We just love this video (put together by BCPhysio), sharing one woman's story about pelvic floor dysfunction. Her story is similar to what we hear from so many of the beautiful women that we treat in our offie. It is so so so so rewarding to be able to help our clients get back to full normal function and most importantly doing what they love.
It's been just over 5 weeks since we welcomed our newest addition. And my, how these weeks have flown!
Our sweet little guy was born, as I correctly predicted, two weeks "early" on a Saturday (just like his older two siblings were). It was a straightforward, normal birth and if you care to know more details, please read on:
Home birth (third time around). Birth in the water (2nd time around). Physiological Birth. Attended by my two midwives and hubby.
Our Other Kids :
I was torn about whether or not they should stay or leave the house. If they were present, would they be distressed to see me in labour? Would it cause me anxiety and prevent me from focusing during labouring? I shared my thoughts with my midwife and she suggested that I borrow some children’s books on home birth from their lending library. So I did - and they were read almost every day for a week leading up to birth.
Emotions and Thoughts:
I was hoping I would have no tearing or perineal trauma. I felt confident in my body's ability to birth but also somewhat nervous about the unknown. I mostly felt a huge sense of urgency because very few things were in place for the post partum period. So for a week before delivery, you’d find me nesting like a crazy woman, trying to cook freezer meals, line up help, find and launder newborn clothes, buying diapers and new born supplies, making a post partum kit, oh - and looking for a mini-van as my new ride (major space upgrade from my VW Rabbit). I felt excited to meet my new little one and wondered if baby would be a boy or girl.
The Day Before:
I had been having contractions on and off for about a week leading up to birth - they were nothing really, just my uterine muscle doing some practice runs. On Friday I was convinced that the baby would arrive within the next 48 hours. So we decided to inflate the birth tub that had been sitting around for a month tempting our curious toddlers. Much to our disappointment the tub began to deflate almost as soon as it was inflated. A leak. Great. So I texted a Christal Malone – a doula friend who I happened to be meeting on Saturday morning at my office - and I asked if she had a spare birth tub. Lo and behold, she did.
The Day Of:
Saturday morning arrived and contractions remained weak and irregular. I met with Christal and during that meeting, my contractions stopped completely. Afterwards, I went home and my hubby inflated the tub. The kids were obviously very excited by the possibility of going swimming in our kitchen, as evidenced by my two year old daughter going to fetch her swimsuit. In the afternoon my contractions had returned with an irregular pattern again. We put the kids down for a nap which left me and my husband some alone time during the day (which frankly is a very rare occurrence). So what did we do? We got down of course!! (Sorry if that offends your sensibilities…) In any case lets just say that being intimate flipped a switch because immediately after, my contractions became a lot more intense and definitely regular. Which was worrisome because being April Fools, I really hoped to avoid delivering so my child wouldn’t have go through life having this conversation on repeat:
Our child: Hey guys…it’s my birthday today.
Friends: Yeah yeah yeah…nice try. We know it’s April Fool’s Day. We’re not that dumb.
Our child: No, really it IS my birthday. Now get me a cupcake.
Friends: Quit trying to fool us. Seriously, you’re such a joker.
The Main Event:
My husband took the kids out so I could get some rest (we hadn’t slept much the night before because it was cook-a-thon and I was too busy cleaning and organizing random things). So I laid down but wasn’t able to sleep much due to the contractions. After about two hours, my family returned home and I finally accepted the fact that I was in active labour.
I called my midwife at around 6pm. She was attending another birth and my other midwife was off call. She sent over another midwife over who arrived really quickly. She checked me and I was 8cm dilated (shocking really)! Things got rolling pretty quickly after that. My husband started filling the pool and we called over our lovely and trustworthy nanny (because we have no family in town) who put our kids to bed.
I laboured on all 4s, on my birth ball, walking up and down my stairs, leaning on the kitchen counter, squatting a bit, and coordinated each wave of contraction with my breath, vocalizing with each surge. I finally got into the pool…which was cold. Not exactly comforting…. So my husband had four large pots of water and the kettle going at all times. The water eventually warmed up but never quite got to my ideal temperature. Regardless, the water was lovely and soothing. In the pool, I spent most of my time on all 4s, in a modified squat position, or resting with my upper body on the edge of the pool. There wasn't much time to rest between surges.
This labour out of all three was probably the most intense….I knew I could do it, but as I reached the transition stage, I really felt like I was not managing the surges well with my breath and just a bit out of control. Apparently this is how you know you're close to the finish line.
I don’t know how long I was in the tub but at one point I tried to stand and bingo, that’s when my water finally broke. Almost immediately, I felt the sense that I would have to push soon. I don’t think I actively “pushed” much – my uterus seemed to be doing most of the work - or so my midwife later told me. After 3 or 4 strong contractions and with many loud sounds on my part, he was out - born exactly at 8:30pm. He weighed 7Lb 4oz - my biggest and chubbiest baby to date.
My husband immediately went upstairs, woke the kids up and brought them to meet their new baby brother. They were absolutely delighted to finally meet the baby! After a short snuggle with my new guy, I came out of the water, delivered the placenta and went upstairs to my bed. The midwife checked for tearing, and hooray!!! Only one “graze”, no tearing or anything requiring stitches. So after that then it was time to try to breastfeed the rather hungry muchkin. And I’ve been feeding him ever since, literally!
So that is my birth story. I’m beyond thankful for the experience I had and for excellent care. I’m blessed to have my son and happy that he is thriving, and for the most part, so am I. I will be writing a post partum series - everything you'll need to know to thrive in the first few weeks after having the baby. Stay tuned!
Does the thought of jumping on a trampoline with your kids want to make you wet your pants? Jumping (especially on a trampoline!) seems to be the one thing that women with pelvic floor dysfunction don't even want to try.
Which brings me to kegels. There is a lot of talk about kegels out there these days, and if you are confused, I don’t blame you! Perhaps your doctor told you to do 100 kegels a day to stop those pesky leaks. Maybe you’ve heard whisperings about the latest and greatest gadget that you can insert “down there” for a super strong pelvic floor. Or perhaps you have read online that you ought to ditch the kegels all together and squat like crazy instead. What is a thinking lady to do?!
The truth is that there is no one right answer or one magical solution (unfortunately!).
Every body is different and every system has different needs. Before starting on any kind of pelvic floor training program, it is vitally important to get assessed: if you don’t know your baseline or starting point, you won’t know where to go from there. A pelvic floor physiotherapist should perform a careful assessment of the pelvic floor muscles; and a really good physio will evaluate the pelvic floor within the wider context of the whole person and their life.
When it comes to kegels, you will fall into one of two categories:
1) You should be doing them.
2) You should not be doing them.
Getting checked will let you know which camp you fall into - if you're in one camp and ought to be in the other, you will get very frustrated.
Let's talk about those who should be doing kegels.
We know from studies that about 50% of women perform kegels incorrectly. They either bear down, or hold their breath, or don't get the necessary lift, or do only a few here and there, or start in poor postures, or use a bunch of other muscles to do the job, or don't learn to engage the entire inner core system. If you find that your exercises don't seem to be working, it is likely that you're doing them incorrectly.
To train the pelvic floor with kegels (ie. pelvic floor muscle contractions), you will need to:
The moral of the story? Kegels have their place, but they are not the be all and end all. You need to first get assessed to make sure kegels are right for you. Then you must work with your physio to retrain a robust and dynamic system that will keep you high and dry, pain free, and functioning normally. Perhaps 2017 is going to be your year to focus on optimal pelvic function. If so, we have a great team of physios that would love to come along side you in that journey! Happy kegeling.
* A version of this article has was originally published in the Mom and Caregiver Magazine, Jan 2017 edition.
Recently I was reading a book and this passage really touched me as I work with so many women who experience pain as part of their daily lives.
(Excerpt Taken from A Grace Disguised: How the Soul Grows Through Loss by Jerry Sittser)
“I have often told myself, not always convincingly, that pain is a gift, a sure sign that we are alive. Only the dead feel no pain, and that includes dead people who, though still alive, have rejected love and goodness and sorrow for so long they have lost the ability to feel anything.
Pain is a gift because it shows we have the capacity to feel, whether pain in the body or pain in the soul. Physical pain demonstrates the capacity we have in our senses to experience the negative side of life in the world. Our nerves give us messages about the world, warning us of dangers as well as informing us of its delights. Pain therefore is the flip side of pleasure. The nerves that tell us of one also tell us of the other. The eye that blinks under the glare of a bright light also gazes in wonder at a mountain peak or meadow of wild flowers. The nose that signals the scent of a dead animal under the crawl space of our house also draws us into the kitchen where bread is baking. The mouth that makes us spit out spoiled food also relishes the taste of our favourite ice cream. Ears that cringe at the wail of a siren also listen with pleasure to a Beethoven symphony.
The index finger is a marvel of well-tuned nerves, an instrument of remarkable precision. It can, for example, produce a wide variety of sounds on a violin under the guidance of a virtuoso. It can give us an infinite range of sensations, from the softness of a feather to the prickle of a cactus. It can communicate love when it strokes the hair of a lover or rubs the back of a friend. But the index finger can also scream at us. Its capacity for pleasure is equal only to its capacity for pain. The same nerves communicate both sensations. A sliver in the foot may hurt, but nothing like a sliver in the finger. A burn hurts anywhere on the body, but in few places will it hurt as much as it does on the index finger. It commands us to do something to mitigate or eliminate the pain.
Hansen’s disease (also known as leprosy) is deadly because it keeps the nerves from informing the person of pain. Thus a sliver under the nail of a person afflicted with this disease does not make the nerves scream. The person does not know enough, consequently to remove the sliver and cannot favor the sore finger as it heals. Little injuries can therefore become big ones over time. Sores become infected, infections turn ugly, and soon the finger is gone – all because the nerves fail to communicate pain.”
Next time you experience pain, don’t ignore it or numb it but stop and listen. Can you describe it? Observe it – are their specific activities or positions that make it better or worse? Try to work as a detective with your body to find what might be causing it. Can you be thankful for this highly specialised system?
It's 6:30am on a Saturday morning. I'm feeling nauseous yet ravenous at the same time. What a horrible position to be in. I desperately hope the kids will sleep in, a couple more hours if I'm really lucky. But probably not. This first trimester of pregnancy is definitely not as easy as the last two that's for sure. Thankfully there is the amazing RED RASPBERRY TEA to the rescue! I go down the stairs, boil a couple cups of water, put the loose leaves into my tea strainer and wait 15 minutes until it's ready.
I was thinking about how amazing it is that in everyday plants around us, there is the potential for health and healing. Although we might not know now, we know that many herbal remedies work. With regard to to Red Raspberry Leaf Tea - if you do a quick search, you will see many a blog touting the amazing effects of it. Now are there actual solid research studies which document beyond a doubt its efficacy for every single pregnant woman?No not really. So science would say that the evidence for this tea is poor. Sara Wickham examines the evidence in this article.
However there is a lot of anecdotal evidence, historical documentation in traditional communities, and personal testimonies about how great this herbal is. It can purportedly help women in various ways including:
As for me, I'm a believer. Even though I'm have a Master's degree in science, I don't always feel that I need overwhelming evidence from a randomized controlled trial before I decide to give something a try. I drank red raspberry leaf tea every day after my first trimester with the last two babes.
With baby number 1 - I had very minimal pain, and he was out in 2 pushes. His labour was so efficient that he arrived before the midwives did...but that's a story for another time. Baby number two was a little different. That time around, I had my husband brew a strong concentrate of the tea to drink while in labour. That labour wasn't as fast and it actually seemed to stall a bit when I should have been nearing transition. But let me tell you....it really did get labour going! I kid you not, after contractions slowed a bit, I thought to try to tea. After about 3 gulps of the piping hot tea, I was suddenly ready to push. The next few contractions were quite intense and they took me by surprise because it all happened literally within 1 minute of drinking the tea. A few minutes later, my daughter was out in 3 pushes. (Midwives and my hubby are my witnesses. I'm not making this up!)
With this pregnancy, I'm going to faithfully drink my red raspberry leaf tea. I have found that it is helping me with the all day sick feeling that I've been experiencing. If you have an appointment with me at my office, you'll probably see a large travel mug with this stuff in it - I sip on it all day long and it really helps. Placebo effect? Maybe. But frankly, I don't really care. If it works, it works. And there are no known adverse effects. If there is a chance that my uterine muscle can be strengthened and made to work more efficiently, I'll take it! I plan on asking Dr. Holly - our lovely Naturopathic Doctor - her thoughts and recommendations. She would be the best person to talk to!
So how about you? What's been your experience with Red Raspberry Leaf Tea? If you're interested in learning more about how to prepare your body (both inside and out) for childbirth, please register for our upcoming pre-natal workshop: Prepare Your Pelvic Floor For Childbirth . See you there!
So apparently childbirth is going to be an Olympic Sport by 2024!!!!! (Whaaaaa???")
So get this, professional "child-bearers" from around the world who qualify will compete for gold, silver or bronze in childbirth. They will be judged on their efficiency, strength, endurance, ability to birth without intervention, presence of multiples, speed of delivery, extent of perineal injuries, length of recovery period, Apgar scores, and of course maternal survival rates.
Ok, so I'm totally kidding. (Gotcha for a second though, huh?)
Childbirth is not and will never be an Olympic sport. (Thank God.) It is not some sort of competition where the winner gets gold (although sadly, many of us women do constantly compare ourselves to other women or rate our experiences against some arbitrary "ideal"). Instead of focusing on how we stack up against others, we should aim for our PB - personal best - in childbirth.
So even though childbirth is not a professional sport, there are many reasons why we should prepare for it as if it is. As a professional athlete, you'd never go out onto the field without training first, right? Even if you were just opting for a quick game of pick-up whatever, you'd do do a little warm up first, wouldn't you?
The reality is that childbirth is hard work - and for a lot of women, it is the most physical thing they will ever do! That's why they call labour labour. I believe wholeheartedly that our bodies innately "know" what to do when it comes to child birth. But things still go "wrong". I mean, this ain't the Garden of Eden no more. Our modern environment that is full of stress, is completely sedentary, lacks optimal nutrition, and worse, still promotes horrible birth practices known to increase the rates of pelvic floor injury. With those odds against us, we need to prepare our bodies. We need to remind our bodies that it can birth a child and do it well while remaining intact afterwards.
So quickly, here are 5 things you can do to proactively train for the physical aspects of childbirth (notice, I didn't even mention the mental or emotional aspects of preparation which is also extremely important.)
Now I'm not promising that you will have the "perfect" birth just because you do all five of these things. When it comes to pregnancy or childbirth, there is always that x-factor of things that can happen which are truly beyond your control. But remember, we're not aiming for perfection (whatever that is...). We're aiming for your PB. And we know that women who go into childbirth in excellent physical condition and armed with evidence based knowledge will have:
So if you're a woman who is pregnant or trying to get pregnant consider yourself in basic training and aim for a personal best in your main event (ie. bringing a baby into the world).
We'd love to help you get your body functioning well for birth. If you want to go in strong and come out still strong, register for our Preparing Your Pelvic Floor For Childbirth Workshop coming up this fall.
It will be some of the best childbirth preparation that you do.
It's world breastfeeding week! I thought I would throw in my two cents on this topic. Why? Because surprisingly, physio has a LOT to say about nursing.
So breastfeeding...it has made a popular comeback since the 60s, and with a vengeance too. That's a really good thing since breastmilk is pretty much a miraculous substance that no laboratory can near replicate. There are many good reasons to breastfeed: the bond between baby and mom, the protection against illness or disease for both mom and baby, the boost for baby brain power, the convenience of it all, and the fact that it's free.
But in my opinion, breastfeeding does have one down side...
That is the potential negative impact on your body.
I'm not really talking about saggy boobs or different sized breasts. Although it can be aesthetically frustrating, it doesn't really impact your life in terms of the ability to function. I'm taking more about the alignment, structural and bio-mechanical changes that can really impact daily movement and function. This is REALLY important. Think about the cumulative effect of weeks, months, and years of poor positioning. I mean, how many hours do you log a month with breastfeeding? For me, I've been going strong for almost 3 years with a short six month break in-between babies. Shoot, I basically have an undergraduate degree in breastfeeding!
Is see it time and time again: women who start off with pretty good posture before baby end up looking (and feeling) like the Hunchback of Notre Dame by the time they're done. I'm talking wrist pain, back pain, rib pain, numbness, neck pain, tingling, tight muscles, feeling weak. That can all start during your breastfeeding career. If you don't interrupt that progression, you may end up looking like a little old granny with a humped back living with a lot of pain.
So, what's a nursing or pumping mom to do?!
Here are five ways you can save your body during your breastfeeding tenure - no matter how short or long that may be.
1) Practice awareness and find your neutral.
Gravity is a powerful force that you can't fight. It will always try to pull you down. We can either lose to that process (which equals pain) or we can overcome it and win. How? By orienting our bodies in the ideal position it was designed to best operate in. Think neutral spine, neutral rib-cage, neutral pelvis, neutral neck, neutral wrist....
Ok, so I know you can't sit or stand perfectly neutral all the time, but the more often we choose "neutral" the better it will be. The main thing needed is for your system to have a choice and be able to adapt to different positions. If it is constantly going into the same non-optimal position...then what your grandma said is true, you'll get stuck in that poor neuro-muscular pattern.
Try this: close your eyes and tune into your body. If you're really aware, you may start to feel twists, shifts, compressions, or added weight, in various parts of your body. If while nursing you feel you're shifted over or discomfort is starting to develop, then just try to shift back into neutral positioning and you'll immediately feel better. If you're not sure how to find that neutral, come in for a visit and we'll help you figure it out.
2) Boobs need support.
During the breastfeeding years, breasts change size and shape. A lot. During the early days they can become larger than you ever thought possible. That sudden added weight can pull you down, causing your upper back to curve forward, your shoulder blades to move further apart, your neck to be pulled forward, and your chest to collapse in. Upper back muscles become overstretched and weak. Chest muscle become short and tight. You often end up slouching through your pelvis which has implications for the lower part of your body.
The larger the breasts, the more support is needed. Support your breasts externally by investing in several really good quality nursing bras. (The higher end cost of a good nursing bra is worth it since you'll likely be wearing them day in and day out for a number of months.) Support your breasts internally by keeping your shoulder girdle and upper back muscles strong. Talk to a personal trainer or physio about some good exercises for your upper body.
3) Explore different nursing positions.
There are many ways to nurse a baby. You don't have to feel confined to the classic rocking chair. Although sitting is certainly an option (and often most practical), I will say that sitting tends to pull you into that hunch back position described in the section above. Instead of sitting all the time, you can try semi-reclined or fully reclined with the baby lying on you. Other positions are side lying with your baby next to you. If you're nursing a toddler, you can sit with your little one straddling you and facing forward. If you're nursing a baby, you can also or try using a baby sling or some other type of carrier. Talk to a lactation consultant to figure out what the best positions are for you and your baby.
4) Use props and supports.
Nursing pillows, neck travel pillows, large blankets, small blankets, lumbar supports, upper back supports and garments, proprioceptive tape.....
Use whatever it takes to help take the pressure and strain off your body. This is especially important if you're nursing for long periods of time or if you have a heavy or floppy baby. Using supports will enable your body to relax and will help you avoid carrying excess tension in your muscles. It will also help your baby feel more comfortable.
You can move WHILE breastfeeding by looking up from your baby from time to time. You can move your neck back into extension or slowly from side to side.
You should do a few stretches immediately AFTER nursing that will help open up your body from that curled and compressed position. Roll your shoulders forward and backwards. Bring your arms overhead and stretch your upper back and shoulders. Stretch out your pecs. Bend your trunk side to side. Then do a few rotations or twists through your spine. Remember to breathe fully to expand your rib cage several times as well. It will literally take you one or two minutes to do all these stretches. Putting in the time after each nursing session will help to counteract that force of gravity and it really does make a difference. If you've got a bit more time on your hands then stretch, out your lower body as well, especially the hip flexors.
Really, the best thing you can do is to cultivate a lifestyle of movement. Let's be honest, a 5 second stretch once every couple of days isn't going to make a huge dent in the accumulated hours of crappy posture. However, if you start to make movement a priority in your life, that will go a much longer way to offsetting the negative effects of static non-optimal postures. Think of one way to add more movement to your life and then just do it.
6. Bonus benefit for your boobs.
Did you know you can see a physiotherapist to get therapeutic ultrasound treatment for blocked ducts? Typically only one or two sessions are needed to completely clear the blockage! You can also learn how to do a breast massage on yourself to keep breast tissue and underlying muscles in good health.
Well there you have it. Nursing and cuddling cute squishy little babies is one of the best things in the world. But don't let it destroy your body. You've got only one and you need it to work for you during the rest of your life too. If you would like some more guidance with any of the above points, please don't hesitate to book an appointment at our office. And fyi, we are breastfeeding friendly!
Happy World Breastfeeding Week.
I know that we have at least another month until it's Back To School time! But since we're gearing up for that season... it's POP QUIZ time. (Yes, I hear the collective groan.)
Test your knowledge of pelvic health by answering these 10 true or false questions. If you score 70% or higher, you're really doing well! If not then this is the perfect opportunity to learn some things you really need to know. Ready, set....go. (No cheating now, ya hear?)
It is normal to leak a little after having a baby or as you get older in age. True or False?
A pelvic floor physio is one of only three types of health professionals trained to assess the internal state of the pelvis. True or False?
How you breathe, sit, stand, walk, and think all have an effect on your pelvic health. True or False?
Every woman should be doing kegels, especially after having a baby. True or False?
To do a proper kegel simply squeeze or clench the muscles that stop the flow of urine. True or False?
A pelvic organ prolapse (downward descent of a pelvic organ - namely the uterus, rectum, or bladder - towards the vaginal opening) is reversible. True or False?
The average healthy adult should be able to last 3 to 3 1/2 hours between urinating. True or False?
Your core is made up your abs, back and sides. They should be toned and strong. True or False?
Regular pain and discomfort during pregnancy is pretty normal and will get better after baby is born. True or False?
When giving birth, lying down on your back with legs up is better than delivering upside down. True or False?
Bonus Question 11:
Men don't have pelvic floor problems. True or False?
Ready for the answers? Click the read more button below.
The Mama's Physio is so pleased to host Dancing for Birth Classes in our studio this fall! Register now to reserve your spot in this awesome class which is for expectant moms AND for moms with babes.
So often in life, I am struck by how our ability to persevere and push through difficult periods comes from hopeful expectation.
My desire for all things fresh produces the motivation each morning to water the tomatoes in their clay planters on my patio.
The joy I receive from friendship causes me to invest in those around me, working through conflict to bring
The fulfillment of nurturing and holding a child brings encouragement during the months of pregnancy and in the midst of labour pain.
The satisfaction derived from eating a slice of fresh bread makes the work of mixing and kneading well worth it!
In our journey towards healing and health, can we invest in small ways in anticipation of the body's innate ability to heal itself? I encourage you as you seek physical restoration, to work patiently with your body, waiting in hopeful expectation for recovery.
The Mama's Physio
We are a team of experienced physiotherapists with a passion for women's health and well being. We focus on pelvic health in the context of the whole body. We care for pregnant and post-partum mamas and women at all life stages from teens to the young at heart. We are mothers ourselves and we are women. We love what we do and we are here to serve you.