health Physiotherapist at Physio Effect
The Core
What do you think of when you hear the word ‘core’?
For most people, they think of the rectus abdominis muscles, or the “six pack muscles”, but the core is so much more than that!
The core is actually a full canister that comprises a top, bottom, front and back. Respectively, these are:
The diaphragm
The pelvic floor
The transversus abdominis (deep stomach muscles)
The multifidus (deep back muscles)
Abdominal canister illustration courtesy of ‘The Wellness Blog for Women.’
These muscles work all the time to hold us upright and provide a base from which other muscles can operate. People will often tell us they ‘have no core’ which simply can’t be true or they would be a floppy noodle! What they mean is that they have forgotten how to tune in to activate their core and the good news is that this can be trained.
Our core canister houses our fluid and organs and is responsible for controlling pressure within the system, namely intra-abdominal pressure (IAP). IAP helps our ribs and spine stay in place and is the central mechanism from which we produce strength and stability. Since the muscles surround the canister, they are in prime position to help to control the pressure. IAP changes to match the task we are looking to perform and without a strong inner unit, it is challenging to keep our bodies moving and functioning effectively.
At Physio Effect we can offer you a path back to exercise safely after pregnancy.
Why do i have weakness in my core?
There are many things which can contribute to the core functioning less optimally - it could be the way you train or perform your sport, from being overweight or just a lack of body awareness of how to engage the correct muscles. In particular, pregnancy can lead to dysfunction as the muscles have been stretched out over nine months to accommodate the baby and then afterwards we often just hope they will go back to doing what they did before. Strength and coordination often need to be retrained and, while traditional abdominal exercises are great, it is important to ensure we have the deep core muscles working efficiently before we layer on the larger muscle groups. When we don’t have good core control, it can lead to injuries anywhere in the body such as the low back or the shoulder.
It is normal to have a diastasis rectus abdominus (abdominal separation) following pregnancy but when the pressure is not well controlled, we see doming at the linea alba (midline connective tissue). If we can work to control the IAP with the core muscles, we can minimise this doming and increase overall strength and performance since we are not losing pressure at our core canister.
Illustration of Abdominal Separation courtesy of Cleveland Clinic.
What can I do to strengthen my core?
It is important to spend time connecting to the core and learning how to coordinate the breath, pelvic floor and deep abdominal and low back muscles before adding more challenging exercises to your program. Our physiotherapists can provide you with some targeted core exercises that are specific to your needs. You could also consider our Clinical Pilates, Pregnancy Pilates or Postpartum Pilates Classes to strengthen your core.
To find out more, give us a call or book in online.
Clinical Pilates Classes at Physio Effect
Clinical Pilates uses a number of original and modified Pilates exercises and is given on a prescriptive basis. It is instructed by a qualified physiotherapist after a musculoskeletal or injury assessment. At Physio Effect, we deliver mat work, small equipment and Reformer based Clinical Pilates on a 1:1 basis and small group classes (maximum of 5 participants) as part of your rehabilitation. This may be suggested as the most effective form of treatment and rehabilitation programme for your condition by your physiotherapist on assessment.
What is Clinical Pilates?
Clinical Pilates uses a number of original and modified Pilates exercises and is given on a prescriptive basis. It is instructed by a qualified physiotherapist after a musculoskeletal or injury assessment. At Physio Effect, we deliver mat work, small equipment and Reformer based Clinical Pilates on a 1:1 basis and small group classes (maximum of 5 participants) as part of your rehabilitation. This may be suggested as the most effective form of treatment and rehabilitation programme for your condition by your physiotherapist on assessment.
The difference between Clinical Pilates and the traditional Pilates method is that you will be firstly assessed by a Pilates-trained Physiotherapist and then have a tailored programme of Pilates exercises given to you. During the session, you will be given exercises to do specific to your individual circumstance. This is usually a prehabilitation or rehabilitation programme relevant to an existing injury (e.g. back pain or post-surgical etc) or a specific condition (e.g. ante - post natal, hypermobility, fybromylagia etc) that will be discussed at an initial Physiotherapy Assessment ahead of you starting your block of classes.
New Class Wednesdays 6PM
Due to popular demand, we have opened a new class time on a Wednesday evening at 6PM from 7th October. This is a rolling class and you can start any time from 7th October. There is a “use-by” date when purchasing a block of classes which is:
10 weeks for a 6 x class block
4 months for a 12 x class block
To find out if there is space in this class or any of our other class times, use the button below:
How much does it cost?
Initial 1:1 Physio Assessment: £49
Single class: £25
6 classes: £120 (£20 per class)
12 classes: £220 (£18.3 per class)
“I have been attending Mariam’s Clinical Pilates classes and they are superb. Because the classes are small (max 5 people) Mariam is able to ensure everyone does exercises which are relevant to their individual problems/injuries.”
Antenatal Pilates Classes at Physio Effect
Some exciting news! We have a NEW Antenatal Pilates class running in our studio within our Northside clinic at Borron Street. This physio-led Clinical Pilates class aims to prevent pregnancy related issues such as pelvic girdle pain (PGP), symphysis pubis dysfunction (SPD), posture related pain as well as a full body programme to prepare you for the birth of your child. During the class, you will be guided through an individualised programme relevant to your stage of pregnancy and any other issues discussed during your initial physiotherapy appointment.
WHEN: Wednesday evenings at 7PM from 21st October
**CLASS NOW FULLY BOOKED**
Please contact us below if you would like to be placed on our waiting list or if you wish to attend any of our other Clinical Pilates classes which will be a mixed group, but you will still be able to do an antenatal programme due to the bespoke nature of the class.
WHEN CAN I START?
As long as you have an uncomplicated pregnancy and your midwife/ doctor approves, you can begin from any time in your second trimester if you have no Pilates experience. If you have previous Pilates experience, you may begin earlier.
HOW DO I GET STARTED?
You will be required to have a 1:1 session with one of our physiotherapists before joining a class for the first time. During this appointment, your physiotherapist will be able to plan a bespoke Pilates programme for you based on your goals, requirements and stage of pregnancy. You will be introduced to the various Pilates props and equipment used during a class including the Pilates Reformer machine.
HOW MUCH DOES IT COST?
Antenatal Physiotherapy Appointment: £49
Single class rate: £25
6 classes: £120 (£20 per class)
12 classes: £220 (£18.3 per class)
You have flexibility to use the class blocks within the following time period:
● 10 weeks on a 6-class block
● 4 months on an 12-class block
WHAT HAPPENS IF I HAVE MY BABY BEFORE I USE UP ALL MY CLASSES?
You may use any remaining class credit towards our Crybaby Pilates Classes. This is our specialist Postnatal Pilates class which you may begin once you are at least 6 weeks postpartum after a non-complicated vaginal delivery or 8 weeks if you have had a C-section/assisted delivery with any complications.
CryBaby (Postnatal) Pilates Class
Postnatal Pilates Classes at Physio Effect
This is our Postnatal Pilates class which you can begin from 6 weeks postpartum if you had a straightforward vaginal delivery or 8 weeks after a C-section or assisted vaginal delivery (with any complications)
The class is designed to help heal and strengthen muscles affected after pregnancy and delivery such as your pelvic floor and abdominals.
We are very excited to announce that we are starting our very popular Crybaby Postnatal Pilates classes again in our Pilates studio within our Northside clinic in Borron Street. This is our physiotherapy-led rehabilitation class for new mums.
Due to the current Covid guidelines and to maintain social-distancing protocols, we are having smaller sized classes with a maximum of 6 participants only.
To join this class, you must be a minimum of 6 weeks postpartum if you had a straightforward vaginal delivery/8 weeks after a C-section or assisted vaginal delivery with any other complications (which can be discussed at your initial postnatal physiotherapy appointment).
NEW CLASS STARTING!
Mondays at 12noon
Duration: 1 hour
The next block will begin on MONDAY 30TH NOVEMBER 2020
Please get in touch below if you would like to sign up. Spaces are limited!
HOW DO I GET STARTED?
If you are starting our classes for the first time since having your baby, you will be required to have a 1:1 Postnatal Physiotherapy Appointment with one of our physiotherapists and you must be a minimum of 6 weeks postpartum for this to take place. This is a pre-screening appointment where you will also be able to discuss your pregnancy, labour and set some goals you’d like to achieve after having your baby. The physiotherapist will assess your pelvic floor and abdominal function and go over some basic, fundamental exercises in preparation to starting the classes. This appointment will take up to 45 minutes.
HOW MUCH DOES IT COST?
Physiotherapy Postnatal Appointment: £49 (you must be a minimum of 6 weeks postpartum)
6-week block: £75
CORONAVIRUS (COVID-19) SAFETY PROCEDURES
The class size will be smaller than usual to allow adequate social distancing (maximum of 6 participants).
Please bring your own mat to the class as well as a mat (and toys) for your baby to lay next to you or they may remain in their carseat next to you. Buggies will have to be left in our reception area outside the studio to allow for more space.
Pilates equipment such as circles, balls, bands, weights etc. will be provided for the class with strict cleaning measures in place before and after use.
A face-mask/covering is required to enter and leave the building and Pilates studio. Once you are allocated your floor space in the studio, you may remove your mask for the duration of the class if you wish.
Hand sanitising gel is provided for entering and leaving the building.
Unfortunately, the EDA Gym lounge area is closed for use however the Coorie Cafe is located in the 100 Borron Street Business Park above the gym which has delicious food, good coffee and outdoor seating. They have also very kindly offered to reserve a space for you all to have a chat and lunch after the class!
You are not your MRI: A Rehab Story.
Fiona Callan is a CrossFitter and Ultra-marathoner who injured her back in 2017. She had an MRI which showed an “L5/S1 disc bulge with nerve root irritation”. In this interview we discussed how she chose to avoid surgery and returned to the things she loved doing best.
Written by Mariam Kilpatrick, Physiotherapist and Clinical Pilates Lead at Physio Effect
Fiona Callan is a CrossFitter and Ultra-marathoner who injured her back in 2017. She had an MRI which showed an “L5/S1 disc bulge with nerve root irritation”. In this interview we discussed how she chose to avoid surgery and returned to the things she loved doing best.
Hi Fiona, thank you for taking the time to share your experience with us. Before we begin, tell us a bit about yourself…
I work in the NHS, primarily an office based job. Preceding my injury I was also studying for an MSc so basically spent all day and night sitting at a desk.
I started running in 2008, mainly 5k and 10k distance on roads but I wasn’t very good and didn’t enjoy it so moved to trail and hill running instead when I started gradually to increase my distance. I met some really cool people to run with as well. In 2012, I was talked into a trip to Nepal by a friend but it wasn’t until around 4 weeks to go that I found out he had signed me up to an ultra marathon. I didn’t even know what that was! It was sheer determination that got me through that and I really caught the ultra marathon bug.
In 2014 I started CrossFit as I thought some strength and conditioning type training would help with my running and I had no idea what I was doing in a conventional gym. The coaching and set workout approach has really worked for me and made me use muscles I didn’t know I had.
So the key question… how did you injure your back?
To be honest I’ve always had a bit of a lower back niggle, probably postural, but thought it would just go away. It was definitely something I started to feel more when I started CrossFit as I really had to use my back and core more than I had been doing running. Slowly I noticed it had started to affect my running, I had pain in my right buttock that shot down my leg now and again and my leg generally felt heavy. If I left it a few days it would go away but it meant I couldn’t really run or CrossFit as much as I wanted to.
It started affecting my job as I couldn’t sit comfortably for any period of time. I was travelling by train to Edinburgh at least twice a week which became difficult. On one journey I had to get off the train and go back to Glasgow as I couldn’t face sitting for an hour.
Then during a workout involving a barbell I cried so much I had to admit that something wasn’t right.
My initial symptoms were primarily in my lower back, there was a build up of pressure around my stomach and back even when I bent over the sink to wash my face. I tried to keep active but really scaled back on what I was doing. I kept up my hill walking as this is an activity I love doing with my nephew – I used poles and made Ewan carry my bag as he’s the young one! I tried running but could only manage 1k before I felt my back stiffen.
One Saturday I went walking with Dad and Ewan in the Lake District. It was an amazing day. The hill wasn’t too hard; we took our time and enjoyed it. It was the shooting pain in my right leg that woke me up early on the Sunday morning. I tried to stand up but my leg just wouldn’t work. I limped to the bathroom hanging onto the wall and at that point I knew there was something seriously wrong. It sounds dramatic but I genuinely felt paralysed down that whole side of my lower body, first thoughts were ‘I’ll never run again!’ and panicked. My boyfriend called NHS24 and a nurse managed to calm me down and suggested I took paracetamol with ibuprofen and try find a comfortable position until a doctor could get to me. A few hours and one injection later the pain had dulled. He said it was my sciatic nerve; I should try to relax and spend less time sitting down!
What treatment did you seek initially?
I got an appointment with Jonny who did some needling on my lower back/ glutes and gave me some exercises to do. I am the most impatient person and after a week of exercises I didn’t feel any different so I saw another physio (sorry!) who basically told me the same thing and gave me the same exercises. I really was in denial about how serious it was. I spoke to coaches in the gym, chatted to other runners and did a lot of Googling but all the answers were the same.
It was the mental part I actually found the toughest to deal with. I have made so many friends through running and CrossFit and my social media is full of it too so I was always seeing and hearing about all these amazing runs and PBs. I just felt stuck and disconnected. I saw my GP as I really felt like I was struggling to cope. People were always asking how I am and telling me I should ‘do this and do that’ and eventually I just got fed up talking about it. My GP didn’t really help me; she referred me to her physio friend but I didn’t go.
At the same time, Jonny had referred me to see Mariam for Clinical Pilates and it was during my consultation that she suggested some short term medication for my nerve problem in my right leg. I went to another GP for this and as well as giving me the medication, he was really keen to get me back running and to the gym so he referred me for an MRI.
What happened after your MRI?
I was really lucky in that I got an MRI pretty quickly. A few weeks after the scan. I received a letter with a hospital appointment but with no other information. Frustrating and worrying. I thought well there must be something not quite right and because of my problem with patience, I called the GP and asked him to give me a brief overview of the scan. He said he could see a disc bulge and I should continue doing my physio exercises until my appointment (with the consultant). I had just started with the Clinical Pilates class so I let Mariam know the issue and she tailored exercises for me until I found out more about the problem.
How did you feel after speaking to the neurosurgeon?
I remember getting a phone call from a surgeon in the spinal unit and it made me feel sick. I actually don’t remember what he said to me as the idea of back surgery just terrified me. I wasn’t exactly in crippling pain so the idea of surgery just felt a bit extreme to me. This was something I definitely wanted to avoid. I just really trusted my physios and they really believed I could get better without it. I didn’t feel that my pain was bad enough for surgery – for me this was the last resort.
At the appointment, the doctor went through my scan which I found fascinating. I actually felt a bit of weight come off my shoulders when I could physically see the issue. It had been hard to accept when I didn’t know for sure what the problem was but there it was clear in front of me. She then told me that they would do surgical intervention if I was getting sharp pains down the top of my leg. I told her I had that a few weeks before but it had been getting much better. We left it at that and I was told to get in touch if anything changed.
I had so many conversations with my boyfriend, my parents (and myself) and decided that it wasn’t the end of the world if I couldn’t run 50 miles or couldn’t deadlift 100kg as long as I could stay active. I would just scale back what I was doing.
You've spent the best part of a year doing some serious rehab with Clinical Pilates. In your own words, what is it and how did it help you?
I had done a bit of Pilates before as I’d read and heard it was good for runners. It was one of those things I struggled to stick to because I never left the class feeling like I’d worked hard and my issue with patience didn’t help. When I told my boyfriend about it he signed me up for 6 weeks because he knew I’d have to go if he paid for it! I noticed a huge difference after these 6 weeks.
It is basically pilates but physio-led so your exercises are all tailored to whatever issue you may have so we’re all doing something different generally. It’s a small class but everyone is in the same boat and really friendly. Mariam checks in with you regularly during the class and pushes you when you’re ready but also changing exercises if something isn’t quite feeling good.
I expected my exercises to all be lower back focused as that’s where my injury was but actually they’ve been full body movements. As well as having a stronger back, I feel stronger and much improved posture. Mariam also spent some time working on my legs, particularly my right leg as the nerve had been affected and I had limited movement and very little strength.
Eventually you returned to CrossFit and trail-running. How long did that take from when you first injured yourself?
I was always doing a scaled back version of CrossFit and a bit of trail running while I was injured but I was mindful of undoing my hard work. It was important to me mentally that I kept in touch with coaches/ friends in the gym and my runner friends.
I accepted my injury in May 2017 and started Clinical Pilates in the October. In May 2018 I was a more confident runner so decided to train for a race following a plan, building up in distance and I finished the Mad Hatters Half Marathon and the Glentress Half Marathon with a PB and no back or leg pain. Not quite back at ultra marathon distance but I’m actually enjoying the shorter runs at the moment. In June 2018 I started back at CrossFit and noticed that I’m better at a lot of the movements as I actually use my back and core as I should. I’m always conscious of loading too much weight on bars and I know certain movements still aggravate my back but I know when to stop and I just need to gradually build my strength back up. I was asked if I’d like to be part of a team from the gym for a CrossFit competition, I said yes why not I can try and we finished in 3rd place with no back pain!
Most people seek the "quick-fix" or miracle cure. What advice would you give them?
Your back is such a major part of your body so decisions on surgery should never be made lightly. Unless a professional is telling you there is no other option, I would encourage people to commit to the exercises and rehab, spend less time being sedentary and stay active by doing anything you find fun.
Working through this injury has taught me so much about my body and my lifestyle as well as making me a better runner and CrossFitter. This is all coming from the most impatient person!
SEEKING GUIDANCE? WE CAN HELP
Our experienced team at Physio Effect Glasgow are specialists in back pain and have helped 1000s of people recover and get back their quality of life. We talk the talk and walk the walk and will combine exercise based rehab such as Clinical Pilates with highly skilled hands on therapies to ensure you get the best possible treatment.
Most importantly we will listen and work with you in partnership to identify your specific issues and formulate an agreed unique treatment plan. We will relieve your back pain and give you long term self management strategies to strengthen your back and reduce the chance of pain relapse.
Please contact us if you have questions about our physiotherapy and Clinical Pilates services. Book an appointment and get your journey to back pain recovery under way.
Having a baby during Coronavirus Lockdown!
Lockdown has made many things more challenging, none more so than giving birth. Here I spoke to one mum who had been attending our Antenatal Clinical Pilates classes up until the country shut down on the brink of a global pandemic.
Written by Mariam Kilpatrick, Physiotherapist and Clinical Pilates lead at Physio Effect
Lockdown has made many things more challenging, none more so than giving birth. Here I spoke to one mum who had been attending our Antenatal Clinical Pilates classes up until the country shut down on the brink of a global pandemic.
Hi Elisa, thanks for taking the time to share your experience with us about being pregnant and having a baby during lockdown. Can you firstly tell us a little bit about yourself and your family?
My name is Elisa and I come from a small village in the Italian Dolomites. I have been living in Scotland for the past 12 years since I came as an Erasmus student studying Environmental Engineering. I met my husband at the University of Glasgow. We now have a very fluffy dog named Leo and two beautiful children: a three year old girl called Joanna Sofia and a our son, Eric Antonio, who arrived this April. He is known amongst our friends and family as our "pandemic" baby!
When lockdown started I was 36 weeks pregnant.
Pregnant Elisa and daughter, Joanna (3)
At what stage of your pregnancy did you start our antenatal Pilates classes in our studio, how did you find it and what did you enjoy about it?
I started the antenatal classes when I was 20 weeks pregnant. I was playing squash twice a week before my pregnancy and I wanted to keep exercising. I felt having a desk job I really needed to keep moving, especially for my back as the months progressed. I had heard great things from friends about the antenatal classes at Physio Effect and when I joined I loved being given exercises by Raz specifically tailor-made for me and my stage of pregnancy. It was also fabulous to meet other mums to be and have a bit of time for myself (which is hard to get with a toddler, a husband and a dog!).
How did you find moving over to the virtual (Zoom) antenatal classes during lockdown?
Virtual Pilates Class
It was a good! Technology wise at work, I use videoconferencing a lot and during lockdown cameras got switched on much more, so it was easy enough. At first it took a bit of time to get organised: finding the right space so that my dog and toddler would not interfere, identify the right room to have physical space to do exercise but after that it was a great opportunity to be active from the comfort of your own home, without the need to travel or drive. I found Raz was able to keep an expert eye on us all the time and could correct me if necessary. I also thought I knew what I was doing having done a few classes at the studio already.
And you had a beautiful baby boy named Eric! What was your experience like having him during lockdown compared to your daughter Joanna?
I have to be honest, it was quite different and worrying at times compared to the first experience. However on reflection it has also been an invaluable family time that I have not had with Joanna. On the run up to the birth I started worrying about going to a hospital and the risk of contracting the virus, not having my husband there at all times and also what to do with our toddler, who would have needed someone to be with her if dad was to be with me in the birthing room. However when the day came, I laboured alone in the hospital and in a way it was better for Joanna not to see me distressed. At the hospital everyone was fantastic, trying to make me feel as supported as they could. I was alone for a few hours but I was really well looked after by nurses and midwives. My husband was with me in the birth room and after the birth I got sent home the day after so my stay in hospital was very quick. We had some truly family time, getting to know each other and in a way not stressing about visitors. It was only us and our new baby, which gave Joanna a chance to not get jealous of her wee brother but instead accept him as a new member, especially since, as she said, he was so tiny and cute!
Can you give us an insight with what life has been like during lockdown, having a newborn/toddler/dog/husband working from home?!
Definitely not the maternity leave I was expecting, meeting other mums in coffee shops and at baby groups. However I do believe it has been the best time we have ever had as a family, with no pressure to do anything a part from being together. Life moved at a much slower pace and the kids, the dog and I had lots of walks in the park, which has been great.
Elisa with daughter Joanna, Baby Eric and Leo the dog
How old was Eric when you had your postnatal physio appointment and how did you find doing it virtually?
Eric was 8 weeks old when I had my "virtual" assessment. I thought it worked very well. I did like the fact I carried out an assessment on myself, getting to understand under supervision how my body was responding to the birth of my second child.
What was your experience like doing the virtual Crybaby (postnatal) Pilates classes? Did you find it enjoyable and would you recommend it?
I really enjoyed again having the time for myself. Life does get busy now and cutting out a bit of time for yourself to feel good I believe is key. I really enjoined them and the progression to harder exercises. I also feel was fantastic having had the possibility to watch the recordings afterwards: I had Eric there with me during the classes and sometimes he needed attention so I could replay the class whenever I wanted, which was brilliant.
From Bump, Birth And Beyond…
Here at Physio Effect, we support mums to stay strong, fit and healthy throughout their pregnancy and into their motherhood journey. For more information on all our ante- and postnatal services, click below:
A Guide On Returning To Running After Pregnancy
Running after having a baby is the obvious choice for many new mums wanting to begin or return to exercise. There are however some important things to consider in order to safely return to running and any other high impact exercise after having your baby. Returning too soon can cause long term implications including pelvic floor dysfunction, pelvic girdle pain and other musculoskeletal issues. This guide outlines the impact pregnancy and birth has on your body and important healing time-frames you must be aware of before returning to running. You will also find 2 free Pilates strength videos to give you an idea of the kinds of exercise that will help prepare your postnatal body for the demands of running
Written by Mariam Kilpatrick - Physio, Clinical Pilates Instructor, Mum and Ultra-marathon runner
One of the most common questions I hear from new mums after giving birth is, “When can I start running?” A fair question, as it’s one of the simplest forms of exercise to fit in around your baby, no gym membership required and a good way to burn off that extra baby weight. We’ve all been there.
There are however some important things to consider in order to safely return to running and any other high impact exercise after having your baby. Returning too soon can cause long term implications causing pelvic floor dysfunction, pelvic girdle pain and other musculoskeletal issues. This usually happens because you haven’t adequately rehabilitated your body following the huge stresses placed upon it during pregnancy and childbirth. Giving birth (either vaginal or C-section) can be considered equal to a major sports injury which would require the same attention, specific rehab and a graded return to any sport. It is just as important to work on muscles affected by pregnancy and childbirth (such as the pelvic floor and abdominals) as it is to work on the muscles around your knee if you’ve had a knee injury/surgery.
My baby is 6 weeks old now so I’m good to go…right?!
Healing of the body after childbirth goes well beyond the traditional 6-week timescale that many health professionals go by.
Did you know…
The levator hiatus, the opening between the levator ani muscles (which forms part of your Pelvic Floor) stretches and widens significantly during pregnancy and childbirth. This can take between 4-6 months to recover (Stær-Jensen et al 2015)
After a C-section, the abdominals only regains 50% of its original strength by 6 weeks postpartum and 73%-93% of original strength by 6-7 months postpartum (Ceydeli et al 2005)
Up to 30% of first time mums will experience urinary incontinence (Milsom et al 2004)
Up to 56% of new mothers between 3-6 months postpartum demonstrate pelvic organ prolapse where one or more of the pelvic organs (bowel, bladder or uterus) descends downwards to the vaginal opening (Bø et al 2017). This can result in incontinence issues and the feeling of heaviness/dragging in the vagina.
You can’t go wrong with strong!
Your Pelvic Floor is a hugely important part of your body. It is made up of layers of muscle and connective tissue. These layers stretch like a hammock from the tailbone at the back, to the pubic bone in the front. They support your pelvic organs and control your bladder and bowel movements. The front passage (pee hole), the vagina and the back passage (poo hole) all pass through the pelvic floor muscles. Throughout your pregnancy, your pelvic floor has carried the weight of your baby, the placenta and a 50% increase in blood volume! As such, this will greatly affect its ability to do its job properly compared to pre-pregnancy function. It is therefore vital to work on these muscles after having a baby, regardless of the type of birth you had (whether vaginal or C-section).
In the latter stages of pregnancy, the connective tissue or fascia between your outermost abdominal wall (your six-pack muscles) can thin out/stretch to allow for a growing baby bump. After giving birth, you can be left with a gap between the two sides and sometimes it can look like you are still pregnant i.e. the dreaded “mum-tum”. This is called a Diastasis Recti or abdominal separation, a common condition that causes a lot of grief for many mums. However, like any muscle in the body, these can be addressed and worked on with specific corrective exercises targeting your deep abdominals.
When you are running, multiple times your body-weight in the form of ground reaction force is produced on impact with the ground. This has to be absorbed and controlled by the tendons, muscles and joints in the legs. Strengthening the muscles of the lower legs and core help prevent injury and increase the muscles’ load bearing capabilities.
Guidelines for postnatal exercise progression
Week 0-2: Walking, pelvic floor muscle strength and endurance exercises, basic abdominal exercises
Week 2-4: Introduce functional body weight exercises such as squats and lunges
Week 4-6: Introduce low impact cardio such as static bike, rowing machine or X-trainer
Week 6+: Progress to resistance training such as Pilates for pelvic floor/core and weights training
Week 12+: Graded/progressive return to running (e.g. Couch to 5K)
Some expert physiotherapists have developed a free guidance to help health and fitness professionals who work with postnatal runners which can be found here.
Postnatal Pilates
Pilates is a great form of rehabilitation to target the working relationships of your pelvic floor and core muscles (abdominals and diaphragm) especially in the first few months after having your baby. The benefits of Pilates include:
Strengthening your Pelvic Floor
Targeting your deep abdominal muscles to help heal Diastasis Recti (abdominal separation)
Addressing muscle imbalances that may be contributing to lower back pain or pelvic girdle pain
Targeting postural muscles of the back, neck and shoulder girdle
Postnatal Pilates Class at Physio Effect
Pilates for Runners
Try these free sample routines for strengthening your legs and gluts:
Pilates legs workout
Pilates Gluts Workout
We Want To Help You Get Your Body Back On Track
Physio Effect specialises in helping mums recover their health, fitness and confidence after having a baby. Our Cry-Baby Pilates classes where new mums attend with their babies has been a great success and very popular!
Want to read some REVIEWS about our classes from other mums? Click the links & read below: Yell.Com Reviews or Facebook Reviews
The cry baby Pilates classes led by Mariam were an absolute highlight of my maternity leave. They offered important rehab for all the changes to my body left by pregnancy and a c-section and the strengthening work got me back safely running sooner than I expected - yay! The classes were warm, friendly and supportive and my baby Helena loved meeting the other babies too (as well as getting cheeky cuddles from Mariam). Couldn’t recommend more highly to new mums!
Katherine C via Facebook reviews
I’ve recently completed 2 blocks of Crybaby Pilates with Mariam & would highly recommend it for postnatal recovery. Mariam was great at making you feel relaxed, gradually building up the intensity of the exercises over the weeks so it wasn’t too daunting in the beginning. I liked how the exercises also allowed you to interact with your baby. The classes are small enough that you get the opportunity to get to know the other mums & babies, which helps you feel completely at ease in the class too. I now feel back to my pre-baby self & body, ready to start running & hitting the gym! Thank you!
Keri. L.K via Facebook reviews
Seek Help & Advice Sooner Rather Than Later
As with everything in life, there isn’t a one size fits all when it comes to returning to running after pregnancy. Factors that need to be considered include:
Type of birth you had; was it a straightforward vaginal birth, a vaginal birth with complications such as forceps delivery/episiotomy/tears, a C-section? The timescales may be different for each case!
Previous level of exercise (e.g. were you a runner before pregnancy?)
Experiencing symptoms of lower back pain, pelvic or pubic pain, leakage and/or feeling of vaginal heaviness (which could be a sign of pelvic organ prolapse), coccyx/tailbone pain (which could be a sign of a hypertonic or tight pelvic floor)
Are you currently breast-feeding? Pregnancy hormones stay in the body for about three months postpartum, continuing to loosen joints, muscles, tendons and ligaments as they did in preparation for delivery. For those breast-feeding, hormones can still have a loosening effect even months after you stop.
Lifestyle changes such as sleep deprivation, lack of routine, demands of breastfeeding and altered eating habits which can cause energy deficiency and fatigue.
If you are unsure, it is advisable to seek help from a specialist trained physiotherapist or a pelvic health practitioner.
If you would like to chat to one of our physiotherapists you can use the link below to book an appointment. Or if you prefer send us a message with any questions you have and we will get back to you as soon as we can.
Thank You
Thanks for taking the time to read this guide, we hope you find it useful. Please share with anyone else who might benefit and if you have any questions comment and let us know. Please subscribe for regular updates and advice on everything health and fitness related - Zero spam promise.
Postnatal Pilates at Physio Effect
Restore your core after pregnancy: A safe return to exercise
Returning to exercise after having a baby can be daunting & difficult. It is possible to cause yourself more harm than good if you return too soon or to the wrong type of exercise. This blog looks at the evidence and guidelines for returning safely to post-natal exercise and the specific benefits of Post-natal Pilates in restoring your Pelvic Floor muscle function, reducing Diastasis Recti and rebuilding your core strength and function. A FREE 30 minute Post-natal Pilates class is linked for you to try.
Written by Mariam Kilpatrick - Physio, Clinical Pilates Instructor, Ultra-marathon runner & Awesome mum
After 9 long months, finally, your cute little bundle of joy has arrived! Goodbye to feeling like a bloated whale and goodbye heartburn. Say hello to sleeping on your tummy and to eating stinky cheese & sushi again. You’re keen to get back to exercise, get that endorphin rush and reclaim your pre-pregnancy body! You’ve had your 6 week check-up and your doctor has given you the all clear to exercise. Yay! BUT…yes there is a but. You can sometimes do more harm than good if you push your body beyond what it is ready for. Here we review the guidelines for returning safely to postnatal exercise and look at the specific benefits of Postnatal Pilates which include improved Pelvic Floor function and reduced Diastasis Recti (abdominal separation). Read on for more….
As the saying goes, you shouldn’t build a house on a weak foundation.
For many women, it has become a common thing to accept “a little bit of wee escaping” with a sneeze or running for the bus, just because you’ve had a baby. But no matter what age your baby is, either 6 weeks or 6 years, this should not be the perceived norm. Some women may feel embarrassed to raise their concerns around continence and other intimate issues but this should never be the case. Please seek professional advice early, as with the right help and guidance, these issues can and should be addressed.
The Pelvic Floor Muscles
Your Pelvic Floor is a hugely important part of your body. It is made up of layers of muscle and connective tissue. These layers stretch like a hammock from the tailbone at the back, to the pubic bone in the front. They support your pelvic organs and control your bladder and bowel movements. The front passage (pee hole), the vagina and the back passage (poo hole) all pass through the pelvic floor muscles. Throughout your pregnancy, your pelvic floor has carried the weight of your baby, the placenta and a 50% increase in blood volume! As such, this will greatly affect its ability to do its job properly compared to pre-pregnancy function. It is therefore vital to work on these muscles after having a baby, regardless of the type of birth you had (whether vaginal or C-section).
Let’s practice how to correctly engage your pelvic floor…
Take a deep breath in, fill your lungs completely and allow your pelvic floor to relax.
As you breathe OUT, close your back passage as if you were holding in a fart, then pull upwards and inwards towards your front passage to close it, as if you were holding in a pee.
Visualise trying to "squish" your anus (poo hole) to your urethra (pee hole) towards your pubic bone.
Do this without clenching your butt cheeks, your jaw or tensing your neck and shoulders (tricky, huh?)
Let everything relax again as you breathe in.
Repeat x 10Now try and engage your pelvic floor as above in 10 x quick flicks on and off.
*Practice turning your pelvic floor on in both sitting and standing positions
**Practice turning your pelvic floor on when doing things at the same time like picking your baby up from his/her cot or picking a toy up from the floor.
Why do I still look pregnant months after giving birth?
In the latter stages of pregnancy, the connective tissue or fascia between your outermost abdominal wall (your six-pack muscles) can thin out/stretch to allow for a growing baby bump. After giving birth, you can be left with a gap between the two sides and sometimes it can look like you are still pregnant i.e. the dreaded “mum-tum”. This is called a Diastasis Recti or abdominal separation, a common condition that causes a lot of grief for many mums. However, like any muscle in the body, these can be addressed and worked on with specific corrective exercises - all hope is not lost! The key is to target the deep layer of abdominal muscles. This may mean avoiding certain traditional core stability exercises initially (e.g. sit ups and planks). Your deep abdominal muscles have functional connections to - guess what - the pelvic floor…so it’s a win-win situation all round!
Postnatal Pilates
Pilates is a great form of exercise to target the working relationships of your pelvic floor and core muscles (abdominals and diaphragm) especially in the first few months after having your baby. The benefits of Pilates include:
Strengthening your Pelvic Floor
Targeting your deep abdominal muscles to help heal Diastasis Recti
Addressing muscle imbalances that may be contributing to lower back pain or pelvic girdle pain
Targeting postural muscles of the back, neck and shoulder girdle
Postnatal Pilates Class at Physio Effect
Here is a short taster video of a postnatal Pilates workout:
We Want To Help You Get Your Body Back On Track
Physio Effect specialises in helping mums recover their health, fitness and confidence after having a baby. Our Cry-Baby Pilates classes where new mums attend with their babies has been a great success and very popular. We are working hard to bring this content to full digital online form so that all mums everywhere can enjoy and benefit from this safe, structured and fun specialist postnatal program. For advanced notice of when this course is available and for special early-bird promotional rates please register for your free sample class below and we will keep you informed.
Want to read some REVIEWS about our classes from other mums? Click the links & read below: Yell.Com Reviews or Facebook Reviews
The cry baby Pilates classes led by Mariam were an absolute highlight of my maternity leave. They offered important rehab for all the changes to my body left by pregnancy and a c-section and the strengthening work got me back safely running sooner than I expected - yay! The classes were warm, friendly and supportive and my baby Helena loved meeting the other babies too (as well as getting cheeky cuddles from Mariam). Couldn’t recommend more highly to new mums!
Katherine C via Facebook reviews
I’ve recently completed 2 blocks of Crybaby Pilates with Mariam & would highly recommend it for postnatal recovery. Mariam was great at making you feel relaxed, gradually building up the intensity of the exercises over the weeks so it wasn’t too daunting in the beginning. I liked how the exercises also allowed you to interact with your baby. The classes are small enough that you get the opportunity to get to know the other mums & babies, which helps you feel completely at ease in the class too. I now feel back to my pre-baby self & body, ready to start running & hitting the gym! Thank you!
Keri. L.K via Facebook reviews
Would you like a FREE 30 minute Specialist Postnatal Pilates class to try?
Please Click the following link to register & we will send you a video link to enjoy
Returning to Exercise - What do the guidelines say?
In the first six weeks after giving birth and when you feel you are able, you may commence your pelvic floor and abdominal exercises, functional bodyweight movements, as well as low impact cardiovascular exercise such as walking.
From six weeks onwards (or a little longer if you’ve had a C-section), you may commence light resistance exercise such as Pilates and light weights training.
The earliest you should start high impact exercise such as Running/HIIT/Bootcamp is between 3-6 months after having your baby. This of course may differ from person to person depending on the type of birth you had. A recent study for guidance in returning to running post pregnancy by some expert pelvic health physiotherapists can be found here
Seek Help & Advice Sooner Rather Than Later
As with everything in life, there isn’t a one size fits all when it comes to returning to exercise after pregnancy. Factors that need to be considered include:
Type of birth you had; was it a straightforward vaginal birth, a vaginal birth with complications such as forceps delivery/episiotomy/tears, a C-section? The timescales may be different for each case!
Previous level of exercise (e.g. were you a runner/gym-bunny/Crossfitter before pregnancy?)
Experiencing symptoms of lower back pain, pelvic or pubic pain, leakage and/or feeling of vaginal heaviness (which could be a sign of pelvic organ prolapse), coccyx/tailbone pain (which could be a sign of a hypertonic or tight pelvic floor)
Are you currently breast-feeding? Pregnancy hormones stay in the body for about three months postpartum, continuing to loosen joints, muscles, tendons and ligaments as they did in preparation for delivery. For those breast-feeding, hormones can still have a loosening effect even months after you stop.
If you are unsure, it is advisable to seek help from a specialist trained physiotherapist or a pelvic health practitioner.
If you would like to chat to one of our physiotherapists you can use the link below to book an appointment. Or if you prefer send us a message with any questions you have and we will get back to you as soon as we can.
Thank You
Thanks for taking the time to read this guide, we hope you find it useful. Please share with anyone else who might benefit and if you have any questions comment and let us know. Please subscribe for regular updates and advice on everything health and fitness related - Zero spam promise.
Postnatal Pilates at Physio Effect
Antenatal Exercise; What the Guidelines & Evidence Say by Raz Leonard
For over a year I’ve been enjoying teaching two Antenatal Pilates classes at Physio Effect and, from the start, the classes have been fully subscribed. Many of the women tend to come from Health Care professions themselves and know the benefits of exercising during pregnancy. I am always surprised at how many old wives’ tales are out there and how many women remain inactive or stop physical activity during this crucial time. I plan to summarise some recent evidence-based reviews on the topic so that the facts can be divided from fiction.
For over a year I’ve been enjoying teaching two Antenatal Pilates classes at Physio Effect and, from the start, the classes have been fully subscribed. Many of the women tend to come from Health Care professions themselves and know the benefits of exercising during pregnancy. I am always surprised at how many old wives’ tales are out there and how many women remain inactive or stop physical activity during this crucial time. I plan to summarise some recent evidence-based reviews on the topic so that the facts can be divided from fiction.
The evidence shows that exercising during pregnancy is completely safe and in fact improves the chance of a healthy baby and mum. There are some exceptions to each rule which is why it is important to check with your midwife/ health care practitioner first and exercise with someone trained to adapt a programme to you. More detail of this evidence is presented below.
The first publication I wanted to share is by the UK Chief Medical Officers (2019) and based on best available evidence. The infographic summarises the key points however you can access the full report via this link.
Smith R, Reid H, Matthews A CMO Physical Activity Expert Committee for Physical Activity and Pregnancy, et al
Infographic: physical activity for pregnant women
References;
Mottola MF, Davenport MH, Ruchat S, et al
2019 Canadian guideline for physical activity throughout pregnancy
British Journal of Sports Medicine 2018;52:1339-1346
Smith R, Reid H, Matthews A CMO Physical Activity Expert Committee for Physical Activity and Pregnancy, et al
Infographic: physical activity for pregnant women
British Journal of Sports Medicine 2018;52:532-533.
The report states that exercise during pregnancy has been shown to reduce high blood pressure and improve cardiovascular fitness. In addition, it can lower the risk of pregnancy related diabetes and gestational weight gain.
My favourite most recent ante natal exercise paper is “2019 Canadian guideline for physical activity throughout pregnancy”. A group of experts in the field have summarised their recommendations and highlighted the evidence they have to back these up as well as writing a detailed list of who should seek further advice before beginning an exercise program. See this link to read the paper in full.
Below is a summary of their main findings.
‘Strong recommendation’ and have ‘moderate’ quality evidence to support this. (The reason they have said the evidence is ‘moderate’ is because it can be challenging to get enough high quality studies that have enough people in them and are designed robustly to back up their statements.)
All women with normal pregnancies should be active throughout.
At least 150 minutes of moderate level physical activity should be accumulated to achieve these health benefits and reduce pregnancy complications
Accumulating this activity over a minimum of 3 days a week is recommended, however daily activity is encouraged.
Higher evidence and so can be seen as an agreed fact (This is a ‘strong recommendation’ with ‘high’ quality evidence, which is great news for exercising mums to be!):
The types of exercise recommended includes a variety of aerobic and resistance training. Stretching and yoga can also be beneficial.
Common practice however seen as ‘weak recommendations’ as have ‘low-quality’ evidence to back them up:
Women should be taught the correct technique for pelvic floor muscle exercises and carry these out daily to reduce the chance of continence issues.
Women who experience nausea, light-headedness or feel unwell when exercising flat on their back, should modify their exercises to avoid this position.
Antenatal Classes at Physio Effect
Our antenatal class offered at Physio Effect incorporates the above guidelines by contributing to the recommended exercise volume & frequency. Stretching, resistance and pelvic floor exercises are given under guidance by a trained physiotherapist. In addition, exercise position is modified with use of equipment such as a foam wedge and the Pilates reformer. It’s also a great way to meet other mums to be. Please click here for details on booking the class.
Note that we also offer a post-natal program which you can bring your baby along to. This is designed to help restore your body and gently bring to back to the correct level of exercise. Find out more about our CryBaby Pilates classes here.
Our antenatal Pilates class is a bespoke class, individually designed for each person who attends. Clients will be assessed by a physiotherapist who will design and teach the class. For example, the program can help with any musculoskeletal injuries and pregnancy related issues such as pelvic girdle pain. In addition, stage of pregnancy, pelvic floor exercises and safe positions for exercise will be incorporated into this programme.
Real Life Stories: Recovering from a disc injury
Fiona Callan is a CrossFitter and Ultra-marathoner who injured her back in 2017. She had an MRI which confirmed an L5/S1 disc bulge with nerve root irritation. In this interview we discussed how she avoided surgery and returned to the things she loved doing best.
Hi Fiona, thank you for taking the time to share your experience with us. We know you've come a long way from a pretty bad back injury. Before we begin, tell us a bit about yourself! What type of work do you do and what's your sport/exercise/fitness background?
I work in the NHS, primarily an office based job. Preceding my injury I was also studying for an MSc so basically spent all day and night sitting at a desk.
I started running in 2008, mainly 5k and 10k distance on roads but I wasn’t very good and didn’t enjoy it so moved to trail and hill running instead when I started gradually to increase my distance. I met some really cool people to run with as well. In 2012, I was talked into a trip to Nepal by a friend but it wasn’t until around 4 weeks to go that I found out he had signed me up to an ultra marathon. I didn’t even know what that was! It was sheer determination that got me through that and I really caught the ultra marathon bug.
In 2014 I started CrossFit as I thought some strength and conditioning type training would help with my running and I had no idea what I was doing in a conventional gym. The coaching and set workout approach has really worked for me and made me use muscles I didn’t know I had.
So the big question, when and how did you injure your back? Was it after one incident or was it something that gradually built up and got worse? What were your symptoms (i.e. back pain? leg pain? numbness etc...)
To be honest I’ve always had a bit of a lower back niggle, probably postural, but thought it would just go away. It was definitely something I started to feel more when I started CrossFit as I really had to use my back and core more than I had been doing running. Slowly I noticed it had started to affect my running, I had pain in my right buttock that shot down my leg now and again and my leg generally felt heavy. If I left it a few days it would go away but it meant I couldn’t really run or CrossFit as much as I wanted to.
It started affecting my job as I couldn’t sit comfortably for any period of time. I was travelling by train to Edinburgh at least twice a week which became difficult. On one journey I had to get off the train and go back to Glasgow as I couldn’t face sitting for an hour.
Then during a workout involving a barbell I cried so much I had to admit that something wasn’t right.
My initial symptoms were primarily in my lower back, there was a build up of pressure around my stomach and back even when I bent over the sink to wash my face. I tried to keep active but really scaled back on what I was doing. I kept up my hill walking as this is an activity I love doing with my nephew – I used poles and made Ewan carry my bag as he’s the young one! I tried running but could only manage 1k before I felt my back stiffen.
One Saturday I went walking with Dad and Ewan in the Lake District. It was an amazing day. The hill wasn’t too hard; we took our time and enjoyed it. It was the shooting pain in my right leg that woke me up early on the Sunday morning. I tried to stand up but my leg just wouldn’t work. I limped to the bathroom hanging onto the wall and at that point I knew there was something seriously wrong. It sounds dramatic but I genuinely felt paralysed down that whole side of my lower body, first thoughts were ‘I’ll never run again!’ and panicked. My boyfriend called NHS24 and a nurse managed to calm me down and suggested I took paracetamol with ibuprofen and try find a comfortable position until a doctor could get to me. A few hours and one injection later the pain had dulled. He said it was my sciatic nerve; I should try to relax and spend less time sitting down!
What was the initial management i.e. what treatment did you seek?
I got an appointment with Jonny who did some needling on my lower back/ glutes and gave me some exercises to do. I am the most impatient person and after a week of exercises I didn’t feel any different so I saw another physio (sorry!) who basically told me the same thing and gave me the same exercises. I really was in denial about how serious it was. I spoke to coaches in the gym, chatted to other runners and did a lot of Googling but all the answers were the same.
It was the mental part I actually found the toughest to deal with. I have made so many friends through running and CrossFit and my social media is full of it too so I was always seeing and hearing about all these amazing runs and PBs. I just felt stuck and disconnected. I saw my GP as I really felt like I was struggling to cope. People were always asking how I am and telling me I should ‘do this and do that’ and eventually I just got fed up talking about it. My GP didn’t really help me; she referred me to her physio friend but I didn’t go.
At the same time, Jonny had passed me onto Mariam for Clinical Pilates and it was during my consultation that she suggested some short term medication for my nerve problem in my right leg. I went to another GP for this and as well as giving me the medication, he was really keen to get me back running and to the gym so he referred me for an MRI.
Am I right in saying you ended up seeing a consultant neurosurgeon? What did the MRI show?
Yeah I was really lucky in that I got an MRI pretty quickly. I think the 2nd GP had something to do with that. A few weeks after the scan. I received a letter with a hospital appointment but with no other information. Frustrating and worrying. I thought well there must be something not quite right and because of my problem with patience, I called the GP and asked him to give me a brief overview of the scan. He said he could see a disc bulge and I should continue doing my physio exercises until my appointment. I had just started with the Clinical Pilates class so I let Mariam know the issue and she tailored exercises for me until I found out more about the problem.
So there was the prospect of having surgery? How did that make you feel? Was this something on the cards or wanting to avoid?
I remember getting a phone call from a surgeon in the spinal unit and it made me feel sick. I actually don’t remember what he said to me as the idea of back surgery just terrified me. I wasn’t exactly in crippling pain so the idea of surgery just felt a bit extreme to me. This was something I definitely wanted to avoid. I just really trusted my physios and they really believed I could get better without it. I didn’t feel that my pain was bad enough for surgery – for me this was the last resort, I’ve never heard positive stories about it.
At the appointment, the doctor went through my scan which I found fascinating. I actually felt a bit of weight come off my shoulders when I could physically see the issue. It had been hard to accept when I didn’t know for sure what the problem was but there it was clear in front of me. She then told me that they would do surgical intervention if I was getting sharp pains down the top of my leg. I told her I had that a few weeks before but it had been getting much better. We left it at that and I was told to get in touch if anything changed.
I had so many conversations with my boyfriend, my parents (and myself) and decided that it wasn’t the end of the world if I couldn’t run 50 miles or couldn’t deadlift 100kg as long as I could stay active. I would just scale back what I was doing.
You've spent the best part of a year doing some serious rehab with Clinical Pilates. In your own words can you explain what that is and how it helped you?
I had done a bit of Pilates before as I’d read and heard it was good for runners. It was one of those things I struggled to stick to because I never left the class feeling like I’d worked hard and my issue with patience didn’t help. When I told my boyfriend about it he signed me up for 6 weeks because he knew I’d have to go if he paid for it! I noticed a huge difference after these 6 weeks.
It is basically pilates but physio led so your exercises are all tailored to whatever issue you may have so we’re all doing something different generally. It’s a small class but everyone is in the same boat and really friendly. Mariam checks in with you regularly during the class and pushes you when you’re ready but also changing exercises if something isn’t quite feeling good.
I expected my exercises to all be lower back focused as that’s where my injury was but actually they’ve been full body movements. As well as having a stronger back, I have a stronger core and much improved posture. Mariam also spent some time working on my legs, particularly my right leg as the nerve had been affected and I had limited movement and very little strength.
Eventually you returned to CrossFit and trail-running. How long did that take from when you first injured yourself?
I was always doing a scaled back version of CrossFit and a bit of trail running while I was injured but I was mindful of undoing my hard work. It was important to me mentally that I kept in touch with coaches/ friends in the gym and my runner friends.
I accepted my injury in May 2017 and started Clinical Pilates in the October. In May 2018 I was a more confident runner so decided to train for a race following a plan, building up in distance and I finished the Mad Hatters Half Marathon and the Glentress Half Marathon with a PB and no back or leg pain. Not quite back at ultra marathon distance but I’m actually enjoying the shorter runs at the moment. In June 2018 I started back at CrossFit and noticed that I’m better at a lot of the movements as I actually use my back and core as I should. I’m always conscious of loading too much weight on bars and I know certain movements still aggravate my back but I know when to stop and I just need to gradually build my strength back up. I was asked if I’d like to be part of a team from the gym for a CrossFit competition, I said yes why not I can try and we finished in 3rd place with no back injury!
Most people in this day and age are seeking the "quick-fix" or miracle cure. In fact, most people in your shoes would opt for surgery given the opportunity. What advice would you give them?
Your back is such a major part of your body so decisions on surgery should never be made lightly. Unless a professional is telling you there is no other option I would encourage people to commit to the exercises, spend less time sitting down and stay active by doing anything you find fun (that’s obviously not going to hurt you)
Working through this injury has taught me so much about my body and my lifestyle as well as making me a better runner and CrossFitter. This is all coming from the most impatient person!
New Mummy Struggles: Exercise after Pregnancy
How one of our Physios managed getting back to fitness alongside the challenges of a new baby!
After giving birth to my first baby five months ago, life had changed as I knew it. Sleep deprivation… endless feeds… nappy changes… How does exercise fit into the picture?
I had always been a fit and active person, exercising 4-5x a week and continued to exercise right up until four days before my daughter was born. Before I knew it, I had this tiny human completely dependent on me. I felt like there was no time for anything else. Not long after I gave birth, we attended a family wedding. A family member commented that I had put on weight since having a baby and decided it was appropriate to tell me to stop eating junkfood. It was at this point I knew I had two choices: 1. Wallow in self-pity and never leave the house again 2. Find the motivation to do the things I enjoyed before having my baby. I chose the latter.
Since giving birth, I knew my body was no longer the same. I realised this after I came home from hospital and a 10-minute walk around the park felt like a marathon. As a physiotherapist who works with a lot of ante- and postnatal women, I am lucky to have the background knowledge on the human body after birth. I knew I couldn’t just jump back into what I was previously doing pre-baby. It was going to take time and patience. For the first six weeks, my exercise consisted of pelvic floor and abdominal exercises shown to me in hospital. This was all well and good when you are advised to do them every few hours, but when you’re dealing with a brand new baby; it’s the last thing on your mind! I therefore incorporated these exercises with a task I was doing constantly throughout the day - and that was feeding my baby (which was every 2-3 hours!) Every time I sat down to feed her, I made myself do them. I also went on daily walks with the buggy, which helped my mental wellbeing just to get outside the house.
After my 6-week check-up, I saw a physiotherapist who assessed my pelvic floor function and measured my belly for a diastasis recti; a condition that happens during pregnancy when the abdominal wall separates. This causes a small gap above or below the belly button. To address this, I attended mother and baby Pilates classes. Pilates focuses on the working relationships of the muscles around your trunk. These include your abdominals, diaphragm, pelvic floor and back muscles – ideal after having a baby! Being able to bring my baby along to the classes also made it easier for me not having to worry about a babysitter.
At 12-weeks, I felt I was ready to begin higher intensity exercise. After we put the baby to bed at night, I would go for a light jog for 15-20 minutes and gradually increased this as I felt comfortable. Thankfully having a baby in the spring meant long daylight hours for me to head out. I also joined a mother and baby bootcamp-style class, which incorporated strength and resistance exercises as well as high intensity interval training.
Common post-pregnancy myths that need to be debunked:
It’s normal to wee myself a little bit sometimes because I’ve had a baby
False: Incontinence post-birth is a sign of pelvic floor dysfunction and could indicate a prolapse. It is important to get this assessed by a women’s health physiotherapist to avoid long-term problems.
It’s normal to have back or pelvic pain because I’ve just had a baby
False: You may be in pain because of muscle imbalances and weaknesses. Seek advice from your physiotherapist for treatment and exercises to address any issues.
I’ve had a C-section so I don’t need to strengthen my pelvic floor
False: Your pelvic floor, regardless of how you gave birth, has been through a lot! It has carried the weight of your baby, the placenta and a 50% increase in blood volume for 9 months. This will greatly affect its ability to do its job properly compared to pre-pregnancy function.
Doing lots of ab-crunches and “planks” will help me get a flat tummy
False: These types of exercises should not be performed early on after birth as they cause excessive force on the abdominal wall, which may actually increase separation. It is best to strengthen the deeper abdominal muscles first with Pilates-type exercises.
It is important to remember that every woman is different. Exercise timescales are determined by your previous level of fitness, the type of birth you experienced and take into account any complications thereafter. Seek advice from your physiotherapist before commencing an exercise regime.
At Physio Effect we provide physiotherapy throughout your pregnancy journey and beyond. This includes ante- and postnatal assessment, treatment and physio-led Pilates classes. Our partners at Everyday Athlete Gym also run special mother and baby exercise classes.
Click here to see more about our ante- and postnatal services here at Physio Effect
One of our physios Mariam Kilpatrick with wonder-baby Aria
Crybaby Classes: Post-Natal Pilates Classes at Physio Effect!
Our Post-Natal Pilates class is designed for new mums from 6 weeks post-partum (8-weeks if by C-section) and onwards. The class is designed to help heal and strengthen muscles affected after pregnancy and labour such as your pelvic floor and abdominals.
Our Post-Natal Pilates class is designed for new mums from 6 weeks post-partum (8-weeks if by C-section) and onwards. The class is designed to help heal and strengthen muscles affected after pregnancy and labour such as your pelvic floor and abdominals. This class can also help manage back pain, pelvic girdle pain, improve continence and treat abdominal separation (diastasis recti). The added bonus is you are welcome to bring your baby along to the class while you exercise.
How do I get started?
For first-timers, you will be required to have a post-natal 1:1 assessment with one of our physiotherapists. This can be booked after you’ve had your 6 week check-up from your physician and given the all-clear to start exercising (usually a little longer if you've had a C-section). During this consultation, you will be able to discuss your pregnancy, labour and set some goals you’d like to achieve after having your baby. The physiotherapist will assess your pelvic floor and abdominal function and go over some basic, fundamental Pilates exercises in preparation to starting the classes. This appointment usually takes 30 minutes and you are welcome to bring your baby along.
When are the classes?
The classes are every Tuesday and Wednesday and run over a 6-week or a 12-week block. Each class lasts an hour. If you would like to start the classes in the middle of a current block, there is an option to pay per class depending on available spaces. The class number is small with a maximum number of 8 mums per class. Please get in touch to find out when the next block is.
How much does it cost?
Physiotherapy post-natal Assessment (if you are attending for the first time): £30
6-week block: £60
12-week block: £110
If you would like to pay per class, for example, if you cannot attend all classes in the block or if you are joining in the middle of an existing block, it would cost £12 per class depending on available spaces (we take a maximum of 8 mums per class).
Up until what age can I bring my baby?
You are welcome to bring your baby up until they are able to crawl/move about (which can be different for every baby, of course!). Otherwise you may find it difficult to do your Pilates exercises.
Are your facilities buggy friendly?
Our Pilates studio is located within the EDA Gym which has ramps for easy buggy access. The studio has ample space for your buggy and there is a lounge area and café where you can buy water/coffee/tea and snacks.
What other Ante- and Post-Natal Services do you provide at Physio Effect?
Here at Physio Effect, we have a number of therapists specially trained to help you through your pregnancy journey and after you've had your baby. Click here for more info on our other services
“Fantastic Pilates class that has helped me regain confidence, strength and my figure after having my son. Mariam is very skilled and knows exactly how to fine tune the exercises to suit individual needs. It is a particular bonus that you can take your baby along and Mariam is on hand to lend a cuddle if one of them is unhappy. There is also a cafe onsite where the group enjoy a coffee and a natter after the class. I would not hesitate to recommend”
We got a new piece of kit in our Studio!
Watch Nicki demonstrating our new Pilates Reformer in our Northside Studio!
We are very excited to get a reformer for our studio here at our Northside Clinic in Port Dundas - read more about the reformer here and see Nicki, one of our Massage Therapists demoing it below!
What is the difference between ‘Regular’ and ‘Clinical’ Pilates?
Interested in Pilates in general but not sure what we mean by Clinical Pilates?
Regular Pilates is conducted by a Pilates instructor, whereas Clinical Pilates is prescribed and supervised by a Physiotherapist. The difference is very important because a physiotherapist has an in-depth knowledge of injury, pathology, body function and movement patterns. The physiotherapist will assess each person and determine which exercises will be the most effective for each individual. This becomes especially important if you have a history of injury such as low back pain, whiplash, hypermobility or an athlete coming back from an injury. There will be certain exercises which need to be adapted specifically for you.
For more information on our Clinical Pilates classes here at Physio Effect, have a look on our Clinical Pilates page
