pelvic health resources for men

Pelvic Health Resources for Men

Happy Father’s Day!  This post is a new collection of my favorite Pelvic Health Resources for men.

Men’s health and wellbeing is important. Please do share this blogpost, not just with the fathers – uncles, brothers, nephews & friends will appreciate you thinking of them too.

Pelvic Health Resources for Men

# Pelvic Floor Exercises

Research shows that problems like: 

  • urinary frequency
  • post-void dribble
  • urgency (strong desire at the wrong time!)
  • flatulance or bowel leaks
  • getting up at night to wee
  • small bladder leaks
  • or erectile dysfunction

all respond really well to improving pelvic floor muscle strength, endurance and control.  

Download and/or print this FREE booklet from my professional organisation.  Clear pictures and instructions on the best technique.

There is also a dedicated section about Men’s Health and audio guided pelvic floor exercise sequence.

Squeezy for Men is an education and reminder App (IOS or Android £2.99)

Squeezy has been designed by chartered physiotherapists specialising in Men’s Health working in the NHS. It is suitable for all men who want to do pelvic floor muscle exercises (also known as Kegel exercises). It is simple to use, discreet & informative. The visual and audio prompts help improve your technique & timing. And it records your practice sessions.

# Bladder & Bowel Health

Sometimes it’s just “operator” error or innocence.  Who teaches us what a bladder does or doesn’t like, or how to sit on a toilet to get the best bowel opening?  Never too late to learn!

a glass how much should you drink in a day

Do you know how much you should drink in a day (like really know, not just guess)??  Have you ever actually counted your fluid in and out??  A bit of tweaking to avoid droughts & floods, and avoid irritating the bladder lining can be life-changing.  Read more here.

baby sitting on potty 3 Ps of a perfect poo

Keeping the bowel moving well keeps pressure off your pelvic organs, lifts your mood and helps concentration.

There are 3 Ps which you should keep in mind during your ablutions. Are you or family doing any naturally?? How do you sit? Do some people in your family take a LONG time in the toilet? Who reads the paper? Should you keep books in the loo? 

Watch my lighthearted talk about good bowel habits (for a public speaking competition).  Reveals the simple secrets of how to have The Best Morning Action.

# The importance of stretching & healthy postures

You’ve heard of “tight” hamstrings or calves?  Pelvic floor muscles and other muscles that attach to the pelvis (inner thighs, gluts, lats) can also get too tight, restricting your pelvic movement and causing irritation to nerves.  Sciatic nerve irritation gives classic leg pain, pudendal nerve irritation can cause testicular or perineal pain.

Men’s Health physiotherapist Bill Taylor shows how to use a spiky ball to release the inner thighs.  Other good pelvic floor awareness & release videos on his YouTube channel.
Tony Riddle promotes Offsetting – how to work from the floor, or anywhere other than a traditional seat.  Recommend his YouTube snippets & the trailer of his Vimeo course  https://vimeo.com/ondemand/chairsittingoffsetting/407898301

# Core Exercise is Not Just for Girls

Both Yoga and Pilates were originated by and for men.  Joseph Pilates first taught his exercises to German compatriots interned on the Isle of Wight during WW2.    Pants and pony tails are optional. 

Plenty of men attend Pilates classes to get the benefit of a weekly supervised stretch, strengthen and mindful movement session. Do email if you’d like to try a real class (in Cambridge area) or virtual class (Saturday mornings) or subscribe to our online PhysioPilates Library.

Not sure if it would suit you? Have a go at home first. Find lots of short sequences for everyone on our PhysioPilates Academy YouTube Channel: https://www.youtube.com/channel/UC07NzCSJa6n806A530-iQZA

If you have any worries that your pelvic floor is not quite what it should be, niggly injuries that won’t resolve or would like a general “MOT” of your situation, get your technique checked before you do too much more DIY.


# Specialist Physiotherapy Assessement

There is so much a specialist pelvic floor physiotherapist can teach you to improve internal muscle strength, endurance & co-ordination. They will also check your posture, core control & consider how previous injuries, surgeries or events may impact on your pelvic health.

 Through post-graduate training, we have the skills to properly assess and examine the pelvic floor muscles with an external or rectal examination.  We do this in a discreet and gentle way, putting you as much at ease as we can.

We aim to help you understand how your body works.  With a better understanding of your muscles’ strength, weakness or tension problems, your exercises will make sense & be motivating. We can show you how to help them to grow stronger or release & stretch.

Do you need MORE SUPPORT?

Ask your GP to refer you to the local NHS services (if you are Cambridge-based you can self-refer). Or do come to see me at my practice South Cambridge Physiotherapy or arrange a virtual appointment.  

Not near Cambridge? I believe finding a local physio is best for your longer term support. My professional body POGP and Squeezy app have national directories of physios who specialise in Men’s Health.

I hope you found this collection of pelvic health resources for men helpful. Please don’t hesitate to get in touch if you have a personal question.

pelvic floor lift exercise

Pelvic floor LIFT exercise: technique tips

Have you heard of the “lift” exercise for your pelvic floor muscles?

You know – the one where you go “up up up” and then “down down down”. It’s been around for years.  Even my mother knows it! 

However, there lately seems to be some confusion about how to do it and WHY?!

Sometimes the lift has an awful lot of floors (I heard recently of 9!) and I worry that there’s an awful lot of over-gripping going on. Everyone thinks its goal is to make your pelvic floor stronger but I think its most important purpose is to help you have more control.

In the video below you can practice it with me, just the way I teach it in physio clinic – and you will be relieved to know that my lift only has 3 floors (but it does have a basement).

Top Tips: for a MODERN lift exercise

  • Make sure you use ALL of the pelvic floor (the back, front and sides) – not just focus on the bladder opening (see Pelvic Floor School)
  • Start with 3 floors  – will be surprisingly tricky if you have only previously done all or nothing!
  • Practice going up first with a crash after the top
  • Then practice starting at the top and coming down slowly
  • Add a basement level as you come down to tune into the feeling of relaxing fully
  • Finally put it all together practicing up and down

For an even more advanced elevator pitch:

  • Build up to discerning between 5 floors (think of gears in a car).
  • Be mindful of being able to breathe at each level
  • Notice that coming “down” IS a more skilled activity than going up (practise it!)
  • Think about WHEN IN REAL LIFE you might choose to use each type/level of pelvic floor activity
  • Improve your awareness of letting go into the basement.

What’s the point of the pelvic floor lift exercise?

In the past all the focus was on contracting your pelvic floor muscles as MUCH as possible.  More is more kind of approach.  This is how we used to do everything in the 80s when this exercise had its hay day.  Sweatier, heavier, stronger, faster.  If your leotard & tights weren’t dripping you weren’t trying hard enough!!

However, this is 2021 and we know an awful lot more about muscles, how they work and especially how they are supposed to function to keep us dry, supported and painfree.

Why do we need to be able to find different levels of pelvic floor squeeze?

  • You need to be able to do your BEST squeeze for a few short seconds if you are going to cough, sneeze or pick up something really heavy (top level).
  • But you also need to be able to maintain a MEDIUM hold when you hold your baby on your hip at playgroup, or carry your bags of shopping back to your car (middle level).
  • You need a “background” (postural) LIGHT level of support ALL the time you are on your feet (lowest level). 
  • And finally – you need to be able to RELAX and STRETCH out so that you can properly empty your bladder & bowel and have comfortable sex (basement level)

Why do we need to practise control of the journey up and down?

  • In every day activitites you move between the lower levels. Just as your neck muscles quietly get on with holding your head up and shoulders level, so your pelvic floor muscles need to automatically create a support shelf between your legs for your pelvic organs to rest on. This shelf needs to sometimes work a little harder to absorb the bumps in the day. These come and go from dashing about, bouncing down the stairs, hopping over stairgates  and shouting for the kids dog. But when it is not needed so much the shelf needs to relax and rest quiety, conserving energy, allowing blood flow.
  • Sporty people (be that zumba netball or running) should practise for 5 “gears”. You will need to keep shifting gears 3-5 zone – as you need a skilled pelvic floor to be background steadily supportive but reactive to a change in direction, hitting a ball, jumping a kerb, picking up a sprint.
  • Everyone needs to be able to “let go” WITH CONTROL all the way down to find 0 & -1.  A vital skill for holding a full bladder until you have reached your toilet and managed to get your clothes down!  If you tend to crash down you will be having leaks before you are quite getting there.

How did you get taught to do yours? Do share!

Field Guide: incontinence pads and pants and knickers

Field Guide: incontinence pads and pants

Trying to stay dry with bladder leakage? Not sure what will work best for you – incontinence pads or pants?  Overwhelmed by the choices in the shops and online? This detailed post & video discusses all the options and explains the difference between them. Don’t waste money buying the wrong thing. Tips and tricks to feel safe and dry without irritating your skin.

This is a practial, unbiased, useful overview of incontinence protection products, to help you decide what might suit you best. 

Even a few drips or spurts when you cough or sneeze (stress incontinence) can quickly make your knickers feel wet and uncomfortable. It’s natural to worry that it has gone through onto your clothes and be anxious that everyone can see what has happened.  Irritable bladders can catch you short before you make it to the toilet, or even unexpectedly empty without much warning (urge incontinence). Those leaks can be very big. 

 Fear makes you avoid doing things.  Feeling anxious takes the edge off life and motherhood.  Let’s start by making you feel safe.  #No More Miserable Mums.

full disclosure: this article contains some affiliate links marked*. As an amazon associate I earn from qualifying purchases. If you make a purchase by clicking through from an affiliate link I receive a small commission  at no further cost to you. Thank you, this helps to support this blog.

#1.  Disposable incontinence pads

Sanitary pads and incontinence pads are not made of the same thing.  It is important to use a pad designed for bladder leakage not menstruation.

The products designed to be used for menstruation are great for that purpose. However, they do not to cope well with liquid.  This is because they are predominantly cottonwool based. So if they get wet, they just go soggy and misshapen. If you are moving about they can get scrunched up, rub,  and leave your skin in contact with urine causing chafing and soreness.

The right pads for the task are worth the little bit of extra cost.   With the advent of new technology you will be amazed how slim a proper bladder leakage pad can be to hold a large amount of liquid, keep damp away from your skin and control smell.  

WHAT TO LOOK FOR IN THE SHOPS (or online )

Products for incontinence are usually in the same ‘feminine hygiene’ aisle (or website section of an online store) separated into one column of shelves for products for periods and one for bladder leakage.

Most brands will send you free samples from their websites.  Collect them up and see which suit you best!

disposable incontinence pads

Some of the main UK brands are Tena, Always, Attends, Poise, as well as supermarket own-brands and Boots’ StayDry range

How much urine leakage do incontinence pads hold?

The most common indicator of absorbency is a row of filled ‘drip’ or circle symbols to indicate the level of leakage they will contain.

In general, pads for ‘lighter’ bladder leakage look and feel like pantyliners. They come in boxes to keep them flat and compact.   This makes a good starting point if you are looking for something to keep you confident and safe against a small leak (up to 6 teaspoons = 30ml). These would work for or a few drips or spurts if you move awkwardly, or cough unexpectedly with a full bladder.  

If you suffer with more severe leakage, you will be worrying about getting wet clothes. Look at the pads in bags which will be more absorbent or disposable absorbent pants (see below).

A bad cough, hayfever, trying anything bouncy for a prolonged period could leak a small yogurt pot worth (= 100ml). Of if you have an irritable bladder (officially called overactive bladder) which can trigger a sudden urge and empty at the front door, or if you wait too long, you have the risk of potentially emptying most or all of your bladder (which could be 200ml – 400ml),

If you are getting wet when you do sport or play with your kids your priority should be to solve the bladder problem further.  Talk to your physio about organising a full assessment. 

TOP TIPS for using pads

  • Shape them – to create a gully (see video)
  • Put them a bit further forward in your knickers, as the bladder tube (urethra) is just below your pubic bone
  • Change them regularly to avoid irritating your skin
  • Wear knickers that hold them snug

#2   MODERN DISPOSABLE PANTS

If you need complete confidence that no matter which way you bend, stretch, move or lie you will have full protection in all directions these are better than a substantial pad that only protects the gusset.   

  • ideal for night time leakage
  • exercise classes with lots of matwork or changes of position
  • crazy play with the kids
  • a bladder that struggles to make it to the toilet first thing in the morning
  • long car journeys or travel when toilets and timing are so uncertain.

The modern absorbent waterproof disposable knicker is technically sophisticated.  Still a way to go on style (they are trying).  Unfortunately, thye need to be big to be absorbent and need a deep waistband to hold them snug & safe. Available in standard white, cream and black.  Some with dodgy flowers.

I don’t believe these could ever feel “normal” (as marketed). However, they do give mums freedom to move without worrying. Put a big pair of “PE” pants (aka Bridget Jones) over the top to make them a tad more “out of sight out of mind” (- and organise a physio appointment to solve this problem).

If you are often using disposable incontinence pads or pants definitely look at the next option, washable knickers.  You will be amazed to see that you can get the same absorbency in a much more “normal” looking knicker.  Worth the upfront costs and kinder to your skin as well as the environment.

#3  WASHABLE KNICKERS WITH INBUILT PROTECTION

We are so lucky to be in the era of textile research and design. I am delighted to see this being applied to continence underwear. 

Advantages:  

  • good for the environment. 
  • great if you are usually fine but like to know you have back up. 
  • more discreet if you need a thicker pad. 
  • look much more like real knickers.
  • most are machine washable
  • available in a range of colours and styles
  • Natural products and airflow around your vulva, less irritation

Disadvantages:

  • once you are wet you need to change the whole knicker
  • some are not machine washable

Brands: washable incontinence knickers UK

Brandwill holdsame as…Laundry
ProTech Dry High Waist Briefs
(also called Maxi Pant)
30-60ml 2-3 tablespoonsUp to 60 degrees
Speax. Hi-Waist, Hiphugger,
French Cut, Bikini
40ml 8 tspsCold wash, tumble or line dry
Speax Thong 15ml3 tspsCold wash
Love Luna (Sainsburys),
Lady Leaks No VPL, Lady Leaks Maternity Knickers, Lady Leaks Midi Knickers
30ml 6 tspscold machine wash, do not tumble
GiggleKnickers 30ml 6 tsps 40 degree, tumble or line dry
Hush Hush
Seamless Panty or Lace waist panty
100ml small yogurt pot
Wearever Underwear
regular absrobancy
Maximum absorbancy
175ml
650ml
half a cup or a full bladdermachine wash warm, tumble dry (cotton style only)
Pro-tech black knickers absorbent for incontinence

PROTECH DRY High Waist Brief (also called Maxi Pant)

made from sturdy cotton, 3 layer mesh-style gusset, surprisingly flat: an absorbant layer (40ml = 8 tsps), odour retention layer & wick away surface, smoothly sealed seams.

www.stressnomore.co.uk

* use SUPPORTEDMUMS at checkout for a 15% discount

Speax washable incontinence pants

SPEAX

From the manufacturers of Thinx period pants. Five different styles: from Hip Hugger, through classic bikini to thong.  Varying prices depending on style £16 – £24 . 

The main knicker is a quality silky material (not cotton), gusset is subtle. Fun colours!

Speax incontinence pads are silky & colourful

NB: they  are  cold wash only (no bleach or fabric softener) with low tumble dry which you might miss in the instructions (and then be very cross about!).  Answers to other FAQs here:

shethinx.com

Giggle Knickers cotton washable incontinence pants

Giggle Knickers

A fresh feeling, environmentally aware, small company with a quality range of machine washable cotton pants designed to replace a liner.

Brief or high waisted £12.99-£14.99

www.giggleknickers.co.uk

GK are zero rated for VAT as long as you are an individual and you don’t buy more than 9 at a time. Compostable mailing bags.

Love Luna (Sainsburys)

Good budget choice. Silky material 91% nylon, gusset is 100% polyester with cotton padding, quite a wide stiff gusset, so a little more ‘aware’ that you are wearing them, than more expensive brands.

3 styles: full knickers, no VPL workout knickers, maternity knickers

£12 per pair.

www.tuclothing.sainsburys.co.uk

Wearever washable incontinence pants knickers

Wearever

A ‘sturdier’ look but this range can cope with more leakage than the more fashion based ranges. Variety of styles, colours and absorbancies (regular or maximum).

pair shown here are silky panel at front with lace panel at back

available from iMedicare at www.mypelvichealth.co.uk

You are eligible for VAT relief on your order if you are an individual purchasing Wearever for the treatment of incontinence.

What will suit you best?

Probably a mixture of different things! Life is sweet with all it’s variety, messy moments, strategic plays and aspirational hopes. No one product will solve a typical situation or day. Be open minded, treat yourself. Mums matter.

And don’t forget – you can CURE this!

80% of women can improve or completely cure their incontinence through the simplest strategy of sticking to a 3 month programme of pelvic floor exercises. Best success comes from a 1:1 assessment of your situation and a bit of supervision by a specialist physiotherapist. You can self refer to an NHS physio or many private clinics all over the UK.

Look after yourself, share your troubles with a friend, encourage other women to seek help. #No More Miserable Mums

Please let us know which products you like best in the comments below. Have you changed your life through the right knickers or exercises?

trampolining to illustrate the Knack

The Knack: No 1 pelvic floor trick for mums

What is “The Knack”

Need a Quick Win with improving your bladder leakage?

The Knack is the magical art of drawing up your pelvic floor muscles just before you cough, sneeze, laugh or pick up something heavy.  Research has confirmed it works to stop urine leakage *

So simple – yet not everyone knows about it

There can be Quick Wins with pelvic floor exercises.  I still clearly remember  when I helped a client stop leaking in just one week by teaching her the Knack – and she was FURIOUS to have waited that long!  Sarah came to physio with the problem of urinary stress incontinence, leaking urine when she coughed and sneezed. It had been happening since her second son was born……….17 years before.

She had diligently practiced pelvic floor muscle exercises as everyone had told her to. When we checked them, properly, with a vaginal examination, her muscles were firm, with an excellent strong contraction.  But, no one had ever explained the connection between practising strong muscle squeezes and WHEN TO USE THE SKILL IN REAL LIFE

I taught her about the Knack.  The next time she came back she was CROSS!  It worked – no leaks when she coughed – and quite rightly she was angry that no one had taught her something so easy, so simple and so effective sooner. It was humbling. 

And my priority ever since to make sure I spread the word about this technique.  I don’t want today’s new mums to wait even 17 hours to figure this one out.

Your pelvic floor is like a trampette

You probably didn’t have to do this pre-contraction of the pelvic floor before you were pregnant, because a pre-pregnancy pelvic floor has a lot of the Knack: your healthy pelvic floor bounces pressure away like a new trampette natural tone and tension in it.  Like a trampette, straight out of the box from Argos, you can bounce up and down on it and your body weight barely makes a dent in the springy surface. 

Pre-pregnancy, most of the down pressure when you cough or jump is deflected straight back up towards your head by the pelvic floor muscles.  Your bladder barely feels a bump.

However, you don’t need me to tell you that pregnancy and delivery have a notable affect on our soft tissues. 

The abdominal wall is a clear indicator of what happens when you stretch  elastic slowly and steadily for 9 months!

 Some are more lucky than others in the natural ‘spring back’ department.  Most women know that they are going to have to work the Knack: after a pregnancy the pelvic floor is stretched like a used trampetteto restore abdominal muscle tone and strength.   The pelvic floor has carried the same baby-burden and if you had a vaginal delivery (or pushed a long time before eventually needing a caesarean) there will have also been some micro tears to the muscle fibres and their connective tissue attachments. 

Now, at least temporarily, the pelvic floor behaves like the well-used trampette – a sense that if you jump too hard your feet might touch the floor!

The Knack creates supportive tension

the knack: what your friends and your pelvic floor are forIf you tighten your pelvic floor muscles, in the exact moment before you cough, it is like two friends pulling your trampette tight for you just for that moment that you want to jump. 

Yes, I admit its not ‘natural’, it’s not ideal, it requires thinking, you didn’t have to do it before……but it can make the difference between a bladder leak or not. 

Practice makes perfect

Practice  the Knack with a ‘pretend’ cough after you have had a wee. Your bladder is empty so you are unlikely to come unstuck.

Then, challenge the system, gently.  Hold your pelvic floor muscles firmly – cough lightly.  After a few days of practice, when that is feeling safe and secure, challenge the skill by coughing a bit harder.  Then increase your confidence by allowing an hour to pass so that your bladder is fuller when you cough (but start with the lighter coughs again!). 

With practice you will train a “learned-reflex”, a habit.  Your brain gets so used to the sequence of prepare, protect, cough that you do it on auto-pilot.

Sneezes are harder (and coughing fits, choking, vomiting….)

Sneezes are harder to resist with your pelvic floor than coughs, because you have less warning that they are coming and generally they create more downward abdominal pressure. Especially if you are one of those people who make everyone in the room jump out of their skin when you sneeze or are prone to 6 in a row?   A hacking cough with a head cold, or an allergy induced coughing fit are jolly tricky too. 

Work on getting the anticipated, lighter coughs sorted first and then the rest can follow as your muscles strengthen.

Allow yourself some slack

Beware multi-tasking – I remember having a full bladder, baby in one hand, the folded Maclaren in the other, one foot on the escalator, and I sneezed – NOPE – the Knack did not work!!!  But hey, I could live with that – it seemed fair – it was a lot to ask of my pelvic floor system. 

If you can successfully use the Knack 9/10 times and only the occasional leak gets through that is excellent. 

Know when to ask for help

The Knack alone might not be enough for you.   Your pelvic floor muscles can be so weak that you need help to get them working again.  And it is possible to have muscles that have repaired too tight or are constantly overworking and becoming easily fatigued or sore.   

Remember there are specialist physiotherapists attached to every UK maternity department who can give you an individual assessment, training and support.   Don’t hesitate to ask your GP to refer you to a specialist physiotherapist  

Does the Knack work for you? Any questions?  Please do ask, I am very happy to help.

*  Clarification and confirmation of the Knack maneuver: the effect of volitional pelvic floor muscle contraction to preempt expected stress incontinence.   Miller, J.M., Sampselle, C., Ashton-Miller, J. et al. Int Urogynecol J (2008) 19: 773. doi:10.1007/s00192-007-0525-3).

Drawings copyright of A M Savage  (Proudly using stickmen since 1991)

is rest as good as sleep?

Is a Rest as good as a Sleep??

Selfcare is not selfish or indulgent.

It is the very OPPOSITE of selfish to keep yourself fit and well. ⁠

Who is going to look after the egg(s) properly, if the Chicken is tired, weak, undernourished and demoralised? Do you need to focus on gaining energy? 10 Rest Tips today – essential reading for Mums (and their physiotherapists!)

picture of chicken self care for mums

Lessons learned (already) in 2020!

I was invited to go to a 3 hour workshop last weekend called NOURISH! – a lovely word-play on the combined skills of the leaders, Lavinia Brown (a life coach @bobmama_net) and Zoe Kirby (a nutritionist & yoga teacher @zoekirbynutrition).  Both inspiring local Cambridge women.

The first step, was taking time to reflect (again) that the need to care for ourselves – mind and body –  has to co-exist with all the demands that come with being a Mama Chicken (or Papa Cockerel, of course). And eggs don’t just come disguised as newly hatched chicks.   There are career eggs, elderly parent eggs & partner eggs, not forgetting house, garden, friends, & pet-type eggs too.  ⁠

REST

Lavinia focused on the need for REST.    Not mindfulness.  Not sleep.  Something a bit different.  Something I hadn’t realised was different, or missing.    REST.  

Do we need it?

Lavinia led a brainstorm of ways to recognise that we need REST. 

Together, we reflected on the familiar, but often ignored, Physical, Mental and Emotional signs & signals, that tell us that our body & mind are struggling to perform.  They are different and combine uniquely for each of us. Think headache, loss of attention, and tearfulness as examples in each category.  You may not know yet what yours are – but I bet you have an inkling of a few?

Signs & signals that rest is needed

Since the workshop, I have further simplified how to recognise my own need for rest.  The analogy that is working for me is visualising myself as a Phone Battery. I am on the look out for LOW POWER MODE.  If I peer into myself I’m no longer in the green. I’m in yellow.  My internal voice is trying to say –  girl watch out – you are dangerously close to red where Nothing Functions Well and next stop is burn out (physical = tight neck, mental = scattered + overwhelmed, emotional = short fuse and/or tears depending on hormone-levels!). 

It’s when I need to Plug-IN

So REST for me is the analogy of plugging my phone into the wall for a short re-charge.  Not that routine long-charging of my phone, to reliably give me the whole of tomorrow.  That’s SLEEP.  Rest is rather a choice to give up using my phone completely for 10 minutes, in order to benefit by getting sufficiently back into the green. Getting enough battery power for a proper 2 hours of full-function ahead.  Delayed gratification in it’s most difficult manifestation?

We DO have choices

Since I started to think of Rest like this, it’s been fascinating to have noticed the choices I make regularly, subconciously (and mostly correctly) for my phone. I’m habitually on it. My phone rarely catches me out. So why should my body battery? REST now feels like a positive CHOICE that I make for myself.  And a pleasantly guiltless no-brainer too.

Now, it doesn’t seem selfish or indulgent to ask myself “Do I want to get through my afternoon clinic offering my patients the best me, clear thinking, enthusiastic, energetic?”  Of course.  Then it’s perfectly OK to stop, close my door, eat my lunch, breathe & BE for 10 minutes.  Me, plugged in.

Yes, even for naptimes!

Reflecting back to my own baby-days, sometimes, (not often enough), I would make the decision to shut my eyes FIRST as soon as baby was asleep. Even if I only had 20 mins half-nap I was always SO much more productive during the remaining time than if I had not bothered.

Rest Tips: keep a list of restful activities in a journal

My 10 take home Rest Tips

(part inspirational Lavinia, part workshop after-thoughts)

# 1   A rest is as good as a sleep.

One of my mother’s favorite expressions.  Meaning just lie there and “be”.  This has value.  Even (especially) at 2am.
# 2   Activities can be rest-full. 

REST doesn’t have to mean Doing Nothing.  Rest can be classic activities like walking, reading a book, gardening, baking, or doing some Yoga practice. Lavinia also pointed out activities which don’t appear “restful” at first glance, yet can be enriching and enlivening, such as having coffee with a friend, drinks out with the girls, going to an energetic exercise class, even cleaning (… as long as multi-tasking doesn’t take you longer to get out of the yellow than if you just literally plugged in and didn’t touch your phone for 10). If the intention (and effect) is to recharge your battery, not deplete it, you could have a long list of options.
#3  Rest can be INVIGORATING or SOOTHING. 

Lavinia highlighted that we need each of these at different times.  And that a single activity might be used for either gain (eg Pilates can be energising or relaxing depending what you choose to do) or going for a run might equally fire you up for your day ahead or allow your mind to clear from the one you just had.
#4 QRT – QUALITY REST TIME

QRT is a similar concept I have heard of in the past.  We identify our QRT options by taking time to notice the activities that feel like quality time even though you are busy – they are the ones that put you in “the zone” where time goes by without you noticing and/or feeling depleted by the task.
#5  Put the BIG rocks in first. 

That old chestnut.  REST FIRST, there is always space to DO more. Particular relevant to naptimes?!?


#6 Make a go-to list for yellow moments 

When you are in LOW POWER MODE it is likely that your thought processes are slower, so it is harder to think what would get you out of the mode.  Keep your list handy.
#7 Why don’t we rest? 

How do we self-sabotage our intentions?  WHY do we do this?  This part of the workshop was incredibly valuable but personal. Not prepared to share!  But do a tiny bit of thinking and you will know that we all do this. Multiple reasons!
#8  ACCEPT low power mode

Sometimes you truly CAN’T actually plug in.  But I’ve noticed there is another potential choice –  if I don’t want to go red I might have to accept that  some functions need to switch off, or are just not an option anymore.  I have to  choose wisely how to use my last bit of power. 

For example when I find it’s impossible to make brainy decisions, I can still get some banking done, or answer some low-key emails .  Or I persuade myself & The Child into a simple card game, as less effort than arguing over homework. I’ve even been known to curl up for some TV-time.  I need to Power Right Down until I can find a proper socket time-slot to re-charge.
#9  Don’t be the Victim

Lavinia’s harshest truth (put very kindly of course).  Am I waiting for someone to give me permission to rest?   Or offer me the rest on a plate – “ooh you look tired, here sit down, I’ll cook dinner….”.  Sure that would be nice but she points out that we disempower our Self by waiting for a Shining Knight , with the risk of becoming bitter and resentful when one doesn’t turn up.  Do I go around plugging other people’s phones in for them?  No.  Do I even remind other people to charge their phones?  No!  It is MY responsibility to keep my phone charged.  
#10 Anticipate: spot patterns

Why am I overwhelmed by friends for supper tonight? Why did I say let’s meet up but now wish I could go to bed?    I want to ENJOY the social stuff like I planned, not resent that I overcommitted?  This is definitely one of my regular patterns.  How  to refresh a work-depleted Friday night battery?  Get a proper  boost to see me through a fun & fulfilling late night? I’m experimenting with a) knowing I need to do this and b) methods –  Long soak or quick shower?  Read for 10 mins? Sort the socks with a podcast?!

What are your triggers/patterns?

Have you noticed that with Small Ones, 4pm is no longer the end of the day? It is merely the lull – before the real work begins! Teatime, bathtime & bedtime are physically and mentally Hard Work. Could you re-charge/re-boost just before it all kicks off? Or get baby to bed, then have 20 mins “time-out” so that you can re-focus on your relationship with your partner and your own personal to-do list – rather than an antisocial crash-out from exhaustion?

#  Bonus .    And one for you – Reframe? 

Do you want to go to your regular postnatal class, Pilates (spinning, run, swim ….) but feel that your power mode is too low to even get you out the door?  Perhaps Re-frame?  Going to your class could be the equivalent of plugging yourself in for an hour, giving you a couple of day’s worth of power, in exchange for that short weary drive (in practically red-mode) to get you to the hall/studio/pool?

Does this concept of Rest vs sleep resonate with you?? Which of the Rest Tips had your name on it? What do you do to stay out of the yellow zone? How to you re-charge?

woman with a cup of tea for self care

Why self-care is a revolutionary act: advice from a life coach

Guest post by:  Lavinia Brown aka BoboMama

Cambridge is a wonderfully small place.   I am delighted to host a post specially written for you by Lavina Brown, a local Life Coach.  Lavinia came to my antenatal pilates class a few years ago.  Now, like many women, she has returned to her work with a change of focus – drawn to helping other mothers be their best selves:

As a life coach for mums who want the most from life – to be the best mama they can be AND to find fulfilment and happiness in the workplace – self-care is one of the most important items in my coaching tool kit. 

Why? Because we can’t have it all and do it all, all at the same time, without it.

Ambition is a great thing – especially when, on the whole, we women tend to seriously undersell ourselves – but it needs to be tempered with a reality check:  

First, that women are naturally empathetic and often also highly sensitive.  If we take on too much, this means we also take on too much of other people’s stuff (emotional and physical) leading only to burnout, depression and disease.

Second, that parenting takes up a huge amount of energy (whether we want it to or not). We simply don’t have the full tanks we used to pre-kids, to expend on what we choose. So we need to be careful about what we commit ourselves to and even more careful about taking time-out to replenish those precious tanks of ‘you juice’.

And that means self-care.

Yes, it’s an overused, slightly wishy-washy umbrella term that could mean lots of different things to different people, but that’s the whole point. Self-care is what makes YOU feel better about yourself, however weird and wacky that activity might seem to others. It could be picking your spots last thing before bed, going for a walk in Nature, indulging your inner neat-freak by colour-coding your wardrobe or learning to fly a plane.

I see self-care as falling into two camps: the nourishing sort (think cups of delicious tea, massage, lying in the sun, reading in bed, chats with your bezzies, steaming hot salt baths) and the revitalising sort (think sports, gardening, dancing etc). It doesn’t matter which camp is your natural self-care go-to, what does matter is incorporating at least one item from either list into your routine, on at least a weekly basis.

And there’s the rub: fitting it in. Actually doing it. Scheduling in time for yourself somewhere near the top of your to-do list rather than at the bottom underneath a myriad of chores.

Why is this so hard to do? Because as a society, we have not been taught to value ourselves over and above what we DO in the world. We have forgotten what it is like to be a human being rather than a human doing and in a world that glorifies the term ‘busy’, we have assumed that to get ahead and achieve our maximum, we should always be switched on.

But is this how we want our kids to grow up? No! So why should we fall in line with this crazy, short-termist attitude to life and health? Why not be pioneers instead?

Let’s see rest as a revolutionary act and start implementing it as though our lives depended on it! (Mama truth bomb: they do).

And if you’re still feeling like self-care is indulgent and selfish, keep my top four reasons to ditch the mama guilt close to hand:

  1. Just think how many hours you have been ‘on duty’and tally that up against how many you plan to take time ‘off’. There’s bound to be a huge imbalance.
  2. Remember that giving yourself permission to do something that feels good and gives you joy, is also allowing others to do the same. By expressing your needs and asking that these be met (something we all struggle with as remote descendants of Victorian disciplinarians), you are showing your partner how they too are worth investing in
  3. Partaking in some self-care without the kids is showing your children that life doesn’t have to be all work and no play. Hard effort deserves celebration – you would celebrate their achievements, so why not celebrate yours, however small, menial or routine they might seem to you at the time?
  4. Happy Mama = Happy Family (and vice versa) You wouldn’t want to inflict shouty, resentful mama on them, would you?

So, self-care or be square. Your kids/partner/health will thank you for it…

Lavinia Brown (aka BoboMama) is a qualified transition coach for mothers. She supports women to reach their greatest potential – at home and in the workplace – whilst successfully managing the ‘life bomb’ that is kids. See www.bobomama.net for more details or follow her on social media for daily doses of mama medicine: click here for Insta and here forFB 

a glass how much should you drink in a day

How much should you drink in a day? & When should you have a wee?

question mark
How much water should you drink? When should you wee?

Two tricky questions…

Other health and hygiene questions are easy.  How often should you clean your teeth?   Wash your hair?  Change your pants? But these two bladder questions – How much should you drink? and When should you wee? are full of issues, myths & legends. This article helps you understand the UK guidelines, understand why how much you drink influences when you will wee – and offers tips & tricks to for a happy bladder!

Bladders & drinks FAQs

  • Does how much you drink cover just water or all your drinks? 
  • Are tea and coffee drinks? 
  • What about the milk in your cereal? 
  • Is it different if you are taller/smaller, fatter/thinner or breastfeeding? 
  • Is it better  to have a few big drinks or sip from a bottle all day? 
  • Should we wee when we first feel it or when we are busting? 
  • Is it ok to hang on……..but how long is hanging on for too long? 
  • Am I normal if I wee in the night?   
  • Is it ok to have just a tiny wee before you go out the door?   ………

Phew….see what I mean about a tricky subject?!

How much water should you drink: official guidelines

Your body needs water or other fluids to work properly and to avoid dehydration. That’s why it’s important to drink enough fluids. In climates such as the UK’s, we should drink about 1.2 litres (six to eight glasses) of fluid every day to stop us getting dehyrated. In hotter climates, the body needs more than this. We also get some fluid from the food we eat.

NHS Choices

Extra (practical & useful) tips & info:

Normal fluid intake should be 1.2 to MAX 2 litres in a 24 hour period.

 It is NOT 1.2 litres of water on top of all your other drinks

  • This is ALL fluids added up together (tea, coffee, water, juices, alcohol).
  • 1.5-2 litres equates to 6-8 standard 250ml mugs a day, or 4 x 500ml water bottles.
  • Don’t count the milk in your cereal. But if you have soup for lunch, jelly to follow and smoothies to drink you might want to be aware of their impact on the total volume.   
  • If you are breastfeeding or doing sweaty exercise you may need an extra glass here & there to replace lost fluid. But unless you sweat profusely or produce gallons of breast milk – this is not nearly as much as you think. 
  • Drinks should be evenly spaced at approx 2 hour intervals. With the last proper drink 2 hours before bedtime (ideally non-caffeine), just sips thereafter. 

How to be nice to your bladder: filling tips

Let’s talk through the look of a ‘normal’ day, in an untroubled happy bladder world. It will help your brain understand how it should all work. 

If you have been suffering with mad dashes to the loo, uncomfortable and inconvenient urges and bladder accidents, these habits will really help. 

# 1 . Take an ‘organised approach’ to when to fill & empty the bladder

A standard mug or glass (of tea, coffee, water etc) is 250ml. Many people are often surprised to realise that you therefore need no more than 6-8 mugs/glasses in 24 hours.

a mug to show size
A standard mug is 250ml

The bladder prefers regular and spaced filling intervals rather than droughts or floods. Though the bottled­ water companies would like to persuade us differently, it is not normal to be constantly sipping water.  A drink every couple of hours should rather nicely lead to needing a wee every couple of hours. 

  • If you look at your wee when it comes out it should be pale yellow.  If it looks like water you are drinking too much, if it is dark yellow you are not drinking enough.
  • Drink every half an hour ? Guess what…you are going to need to wee every half an hour…
  • If 1.2 litres IN gives you 5-6 wees out. Then if you are drinking 3 litres a day, simple maths says that’s about 12 standard wees. Or 6 very very full bursting ones. Those bursting wees are highly likely to be accompanied by some unpleasant sensations or not quite making it!  Cut back on the volume (to 1.2 litres a day) and you could get an instantly happier bladder
  • Monitor your fluid intake carefully for a few days. Your ‘bladder’ problem could be merely operator error at the filling end.

# 2 Not all drinks are equal

It can seem strange that we say 1.2 litres of FLUID and don’t distinguish water from other drinks.  Tea and coffee are, however, just water with flavoring.  Think how you pour the water out of the kettle?

glass of water
Water is the best choice

So they will hydrate you but…you might want to think how the ‘flavoring’ could affect you:

  • Caffeine is a known bladder irritant. Some people notice that they react worse to ‘real’ coffee than instant (or vice versa).  Adding fat (milk or cream or on trend is butter!) slows the absorbtion of caffeine.
  • Tea can be ‘light’ by design (eg Earl or Lady Grey). Or light in the making; a few leaves gently steeped is very different from squashing the teabag to death in a mug.  The ‘builders’ tea’ version has extra caffeine and tannins – that’s what stains the mug.
a cup of tea
How do you ‘take’ your tea?
  • Alcohol is a diuretic (for every glass in, you will get one and half out…think hangover…dry mouth, dehydration, headache…).   
  • You may notice your bladder reacts to certain types of alcohol (spirits, wine, fizz) differently.  Find your tipple of choice and note what to avoid when there isn’t a handy toilet!
  • Fizzy water and de-caf coffee can also be irritating for some people. It is thought that it is something about the manufacturing process.
  • Watch out for ‘sneaky’ ingredients.  Fruit teas are high in sugar. Green tea has caffeine (and is also a diruetic – hence drunk on ‘diets’). Many hot chocolates are high in sugar & can contain caffeine.

#3 Take more notice of how drinks affect you

Start to notice how long it takes for different drinks to pass through you and make your bladder uncomfortable. 

Squeezy App (which reminds you to do your pelvic floor exercises) has a bladder diary you can use to monitor your fluid intake and trips to the loo or download a chart here.

  • You may find you are not as ‘tolerant’ of your favorite drink as you used to be. 
  • Don’t feel you have to go cold turkey. Just cut down a bit on the likely culprits. Then increase the balance of plain water. You will likely see a quick reduction in bladder urgency and increased capacity to hold. 
  • Pick your moments. It doesn’t mean you can’t drink your favorite double strength cappaccino…but maybe not just before a long car journey or the cinema?

#4 Sweating? Breastfeeding?  When you might need extra fluid

people at a yoga class
sweating or just a glow?

Hot days & exercise:   We don’t just lose fluid from our bodies when we wee.  It also escapes from our body in our breath (think how you can steam up a mirror). Also when we sweat.  If it is a hot day, we need extra fluid.  If you are doing an extra sweaty activity, drink a little extra before and be sure to re-hydrate after.  “Guesstimate” the amount that you might have glowed away. As well as the drink you were probably due about then anyway. But don’t over do it.

baby breastfeeding
drink extra to replace the volume given to the baby

BreastfeedingIt is important to have some extra fluid each time you feed…but again don’t over do the drinking or you will just be weeing more. To estimate the amount you need to re-hydrate – think about the milk volume that you produce when you express? Probably about  200-400ml?  So an extra glass/mug of fluid is all you need back again. You don’t need to down a pint of water – your poor bladder will just fill to bursting really quickly and not love you for it.

When should you have a wee?

A quick summary of the daily OUT routine. IF you are drinking 1.2 litres fluids in 24 hours (which is one 250ml mug roughly every 2 hours)

  • One wee in the middle of the night is considered normal 
  • On waking up expect a BIG wee  (400-600ml) – you could possibly fill a pint glass
  • Then through the day expect 5-6 average wees (200-400ml) – each one could fill a big mug
  • You do not need to wait until you are bursting to empty your bladder.
  • Aim to empty when your bladder holds a good mug-full. Little ‘yogurt pot’ wees should be avoided.

How to be nice to your bladder: emptying tips

# 1 The first sensation is usually too early

 After 45 minutes to an hour your bladder would normally hold about 120ml (a yogurt pot) of urine. Then you would get a ‘I might need a wee‘ sensation. This happens as the walls of the bladder (it’s a muscle) stretch for the first time.  

pot of yogurt
120ml “a yogurt pot wee” is a bit early

Our brains should know to recognise this as an ‘irritating-stretching-message’ not a ‘need-a-wee-now’ message.  Subconsciously we should

  • clock the time,
  • do the maths (only an hour since I last had  a wee)
  • tighten our pelvic floor muscles in a slow steady way,
  • distract ourselves with the job in hand

and within 2-3 minutes the feeling of wanting a wee completely disappears – like we never needed one in the first place – we go on with our activities, almost forgetting that we have a bladder.

This is the bladder’s normal first response.

That first annoying signal isn’t particularly useful. It’s just a very early warning signal. Like your petrol gauge alerting you when you still have 60 miles in the tank.   You don’t need a wee when there is only a yogurt pot worth in the bladder, even if the bladder feels a bit scratchy about it.  Just ignore it and it will go away.

mini-van
safety or just-in-case wees are for long car journeys – ONLY

 If circumstances are justified,  it’s ok to have a “just-in-case” or “safety wee“.  Say you’re  about to go on a a long car journey. Or about to have a swim or a shower. Or go to bed.  Then it makes sense to get rid of even the 120ml so that you have a long run ahead of you.  But you need to justify to yourself why you didn’t just ignore the feeling.   Otherwise it can quickly become a habit to have a wee every time you get a bit of sensation. That can be very disabling.

#2 . Ignore the first message and wait for the next one

Normally, that first message quickly disappears. We forget all about the bladder. We can fill it for a second hour (or so) till there is more like 300ml. Think a large ‘Cath Kidston’ mug-worth. Then you should get a dullish, polite “you need a wee” sensation that sends us off for a comfortable-but-not-urgent wee. 

big mug
A nice big mugfull – 200-400ml – is a perfect comfortable wee

This is when you should go.  There is still a bit of room in the bladder. If you have to stand in a queue, find your front door keys, answer the phone.  There is a bit of give and it is not too heavy if you need a cough or a sneeze.

# 3. But do not leave it for a third or fourth message…

But do we go when we should go??  Of course not……Many people (and especially busy, distracted mums)  leave it TOO LATE.  

You can ignore the middle message, and head into a third or even fourth hour. You can fill to nearly a pint (shift workers, teachers and nurses can often hold even more). BUT filling to your max tends to be accompanied by a sudden, very uncomfortable and urgent “need for a wee” message. The type that makes you sweat, your eyes water and comes with a strong sense of panic. Panic that you might not make it (and indeed you might not). 

pint of beer
A pint (500ml) will make your eyes water and could lead to accidents – save for first thing in the morning & emergencies ONLY

These maximum capacity wees are intended for first thing in the morning or an emergency.  BTW an emergency is being unexpectedly stuck on a motorway. NOT just putting it off for …one more paragraph, one more chore or an advert break.   And not just because you are too busy to remember to go for a wee!

#4 . Is there really something wrong with your bladder – or is it poor human judgement?

So many times the problem is really operator error. The human operator is not listening to the (rather good) system properly.  Guilty???  Which are you? Tend to go too early (friends and family tease you about always needing a wee)? Or tend to leave it too late (lots of sweaty near misses or trouble at the front door)?!

lady busy at computer
Concentrating? Distracted? or just too busy?

Or, not uncommon are you swinging between too early and too late? Do you push your limits…push your limits…leave it…leave it…just one more thing and THEN you very nearly have an accident?!  The problem is this makes your bladder very nervous. You start doing lots of little wees as soon as you feel something, just to be safe. You keep weeing early to avoid another bad experience? But then you think…this is silly… I need to train my bladder. So you start again, filling and filling, past the ‘right’ signal, on up and up …nearly bursting.. having an accident. And then you get nervous and go early again….a real viscious cycle.

What can you do to improve your bladder habits?

Homework this week. When you are heading to the toilet for a wee, try to predict the size of the wee you are going to have. Use the simple categories of:

  • yogurt pot
  • big mug
  • or pint class

( aka: small, medium and large).

I’m prepared to take a reasonably large bet that as soon as you start taking a bit more notice of what’s going in at the top and what the wees feel like at the different size points, you will quickly  tune in to the bladder sensations and interpret the messages better.

WC sign
This week monitor your fluid in and out

The hardest one to spot and get in tune with is the ‘middle’ one. It can almost be too polite to be properly useful.  A bit more interesting would mean it wasn’t so easily missed!  But we can’t change nature. Once you are familiar with the feeling of a “comfortable-size wee” you will be able to spot when to have a wee more easily. This will help stop the cycle of under or over-filling.

Exceptions – when to seek more help

If you thought you were going to have an enormous wee but only get a tiny one – or a tiny one but get far more – you may find your body is not well tuned to the sensations.  Sometimes the nerves stay confused after the pressures of pregnancy and childbirth and need retraining.   

If you do not feel that you get the ‘right’ sensations guiding you towards having a wee at that middle point and you leave it too late before the bladder suddenly decides for you, or you get unexpected leakage, then I would suggest you use the clock as a guide for a while (but all the while trying to tune in to any sensations you are getting).

looking at wrist watch
Use a watch to keep on track

Start with an hour, then have a wee, noticing how small they are at this stage. Then, once you are comfortable with this, don’t stick here too long or your bladder will get into an annoying ‘habit’ of thinking this is all you can do. Move up in 15 minute increments as feels comfortable and ‘safe’ to do.   Remember the goal is just 2-3 hours of holding  – no need for more. 

There are also medical conditions of the bladder

  • Overactive Bladder (OAB), often colloquially termed ‘irritable bladder’ is a pathology with symptoms of frequency, urgency and urge incontinence.  Commonly you feel a strong urge to wee but only a small wee comes out. Or you feel the bladder suddenly contract and leak, partially or completely (called urge incontinence).  If you have tried the tips above, but you still struggle with bladder control, keep a bladder diary to discuss the pattern with your GP.  There is medication that can help ‘calm’ a bladder. Or working with a physiotherapist on your pelvic floor muscles will also improve your control.
  • You can have a low grade bladder infection and not necessarily realise this.  Watch for cloudy urine, funny smells, feeling off colour.  The dipstix test at the GP is not that reliable – you may need to send your urine off for testing
  • You may not be making the hormones that suppress night time bladder production. If you have massive urine volumes at night, even though you are not drinking, discuss this with your GP.
  • Paradoxically – wearing a pad to prevent leakage can irritate the bladder tube and increase urge and leaks.  Try going without a pad or wearing knickers with an inbuilt pad to see if this is the case.
  • a CHANGE in bladder habits can also be an indicator of several other medical conditions.

If your symptoms aren’t getting better, ask your GP to check you and if appropriate refer you to a specialist physiotherapist.

Weird stuff affects bladders

Ever have one of those  days where you seem to need to wee and wee and wee?  Not necessarily unpleasantly but  you think “where is it all coming from????”

hands writing in a notebook
Rings and ankles give clues to fluid on board

The body constantly re-adjusts our fluid balance – and sometimes does this really dramatically.  You see it best by watching how tight/loose your rings are.  Notice this week how sometimes you can slide your rings about easily but other times they are stuck on tight.  The body holds fluid when it is hot and dumps it as it gets colder.  We also have circadian rhythms that affect fluid in and out. Most people wee more in the mornings and less in the afternoon.

Stress affects bladders

When we are ‘stressed’ (anxious, worried, cross, running late) our system is releasing adrenalin.  Adrenalin triggers our Fight, Flight or Freeze response.  If a tiger walked in your door right now – your hairs would stand on end, your heart would beat faster…and you would wet yourself.  Likely bowels too.  I think it’s supposed to be so that you can run faster.

Fortunately,  you are unlikely to encounter seriously stressful moments too often but we experience mild ‘stress’  all the time.  When you are feeling anxious, worried, cross, running late , the brain ‘drips’ adrenalin into your system to help you cope.  But with that comes bladder (or bowel) irritation.  Think of standing in a queue to do an exam, or waiting to give a presentation at work…that strong need to wee…and then even to wee again.

girl with a tiger
identify your day-to-day “tigers”

So if  you are having a day needing lots of wees, ask if you are stressed? Your bladder could be used as a barometer to your stress levels?  Rather than try to ‘fix’ the bladder…can you decrease the source of the stress?

Peaceful sleep & your bladder

It is normal to get up for one wee in the night  (assuming sleeping for 6-8 hours).  Annoying…but perfectly normal. Nicer if you don’t have to but some bodies just do. 

woman sleeping
last proper drink 2 hours before bedtime
  • But don’t be hard on the grandparents. Over the age of 60 it is normal to wee once or twice in the night. Hormone changes of aging affect the way the kidneys process urine.
  • aim to have your last drink 2 hours before bedtime. Then the fluid has plenty of time to go through your system with a good wee before getting into bed. 
  • Best to avoid caffeine late. 
  • Beware, sneaky sources of caffeine like Green Tea & some hot chocolate mixes
  • alcohol is a diuretic ie more volume comes out than went in (just think hangover….dry mouth….)

if you do have a late night drink (party!)) then don’t berate your bladder for needing a 2am wee!

That first morning wee…

 If you don’t wake in the night most people wake up with a very full bladder. You will need to make getting to the toilet your priority on waking.  

====    Mums go first!   ====

I appreciate that this was a LONG blog post – but I couldn’t leave anything out. I hope it has been helpful. Do let me know if this has helped you?

standing pelvic floor exercises

My favourite standing pelvic floor exercise, ever

This is absolutely my favourite standing pelvic floor exercise.   I love that it anchors you to the spot with a quick little routine to stop you getting distracted part way through. 

Honestly takes 35 seconds but pings your pelvic floor muscles awake.  Little and often improves muscle memory, reaction times, and encourages quick muscle growth.

  1.  Turn your toes out, like a ballet dancer, 5 squeezes of the back passage

Turn your toes out, like a ballet dancer.  Tighten your pelvic floor and notice how this position favours the back passage (the anal sphincter) just like you are stopping wind.  Pretend you are having tea with the queen and made the mistake of baked beans for lunch.  You need to effectively close the anus opening, without clenching your buttocks more than a smidgen and without it showing on your face!  Do 5 on and off squeezes, not trying to hold, just a good squeeze, then let go completely.

2.  Turn your toes in, like a pigeon, 5 lift and tucks of the vagina/bladder tube area

Then turn your toes in, like a pigeon. Now when you tighten up underneath it should feel different.  Less going on at the back and more focus at the front, around the bladder tube and vagina area.  Let the area be soft, almost a bit saggy,  then lift and tuck the vagina up inside.  Let go – completely.  Then repeat 5 on – off contractions.  Best lift you can do ….and relax. Don’t worry if your abdominal muscles join in a little bit but keep the focus on your pelvic floor.

3.  Turn your toes normal, both areas together as a unit

Finally turn your toes into your normal standing posture.  Now try to do both the previous actions at the same time.  Most people start with the back tightening and then like a big zip come forward to lift and tuck the front.  When you let go each time now it should feel like there was a bigger ‘up’ and a bigger ‘drop’.  Repeat.  If you are feeling clever add in some side to side tension too (yes, the pelvic floor is bowl shaped, see this in my video showing a model pelvis in the pelvic floor school)

When you have done 5 squeezes with your toes turned out, 5 with your toes turned in and 5 with everything together you will have done 15 really good pelvic floor muscle contractions.  NOW your muscles will be thinking – hey she doesn’t normally work us like this – we are going to need to grow!

In this video I go through the exercise with Stephanie from Kegel8 and The Knack too.

When to do it?

Perfect exercise to do little and often through an ordinary day.  It tags on really well to cleaning your teeth – or after a wee.  At home, use that quiet moment in the toilet to focus on yourself.  If you are working, linger in the cubicle for an extra 40 seconds – you are getting paid to exercise!

Important note

If you think this exercise is mad and you couldn’t feel a thing when you tried to do it – try it  lying down, not so much the feet positions but focusing first on the back passage and then on the front.  This positon  takes the weight of your organs off the pelvic floor and gives you more chance to ‘feel’ the muscles working.  If that still leaves you cold – then I would recommend you have a chat to your GP and ask for a referral to a specialist pelvic floor physiotherapist for a full assessment and examination.  There are lots of things we can teach you in clinic 1:1 to help you find and improve your muscle function.

baby sitting on potty 3 Ps of a perfect poo

3 Ps of a perfect poo: are you sitting comfortably?

There are 3 Ps of a perfect poo which you should keep in mind during your ablutions!

Are you or family doing any naturally??

  • How do you sit?
  • Do some people in your family take a LONG time in the toilet?
  • Who reads the paper? (Should you keep books in the loo?)
  • Might you be helping too much?

Do see the video below to learn more about good bowel habits and promote some healthy/unusual/hilarious family discussions!

[Before you watch  – to explain the context  – this was an adventure on to a public speaking course a while back.  There was a Gala Finale with the brief to give a ten minute inspirational speech… well with a challenge like that it’s hard to hold a physio back….Apologies, a bit squeaky at the beginning – I was very nervous!!  ]

P for Position

They have actually done lots of research about the best way to sit on a toilet.  Yes really.  In Australia.

Nature did not intend us to sit lady like on a ceramic toilet.  We are supposed to squat down behind a tree.   The key thing is knees higher than your hips.  This un-kinks the bowel and relaxes the pelvic floor muscles.

  • sit with your feet up on a toddler step or box
  • Bottom well back on the seat
  • Rest your elbows on your knees
  • Untuck your tail bone keeping your back relatively straight
  • Let all your body muscles relax, especially your pelvic floor and abdominals

P for Patience

Emptying the bowel is a natural thing that the body does best on automatic pilot.  It is not something that ‘we’ do.  Like sneezing.  The best ones come from nowhere.  And just like a juicy sneeze that you can feel coming – if you think about it too hard (and especially if you say “I think I am going to sneeze”) – it will disappear!

An age old trick – READ –  a book/magazine/back of a shampoo bottle….anything to distract your corticol (thinking) brain and let your automatic brain do it’s own thing.  Give your body some time.  You are waiting for something solid to move out – it doesn’t just fall out like liquid.  Your body needs to accept that it is a quiet, private moment.

P for don’t Push – rather Pant!  

[This last P got a bit lost in the talk ( I got a bit flustered when they showed me the 2 minute warning notice!).  I got to fill in the gap to the audience in the awards bit – they voted it the “peoples choice” which was encouraging.]

The danger of a traditional “hold-your-breath” push is that you can accidentally tighten your pelvic floor just as the stool is trying to come out.  This can cause it to be pinched off midway so you get some out but lots gets left behind in the rectum. You might not be able to feel it there but it goes on giving off gas, making  you windy, pressing on the rectum walls, making you uncomfortable, and drying out into small pebbles.

Rather open your mouth (which helps relax your pelvic floor) and let out pants or sighs, just as the midwives teach you to pant to deliver your babies head.  This allows the poo to come out as one full tube with just a nudge and light pressure from you.

Now you really know everything!  Do go share!

About to have a baby or just delivered??  Do see the post 10 tips for the first postnatal poos for more ways to help you have comfortable bowel movements.

PS  It was a great Public Speaking course – I highly recommend the team at Ginger

**  My original title was The Life Changing Magic of Sitting Comfortably.. but it now seems to be known as the 3 Ps talk……

why do tampons go sideways picture

Why do tampons go sideways?

Have you ever had the experience of an uncomfortable tampon or one that looks as though only the side half of it has absorbed anything?  

Why do tampons go sideways? There are few reasons:

1. There’s more space inside than you might think

The vagina is surprisingly wide and stretchy. Essential for babies heads to come out but leaving plenty of room for things to move about – especially for tampons to go sideways.  

I think we mentally picture the vagina as a narrow tube – rather like a hosepipe. However, though you can’t see much at the opening, inside the vagina there is quite a decent space.  The vagina is a tube, but not an evenly shaped one – more like a squashed tube, wider side to side than top to bottom.

the vagina is like a squashed tube

This clever shape helps to let a babies head out without damage to the vagina itself. 

The pelvic floor muscles should support the tube from below and from the sides. However, pregnancy, childbirth, straining for constipation, pressure from chronic coughing or lots of lifting can all stretch and weaken the pelvic floor muscles. As a result the vagina tube can feel more “gapey” or spacey – and it’s easier for tampons to drift off centre or tilt to one side.

2. the cervix deflects the tampon sideways

If the end of the tampon comes up against the cervix it can tilt off sideways into the ‘cheek’ area giving you inadequate protection and that ‘half used’ look when you remove it.

The cervix is the opening to the uterus (womb). It sits right at the back of the vagina tube, dangling down from the top of the tube (similar to the way your epiglottis sits right at the back of your mouth). The cervix is the size and shape of a nose.  You can put your finger inside and find it.

The cervix is pretty solid and though it pushes up out of the way during sex, it is quite easy to accidentally knock into it by accident when inserting a tampon.

3. The tampon touches the cervix and annoys it

Have you ever put a tampon in and then barely 5 minutes later you have an overwhelming desire to pull it back out ?  It is just not right, or downright uncomfortable, almost as if your body is rejecting it?  

This is because the cervix is the only bit inside with decent nerve endings (if you knock it during sex it you might get a short sharp mild pain and find yourself shifting position.) If a tampon is relentlessly pressing on the cervix you get this strong urge to bear down and feel that the tampon is pushing out or that you need to take it out.  Have you ever had this sensation?


A video to show the anatomy of the vagina & cervix:

Are you a visual person?  I use a 3D model (and a piece of paper!) in this video to explain to Stephanie Taylor from Kegel8 how our internal organs are supported by our pelvic floor:


TIPS TO GET TAMPONS IN THE RIGHT PLACE

  • Don’t rush the process (mums!   you know you do)
  • Visualise what you are doing.  Keep contact with the back wall of the vagina (the bowel side) as you are putting the tampon in and it will end up underneath the cervix rather than on it.  Aim for your back passage.
  • Not all tampons are the same. Some types expand widthways but others expand lengthways so they can effectively push themselves out as they become elongated when full. If you can’t picture what yours do, drop one  in water and see what shape it becomes.
  • Applicator tampons give you a bit more option to position the tampon before you let go – nice to use for the beginnings and ends of periods when the vagina is a bit drier and less easy to slide tampons in
  • Pop a dab of lubricant (water-based) on the end of the tampon to help it slide in more easily
  • If you feel your cervix is sitting very low since your baby try using a menstrual cup (like a MoonCup  *) instead of tampons – these are designed to sit closer to the opening of the vagina rather than deep inside (more like the position of a cork in a bottle).   * use SUPPORTEDMUMS at checkout for a 15% discount
  • make time for your pelvic floor exercises with particular emphasis on the sides. Follow the videos in our Pelvic Floor School.

How have you got on with returning to having periods and using tampons and sanitary pads?  Any questions?